Olive: My name is Olive and I am the Communications and Advocacy Officer with Youth Network for Community and Sustainable Development (YNCSD). YNCSD is a youth-led organization working towards achieving success by leading young people and amplifying their voices to speak for human rights through targeted advocacy to key players, capacity building and development, communication and media engagements, partnerships and programme implementation. We also work on other Sexual Reproductive Health and Right issues affecting women and girls.

In this first episode of our podcast series and throughout our series, we hope to share some of the knowledge we have gained in working to make abortion safe, legal and accessible. Most of these have come from working with lawmakers, women and young girls, the media and other Civil Society Organizations. Additionally, we also hope to continue to spread accurate information about abortion in a bid to normalise having conversations around abortion as well as reduce the occurrence of unplanned pregnancies and unsafe abortions. And, at the heart of all this is ensuring that women and girls get to enjoy their Sexual and Reproductive Health and Rights.

In today’s podcast I will be chatting with Nnamdi about Values Clarification and Attitude Transformation in abortion related advocacy, its relevance and expected outcomes. YNCSD is of the opinion that it is important to understand why people support or hold certain biases about abortion and what has contributed to their stance. So, before we go on, I am going to let Nnamdi introduce himself.

Nnamdi:  Hello everyone, my name is Nnamdi, I am the Senior Technical Advisor for Youth Network for Community and Sustainable Development and today we will be talking about abortion VCAT and I am really excited to be here. I look forward to an interesting conversation. Thank you.

Olive: Thank you Nnamdi, so before we go into the conversation about the relevance and objectives of Value Clarification and Attitude Transformation, could you give us a general overview of VCAT, just so we understand what it means when we talk about VCAT and how it relates to abortion advocacy.

Nnamdi: Thank you for the question. VCAT means Values Clarification for Attitude Transformation. With VCAT we can get people to understand values and what it is that guides the way they think, the way act and the way they relate with people.

And, we define values as the behavioural standards, morals and beliefs which guide a person’s actions or attitude which is very common about what makes us who we are in terms of the way we relate with people. After identifying their values, participants go through the process of examining and reassessing these values to see if it is in line with expectations of their work or their ethics within their various field of endeavours. Abortion Values Clarification and Attitude Transformation was developed by Ipas, an organization that works globally to support service providers and advocates improving safe abortion care. Since this development, many organisations such as ours, YNCSD, have adapted this training to effectively facilitate the session to get service providers, advocates, activists and relevant stakeholders in the know about the basics of abortion VCAT.

Olive: So, while you were speaking, you mentioned participants going through a process of examining and reassessing their values, so I am guessing that is what forms the process of clarifying values?

Nnamdi: Yes. Values Clarification helps people to reflect on their value systems and how this may have certain effects on issues in the society. Like I said earlier, a value clarification helps you define how you relate, act and interact with people on certain issues – such as abortion and child marriage. I see it as an exercise that helps people articulate how their personal values may have influenced the way they interact with people whom may have had or seek to have an abortion. The goal of Values Clarification is that participants become aware of the influence their values have on their attitude and how this reflects on the society. For example, a service provider who hasn’t had abortion clarification and attitude transformation would display certain provider biases to people seeking abortion and this could deter people, especially young people and the most vulnerable from accessing essential abortion services. That is why VCAT is really important for everyone to understand.

Olive: So, speaking of society and deterring people from having abortions based on their attitudes, what other consequences could people’s values have on people seeking abortion?

Nnamdi: Thank you for that valid question. Building from what I have just said, people’s attitudes to abortion have the power to be a deciding factor on whether a person chooses to have the abortion or not and this is key to accessing abortion especially to people coming from rural poor communities and those who have very little information about how to access essential service relating to abortion. Negative attitudes often contribute to stigma. Women and girls who have had abortion, healthcare professionals who provide safe abortion service and abortion advocates are stigmatized as a result of people’s personal beliefs and values on abortion care. We understand that we have strong beliefs and our cultures are deeply rooted in the way that our mind is shaped so it is important that we are careful when we display some of these attitudes because it can discourage a lot of people who need essential abortion services from accessing them.

I should also point out that this is the point of abortion related attitude transformation – that after assessing the values, people can understand what influence they may have on women and girls who may have unplanned pregnancies. So, when we speak generally about society, this is one of the consequences of not having a proper VCAT mentality as a service provider or as a member of the society.

Olive: Thank you Nnamdi. So, from all that you have said, I understand that VCAT has a lot of objectives and expected results but can we also say that VCAT is aimed solely at changing negative attitudes towards abortion?

Nnamdi:  Well it is one of it. VCAT has other objectives such as differentiating the myths and facts around abortion, critiquing abortion-related stigma and leading participants to understand the right of women and girls to making independent bodily choice and to enjoy the autonomy of their body. When there are participants who are already considerably prochoice i.e. they support access to safe abortion, discussions with them center around being supportive or areas where prochoice supporters may not always agree such as parental and spousal consent, second trimester, third trimester abortions sex-selective abortion. It has other objectives

Essentially, what VCAT is trying to do is to change the way in which abortion is perceived and talked about and also to create an enabling environment for safe access to abortion which is making it accessible, taking away the issue of stigma and making it being considered as human right i.e. women should have the right to decide for themselves when, how and why they want to have babies.

Olive: I think earlier you mentioned health care professionals, what other variety of participants might we encounter in the VCAT session?

Nnamdi: You can have policy influencers, those who are key to the formation of policies, you can have parents, you can have young people who are more at risk of unplanned pregnancies, you can have directors, teachers as well as religious leaders. Generally speaking, you can have anyone when it comes to a VCAT session because it helps in attitude transformation and attitudinal change is something that is particular to society and we, as individuals make up the society. But for this particular session I think that there is a lot of stigma towards and coming from abortion service providers, so it is important that we start there. It is not going to be immediate, changing attitude is a process, we are starting with healthcare service providers which often is the people that those who seek abortion go to first, and we think it is an effective strategy to use.

Olive: Just to deviate a little, because I have supported in the development of VCAT manual, I have found VCAT for healthcare professionals to be very exciting. So, what do you have to say about VCAT for healthcare professionals?

Nnamdi: Well, I think exciting is the right word to say. Interesting, enlightening and educating are all the right words to use. It is really important to focus on healthcare professionals because they are the ones at the front line of providing these services. Like I had mentioned earlier, a lot of health care workers might refuse to provide abortion services for a number of reasons: the major one being the legal provisions for abortion in many countries. I know there are some internal and personal biases which might also be a barrier to the provision of abortion care. VCAT helps to assess the willingness of these healthcare service providers and their motivations to provide this service. When we speak about the motivation behind their action, we are talking about what drives them. That is where attitude comes in, that is where culture comes in, that is where we need to have that behavioural transformation and that value clarification so that we don’t have adverse cases. We need to look at the motivation as to why they are refusing the provision of this service, we need to emphasize that their attitudes have a significant impact on the provision of services and the experience people seeking abortion might have. Healthcare professionals are very important in the quest for ensuring safety and availability of abortion services.

I want to also say that it is important to know that they have no bias, for example in regards to the person’s marital status or age, it is also important that they know that their personal belief should not affect the provision of abortion related services. They should maintain professionalism and they should look at the conditions or reasons why the person seeks to have an abortion. We are encouraging assertiveness of the human body and the right to choose, so it is important that your personal bias do not affect someone’s life or someone’s future and does not affect someone’s progress when it comes to ensuring the best of their reproductive and sexual health.

Olive: I totally agree with you because I think when we talk about safe abortion one of the component for securing safe abortion is that the person who wants to have an abortion also engages in pre-abortion counselling or speaks to a health care professional, so I also think it is important that health care professionals are able to provide unbiased pre-abortion counselling and recognise the right of the woman or girl. So this sort of points back to the aforementioned objectives of a VCAT session.

Nnamdi: I agree with you. I will say that every VCAT activity is a learning point directed towards leaving participants with more positivity and objectivity about safe abortion services than towards negativity or biases. Lawmakers, for example, or policy makers have the role of enforcing or interpreting laws and policies, developing guidelines that affect women’s access to care, so it is important that these stakeholders let go of values and attitudes borne out of misinformation, born out of personal negative biases, social norms and they should have an understanding of how restricted access to abortion increase the risk of maternal mortality and morbidity through unsafe abortion and practices.  So it is very important that there is freedom and there is an openness for people who seek abortion services otherwise they will go underground and we know that going underground poses twice the risk to abortion in terms of mortality and morbidity. So, it is really important that we clarify values and transform our attitudes if we have any that is negative towards people seeking abortion services.

Olive: Thank you Nnamdi, just to round up I think we mentioned particularly that it has to be based on the objectives of VCAT and expected outcome such as the change we expect to see from people who take part in VCAT, so would you say from personal experience that VCAT has been able to achieve some or all of its intended objectives?

Nnamdi: Well, I will say from my personal experience I have seen people who came out of a VCAT session with a better focus on the consequences of abortion stigma and restricted access. It is not always that people come out of VCAT sessions with the desire to become prochoice but it is a helpful way that we can engage change in small doses. Like I said, it has to do with transformation of attitude and this is a process, so the continuous engagement of key persons or key stakeholders on VCAT sessions will help to shift those personal biases and begin to enlighten people on what they should do. Usually facilitators might administer a pre-test, questionnaires and pro-test to assess change in value, attitude and behaviour. However, some people need some time to process the information they have gotten because a lot of people come to this training with a very strongly held bias, so the idea for a pre-test and a pro-test might not give a true picture of their feeling at that point or if there is any significant change no matter how small in terms of their knowledge, attitude or behaviour. There is almost always a change, so I agree that VCAT can contribute to a process of change.

Olive: Thank you Nnamdi for engaging me in this conversation, I think you have given us a lot to think about today, particularly as it relates to how attitudes influence people’s actions toward those seeking abortion or those who might have had an abortion. For me, the key takeaway is that VCAT is not just for people who do not support abortion rights but we might have a variety of participants even those who already support abortion or who are prochoice and support access to safe abortion care. Thank you again, it’s been lovely talking with you today.

Nnamdi: Thank you for having me, it’s my pleasure.

Olive: Thank you everybody for listening. For more information including the transcripts for this episode, you can check our website and you can also find us on our social media platforms @ynscsd on Twitter and Instagram. Thank you for listening.


Listen to the podcast here.