2. Introducing Emergency Contraception in Morocco: A Slow Start after a Long Journey
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27 2 Introducing Emergency Contraception in Morocco A Slow Start after a Long Journey Elena Chopyak Progestin-only emergency contraceptive pills (ECPs), already long available in Tunisia, Iran, Lebanon, and Turkey, were first registered and distributed in Morocco in 2008. In her first official act as minister of health, Yasmina Baddou approved the registration of NorLevo®, the first postcoital contraceptive product in Morocco, after more than eight years of waiting, confusion, and disappointment. However, in the year after the product became available, awareness of emergency contraception (EC) and sales of NorLevo were lower than health officials and pharmaceutical companies had anticipated. This chapter outlines the introduction of EC in Morocco and explores the ways in which legal, religious, and social norms and expectations have framed the awareness-raising strategies and discourses surrounding it in the wake of product registration. After providing an overview of the history of family planning in Morocco and exploring the dynamics shaping early efforts to register a dedicated ECP, I draw from the original research I conducted in Morocco in 2009 and 2010. I examine the ways in which EC was framed in French-language Moroccan women’s magazines and journals and in the promotional materials developed by the local pharmaceutical distributor of NorLevo to showcase the ways in which postcoital contraceptives and their potential users were positioned. On the basis of key informant interviews, in-person interviews with retail pharmacists in Rabat, and responses to a survey I conducted with a small group of university students, I argue that policies restricting direct-to-consumer advertising of branded pharmaceutical products, the conflation of ECPs with abortion, and broader social taboos surrounding unmarried women’s sexuality hampered awareness-raising efforts and limited uptake. Although more recent sales data suggest that use of EC in Morocco is on the rise, I conclude with a discussion of possible avenues 28   Abortion Pills, Test Tube Babies, and Sex Toys by which access to postcoital contraception could be expanded and ways in which future reproductive health technologies could be more effectively introduced. A Brief History of Family Planning in Morocco Between the 1960s and early 2000s, Morocco experienced a rapid decline in the total fertility rate (TFR), from over seven children to 2.5 children per woman (Ministère de la Santé [Maroc] 2005; Bouzidi 1981). Family planning programs and an increasing age at first marriage for women, are responsible for this decline. Media and educational campaigns promoting the use of condoms, daily oral contraceptive pills (OCPs), and long-acting reversible contraceptive methods, such as the intrauterine device (IUD), helped bolster contraceptive prevalence and fulfill previously unmet contraceptive need. The principal impetus behind the National Family Planning Program did not originate in a concerted effort from the Moroccan medical community or in a desire to advance women’s empowerment. Rather, the catalyst for Morocco ’s family planning program stemmed from the theorized economic benefits of reducing the birth rate to increase per capita wealth and manage unemployment rates (Grosse 1982). A 1965 report from the Moroccan Ministry of Planning projected population growth in Morocco from 1965 to 1985 and estimated that the high TFR would have a significant negative impact on education, housing, and unemployment. Government officials postulated that Morocco would benefit from greater economic gains if the TFR were to decline in the ensuing decades. A 1966 World Bank report echoed these sentiments, warning that population growth had the potential to overpower economic growth. The US government also pressured Morocco to focus on population growth control measures (Brown 1968). Along with eleven other heads of state, including those of Jordan, Tunisia , and the then–United Arab Republic, King Hassan II signed the 1966 United Nations Declaration on Population, which asserted that “the majority of parents desire to have the knowledge and the means to plan their families; that the opportunities to decide the number and spacing of children is a basic human right” (United Nations 1966). The following year an additional eighteen heads of state signed the declaration. In the 1960s, the international community, including the United Nations and the International Planned Parenthood Federation (IPPF), linked population control with economic growth and generated a discourse that many nations incorporated into their population and health policies (Boli and Thomas, 1999). Hassan II also Introducing Emergency Contraception in Morocco   29 made a public statement in support of stronger efforts to reduce the TFR in Morocco, although this statement received little attention in the Moroccan press (Grosse 1982). Thus in 1966, nearly ten...



Subject Headings

  • Human reproductive technology -- Middle East.
  • Human reproductive technology -- Africa, North.
  • Birth control -- Middle East.
  • Birth control -- Africa, North.
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