Unmarried, unwanted, unsafe: New sexual and reproductive health research in Morocco is breaking barriers to keep women healthy

 
Four people sit around a table in discussion.
Meeting between the Université Hassan II research team and Naïma Ame, president of the Association de Solidarité féminine, to discuss the qualitative survey with single mothers.

In a country where premarital sexual relations between two consenting adults is illegal, a recently published study found that 54.4% of men and 26.6% of women surveyed in Morocco said they had engaged in premarital sex. Yet unmarried women and girls cannot access family planning products and services, given that premarital sex is prohibited under Article 490 of the country’s Penal Code. As a result, contraceptives are difficult to obtain, leading to unwanted pregnancies and unsafe, illegal abortions, infanticide or child abandonment.

Unmarried pregnant women and girls offer but one example of women in vulnerable situations who face significant challenges accessing sexual and reproductive health (SRH) services in Morocco. Migrant women are even more at risk; they face discrimination and have little or no access to SRH services. Gaps in the health-care system, religious beliefs, discrimination and the criminalization of premarital sex all contribute to gender inequalities that overwhelmingly leave women and girls at risk. Periodic backlash against migrant populations puts migrant women at even higher risk. 

IDRC is funding two research projects to gain deeper insights into these pressing problems. Researchers are generating evidence to inform policy decisions, improve access to sexual and reproductive health services, and create better conditions for women and girls in Morocco.

Unmarried women, unwanted pregnancies

In the first project, researchers at the Université Hassan II in Casablanca are addressing the alarming gap between policy and reality. Using a gender lens and mixed research methods, they are exploring:  

  • sexual behaviours, beliefs and practices among young people  
  • risk factors for pregnancies and obstacles to accessing contraception  
  • masculinity and gender-based discrimination in unwanted pregnancies 
  • resilience of unmarried women following an unwanted pregnancy 

Voices from the frontlines: From research to impact

“I’m glad to hear the university is committed to research on the topic of unwanted pregnancies. I look forward to the scientific data that will emerge from this work. It’s this kind of data, which we have always lacked, that we need to support our advocacy for the rights of young girls and single mothers.”  

– Naïma Ame, president of the Association de Solidarité féminine 

The research team is finding answers by seeking out the stories and lived experiences of unmarried women and girls dealing with unwanted pregnancies. In a pilot study, they surveyed 61 pregnant women and girls aged 15 to 37 years old. The study found that: 

  • 81.9% had sexual intercourse for the first time between the ages of 15 and 25  

  • 47.5% had sexual intercourse in the context of an ongoing relationship and 31.1% did so following a promise of marriage 

  • 77% have not considered abortion because they do not have the financial means, they are unfamiliar with how to access the procedure, and, above all, for religious reasons

In half of the cases under study, the male partners took no responsibility when they learned of the pregnancy, resorting to escape, rejection or violence.

With their dignity ignored, the preliminary findings show that women and girls are at a clear disadvantage, facing overt and covert discrimination when it comes to their sexual and reproductive health. In the next phase of the project, researchers are holding focus group discussions with young women and men to learn about their lived experiences, attitudes and gendered behaviours. They are also gathering life stories from young women living in shelters and interviewing health-care professionals for their perspectives. 

A watershed moment: Knowledge sharing on a pan-African scale

Morocco hosted the 11th African Conference on Sexual Health Rights and Family Well-being in early 2024. This was a defining moment in Morocco’s sexual and reproductive health and rights trajectory, signaling that positive changes may be coming, especially for women and girls. The research team shared the pilot study’s results with attendees.

In a side discussion at the conference, research leads Rachid Aboutaeib and Latimad Moutaouadia explored the significance of the moment. “If the political debates currently taking place in Morocco lead to the repeal of Article 490 of the Penal Code, and thus to the decriminalization of sexual relations between two consenting adults, single mothers will no longer be worried when they come to give birth in hospitals. Health authorities will no longer be allowed to reserve contraception for married women. Consequently, the national contraception program should be extended to all women of childbearing age, even those who are not married.” 

Breaking through barriers for migrant women

In the second project, researchers from the Université Mohammed VI des Sciences et de la Santé are examining the urgent issue of poor access to quality SRH services by migrant women in Morocco. Located in the Strait of Gibraltar, Morocco is the closest country to Europe on the African continent, making it a major migratory corridor and destination country for a growing number of migrants, especially those coming from the Southern Hemisphere.

This presents a specific set of challenges when it comes to sexual and reproductive health and rights and SRH services. Migrants often come from difficult social, political and economic backgrounds. This population is more likely to experience human rights violations and economic hardship during migration or once they are in the host country. Women are in double jeopardy, facing double discrimination for their sex and reproductive health needs, as well as for being displaced. They often have trouble accessing SRH services and products, and even more so if they are unmarried. This set of conditions makes migrant women particularly vulnerable. 

Morocco’s National Immigration and Asylum Strategy

In 2014, Morocco adopted a national strategy on immigration and asylum, which allows migrants to access free services from a network of primary health facilities. But this system is not a perfect one.

Professor Saad Zbiri, one of the project’s leads, sheds light on the issue, “Despite the implementation of the national migrant health strategy to promote access to health care as it is for national citizens, migrants and refugees still have difficulties accessing health services in Morocco.” 

The project aims to improve how migrant women in Morocco are accessing and using quality SRH services. It will contribute to addressing SRH and morbidity and mortality related to gender-based violence among migrants living in Morocco, particularly women and girls.

Researcher interviews a subject at a table.
A researcher interviews a single mother benefiting from the Association de Solidarité féminine program.

The project’s activities include a population survey, focus groups and interviews with migrant women and girls, health-care providers and health managers. Researchers will target popular centres for migration, with a focus on Casablanca, Rabat and Tangiers.

Objectives include: 

  • generating evidence on what prevents migrant women from accessing and using SRH and  gender-based-violence services, and what could increase their use of these services 

  • identifying local solutions to improve access and use of public health services by migrant women and girls, with a particular focus on SRH services  

  • Informing evidence-based policies on migrants and migrant health issues in Morocco 

This project has the potential to have an impact on public policies that deal with health care for migrants, specifically SRH services. So far, it has brought together ministries, international organizations, civil society organizations, universities and research bodies to discuss the issue, creating a new dynamic in this area of public health in Morocco. The research team published the findings of its scoping study on interventions to improve migrant access to SRH services in the peer-reviewed journal, BMJ Global Health.

IDRC-funded research supports meaningful change

Both research projects are underway at a pivotal time for SRH policy in Morocco. The country is reviewing its Family Code, or the “Moudawana,” a set of legal rules that govern family law. Updates to the code would reflect more socially progressive values, which could improve access to SRH services for some of Morocco’s most vulnerable groups. This couldn’t come soon enough, as the world is this year commemorating the 30th anniversary of the International Conference on Population and Development Programme of Action.

Projects like these build evidence and provide data for discussion, debate and advocacy on quality access to SRH products and services. By gathering the perspectives of women and girls who are most impacted by discriminatory systems and practices, researchers can share their stories to impact policy discussions and create meaningful change.