Maternal health programmes to suffer under Trump presidency

Kenya's reproductive health programmes dependent on donor funding will be among casualties of a policy shift by US President Donald Trump.

In a move that could spell disaster for maternal health programmes in Kenya, Trump has reinstated the Mexico City Policy, which prohibits funding for reproductive health programmes.

Trump signed the executive order on Monday, also known as the Global Gag Rule, in a move viewed by many as an affront to reproductive health rights as it will deny certain organisations about $600 million (Sh60 billion) annually.

Kenya is one of the countries that will face the consequences of this action as both government and non-governmental organisations will lose out on funds to carry out family planning programmes.

In Kenya, abortion, which is one of the programmes funded under the policy, remains a very emotive issue that has seen the Ministry of Health refuse to ratify a document on standards, policies and guidelines on abortion as the Constitution notes that abortion is allowed under special circumstances.

Echoes of disapproval of Trump's action have started rising, though the Church in Kenya has been speaking the same language as the leader of the free world, with the Catholic Church being in the forefront.

Ironically, the law only applies to organisations working in other countries, leaving the US and its abortion laws intact.

Centre for the Study of Adolescence (CSA) Executive Director Albert Obbuyi noted the move will roll back the gains made in the sector.

Obbuyi said consequences of Trump's action would be far-reaching as they would lead to increased cases of maternal and infant deaths, family sizes and unsafe abortions.

The policy has been a back and forth between Republicans and Democrats as each of them roll back what the other has done. It creates the impression that Republicans are pro-life while Democrats are pro-choice.

"Democrats have been more progressive in health interventions compared to Republicans," argues Obbuyi.

First issued in a memorandum by former US President Ronald Reagan in 1984 at the United Nations Population Conference held in Mexico City, the policy has always been rescinded by Democratic Party presidents only for it to re-instituted when the Republicans takes over.

President Reagan served two terms after which George H W Bush took over without making any changes to the policy.

But when Bush was defeated by Democrat Bill Clinton, he issued an executive order just two days after being sworn-in in January 1993 – and it remained in force until his tenure ended.

When George W Bush took office, he also issued a decree just two days after being sworn-in and restored the policy.

In the same year, Bush withdrew funding for UNFPA, which it accused of being the brain behind China's one-child policy that led to forced abortion and sterilisation.

When former President Barack Obama got into office, he also kept up with the speed which his predecessors had acted on the policy. He signed the executive order on January 23, 2009 – just three days after assuming power.

The Mexico City Policy, prohibits NGOs receiving US funds from promoting or providing abortions, as a method of family planning and also prohibits them from advocating for abortion laws in the countries where they operate.

Centre for Reproductive Rights Executive Director Evelyn Opondo said in Kenya, not only organisations dealing with planned parenthood will be affected, but also those handling other issues like female genital mutilation.

She warned that these agencies might just close shop.

"The Global Gag Rule does not just stop funding for organisations offering abortion services but also stops information on sexuality," notes Ms Opondo.

She argues that with lack of information, there would likely be an upsurge in unplanned pregnancies and backstreet abortions.

This will most likely increase the number of women with an unmet need for contraceptives, which the World Health Organisation defines as women who are fertile and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child.

Currently, about 220 million women in developing countries have an unmet need for family planning.

The reproductive healthcare Bill by nominated Senator Judith Sijenyi is still stuck in the Senate.

The Bill seeks to facilitate the provision of adolescent–friendly reproductive health and sexual health information and education.