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Time to put a stop to needless deaths resulting from unsafe abortion

 Various women groups and youth groups on a procession at Kaburengu along Kakamega- Kitale road on their way to a function to mark the World Contraceptive day held at Matete grounds in Lugari Sub-County, Kakamega County. [Benjamin Sakwa, Standard]

Lack of access to safe abortion due to known barriers remains unacceptably high. Unsafe abortion is a public health concern and according to 2013 findings of the 'Magnitude and incidences of unsafe abortion' study conducted by the Ministry of Health, unsafe abortion in the country is among the highest in Africa.

Maternal mortality is high at about 6,000 deaths per year, 17 per cent of them from complications of unsafe abortion. The study, conducted by the African Population and Health Research Centre in collaboration with the Ministry of Health, Ipas, Guttmacher Institute and other partners estimated that 464,690 induced abortions were conducted in Kenya in 2012, corresponding to an induced abortion rate of 48 abortions per 1,000 women of reproductive age (15-49 years), and an induced abortion ratio of 30 abortions per 100 births.

Part of these statistics represent untold miseries of young girls, some who are bread winners living in poor conditions. The study also estimates that 157,762 women received care for complications of induced and spontaneous abortions in health facilities in the same year. Of these, 119,912 were experiencing complications of induced abortions.

The World Health Organisation defines unsafe abortion as a procedure for terminating pregnancy, carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. The situation is further compounded by people of different persuasions who insist on imposing their misinterpretation of safe abortion rights on other members of the society. While all this happens, the number of admissions for post-abortion care in public facilities increases while a good number of children remain orphaned because their mothers could not access safe abortion services. Despite the glaring challenge, pleas by human rights organisations and women groups to compel the government to make accessible safe abortion services have often fallen on deaf ears.

Article 26(4) of the Constitution allows for abortion under certain circumstances such as in the opinion of a trained health professional. Organisations working to advance the rights of women such as TICAH have made a case for safe abortion as a means of reducing the maternal mortalities resulting from the high number of unsafe abortions. However, there have been attempts to frustrate efforts of reducing maternal mortalities by failing to operationalise progressive guidelines such as the standards and guidelines to reduce maternal mortality rates developed by the Ministry of Health that have been left to gather dust in the ministry's shelves.

The same can also be said of laws that experience slow implementation in case they are found to expand, to the smallest extent possible, the range of sexual and reproductive health services, and we can only wait to see if the proposed handbook on the prevention and management of the big five direct causes of maternal morbidity and mortality in Kenya will be followed through. A High Court ruling in Malindi on March 25, 2022, affirmed that abortion care is fundamental right under the Constitution and that arbitrary arrests and prosecution of patients and healthcare providers for seeking or offering abortion services are illegal.

The court also directed Parliament to enact an abortion law and public policy framework that aligns with the Constitution. However, until now, levels of unintended pregnancy and unsafe abortion continue to be high due to low contraceptive prevalence. The clarion call during last week's International Safe Abortion Day was for the Health ministry and related government institutions to rise above all biases that may come in the way of providing safe abortion and instead adhere to scientific evidence in formulating the policies and guidelines and while still at it, boldly reclaim their position in ending the unsafe abortion.

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