By Oliech Okun

OPINION –Unsafe abortion is widespread and it does not know boundaries or age. The burden of unsafe abortion is largely borne by those who are most vulnerable and least able to access safe abortion services. Poor women, young women, rural women and their families bear the lasting consequences of unsafe abortion.

In Kenya, unsafe abortion is a commonly neglected reproductive health care problem yet it poses a serious threat to the health of thousands of women during their reproductive lives. Until unsafe abortion and its consequences are eliminated, complications from unsafe abortion will remain a major cause of maternal mortality and morbidity in Kenya.

The root cause of women seeking an abortion is the prevalence of unwanted pregnancies, which in turn reflects the failure of family planning programmes to meet the contraceptive needs of all women at risk of unintended pregnancy. For the growing number of women and men of reproductive age who wish to regulate their fertility and have fewer children, there is a need for correct and consistent use of effective contraceptive methods.

However, problems such as difficulties in access to preferred methods of contraception, incorrect or inconsistent use of contraceptive methods, and potential contraceptive method failure are not easily resolved and may lead to unintended pregnancies. Other reasons for unwanted pregnancies include forced or unwanted sexual intercourse and a lack of women’s empowerment over sexual and reproductive health matters. Societal norms, economic conditions, legal obstacles and other systemic factors are likely to have a profound impact on women’s recourse to abortion and especially unsafe abortion.

The 1994 International Conference on Population and Development which Kenya is a signatory to, highlighted the pressing need for work on unsafe abortion, and in its Programme of Action, it urged governments and other relevant organizations to deal with the health impact of unsafe abortion as a major public health concern and to reduce the recourse to abortion through expanded and improved family planning services. It further declared that in circumstances where abortion is not against the law, such abortion should be safe.

Unfortunately, safe motherhood programmes generally do not address the causes and consequences of unsafe abortion. Consequently, as the other causes of maternal mortality decrease, deaths from complications of unsafe abortion increase as a proportion of all deaths.

Although Kenya has made huge strides by investing in family planning, much work needs to be done to ensure that unsafe abortion becomes a public health concern of the past. To achieve the overall goal of eliminating unsafe abortion, the government of Kenya and civil society must focus in research, capacity building, norms and tools, and advocacy to reduce the burden of unsafe abortion on women, their families, and health systems.

I call upon the Kenyan government and civil societies to take up the following recommendations;

• Develop guidelines for safe abortion and post abortion services.
• Improve the quality of safe abortion services and post abortion care.
• Disseminate information to reduce unsafe abortion.
• Explore the role of men in preventing unsafe abortion.
• Measure the incidence of unsafe abortion and its consequences.
• Assess the costs of unsafe abortion.
• Analyze the relationship between laws/policies and abortion.
• Assess the linkages between sexuality, violence and abortion.