ICPD commitments remain unfulfilled in Africa

Ten years after a landmark United Nations population conference in Cairo, Egypt, African women still face elevated risks of dying from pregnancy-related causes, with unsafe abortion posing a particularly dangerous threat.

In a new report released to coincide with a meeting in Senegal this week to review Africa's progress in achieving the Cairo conference's Programme of Action, Ipas outlines some major challenges that demand attention from governments, nongovernmental organizations and communities in ensuring women's reproductive health and rights. The report focuses on the need to address more effectively the incidence and consequences of unsafe abortion, which claims the lives of at least 34,000 African women every year.

"In the last 10 years, very important strides have been made in several areas, including improving the quality and availability of emergency treatment and contraceptive services for women who have undergone unsafe abortion," said Ipas Regional Director for Africa Uche Ekenna.

"But too many African women desperate to end unwanted pregnancies still turn to clandestine, often illegal abortion, with tragic results for themselves, their families and their communities. Governments have not adequately confronted this entirely preventable problem."

The 1994 International Conference on Population and Development (ICPD) marked the first time that the world's governments collectively recognized unsafe abortion as a major public-health problem requiring immediate and sustained action. Along with pledges to improve couples' access to modern contraceptive methods to help prevent unwanted pregnancy and thus abortion, the 179 countries that endorsed the conference's Programme of Action agreed that high-quality postabortion care should be universally available to all women who need it and that safe abortion should be accessible for circumstances in which it is not against the law.

According to the new Ipas report, titled "Lives worth saving: Abortion care in sub-Saharan Africa since ICPD," these promises have been only partially kept. Postabortion care programs have been created or strengthened in numerous countries, for example, and access to abortion-related care has been expanded in several by authorizing and training a wider range of health-care providers to offer such care. Public awareness and discussion of the impact of unsafe abortion on women's lives has also increased, in some cases leading to liberalization of laws governing provision of abortion.

Notably, in 1996, in response to high-rates of death and injury from unsafe abortion, South Africa made abortion available on demand during the first-trimester of pregnancy. To ensure that women in rural areas would be able to access safe legal abortion, the government authorized and trained nurse-midwives to perform the procedure.

Elsewhere, however, progress in improving women's access to safe abortion, even in accordance with existing laws, has been scant. With a few exceptions, Africa's laws concerning provision of abortion - many the legacy of colonial law -- are among the most restrictive in the world. Nevertheless, the World Health Organization estimates that more than 4 million African women undergo abortions every year, usually performed by unqualified providers in dangerous conditions.

The Ipas report outlines numerous challenges in improving African women's access to safe abortion care, including overcoming limitations of poor health infrastructures; securing resources for abortion care; mobilizing political will to support comprehensive reproductive health programs; addressing abortion in the context of the HIV/AIDS crisis; and meeting the special needs of young women.

Although these challenges might seem daunting, the knowledge and resources to end unsafe abortion are readily available, said Ekenna. "Providing safe abortion services is possibly the easiest technical approach to reducing maternal mortality," he said. "All we need is the political will."

"Lives worth saving: Abortion care in sub-Saharan Africa since ICPD" is available for free download on the Ipas website.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258