Newly published study highlights critical need to address unsafe abortion in Kenya

Many women in Kenya will be affected by the consequences of unsafe abortion.

Photo courtesy of Dieter Telemans, Panos Pictures.

A study underscoring the need for more effective action to prevent unwanted pregnancies and unsafe abortions has been published by BJOG: An International Journal of Obstetrics & Gynecology. The study by several organizations in Kenya recommends increasing the availability of contraception and legalizing abortion.

The study was undertaken by the Kenya Medical Association, the Federation of Women Lawyers Kenya (FIDA Kenya) and Ipas. Its purpose was to provide current information on the magnitude and consequences of abortion complications in Kenya to inform national-level policy decisions.

Although several studies in the past decade had yielded data about unsafe abortion, no previous study had taken a national perspective on the issue. With funding from the Rockefeller Foundation, the researchers set out to fill that knowledge gap through a nationwide study, which took place during three weeks in 2002.

Carried out in 60 public-health facilities across the country, the study uncovered very high rates of abortion-related complications, associated with a considerable cost burden to the health system and a particularly troubling toll on young women. For example:

• Based on their findings, researchers estimated that 20,000 women are hospitalized with abortion-related complications in the public health system alone each year. They further estimated that as many as 300,000 abortions occur in Kenya each year.
• Study data shows that about 16% of women presenting with abortion complications were less than 20 years old; 57% of the women were from urban areas.
• During the three-week course of the study, seven out of the 809 study participants with abortion complications died – nearly one in 100. Six of these women were in the second trimester of pregnancy.

"Clearly this problem has received inadequate attention," said Dr. Eunice Brookman-Amissah, Ipas's Vice President for Africa. "The pervasive denial of the reality of unsafe abortion is taking a huge toll on the health and lives of women and girls all over the country, as well as on our public health system."

In the full report, researchers recommended a range of actions to address unsafe abortion, including better equipping district hospitals to manage its complications. Other recommendations include:

• Training midlevel health care providers, including nurses and midwives, to offer abortion-related services, since they far outnumber doctors and are more accessible to most Kenyan women
• Addressing the special needs of youth for comprehensive reproductive-health information and services
• Improving family planning services, including those available to women who have undergone abortion
• Educating women about existing provisions for legal abortion, so that they can avail themselves of safe legal abortion to the full extent permitted by law, and
• Reviewing current abortion laws

"We now have ample evidence of the widespread impact of unsafe abortion in Kenya," said Brookman-Amissah. "Policymakers have the information they need to formulate effective policies to address this issue and thus to improve the lives not only of Kenyan women but also of their families and communities."

BJOG is an editorially independent publication of the Royal College of Obstetricians and Gynaecologists that publishes original, peer-reviewed work in all areas of obstetrics and gynecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality of medical research in women's health, worldwide.

Read the study abstract.

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