Joyce Mulama
NAIROBI, Aug 30 2006 (IPS) – Local communities have been urged to act as agents of change and break the silence on illegal abortions fuelling Kenya s maternal mortality.
Abortion is illegal in Kenya and only allowed when a woman s life is in danger.
Despite the laws banning the practice, termination of unwanted pregnancies take place and women and girls continue to die from complications of unsafe abortion.
Around 300,000 terminations of pregnancies occur in Kenya every year, with an estimated 20,000 women and girls being admitted with abortion-related complications in the hospital, according to a 2004 national study.
Abortion remains shrouded in secrecy, and communities have been urged to break the silence and change the negative attitudes attached to the practice.
Whenever abortion discussions come up, they are often prejudiced. Those who have procured abortions are called all sorts of names including devils. They are not devils but members of our communities. Our women and girls get unwanted pregnancies and they terminate them, and some of them die, said Joachim Osur, assistant programmes director at Family Health Options Kenya (FHOK).
His group, a Nairobi-based non-governmental organisation (NGO), offers reproductive health services across Kenya.
If communities can be encouraged to openly talk and get the right information on reproductive health, including how to deal with unsafe abortions, we will not have some of these maternal deaths, Osur noted.
Official statistics show that 30 to 50 percent of all maternal deaths are directly attributed to unsafe abortion. Kenya s maternal mortality now stands at 414 deaths to 100,000 live births, according to the 2003 Kenya Demographic Health Survey.
To achieve good results, always involve communities. Even for maternal deaths to be addressed adequately, communities must talk. They are the ones who know what happens where and how. They have their own traditional ways of dealing with this matter (abortion), said Josephine Moyo of Ipas, a US-funded group that advocates for women s reproductive health rights.
Some of their ways may be dangerous. That is why they (communities) must be encouraged to share their experiences so that they can receive the right reproductive health information including seeking medical attention when faced with complications of unsafe abortion, she added.
Some of the traditional methods of dealing with abortions include the use of herbs, roots and leaves inserted into a woman s vagina in order to remove the foetus. It s done by herbalists and traditional midwives.
When handled carelessly, overdosing can result in the death of the woman or girl. Complications such as excessive bleeding or perforated uterus, which herbalists or traditional midwives cannot handle, can kill patients.
While the campaign to involve communities in addressing unsafe abortions intensifies, the efficacy of this initiative is slowly being noted.
A study launched early this month highlights how community participation can help change people s attitudes and responses towards unsafe abortions.
The study, Testing Community Level Strategies to Reduce Unwanted Pregnancy and Unsafe Abortion in Western Kenya, is an outcome of a research conducted in Suba, a remote area in western Kenya. Conducted between 1999 and 2004, the study sought to find out if communities could be effective in reducing abortion-related deaths.
The study reveals that communities in Suba were able to reduce abortion-related mortality. This followed community education and the training of informal community health workers to administer first aid measures to women who had terminated pregnancies, as they ensured timely referrals to nearest clinics with trained medical personnel.
There was a significant decline in abortion-related mortality from 87 percent in 2001/2002 to 13 percent in 2003/2004, says the study. It was conducted by the regional office of the U.S.-based Centre for the Study of Adolescents, the U.S.-based Pacific Institute for Women s Health and the Kenya Medical and educational Trust, a non-governmental organisation.
Apart from addressing unsafe abortion issues, reproductive health experts have emphasised the importance of preventing unwanted pregnancies through increased supply of contraceptives.
Kenya has experienced a shortage of contraceptives which has been attributed to the widespread abortion incidences in the country.
Donors, who used to fund Kenya s contraceptive package bills, have diverted funds elsewhere. All the focus has gone to HIV/AIDS to the extent that family planning has been relegated to the backdoor, noted Solomon Orero, a Nairobi gynaecologist.
Last year the government of President Mwai Kibaki allocated 2.7 million dollars for contraceptives and other reproductive health services, the first time in Kenya s history. It has been felt that the amount, which was allocated for the 2005/06 financial year, is just a drop in the ocean.
It s unclear how much of that amount would be spent on reproductive health, particularly contraceptives.
According to Osur, FHOK alone, which meets three percent of the country s reproductive-health service bills, spends more than 2.7 million dollars a year on contraceptives and other reproductive health services.
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