In Kenya, in 2012, the African Population and Health Research Center (APHRC) completed a study to assess the incidence of induced abortion and its impact. There is an informative 2 page summary of the findings here and the full study here.
Abortion in Kenya is highly restricted and most women resort to seeking services outside of the formal healthcare system (backstreet).
APHRC reports that in 2012 there were 465,000 induced abortions in Kenya, equating to an age-standardised abortion rate of 48 per 1,000 women of reproductive age (WRA). That is almost three times higher than the same measure in England and Wales, which was reported by the Department of Health as 16.5 in the same year.
According to APHRC, during that year nearly 120,000 Kenyan women were treated in healthcare facilities for complications arising from these abortions, and some 75% of these adverse events were recorded as either moderate or severe. This shows a complication rate of more than one for every four abortions. This is staggeringly high, 175 times higher than the same measure in England and Wales, reported at just one in every 700.
This shows the very significant impact of unsafe, unregulated, abortion on women’s health and the resulting strain placed on an already overstretched healthcare system.
Of those 120,000 seeking post-abortion care (PAC), more than 70% were not using a regular method of family planning prior to becoming pregnant. The Demographic and Health Survey in Kenya (2008-2009) found that 43% of births in the preceding five years were reported by women as unwanted or mistimed, reflecting significant, and multiple, barriers to family planning access and use.
Uncovering and responding to each of these barriers is complex, but something that programme planners must continue to work hard to achieve. We need to find better ways to satisfy any unmet need, and indeed to improve understanding and stimulate increasing interest in the use of long acting methods. If we can help to reduce the numbers of unintended pregnancies, that in turn will lead to a reduction in the numbers of induced abortions and the resulting harm from these.
Increasing provision of comprehensive abortion care (CAC) – which includes counselling, provision of safe abortion services, follow-up care and provision of the family planning method of choice – will be a key factor in harm reduction.