OPINION: There’s need to sensitise, train healthcare providers on emergency abortion services

By Evelyn Odhiambo

African laws largely restrict abortion with only 3 countries; Tunisia, Zambia, and South Africa where abortion is broadly permitted even upon a woman’s request.

In many African countries, abortion is restricted with a provision like: when the life of the mother is in danger or case of an emergency. Kenya is among the many African countries where abortion restricted under article 26 (4) of the 2010 constitution.

According to WHO, it was in the 1960s, when laws legalising abortion were being passed in industrialszed and developing countries.

Since then abortion has become the fastest and most used clinical procedure by many women across the world. In 2005, WHO listed medical abortion as essential medicines although many laws and policies have since lagged in responding to these major health changes.

In Kenya the provision of abortion is guided by the constitution although many providers are still scared of providing these services even in emergencies.

The use of culture and religion to criminalize abortion has led to increased unsafe abortion deaths even among adolescents the case of ‘JMM 2019′, a 14-year-old who died in 2018 after suffering sepsis and hemorrhage due to lack of post-abortion care treatment.

JMM isn’t a unique case in our communities. Many adolescent girls suffer from unsafe abortions complications leading to long term disabilities for not being able to access post-abortion treatment in good time.

Many providers in public health facilities that are financially and geographically accessible for many people lack the necessary skills, equipment, and knowledge to offer post abortion treatment.

In 2009, Jackson Tali a health provider, was arrested and charged with murder after a patient was found dead at the back seat of his car.

Later in 2014, Jackson was sentenced to death by hanging although acquitted in 2016 after Civil society organizations intervened in his case.

Jackson just like other providers’ quick action to save a life, by putting a patient suffering from unsafe abortion complication in the back seat of his car for referral to a facility equipped to perform the post-abortion lifesaving treatment found himself behind bars and with no evidence to support his case due to lack of data entered in his facility.

Having not done client assessment and recording the patients’ details, Jackson had no proof of his act to save the woman’s life and all evidence pointed at him.

Just like Jackson, we have witnessed reproductive health providers harassed, and extorted by the police making it hard for them to fully perform the lifesaving treatment.

The he community stigmatisation, labeling and even demonstration against these providers’ facilities, have made it difficult for providers to operate peacefully and even offer post-abortion care.

It’s important that providers are medically equipped and trained to offer these essential services. It’s proven that in skilled hands, surgical methods of abortion using aspiration techniques as at up to 15 weeks of pregnancy, and dilation and evacuation in the second trimester, are very safe, as in medical abortion.

The ministry of health needs to facilitate and conduct abortion training programs for health care providers in all public health facilities ensuring they are equipped to save the lives of women and girls coming in with severe unsafe abortions, missed abortions or incomplete abortion complications being these are primary health facilities many Kenyans access.

The ministry of health should also fast track the dissemination of the standards and guidelines 2012 to reduce maternal mortality and also conduct capacity building for health care providers across the country per the 2019 post-abortion care a pocket guide for health providers.

Ms. Evelyn Odhiambo is the Youth Coordinator Reproductive Health Network Kenya (RHNK)

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