This week, the Guttmacher Institute released new reports on the issue of unsafe abortion in Kenya and Pakistan, two countries where abortion-related complications help to drive persistent high levels of maternal mortality and morbidity.
In Kenya, researchers working in coordination with the Ministry of Health undertook a study using a nationally representative sample of health facilities in order to assess the number of abortions annually in Kenya, the extent of unsafe abortion, the characteristics of women who seek abortion-related care in Kenyan health facilities and the quality of care available. They found that unsafe abortions were not only common, but carried a major, unnecessary threat to women’s lives, with a case-fatality rate of 266 deaths per 100,000 unsafe procedures – nearly all of which could have been prevented.
Meanwhile, in “Post-Abortion Care in Pakistan: A National Study,” researchers from Guttmacher and the Population Council focused on the issue of post-abortion care as they examined the conditions under which women obtain abortion in Pakistan; the incidence, coverage and quality of facility-based postabortion care (PAC); and the extent to which recommended standards for PAC have been implemented in health facilities. The study drew on research with women and in health facilities to compare the 2012 situation to 2002. There was clear evidence that things have improved in some ways: for example, safer methods of PAC are now much more common than they were ten years ago. However, there was also clear evidence that clandestine, unsafe procedures remain far too common in the first place.
In both countries, researchers found that unsafe abortions remain common, and that most of the women who seek post-abortion care have moderate to severe complications. Further, both found serious shortcomings in critical health services, including family planning, and PAC, calling on governments and health institutions in both countries to improve these services.
For instance, the authors of the Kenya report noted:
“More than 70% of women seeking postabortion care were not using a method of contraception prior to becoming pregnant. Similarly the results of the 2008/09 Kenya Demographic and Health Survey found that 43% of births in the preceding five years were reported by women as unwanted or mistimed. Both of these findings illustrate that there are still significant barriers to access and use of effective contraceptive methods in Kenya.”
And, a policy brief accompanying the Pakistan report argued:
“At the moment, there is a very weak response to a large need, and an opportunity to provide quality counseling and family planning services to the very women who are most in need: women being treated for complications of abortion, almost all of whom have experienced an unwanted pregnancy.”