BY AYOKI ONYANGO
A study conducted in Kenya recently identifies unsafe abortion as a major threat to the lives of most pre-menopausal women. The study also highlights unsafe abortion as the leading contributor to maternal deaths in the country, constituting 30 per cent of maternal deaths nationally. Conducted by the National Council for Population and Development (NCPD ), the study also shows that unsafe abortions account for between 40 and 70 per cent of all gynaecological problems.
Still, the study does not capture the many other women who die at home or never reach reach hospital for treatment for abortion related complications. To respond to the challenges linked to unsafe abortions, stakeholders among them medical experts on reproductive health and policy makers undertook a study to help identify causes of unsafe abortions and how to address them to reduce maternal deaths and other health complications as a result.
The research, which was funded by the World Bank and United States Agency for International Development among other local and international agencies, invited experts on women reproductive health issues to collect data that points to a large and serious public health problem of high magnitude. “Bleeding, infections, haemorrhage and sepsis were found to be the most common complications associated with incomplete or unsafe abortions,” says Prof Richard Muga, an expert on reproductive health and former Director of Medical Services. Prof Muga who is now the Chancellor of Great Lakes University, observes that 35 per cent of most maternal deaths in Kenya and other African countries are abortion-related and caused by sepsis.
One of the major findings of the study is the realisation that most research and studies have been based on hospital or clinical settings even though there are many abortion related maternal deaths that occur in rural homes and remote villages and other places with no clinical facilities. For this reason, experts are suggesting that there is need for more community based studies that will give a more accurate picture of what is happening outside official health systems. This is very important since even the Health ministry’s annual report is based on information recorded from clinics and hospitals. Rarely is official data/information gathered from rural villages or settings.
The researchers say women treated for unsafe abortions did not use any contraceptive methods at the time of conception. “It is advisable that doctors and clinical officers give quality services to women who seek treatment for abortion-associated complications,” says Dr Nicholas Ochieng of Kenyatta National Hospital. Interviews with women in Kariobangi South reveal that lack of access to family planning information and services was the reason for not using protection during sex.
Another reason given by most women in rural areas was lack of money to buy the products. “ Abortion related sicknesses also happen as a result of insanitary conditions during performance of abortions,” says Dr Ochieng. Another study conducted in Nairobi’s Majengo and Kibera slums, reveals a 42 per cent rate of condoms bursting during commercial sex. This is a major reason for unwanted pregnancies and unsafe abortions
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