National Maternal Health Advancement nearing the ditch after Global Gag Rule Executive Order

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After the promulgation of the Constitution of Kenya (2010), maternal health projects saw light and there was hope of finally acknowledging women and upholding their rights. This was seen as a step in the right path after the National Guidelines for reducing maternal mortality and morbidity from unsafe abortion in Kenya were instituted in September 2012.On the eve of Madaraka day in 2013, His Excellency the President declared free access to maternal services in all public health facilities which was a notch higher towards realizing global development.

However, on 3rd December 2013, the then Director of Medical Services withdrew the same guidelines under unclear circumstances which caused uproar among reproductive health advocates nationally. This marked the beginning on the bumpy industry as the providers were reluctant to provide comprehensive reproductive health services.

According to a study carried out by African Population and Research Center in 2012, an estimated 464,690 induced abortions occurred in Kenya in 2012, corresponding to an induced abortion rate of 48 abortions per 1000 women of reproductive age (15-49 years), and an induced abortion ratio of 30 abortions per 100 births in 2012. This high rates and complications from unsafe procedures accelerated maternal deaths nationally.

At the global arena, the former US President’s Administration was supportive of the maternal health programs but as expected by many reproductive health advocates, the Trump administration was to be a backlash. Little be told that, majority of the people around the world had expected Hillary Clinton to win the US elections and hence many were comfortable that there was to be a buy-in and continuation of the Obama Legacy. This meant that there was no contingent plan as what would be the next step in case the unforeseen happens, which indeed happened.

Every time there is a new administration in US, there is always that critical decision on whether or not to adopt the Mexico City Policy. First announced in Mexico City in 1984 by President Reagan’s administration, the policy requires all nongovernmental organizations operating abroad to refrain from performing, advising on or endorsing pregnancy by choice initiatives if they wish to receive federal funding. To date, support for the Mexico City Policy has been strictly partisan: it was rescinded by Democratic President Bill Clinton on 22 January 1993, restored by Republican President George W Bush on 22 January 2001 and rescinded again by Democratic President Barack Obama on 23 January 2009 and again restored a few days ago by President Trump.

The Global Gag Rule or Mexico City Policy stipulates that taxpayer dollars should not be used to pay for pregnancy by choice programs or related services (such as counselling, education or training). The impact of the Policy is an increase in maternal deaths and morbidities aggravated by unsafe abortions. This move will deny thousands of the Kenyan Women access to the comprehensive reproductive health services through the Ksh. 60 billion annual grant from the US government. As of today, 220million women from developing countries have unmet need for family planning in which Kenya is included.

Alternative avenues need to be portrayed for the women to have a voice in this world at this stage. Most recently the Canadian and Dutch governments have come in support for women and will fill the void left by USAID in the developing nations. More needs to be done across the globe

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