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Safe Access to Abortion Crucial to Reducing Maternal Mortality in Kenya

First Lady Kenyatta’s “Beyond Zero” Campaign Ignores Key Issue

Kenya's President Uhuru Kenyatta, center, and his wife Margaret, center-right, attend a ceremony to mark Jamhuri (Republic) Day at Kasarani stadium in Nairobi, Kenya, Tuesday, Dec. 12, 2017. © 2017 AP Photo/Brian Inganga

Five years ago, Kenya’s First Lady, Margaret Kenyatta, launched the “Beyond Zero” campaign to eradicate preventable maternal and child mortality in Kenya. The initiative has drawn support and criticism in equal measure from Kenyans, and it has earned this criticism by ignoring a crucial aspect of women’s health – access to safe abortion.

A charity half marathon last weekend to mobilize resources for the campaign was met with wide-ranging criticism from Kenyans. Activists infiltrated part of the run to stage an anti-corruption protest, arguing that corruption and government failure to prosecute officials implicated in these crimes are the main factors behind Kenya’s failing health sector. Other critics say that the first lady’s campaign is diverting much-needed resources from the public health system.

Notwithstanding any merits of the “Beyond Zero” campaign, a key issue the campaign has ignored is the urgent problem of unsafe abortion, a leading cause of preventable death and harm for Kenyan women and girls. A 2018 study showed that treatment for complications of unsafe abortion costs public health facilities substantial financial and human resources – an estimated US$533 million in 2016.

While the government acknowledges unsafe abortions drive Kenya’s already high mortality rate higher at enormous financial cost, the abortion law remains restrictive allowing termination only where, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger. In December 2013, the Director of Medical Services without explanation withdrew the 2012 “Guidelines for Reducing Morbidity and Mortality from Unsafe Abortion,” and put a ban on training in safe abortion for health care providers. No new guidelines have been issued since.

“Beyond Zero” is a high-profile campaign that could mobilize support for these guidelines to be instituted. The campaign could also prompt the government to address the root causes of unsafe abortions which include high rates of teenage pregnancy, lack of access to modern methods of contraception, and lack of access to age-appropriate, comprehensive reproductive health education for girls and young women. A comprehensive approach to sexual and reproductive health is needed to stop the unnecessary deaths of women and girls in Kenya, and if Kenyatta wants to save women and girls, she should put her star power behind this effort.

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