HEALTH-KENYA: Contraceptives? You’re Lucky if You Get Them

By IPS Correspondents Reprint | | Print |

Joyce Mulama

NAIROBI, Nov 5 2004 (IPS) - Kenya’s government has again been criticised for its failure to provide enough contraceptives for its citizens – this at a two-day conference on maternal deaths and unsafe abortions that was held in the capital, Nairobi.

The meeting, which concluded Friday, was organised by the Kenya Medical Association (KMA), a body of medical professionals. It attracted about 150 participants from across the country – including health workers, lawyers and human rights activists.

Delegates to the conference claimed that the lack of contraceptives had contributed to an increase in abortions in Kenya. As this procedure is only allowed in instances where it will protect the life of an expectant mother, women typically opt for “backstreet abortions” that are a major cause of maternal mortality in the country.

According to James Nyikal, director of medical services at the Ministry of Health, up to 6,000 maternal deaths occur annually in Kenya from complications during pregnancy – 2,000 of which can be ascribed to unsafe abortions.

“About 60 percent of all beds in the gynaecological ward at Kenyatta National Hospital are occupied by patients with abortion complications,” added Nyikal. Located in Nairobi, Kenyatta National is reportedly the largest referral hospital in East and Central Africa.

His comments echoed concerns that were raised in May this year upon the release of a report, ‘A National Assessment of the Magnitude and Consequences of Unsafe Abortion in Kenya’, which asserted that about 300,000 abortions take place annually in Kenya.

The study was conducted by the KMA, the Kenyan chapter of the Federation of Women Lawyers, the Ministry of Health and International Projects Assistance Services. The latter, based in the United States, is an organisation that promotes women’s reproductive rights.

The report also stated that an estimated 20,000 women and girls were being hospitalised every year with abortion-related complications. However, delegates to the conference heard that such hospitalisations are increasingly the fate of poor women in Kenya.

“Quite paradoxically and despite the restrictive laws, safe abortion services are available for women from the upper middle class who can afford abortion services from private clinics and hospitals by trained medical persons, at a fee,” said Njoki Ndung’u, a member of parliament.

“Those who are economically endowed can even travel outside the country for the service,” she added.

According to Peter Gichangi, a gynaecologist and obstetrician, abortions conducted in private facilities could cost as much as 625 dollars – a fee beyond the reach of most women, (the 2004 Human Development Report, published by the United Nations Development Programme, says that about 23 percent of Kenyans live on less than a dollar a day).

A backstreet abortion, on the other hand, can cost a hundred times less: 6.25 dollars.

Women parliamentarians, under the auspices of the Kenya Women Parliamentarians Association, have been at the forefront of lobbying for a review of the abortion law – particularly in cases of rape and other forms of sexual abuse.

“How do you explain a mentally-challenged woman having been forced into sex while she is not in a position to say ‘yes’ or ‘no’? In the same vein, how do you fathom a girl who has been raped and impregnated by her father?” Ndung’u asked.

“I do not intend for it (abortion law) to be like that of other countries which provide for abortion on demand,” she added, “But I want to expand it to include termination of pregnancies resulting from rape and defilement.”

Ndung’u’s remarks come in the wake of a police report issued at the beginning of this month which showed that rape appears to be on the increase in Kenya.

While 1,675 cases were reported in 2000, 1,987 were reported in 2001. This figure rose to 2,013 in 2002 – and 2,308 last year. In the first eight months of this year, 1,895 rape cases were recorded.

Concerns about rape have even seen the proposal of a law to castrate sexual offenders. “The bill is receiving support from all sides of the house and debate is expected in the next two week,” Ndung’u told IPS.

South Africa was cited as one of the African countries which had pressed ahead with abortion reform, along with Uganda and Ghana.

Despite the advocacy of women parliamentarians and activists, religious communities in Kenya are firmly opposed to an alteration of the abortion law.

This leads the debate back to the lack of contraceptives – a reliable supply of which would go some way towards preventing the unwanted pregnancies that often lead women to seek abortions.

Nyikal admitted that government had some way to go on the matter of contraceptive provision.

“As a country, we have not put in money to cater for this need because (our resources) are strained. The estimated annual budget to provide a complete mix of contraceptives is about one billion Kenyan shillings (approximately 12.5 million dollars),” said Nyikal.