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January 16, 2019

EVELYN SAMBA: Access to information and services the sure way to reduce unsafe abortions

Anti-abortion demonstrators in the U.S. in 2016. /COURTESY
Anti-abortion demonstrators in the U.S. in 2016. /COURTESY

In the last one week, there has been an animated conversation about unsafe abortions and their impact on the lives of women and girls. This conversation was sparked by a story published in a local daily. The story rekindled debate on the state of sexual and reproductive health, especially of adolescent girls and young women up to the age of 24.

Listening to the conversations, especially on broadcast media, the sense of despair among many contributors was palpable. Many wondered what needs to be done to change the situation.

The subject of unsafe abortions is complex and multifaceted. One of the strategies public health officials have proposed, to avert over half a million unsafe abortions, is that every sexually active woman of reproductive age has access to family planning information, services and contraceptives.

As the article correctly pointed out, women and girls seek to terminate pregnancies because they are unintended. Scores of sexually active women who want to stop or delay childbearing are not using any method of contraception. In technical terms, they are referred to as women with unmet needs for family planning.

The two women whose story is told in the article were sexually active but wanted to delay childbearing, yet they were not using any contraception.

Reducing the number of women with unmet needs for family planning is key to any efforts to stem the need for unsafe abortions.

All interventions to ensure that all sexually active women of reproductive age have access to family planning information and services they need comes down to sufficient funding.

Over the years, the family planning programme in Kenya has mostly depended on donor funding. A source that is unsustainable and fast dwindling.

The reproductive and maternal health services unit at the Health ministry recently provided figures to show just how dire the reduction has been. A fall from Sh700 million to Sh100 million over the last five years.

With the advent of devolution, the responsibility of planning and executing family planning programmes fell on county governments. The county governments also bear the responsibility of investing in the necessary enablers to provide family planning services.

Many county governments are currently developing multi-year actionable roadmaps called family planning costed implementation plans, designed to help them achieve their family planning goals.

These plans address and budget for all aspects of a family planning programme: demand creation, service delivery and access, contraceptive security. policy and enabling environment, financing and stewardship, management and accountability.

Nandi county, for example, recently launched its family planning costed implementation plan 2017–2021. The plan estimates that the county needs Sh1 billion over the next five years for the family planning programme. The funds are earmarked for things such as medical supplies, awareness campaigns and to pay for salaries for healthcare workers.

Other counties that have launched plans include Kilifi, Mombasa and Nakuru. Hopefully, these plans will result in sufficient budgetary allocation for the health sector. And that this will enable the sector to lead efforts in bringing down the high number deaths and injuries that hundreds of thousands of women and girls suffer due to unsafe abortions.

Country director, Deutsche Stiftung Weltbevoelkerung (DSW)

[email protected]

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