Introduction
Abortion is a sensitive aspect in the various dimensions of life, which include religious, cultural and political aspects. It is a concern that has led to public debate over the decades and an area of interest in the public health sector as evidenced by the World Health Organization. At least, a huge percentage of the world population come from countries where the practice is prohibited, and if permitted, it is on the grounds of saving a woman's life, such as in Kenya (Izugbara et al., 2015). However, despite the policies to manage the practice, it is important to appreciate that abortions still take place, and unskilled personnel conducts most of the practices. As evidenced by the above study, it is suggested that such unsafe abortions have claimed the lives of many women, especially in the developing countries, as compared to the developed states. The practice leaves a lot of women with unsafe conditions that are irreversible, contributing to serious health problems among the victims. The paper intends to shade light on the practice in Kenya, compare it with the USA and offer a recommendation on how unsafe abortion can be controlled.
Main Body
Situation in Kenya
Until 2010, abortion was regarded illegal in Kenya, but the promulgation of the new constitution saw the reformation of concerned policies that allow abortion for purposes of protecting the health and lives of women. Previous policy tools affirmed that the act was only legal on grounds that the life of the pregnant women was endangered. However, the reformed doctrine holds that abortion is legal on grounds that a health professional advises for a need for emergency treatment or in case permitted by law. However, in case a person engages in unlawful abortion, which is a typical case in the country, the concerned person is subject to a prison sentence of about 7-14 years.
Statistics indicate that unsafe abortion is common in Kenya and the entire East African region as compared to other countries such as the US. However, although the practice is highly restricted in the area, it is estimated that about 2.4 million induced abortions were carried out in 2008 (Mohamed et al., 2015). The statistics, therefore, indicate that for every 1000 women of reproductive ages, at least 36 engage in induced abortion, which is the highest rate in the world. Kenya has a poor record on the abortion statistics with a valid record of 2002 indicating the number of pregnant women treated in the public amenity facilities for pregnant related health complications. Statistics suggest that almost 300,000 abortions are carried out in Kenya annually (Mohamed et al., 2015). One of the key challenges that limit the availability of information on abortion record is the fact that abortion is highly restricted in the region.
The Eastern African region is renowned for its prevalence in practicing unsafe abortion in the whole world, and according to statistics, it is evident that one in every five deaths regarding maternal complication is due to abortion (Izugbara et al., 2015). In total, for every 100,000 unsafe abortions conducted in the area, at least 500 succumb to death, which is too high as compared to the developed countries like the US. The U.S has legalized abortion; hence, it is carried in a safe manner and experiences 0.6 deaths for every 100,000 unsafe abortions. Chances of women dying after giving birth are very high in Kenya as compared to the U.S as revealed by studies conducted in the slums of Kenya, which indicates that at least 706 deaths out of one hundred thousand births are experienced. Therefore, it is evidenced that besides abortion, the maternal mortality rate remains high due to various issues related to giving birth in the country. Maina et al., (2015) in his studies asserts that the maternal mortality rate in the developing countries is very high as compared to the developed states. A survey carried out in Nairobi (the capital city of Kenya) on the causes of maternal death was in harmony with the one conducted in Nakuru (another city in the country) as both cited unsafe abortion to be among the principal causes of such deaths.
In Kenya, most women practice abortion using varied dangerous methods that are provided by unqualified individuals and involve multiple approaches. Some of the common procedures include insertion of foreign objects into the cervix, taking an overdose, taking poison, and engaging in extreme activities that exert a lot of pressure on the abdomen. The principal reason as to why most women participate in unsafe abortion is because of the restrictions imposed by the government towards abortion. Therefore, for this reason, most women are assisted by the traditional providers or else the private individuals whose qualification is questionable. The cost of conducting an abortion in the country varies based, and according to previous studies, it is evidenced that it lies between $12-122. The 2006 policy issue to enhance the effort to offer post-abortion care (PAC) is yet to be met, a feature that has adversely impacted the health sector, resulting in increased cases of maternal deaths in the country.
Other significant challenges experienced in the country include the fact that the rate of unintended pregnancy is high in the nation, an aspect that makes most women to end up seeking an abortion. The 2008 research study carried out in the country indicates that the country experienced a very high rate of unplanned births, which was 40% (Osur et al., 2015). The main reason that resulted in the above situation is the fact that the country has limited access to contraceptives as a practical approach used in controlling birth. However, a significant number of women in the country were found to use family planning as a method to regulate birth control to prevent cases of unwanted pregnancy that may result in abortion. Therefore, the state has proved to experience challenges in meeting the contraceptive needs and other modern methods used in planning childbearing.
The government has a program to provide contraceptive to its citizens at no cost but is yet to meet the rising demand, which is a challenge. Most people in the country come from a poor background, and those that lack the resources to purchase the contraceptives are therefore forced to go without. Moreover, the program to enlighten women with the use of contraceptives and family planning methods is not sufficient as it does not stretch to rural areas where the services are in high demand. Besides, the number of adolescents who engage in premarital sex in Kenya is very high and only 30% of the population get access to the use of modern contraceptives, leaving a huge percentage contracting to unwanted pregnancy that may lead to abortion (Osur et al., 2015). Another important issue that leads to increased rate in the country is the fact that most people believe that the use of contraceptives causes diseases such as cervical cancer. Religion also plays a role as some people believe that God created humans to procreate and by using contraceptives, people are going against His will.
Situation in the USA
Abortion has effectively been managed in the U.S as compared to other countries across the globe, as it reached its lowest in 2011 due to the reformation of the various policies concerning the practice. Abortion in the U.S was legalized in 1973 by Wade's decision, an aspect that contributed to a significant drop in the same by 1990 (Beauchamp, 2015). The state, therefore, has qualified individuals who assist women in conducting an abortion in the country and offer adequate facilities to engage in safe abortion. Moreover, the country has effective planning on the supply of contraceptives to its citizens, an aspect that has effectively assisted in the control of unwanted pregnancy in the country. In 2008-2011 alone, 13% reduction in abortion cases was experienced, besides most people in the country are well informed on the various types of contraceptives to use as compared to Kenya.
However, critics in the country indicate that the utilization of the contraceptives leads to increased cases of abortion than control, which is caused by the complication experienced in the later life of the people. Despite the fact that most people engage in protected sex or use contraceptives in the U.S, it is worth noting that the government has put in place adequate abortion clinics that provide safe abortions. As per 2011 statistics, it is evidenced that the country had at least 329 clinics that provided the abortion services in the country, and the figure has increased in the recent past (Flynn, 2016). Moreover, the country has received a lot of policy issues that regulate abortion practices in the state, leading to the closure of some of the clinics.
Reduce the unmet need for contraception in Kenya and counter the various challenges experienced that hinder access to family planning programs. More programs should be enacted to reach more people, especially in the rural areas to enlighten women in the local communities on the issue.
The government should consider enhancing sex education in schools to make students informed as they are the most vulnerable in the society
The last recommendation for the policy makers in the country is to ensure that they increase access to safe abortion as the new constitution legalized the practice in the country. To achieve the above goal, the government should enhance public awareness that the practice is vital to protect the health of the people.
Conclusion
References
Beauchamp, A. (2015). Regulation, imperfect competition, and the U.S. Abortion market. International Economic Review, 56(3), 963–996.
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Izugbara, C. O., Egesa, C., & Okelo, R. (2015). ‘High profile health facilities can add to your trouble’: Women, stigma and un/safe abortion in Kenya. Social Science & Medicine, 141, 9–18.
Maina, B. W., Mutua, M. M., & Sidze, E. M. (2015). Factors associated with repeat induced abortion in Kenya. BMC Public Health, 15(1), 1048-1055.
Mohamed, S. F., Izugbara, C., Moore, A. M., Mutua, M., Kimani-Murage, E. W., Ziraba, A. K. Egesa, C. (2015). The estimated incidence of induced abortion in Kenya: A cross-sectional study. BMC Pregnancy and Childbirth, 15(1),
Osur, J., Orago, A., Mwanzo, I., &Bukusi, E. (2015). Social networks and decision making for clandestine unsafe abortions: evidence from Kenya. African Journal of Reproductive Health, (1), 34.
