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Health advocates resurrect safe abortion fight

Dr Charles Kiggundu, a senior gynaecologist at Mulago national referral hospital, sees many women a week who have undergone unsafe abortion.

These are as young as nine to 15 years, and as old as 40.

“Many girls opt to terminate pregnancies that are as a result of incest and rape,” he says.

He says much as some can afford to have a safe abortion, many others use rudimentary means to terminate pregnancies.
Kiggundu blames the lack of clear legislation in Uganda for the many unsafe abortions, most of which result into deaths.

“Unsafe abortion continues to constitute a serious public health, human rights and social equity issue that affects millions of women in sub-Saharan Africa, and causes 29,000 deaths annually,” he says.

“Women of all social standing seek abortion services, but it is mostly young women and poor women who die or suffer long-term consequences from unsafe abortion due to the severe socio-economic deprivation they encounter,” Kiggundu says.  

According to World Health Organisation, of the 6.4 million abortions in Africa carried out in 2008, only three per cent were safe. One quarter of unsafe abortions occurred among adolescents aged 15-19, and 60 per cent were among women under age 25.

Additionally, unsafe abortion accounts for 13 per cent of global maternal deaths and up to 40 per cent of maternal mortality in African countries.  

Uganda has one of the highest rates of unsafe abortion in Eastern Africa, which places a huge cost on the public health system; approximately Shs 7.5bn is spent annually to treat resultant complications.

According to Kiggundu, Uganda’s abortion laws permit abortion only to save the life of a pregnant woman. However, conflicting and restrictive interpretations of the abortion provisions under the 1995 Constitution of Uganda, the Penal Code Act and National Reproductive Health Policies have created confusion about the correct legal status of abortion.

This is why Prof Ben Twinomujuni, a Law don at Makerere University, together with Centre for Human Rights and Development (CEHURD) filed a petition in March seeking that the Constitutional court orders government to pass a law regulating termination of pregnancies to reduce maternal mortality from unsafe abortions.

In their March 3, 2107 petition, the activists say the existing legislation does not protect young girls and married women who may get unwanted pregnancies, hence resorting to unsafe abortion methods.

The petitioners argue that other African countries such as Kenya, Rwanda, Ethiopia, Ghana and Tunisia developed laws to protect the rights of women by prescribing circumstances under which a woman is allowed to terminate her pregnancy.

“Because the government has not operationalized Article 22(2) of the 1995 Constitution of Uganda as a way of clarifying the parameters for legal abortion, healthcare providers are unable to provide safe and legal abortion services, while law enforcement officials and judicial officers do not effectively enforce or implement laws that permit abortion thus denying women and girls access to safe and legal abortion services,” Twinomujuni says.

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