Embrace safe abortion to eliminate maternal deaths – WHO

By Chris Kiwawulo in Accra

AFRICAN countries need to embrace safe abortion if they are to eliminate maternal deaths and injuries that arise from unsafe abortions, a World Health Organization (WHO) official has advised.

Dr. Charles Fleischer Djoleto, the WHO office focal point officer for Ghana, noted that 13% of the global maternal were due to unsafe abortion, meaning that about 130 women die every day from unsafe abortion of which 99% (129) live in developing countries like Uganda. He said WHO supports the move to legalise abortion in Africa, noting that unsafe abortions mostly take place where the practice is illegal.

Speaking at the opening of the regional conference on eliminating abortion in Africa on Monday (November 8), Djoleto said a critical component of eliminating unsafe abortion is preventing unintended pregnancies, using contraceptives. The one-week conference themed; ‘Keeping our promise: Addressing unsafe abortion in Africa’, is taking place at the Ghana College of Physicians and Surgeons in Accra.

“If contraceptive needs were fully met globally, unsafe abortions would decline by 73% from 20 million to 5.5 million per year and the number of women requiring treatment for abortion complications would decline from 8.5 million to 2 million annually. Can you imagine the impact that would have on African women’s lives and the lives of their families?” Djoleto wondered.

Ipas, a global women’s rights advocacy NGO, in collaboration with African Network on Medical Abortion, African Women’s Development and Communication Network, Maries topes International, the International Planned parenthood Federation, Ghana’s health ministry and the United Nations Economic Commission for Africa organised the conference.

Much as use of contraceptives reduces unsafe abortions and thus deaths, Djoleto revealed that legalising safe abortion is paramount. Quoting a 2009 WHO report dubbed ‘Women Health: Today’s evidence, tomorrow’s agenda’, Djoleto said women who seek an abortion will do so regardless of legal restrictions and that where restrictions are few, deaths and illnesses dramatically reduce.

“Even if contraceptive needs are fully met, an estimated 33 million women are expected to experience accidental pregnancy while using contraception and thus the need for safe abortion,” he pointed out. Djoleto said WHO does not tell countries what to do regarding their national laws and policies, but it provides evidence that they can use to make their own decisions about health.

Ipas president and chief executive officer, Elizabeth Maguire, noted that efforts to address women’s unmet need for contraception and to prevent unsafe abortion were still implemented separately in many African health systems. “Yet we know from experience that an integrated approach to contraception and safe abortion is critical to solving the global public health crisis caused by unwanted pregnancies…and to meeting both the International Conference on Population and Development agreed action and Millennium Development Goals.”

Maguire added that access to basic health services is essential in ensuring each woman’s basic human right to decide whether and when to have children. In Uganda, statistics show, the unmet need for family planning is still high at 41%. In Ghana, one in every three women have an unmet need for family planning. On the entire African continent, the average contraceptive intake is still low at 15% compared to countries like Thailand where it is at over 70%.

Maguire called for active participation of the civil society and public sector in order to extend the availability of comprehensive abortion and contraception to surface the voices and needs of women, inform them and mobilize action.

The Ghanaian President, Prof. John Evans Atta Mills, pledged that his country will support the elimination of unsafe abortion and urged other African leaders to follow suit. In a speech read for him by Rojo Mettle Nunoo, Ghana’s health deputy minister, Mills said; “Nobody like abortion, certainly not the victims! But we all have a common ground of preventing hardship, illness and deaths.”

Mills noted that whereas abortion has been legal in Ghana since 1985, religious and moral inclinations against abortion result into some uneasiness among service providers who face a dilemma between preserving these values and saving women’s lives.

“There is a wide spectrum of interventions which can involve everyone – from religious leaders, civil society, traditional leaders, legal system and law enforcement agencies, health system, education system, youth, men, women, individuals and groups from all walks of life can play key roles in addressing these issues from various angles.”

The conference brought together over 200 participants from over 20 African countries who converged to develop strategies for the future of women in ensuring their access to safe abortion. All participants agreed that unsafe abortion was largely responsible for the high number of maternal deaths in their countries and called upon their leaders to legalise the practice.