Unintended Pregnancy and Abortion in Kenya

By Joyce Mumah, Post-doctoral fellow, with Jean Christophe Fotso, Head of Population Dynamics and Reproductive Health Program

Last week lawmakers from 110 countries reaffirmed their support of the 1994 Cairo International Conference on Population and Development (ICPD), promising their continued work to reduce poverty and safeguard people’s health and rights, including sexual and reproductive health and reproductive rights. 

This affirmation is excellent news, because it remains imperative that the discourse on reproductive and sexual health remain at the fore front of policy makers’ agendas. However, for there to be actionable policy implemented, there needs to be continued research to fully understand the status of family planning (FP) and reproductive health among the poorest and most vulnerable, in developing countries.

This is where we--the researchers-- come in. At APHRC, we are working to better understand the status of family planning and maternal health through several key studies such as the STEP UP project (Strengthening Evidence for Programming of Unintended Pregnancy.The ultimate goal of this research project is to improve reproductive and maternal health of the poorest and most vulnerable, particularly women, in the developing world.

What is The STEP UP Project?

The purpose of the STEP UP project is to generate a coherent body of robust research based evidence, aimed at addressing reproductive and maternal health, through reducing unmet need for Family Planning (FP) and improving access to Safe Abortion (SA) services in five priority countries, including Kenya. The project is implemented through a Research Program Consortium (RPC) that includes the Population Council (PC), International Center for Diarrhoeal Disease, Bangladesh (iccdr,b), London School of Hygiene and Topical Medicine (LSHTM), Marie Stopes International (MSI), and Partners in Population Development (PPD). APHRC’s role in the Consortium is to ensure that the RPC’s activities in sub-Saharan Africa address regional and national priorities.

To achieve its goals, the project is working to develop a country profile of what we currently know about unintended pregnancy and abortion in Kenya. The profile will be a synthesis of existing evidence and will include descriptions of policies, programs, as well as descriptions of the demand and unmet need for FP and safe abortion.

Kenya Facts on Family Planning and Reproductive Health:

• Kenya is characterized by high unmet need, low contraceptive usage (though high compared to African countries), and high rates of unintended pregnancy.
• The Kenyan Demographic and Health survey (KDHS) indicates that 44.5 percent of births to women ages 15- 49 are unplanned (includes unwanted and mistimed pregnancies).
• The level of unwanted or mistimed pregnancies in Kenya has changed little from 2003, according to estimates from the 2008/09 Kenyan Demographic and Health Surveys (KDHS).
• One in four married women in Kenya has an unmet need, while the contraceptive prevalence rate is estimated at 39 percent (KDHS)^[1].
• The likelihood that a woman will seek to terminate an unintended pregnancy increases with unmet need, making more imperative the demand for safe abortion services.
• It is estimated that there are 316,560 spontaneous and induced abortions annually i.e. for every 100 live births in Kenya, there are 29 abortions that occur. It is also estimated that one in 39 women die from pregnancy- related causes in Kenya (Ipas, 2009)[2].

The country profile report will include information like the facts above and will also include  information on the legal, policy and sociocultural context of sexual and reproductive health rights, Family Planning (FP)and Reproductive Health (RH)indicators, access to and quality of FP and post-abortion /abortion services; financing and delivery mechanisms; and the outcomes of unintended pregnancies (apart from abortion). The profile will conclude with actionable policy and programmatic implications.

By focusing on issues surrounding unintended pregnancy and abortion in Kenya, this comprehensive report seeks to: 1) identify knowledge gaps around the nature and determinants of unmet need in Kenya; and 2) identify actionable policy implications that can be used by policy makers in developing mechanisms for reducing unmet need, unplanned pregnancies & increased access to safe abortion services.

2015 –the deadline for the MDGs--is right around the corner, and even though new estimates confirm maternal mortality is declining, 800 women still die every day from pregnancy-related complications[3], which means that there is much more to be done. Learning from evidence based research and highlighting poverty, gender, age, and other disparities will help us to assess the gap between need and available resources and help move along the policy debate to help us improve maternal health.

The country profile project is currently underway, so stay tuned for the results of the profile report which will come out in October 2012.

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