BY Lisa Owino
In June and July of this year, I attended three conferences on sexual and reproductive health: the Africa Conference on Sexual Health and Rights; the Scientific Conference on Adolescent Sexual and Reproductive Health and Rights and a conference held by the MAMA Network that gave me the space to reflect on the effectiveness of my work.
I work in Kenya and the statistics are concerning, to say the least. A 2012 study (the most recent data available) showed that 465,000 induced abortions occur annually, most of them unsafe. 2,600 people die from unsafe abortions annually. Kenya has the third-highest number of teenage pregnancies globally.
The Constitution of Kenya provides for circumstances for legal abortion, but any attempts to develop a guiding framework on abortion have been resoundingly quashed. It barely took a whisper of ‘abortion bill’ for both attempts to legislate on reproductive health since 2014 to fail. The Penal Code criminalises it, and people are harassed and arrested regardless of the Constitution. The Ministry of Health’s attempt to put in place guidelines and training protocols on the provision of abortion in 2012 resulted in such immense backlash from the Church that they were withdrawn. Marie Stopes – a provider of safe abortion and contraception services – Kenya’s operations were temporarily banned after a private citizen accused them of conducting illegal abortions for running an informational campaign in 2018. The recently launched National Reproductive Health Policy 2022 – 2032 has no meaningful policy direction on abortion, yet it legitimizes crisis pregnancy centres.
I participated in the National Reproductive Health Policy development process and witnessed first-hand the hostility to any significant policy on abortion. It’s understandable then, that these conferences found me reflective on whether policy advocacy is as useful as I once thought. The logic seems sound. If abortion is provided for in law then the Government MUST take steps to ensure it, and a disregard for legal provisions fuels stigma and drives people to quacks. But this is only sound where governments are bound by the rule of law. How many constitutional provisions remain unimplemented? Laws? Policies?
I wonder how many compromises we make in the name of ‘taking a step’. The very wording of the Constitution on abortion is a reflection of compromise. It states that “abortion is not permitted unless in the opinion of a trained medical provider…” The power to decide lies with a health professional who determines whether you are worthy enough for a ‘safe and legal abortion’. Did our constant refrain that ‘abortion is healthcare’ contribute to this limiting provision? Does the definition of safe abortions as carried out with a WHO-recommended method and by a person with the necessary skills resonate with the girls in Kilifi County who consider social safety over medical safety in seeking abortions? Maybe not.
My mind will change time and again on the place of policy advocacy, but I hope these thoughts of a MAMA Network colleague guide me: why ascribe legality or illegality to something so autonomous as my body?