By Daniel Otieno
“Women were not dying because they ended pregnancies; they were dying because of how and where the procedures took place.”
According to the World Health Organization, six out of ten unintended pregnancies ended in unsafe abortion, and an estimated seven women died every day from complications related to unsafe abortion. While global figures existed, the exact prevalence and drivers of unsafe abortion in Kenya remained insufficiently documented. These gaps in data undermined efforts to design effective policy, allocate resources, and strengthen health services.
Evidence indicated a substantial burden that demanded better measurement and routine reporting. Without disaggregated, high‑quality data, decision‑makers struggled to identify where risks concentrated, which populations were most affected, and which interventions delivered the greatest impact.
Homa Bay County had been cited as a high‑burden area, where the number of unintended pregnancies was elevated due to low utilisation of family planning services. Although researchers suspected that cases of unsafe abortion were high, their work was constrained because many cases went unreported. Without reliable and comprehensive data, determining the true scale of unsafe abortion—and addressing its root causes—remained difficult.
Several factors contributed to the persistent lack of accurate statistics. Weaknesses within the health‑care system, limited support for health‑care workers, stigma surrounding abortion, and the cost of seeking care created an environment in which many women avoided formal health facilities.
Health facilities that lacked essential medical supplies, alongside health‑care workers who feared providing abortion‑related care due to restrictive laws or unclear guidelines, further contributed to underreporting. These gaps obscured the real picture of unsafe abortion across the country.
Creating an enabling environment for post‑abortion care required facilities that consistently stocked essential medical products, were staffed by well‑trained personnel, and operated without stigma or judgment. High‑quality data remained essential: it guided interventions, informed policy decisions, and strengthened health systems.
When abortion care was approached from a human‑rights perspective, stigma reduced, the use of dangerous methods declined, and access to contraception improved. Evidence showed that strict laws did not prevent abortion; rather, respect for human rights, non‑judgmental attitudes, and equitable access to care supported safer outcomes.
What Policymakers, Donors, and Implementers Should Do
- Invest in robust health information systems that captured abortion‑related indicators, including complications, post‑abortion care utilisation, and commodity availability.
- Ensure continuous supply chains for essential medicines and equipment for post‑abortion care, and integrate stock‑monitoring into routine supervision.
- Train, support, and legally protect health‑care workers to provide evidence‑based, non‑judgmental services in line with national guidelines.
- Fund stigma‑reduction initiatives and community engagement to encourage timely care‑seeking and truthful reporting.
- Expand access to contraception – particularly for adolescents and young women – and use data to target underserved geographies and populations.
- Standardise definitions and reporting tools across counties to reduce underreporting and enable comparability.
Conclusion
Women did not die because they ended pregnancies; they died because of how and where those procedures took place. To save lives, Kenya needed reliable data systems, strong supply chains for medical products, empowered and protected health‑care workers, and a sustained rights‑based approach to reproductive health. Only then could the country meaningfully address unsafe abortion and protect the health and dignity of women and girls.
— Daniel Otieno, Programme Associate, NAYA Kenya
