Separating Myth From Reality

By Estelle M. Sidze, Associate Research Scientist, Beatrice W. Maina, Research Officer, and Joyce N. Mumah, Associate Research Scientist, APHRC

What does donor funding for abortion-related projects in Africa support?

Anti-abortion voices across Africa have always denounced what they perceive as the imposition of a foreign-driven abortion culture in the lives of people in Africa. In Kenya for instance, the promulgation, in 2010, of a new constitution that explicitly permits abortion (when, according to a trained health professional, there is need for emergency treatment; or the life and health of the mother is in danger.)^[1]*) received criticism from certain quarters.  Particularly, there were claims that the Obama administration had spent over $23 million to persuade Kenyans vote for the new constitution to allow unlimited abortions.^[2]

Available evidence indicates that about 6.3 million unsafe abortions occurred in African countries in 2008, representing one in two young women under age 25.^[3] A recent report published by APHRC together with the Kenyan Ministry of Health and other partners shows that 465,000 induced abortions occurred in Kenya in 2012, with 120,000 of these women receiving care for moderate or severe complications in health facilities.^[4] These alarming numbers remind us that urgent efforts are needed to provide universal access to family planning services (including information, counseling and range of methods) which could help prevent the inextricable consequences of unintended pregnancies.

Abortion laws in the continent vary immensely but are mostly restrictive. In a majority of African countries, abortion is only allowed to save the life of the mother. There are also few instances where abortion is allowed to preserve physical and mental health and on socio economic grounds. ^[5] For example, in Zambia, the law also permits abortion on socio-economic grounds while in Ethiopia, abortion is also allowed in cases of rape, incest or serious fetal impairment; or due to deficient physical or mental health. Similarly, in Cameroon, abortion is permitted to save a woman’s life, preserve physical and mental health or in case of rape or incest. In South Africa, a more liberal abortion law exists and varies by the gestational age of the pregnancy. Abortion is unconditionally permitted if the pregnancy is below 13 weeks old. Between 13 and 20 weeks, abortion is only permitted if the woman’s own physical or mental health is at stake; severe mental or physical fetal abnormalities; in cases of incest or rape; or for socio economic reasons. If the pregnancy is more than 20 weeks, abortion is permitted only if the woman’s or the fetus’ life is in danger or there are likely to be serious birth defects.

Debates on abortion (including proposals to legalize unrestricted abortion) continue in various African countries. ^[6] As a corollary, regional bodies such as the African Union have taken a stand on abortion by requesting member states to reduce the maternal mortality rate by taking adequate measures to provide effective access to reproductive health services including access to legal medical abortion to women. ^[7]

The pressure on many governments to liberalize the laws on abortion by civil society, advocacy organizations and researchers has been seen in some quarters as driven by Western donors who might lobby for an effective realization of women abortion rights (notably to decide whether to have an abortion or not). The Resources Flow Project data** offers a unique opportunity to gauge the extent to which donor assistance for population activities has funded abortion activities and to separate the myth from the reality. Statistics on significant projects funded by various international donors from 200 to 2011 that included a percentage of funds for abortion-related activities are presented in Table 1. These data indicate that donors have focused largely on PREVENTING CASES of induced abortions through the reduction of the numbers of unintended pregnancies. Because the burden of disease is high from these induced abortions, funding is also tilted towards POST-ABORTION CARE management and treatment services. Donor-funded projects have also covered the broader salient issues of reproductive health such as creating gender-appropriate, youth-friendly services; providing support to victims of gender based violence; integrating health services; improving medical practices (the use of Misoprostol in this case); developing facilities/providers’ capacity to provide good quality care; and informing public policy.  It could be argued that beneath these overarching strategies are mechanisms that encourage women to access safe abortion services. This argument however, will be speculative at best, for we cannot ascertain this premise based on the current data.

Far from driving a pro-abortion agenda therefore, donor funding has been geared towards preventing the root causes of unsafe abortion and especially a reduction in levels of unintended pregnancies. Regional expansion of these projects to include the West and Central African region (which appeared under deserved considering the beneficiary countries) is pertinent and necessary considering the magnitude of abortion in these regions***

Table 1. Funded projects with an abortion component, 2000-2011(donor data) 

Source: The UNFPA Resource Flows (RF) project database, donor data.

References:

[1] The Constitution of Kenya, revised Edition 2010, Chapter four, 26 (4)

* Up to that time, abortion was only permitted to protect a woman’s life.

[2] View in Article http://archive.lifenews.com/int1598.html

[3] Shah IH and Ahman E. Unsafe abortion differentials in 2008 by age and developing country region: high burden among young women. Reproductive Health Matters 2012, 20(39): 169-173

[4] Incidence and complications of unsafe abortion in Kenya. Key findings of a national study.

[5] Grimes DA et al. Unsafe abortion: the preventable pandemic. The Lancet Sexual and Reproductive Health Series, October 2006.

[6] Brookman-Amissah E. and Banda Moyo J. Abortion law reform in sub-Saharan Africa: No turning back. Reproductive Health Matters 2004, 24(12): 227-234

[7] Resolution on the Health and Reproductive Rights of Women in Africa, Accra, Ghana, May 2007.

** The Resource Flows (RF) project monitors progress achieved by donors and developing countries in implementing the financial resource targets agreed upon at the International Conference on Population and Development in Cairo in 1994 and the Declaration of Commitment adopted at the United Nations Special Session on HIV/AIDS in 2001. The RF project collects data and subsequently reports on international population assistance and domestic expenditures for population activities in developing countries. The project started in 1997 as a joint collaboration between the United Nations Population Fund (UNFPA) and the Netherlands Interdisciplinary Demographic Institute (NIDI). Domestic data for sub-Saharan African countries are collected in collaboration with the African Population and Health Research Center (APHRC). The information is collected for every financial year on the sources and recipients of funding, type of projects funded and future funding commitments. Details are available at: http://www.resourceflows.org/.

*** The statistics indicate indeed that women in eastern Africa and Western Africa are more likely to have an unsafe abortion than are women in other African regions. See Grimes DA et al. Unsafe abortion: the preventable pandemic http://www.who.int/reproductivehealth/publications/general/lancet_4.pdf