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ABSTRACT
Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.
ARTICLE HISTORY
Received 20 February 2018
Accepted 2 June 2018
RESPONSIBLE EDITOR
Stig Wall, Umeå University, Sweden
KEYWORDS
Unsafe abortions; maternal mortality; Eastern; Central; Northern Africa
Background
The World Health Organization (WHO) estimates that 44 percent (25.1 million) of the approximately 56 million abortions that occurred annually between 2010 and 2014 were unsafe [1]. The proportion of unsafe abortions was higher in countries with restrictive abortion laws, such as in the East, Central, and Southern Africa (ECSA) health community [1]. Restrictive abortion laws, poverty, gender inequality, and stigmatisation contribute to inequitable and inadequate healthcare access, causing higher proportions of unintended pregnancy and unsafe abortions in ECSA [1,2]. Inadequate access to comprehensive abortion care (CAC) impedes women's sexual and reproductive health and rights (SRHR). Previous research shows that some healthcare providers report hesitancy in providing such care and have judgmental attitudes towards women-seeking abortions [3,4]. This hesitancy may be explained by a conceptual conflict between human rights and societal norms, which also causes misconceptions [4]. Such misconceptions create fear of being stigmatised and discourage women from seeking adequate care [5]. The WHO's technical guidelines on safe abortion from 2012 emphasise the simplification of...