By George Asiimwe
Approximately 300,000 abortions occur among Ugandan women aged 15–49 annually.
Of these cases, 83% are carried out under unsafe and crude methods contributing 26% of the total maternal mortality due to abortion complications.
Adolescent Girls Young Women (AGYW) especially those in rural communities are more prone to unsafe abortions.
The situation even gets worse for vulnerable groups like refugee girls and women, women with disabilities and those living in extreme poverty in hard to reach communities including refugee settlements, emergency settings and slums.
This is partly attributed to sexual reproductive health challenges faced in such settings including early marriages, rape, limited knowledge and access to sexual reproductive health information, limited access to youth friendly spaces, cultural values and norms.
Although post abortion care is legal in Uganda, there are women and girls in rural and poverty stricken settings and emergencies who even fear to seek such services for fear of being implicated for having induced an abortion.
The restrictive social and legal environment on sexual reproductive health rights has increased abortion stigma thus contributing to the already staggering 1,500 women dying annually due to unsafe abortions in Uganda.
For a rural illiterate woman, it is extremely hard her to seek post abortion care services at any health facility while knowing she will be asked to explain the circumstances her condition.
As a result, women, health workers, justice actors especially police, local and cultural leaders do not even want to speak about the subject.
This has limited access to health care especially post abortion care services to the most vulnerable women thus increasing unsafe abortion and maternal mortality rates.
Silence on abortion stigma has adverse effects on access to post abortion care and has increased maternal deaths due to unsafe abortions as women, health workers, justice actors and their communities fear to speak it.
We must end abortion stigma to save women’s lives. The harm reduction model can save women’s lives through ending abortion stigma because it initiates conversations, builds the confidence of women, health workers and law enforcement officers to understand abortion from both human rights and public health perspectives.
In 2019, we held capacity building sessions for 12 university adolescent girls and young women, health workers and police officers on utilizing the harm reduction model as a tool for storytelling to end abortion stigma as part of our efforts to end maternal deaths due to unsafe abortions in Uganda.
The sessions included harm reduction principles, reality stories on limitations in accessing post abortion services as told by the women across different regions of Uganda, patients’ rights, health workers and justice officers’ obligations in ending maternal mortality due to unsafe abortions.
A photo voices booklet was developed to be used by the rural women, health workers and justice actors as ambassadors of change in different rural regions of Uganda to ensure access to post abortion care health services for rural women.
The best lesson learnt in this project was that the harm reduction model increases confidence for women, girls, health workers and justice officers in storytelling and experience sharing to end abortion stigma by viewing it from both human rights and public heath perspectives.
To achieve universal health coverage, health challenges affected the most vulnerable persons including women must be addressed.
It is everyone’s responsibility to end abortion stigma to save women’s lives especially in emergency and poverty stricken communities where women suffer the most oppressing sexual reproductive health challenges.
About the author:
George Asiimwe is a communications officer at Rural Aid Foundation