Kampala — In Uganda, induced abortion is permitted only when continuation of a pregnancy would endanger a woman's life. The country's major religions too, outlaw the practice. Because of this, it is often practiced in secret, with many women having to rely on practitioners who use dangerous methods under unsanitary conditions. An estimated illegal 300,000 abortions are said to occur annually in the country. And the consequences have been deadly for many women.

The state of affairs surrounding abortion makes it difficult to get facts on the practice. However, a new study by the Guttmacher Institute "Abortion Worldwide: A Decade of Uneven Progress" offers some new data, which could have policy implications. "Surveys of knowledgeable health professionals suggest that in Uganda, 23 per cent of women seeking abortions go to traditional practitioners, many of whom employ unsafe techniques, and 56 per cent go to doctors or nurses, who generally provide safer services" says the study. "Some women try to self-induce using highly dangerous methods (15 per cent), while others purchase abortion-inducing drugs from pharmacists or other vendors (7 per cent)."

The study further shows that urban women in Uganda are much more likely than rural women to use the services of doctors (42 per cent vs 16 per cent). Similar results were reported in Burkina Faso and Côte d'Ivoire for this multi country study. In Uganda, just like in Cameroon, Ghana and Zambia, women cited fear of legal consequences, social stigma, high cost and lack of access to trained health professionals as important factors preventing them from obtaining safe abortions. Further data on Uganda, the study shows, experts estimate that 50 per cent of all women having clandestine abortions experience health complications requiring treatment. "Such complications are thought to be more common among poor women than better-off women (55 per cent vs. 38 per cent)."

The study also indicates that an estimated 45 per cent of all women who experience complications requiring treatment do not receive medical care at a facility, and the proportion is even higher among poorer women. Data from the reproductive health division at the Ministry of Health show that abortion related complications are among the top five direct causes of maternal deaths.

However, when they make it, many women with untreated complications suffer long lasting health effects, such as anaemia, chronic pain, chronic inflammation of the reproductive tract and infertility. Uganda is this week playing host to an international conference on family planning. This conference presents the chance for authors of the abortion study to drum up support for one of their major recommendations.

They recommended: "Programmes and policies that improve women's and men's knowledge of, access to and use of contraceptive methods should be established or strengthened, as contraceptive use is the surest way to prevent unintended pregnancy - and thus the need for abortion."

The author is a fellow with the Makerere University School of Public Health - U.S. Centres for Disease Control Fellowship Programme.