Kenya: Clinics Close Over Abortion

Nairobi — Seven clinics supporting safe abortion and offering post-abortion care have closed down following withdrawal of funding by the US government.

The Bush administration has stopped funding totalling about Sh76 million (one million US dollars) to the Family Planning Association of Kenya and Marie Stopes International-Kenya for their support to family planning services that support the rights of the woman to procure safe abortion and receive post-abortion care services.

An estimated total of 1,560 women, men and children who received services everyday from three clinics- one each in Embu town, Kisii and Eastleigh- operated by the association- can no longer get them after the organisation was forced to shut down the clinics.

Also affected are the association's clinics which used to function as clinical training sites for the Ministry of Health to train doctors and nurses on how to insert Norplant and IUDs, perform sterilization procedures and Improve quality of STI and HIV/Aids counselling.

Because most of these clinics are located among the poorest of the society in slums and rural areas, populations that depended on them for other heavily subsidised health services like immunization of the children, vitamin A supplements, malaria treatment, Sexually Transmitted diseases and HIV/Aids, have been adversely affected by the sweeping decision.

The Bush anti-abortion decision is in line with implementing the unpopular 'Global Gag Rule' provisions instituted by his government immediately he ascended to power.

The rule prohibits United States Aid for International Development from funding NGOs or organisations offering abortion or post-abortion care services. Affected organisations were asked to sign and commit themselves to the Gag Rule provisions if funding had to continue. At the same time, they are expected to ask women intending to abort to give birth and then give-up the child for adoption.

In contradiction, the number of unsafe abortions and maternal mortality rates are said to have increased to around an estimated 800 a day since the rule was introduced.

A study released recently to gauge the effects of the Gag Rule shows that in Kisumu, more than 400 women who were attended to every day in one of the Marie Stopes-Kenya clinics no longer receive family planning and HIV/Aids services.

The association and Marie Stopes-Kenya are categorical that they do not procure abortion since it is illegal in Kenya. Instead, they insist, they offer post-abortion care services just like what Kenyatta National Hospital does.

Conducted by Planned Parenthood Federation of America, Inc., Pathfinder International, Population Action, IPAS and EngederHealth in four countries, Kenya, Ethiopia, Zambia and Romania, the study, Access Denied: US Restriction on International Family Planning, warns: "The Global Gag Rule has eroded women's access to contraception and reproductive health care. This can only lead to more, not fewer, unsafe abortions and maternal deaths".

Leading sexual and reproductive health service providers like International Planned Parenthood Federation, which fund organisations like FPAK with funds received from the USAID, have not been spared either. The federation has been denied over $18 million given to it annually by USAID because it supports safe abortion and post-abortion care.

But, IPPFAR governing council also refused to abide by the rule, and warned organisations receiving its funding to expect them withdrawn if they commit themselves to the Gag Rule provisions.

Since the Rule was instituted, USaid, which is the leading donor to health programmes in the country, has stopped funding, sounding the death knell on many organisations not toeing the line.

Funding for support of family and reproductive health programmes, mostly in developing countries, has been cut by over $35 million, as result of the Gag Rule, according to a source at USaid.

The irony though, is that some of the decisions the Bush Administration has taken are taking countries in which the affected organisations operate many steps behind in achieving the millennium development goals supported by the same administration.

These goals include reducing maternal maternity by three quarters, child mortality by two thirds, and promoting gender equality and empowerment of women as well as combating HIV/Aids malaria and other diseases. Others are eradication of extreme poverty and hunger by half, among the eight countries are expected to fulfil by the year 2015. Safe motherhood and abortion are captured in the goal on maternal mortality.

All of these are intertwined and interlinked in any sustainable development model, with the success of one area having positive spin-off effects on the others.

Yet uncontrolled population growth occasioned by failure to provide family planning services results in population pressures that erodes the environment, increases poverty and maternal mortality and puts the family and the country into a vicious cycle of poverty and underdevelopment.

Similarly, during the 1994 international Conference on Population and Development held in Cairo, Egypt, the meeting came up with a comprehensive plan of action on issues ranging from safe motherhood and abortion to reducing poverty and ensuring sustainable development. Kenya is a signatory to this plan, meaning it has committed itself to implementing the agreements reached.

Empowerment and improvement of the status of women, educating and providing user-friendly and accessible sexual reproductive health information services to adolescents, and easier access to contraceptives, are some of the key plan of action's recommendations Kenya and other stakeholders are expected to implement.

Ten years since the PoA was adopted, Kenya is one of the countries that in the next three weeks is expected to table what it has done during the June 23-25 Africa regional meeting marking the 10th anniversary of ICPD, to be held in Nairobi.

The meeting, organised by IPPF-Africa region, African Population Advisory Council, Centre for African family studies, WHP, Rainbo, and Union for African Population studies, will assess the progress made so far, the challenges and how to increase the momentum of implementing the PoA.

At this meeting, issues of safe motherhood and abortion, sexual and reproductive rights, poverty and sustainable development, and youth access to SRH information are to be discussed.

Recently, when the government submitted its report on what it has done on these issues, it avoided discussing matters to do with abortion. However, in the ICPD's plan of action, the same government is expected to explain what it has done to reduce unwanted pregnancies and the recourse to abortion through expanded and improved family planning services.

Analysts think the government does not want to take a strong and clear position on the matter for fear of antagonising certain sections of the population and development partners. This may include organisations like USaid that oppose abortion services and other organisations which are pro-choice. An AWC-Feature

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