Background

Abortion in Sub Saran Africa
In Africa almost 5 million unsafe abortions are performed every year. This is approximately 30 unsafe for every 1000 women of reproductive age. The risk of death from unsafe abortion of 1 for every 150 procedures is by far the highest in the world. 99% of all abortions carried out in Africa are considered unsafe.  Totally accurate data on the incidence and the health consequences of unsafe abortion are not readily available. It is estimated that 50 to 60% of admissions in gynaecological wards in African cities are due to complications of abortion.

Country context

As in other Sub-Saharan African countries, unsafe abortion is a major reproductive health problem in Uganda.  An estimated twenty to thirty percent of maternal deaths in Uganda are linked to complications of unsafe abortion.  Most abortion-related deaths occur among young women.  The adolescent pregnancy rate is 43%.  In 1995, Uganda enacted a National Population Policy that emphasizes individual choice, reproductive rights, and an increased focus on adolescent health programs in order to reduce the country’s high annual population growth rate (2.9%), lower fertility, and reduce maternal morbidity and mortality.  The public sector suffers from a lack of trained professionals, an inadequate infrastructure, and financial overburden.  Perhaps unsurprisingly, only thirty percent of all Ugandans use modern health services. Of these, forty percent use public health facilities, whereas sixty percent use the private sector (PRB, 1998). 

Based in part on Ipas’s long history and good partnership with the Ugandan MOH, postabortion care is a priority feature of the Ugandan MOH 2000 strategy for “Strengthening Sexual and Reproductive Health in Uganda.”  This strategy mandates the training of “front line providers” to provide postabortion care services for Ugandan women and the expansion of these services to the district and community level.  Ipas has helped strengthen the commitment of the Ministry of Health and many organizations working in reproductive health to initiate and expand programs focused on unsafe abortion and women’s reproductive health and rights.   Ipas has focused on the challenges of decentralizing life-saving services to women by involving mid-level health professionals, private sector providers and community leaders in fostering improved services at the community level. 

With  IPAS  support  , UPMA  seeks  to  empower  private  midwives with knowledge  and skills  Post Abortion service provision . This is a collaborative project between Ipas and UPMA in the central and western regions of Uganda between the months of July 2009 and June 2010. The project is aimed at reducing maternal mortality and morbidity arising from unsafe abortion.