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Jessica Malter
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IN TANZANIA, UNSAFE ABORTION IS A LEADING CAUSE OF MATERNAL INJURY AND DEATH

Urgent Action Needed to Safeguard Women's Health

Despite the country's restrictive abortion law, many women in Tanzania resort to abortion when faced with an unintended pregnancy. A new report, "Unsafe Abortion in Tanzania: A Review of the Evidence," by the Guttmacher Institute and the Association of Gynaecologists and Obstetricians of Tanzania (AGOTA), finds that virtually all abortions in the country are unsafe, posing grave risks to women's health. According to the Tanzanian Ministry of Health and Social Welfare, 16% of all maternal deaths in the country result from complications of clandestine abortions. Some small-scale studies show that in some parts of the country this figure may be high as 25%.

"While we do not know precisely how many clandestine abortions occur in Tanzania, we do know abortion is widely practiced," says Dr. Andrea B. Pembe, senior lecturer at Muhimbili University of Health and Allied Sciences and member of AGOTA. "Many women attempt to end their pregnancies using extremely dangerous methods, such as drinking toxic substances or inserting sticks into themselves, while others rely on untrained providers. Either option puts their lives and health at risk."

The prevalence of unsafe abortion in both urban and rural areas has been well documented in hospitals and other health facilities. These studies show that up to 60% of all women admitted for treatment of a miscarriage actually have had an abortion. The true number of women who suffer complications from unsafe abortion procedures is not known, given that some women do not receive the medical care they need.

Though the Tanzanian government, through its National Package of Essential Health Interventions, has committed to providing access to postabortion care and has assisted in implementing services at lower-level health facilities, progress has been slow. Facilities may not be adequately stocked, and staff may not be sufficiently trained. As a result, many women do not receive the care they need. A study of health facilities in three districts found that only 24% had manual vacuum aspiration kits, and only one in five hospitals had both the kits and misoprostol, which are used to treat incomplete abortion.

Recourse to unsafe abortion is one indicator that many Tanzanian women have difficulty controlling the spacing of births and number of children they have. One in four married women and one in three sexually active unmarried women want to delay or stop having children, but are not using a modern contraceptive method. This proportion has barely changed over the last decade. The level of unmet need for contraception is even higher among women who are poor, less educated or living in rural areas.

"Ensuring access to postabortion care will greatly reduce the deaths and injuries resulting from clandestine procedures," says Akin Bankole, director of international research at the Guttmacher Institute. "But more also needs to be done to help women avoid unintended pregnancy, the root cause of most abortions. This will require expanding and strengthening family planning programs."

For more information:

Click here for the In Brief: Unsafe Abortion in Tanzania: A Review of the Evidence
Click here for the Fact Sheet: Unsafe Abortion in Tanzania also available in Swahili

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