Unsafe abortion is a major cause of mortality and morbidity and has been identified as one of the key health crises on the global health agenda. Ninety-eight percent of unsafe abortions take place in middle- and low-income countries with the most deaths occurring in countries with restrictive abortion policies.

It is no coincidence that the risk of death from unsafe abortion is the highest in the African region compared to the rest of the world. Along with a restrictive legal context, the continent is grappling with overburdened and weak health systems and the largest (and growing) youthful population in the world.

There are large disparities in the availability and accessibility to safe abortion care across the region. Even in restrictive legal contexts, safe abortion services will be available in some form. However, only women and girls who are socially, culturally or economically advantaged are likely to be able to access these services. Poor and rurally based women and girls of adolescent age are the most exposed to the possibility of harm and suffer disproportionately from complications related to unsafe abortion. There is great diversity in women’s and girl’s reproductive experiences and there is need to better understand which groups are most vulnerable to harm through being differentially situated in their economic, social and political contexts.

Over the last two decades, abortion research has been shaped by a complex set of ideological, legal, funding and methodological challenges which has contributed to significant gaps in our understanding over the extent and consequences of unsafe abortion in Africa. These challenges promise to be compounded by the narrowing of opportunity to support critical rights-based sexual and reproductive health issues; an example of which is the recent reinstatement and expansion of the scope of the Mexico City Policy under the Trump administration. Despite (and because of) these challenges, it is pressing that academia deepen the focus and generate new knowledge around the issue of unsafe abortion to better understanding the nexus between political, social, economic and health inequalities and outcomes and how these unfold at both State and nation level. This can have impact on policy reform and access to quality reproductive health services.

In the forthcoming months, HEARD’s Sexual and Reproductive Health and Rights Programme will be presenting a research series based on their current and planned abortion-related research in the Eastern and Southern Africa region. HEARD conducts applied research and supports policy development on critical health and development challenges for the African continent. HEARD’s research is located within a human rights framework and seeks to influence and support evidence-based policy and good practice to more effectively address Africa’s health and development challenges and to contribute to achieving health and sustainable development across the continent.

Unsafe abortion country factsheets