Women doctors in Kenya want abortion covered in universal health plan

By Gatonye Gathura

Women doctors want abortion covered in the universal health care plan being rolled out through the National Health Insurance Fund.

“Abortion and attendant complications are responsible for most maternal deaths in the country and their care should be financed through the new health plan,” says Prof Maryanne Nyamongo,

Prof Nyamongo proposal was strongly supported at a one day scientific symposium organized by the Kenya Medical Women’s Association (KMWA) in Nairobi on Friday.

Already, she said public hospitals are spending almost half a billion shillings annually to treat medical complications from botched abortions.

Prof Nyamongo was citing a report published by the Ministry of Health in February estimating that public hospitals spent Sh533 million in 2016 to treat post abortion complications.

A consultant gynecologist, Prof Nyamongo said most of these women require extended hospital stays, intensive care and attendance by highly skilled health personnel.

“To stop the suffering of such women and the huge costs being incurred the universal health care plan must comprehensively cover abortion within the law and contraceptives,” said Prof Nyamongo.

Abortion in Kenya is still largely illegal but permitted if in the opinion of a trained health professional, there is a need for emergency treatment, or the life or health of the mother is in danger.

It is estimated that 21,000 women are admitted to hospital each year due to abortion related complications from unsafe backstreet procedures. Of these, 2,600 eventually die.

“Surely there must be a way of saving these women. Making good medical care available is one such solution,” she told the conference.

Dr Susan Musyoka a founder member of KMWA said by covering contraceptives the country could dramatically reduce the number of dangerous abortions.

Most of the estimated 310,000 annual abortions in Kenya, she said occur because most of the pregnancies have not been planned.

Ministry of Health data show up to 40 per cent of the estimated 1.1 million annual births in the country are not planned. This, says Dr Christine Sadia, KMWA chairperson rises to almost fifty per cent among teenagers.

“If this women had information and access to contraceptives, we certainly would have saved a lot of lives, reduced the cost for treating post abortion cases and met our  family planning targets,” said Dr Sadia.

There are indications that the Ministry of Health may be warming up to the idea of providing some abortion services in public facilities.

The report: Saving Mothers Lives: Confidential Enquiry into Maternal Deaths in Kenya, launched by the ministry in February recommended that county governments equip facilities to be able to provide safe abortion services.

But Dr Musyoka went further to demand that the universal health care scheme also cover women for assisted fertility births or In Vitro Fertilization (IVF) popularly known as test tube babies.

“Many couples who can’t get children go through immense psychological trauma and depression and need help but cannot afford the now largely available IVF services,” said Dr Musyoka.

Currently there are about nine IVF clinics in Kenya most of them in Nairobi whose services on average costs about Sh400, 000.

“This means only a few couples can afford the crucial treatment, consequently discriminating many others who rightly need the services. It is only fair that these also be covered through the universal health plan,” said Dr Musyoka.

A 2011 study by the Aga Khan University Hospital, Nairobi showed there are at least two million couples requiring assisted births and most of them poor and in rural areas.

Currently NHIF covers infertility treatment only for civil servants but not in the national cover arguing it is too expensive.

The KMWA conference which was laying the ground for an international scientific symposium to be held in November said for the universal health plan to succeed the health sector must improve on financial accountability and service delivery.

“It can’t be business as usual, this is a major and expensive undertaking and we must get it right,” said Dr Sadia.

Among suggestions made for financing the plan, most popular were for targeted taxations on some consumer goods and services such as mobile money transactions.

“For example a graduated 1.4 per cent tax on mobile money transactions could raise significant amounts of revenue to support health care,” suggested Dr Vincent Okungu a researcher and health economist with Pharma Access Foundation.



Some Facts

Women doctors want abortion and IVF covered by NHIF

An estimated 1.1 million annual births in Kenya

40 per cent of them not planned

There are 310 abortions annually

21,000 botched abortions treated in public hospitals annualy with 2,600 deaths

In 2016 public hospitals spent Sh533 million on botched abortions

There are 2 million infertile couples

Nine IVF clinics in Kenya

IVF services cost Sh400, 000

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