By Jean-Pierre
Unsafe abortion remains a pressing public health concern in Kenya, with data indicating a rise in abortion incidences largely driven by expanded access to medication abortion drugs, which allow women to terminate most unintended pregnancies.
A recent study launched by the Kenya Ministry of Health, the African Population and Health Research Center (APHRC), and the Guttmacher Institute presents a concerning picture of rising induced abortion rates. The study estimates that there were 792,694 induced abortions in Kenya in 2023—an incidence rate of 57.3 per 1,000 women of reproductive age. This figure also translates to 48.1 induced abortions per 100 live births.
In the study’s foreword, Dr. Patrick Amoth, Director General of the Ministry of Health, notes: “The Kenyan government has made considerable progress in addressing maternal morbidity and mortality through policies that enhance access to maternal health services. Nonetheless, unsafe abortion remains a significant public health challenge.”
Despite efforts to improve maternal health, progress in reducing the maternal mortality rate (MMR) has been slow. Kenya’s current MMR stands at 355 deaths per 100,000 live births—well above the Sustainable Development Goal (SDG) target of fewer than 70 deaths per 100,000 live births by 2030.
According to the 2022 Kenya Demographic and Health Survey (KDHS), 39 percent of recent births were unplanned, corresponding to approximately 643,294 unplanned births in 2023.
Abortion in Kenya remains highly restricted and is only permitted when, in the opinion of a trained health professional, it is necessary for emergency treatment, when the life or health of the mother is at risk, or if allowed by any other written law.
The study estimates a total of 1,435,988 unintended pregnancies occurred in 2023, translating to an unintended pregnancy rate of 103.8 per 1,000 women of reproductive age. In total, Kenya experienced approximately 2.85 million pregnancies in 2023. Among these, 27.8 percent ended in induced abortion,14.3 percent ended in miscarriage,22.6 percent resulted in unplanned births, 35.3 percent ended in planned births.
The study authors note that several key indicators related to sexual and reproductive health have shifted since the previous national abortion study conducted in 2012. Notably, the unintended pregnancy rate declined from 120.0 per 1,000 women in 2012 to 103.8 in 2023—suggesting improvements in contraceptive access and family planning services.
However, the induced abortion incidence rate increased from 48.0 in 2012 to 57.3 in 2023, and the abortion incidence ratio rose from 30.0 to 48.1 per 100 live births. This increase is attributed, in part, to greater access to medication abortion drugs over the past 15 years.
Additionally, the proportion of unintended pregnancies that ended in abortion rose significantly—from 40.5% in 2012 to 55.2% in 2023.
“While this increase likely reflects higher abortion rates, it may also result from a decrease in unintended pregnancies overall—leading to fewer unplanned births,” the report explains.
According to the KDHS, the proportion of births that were mistimed or unwanted declined from 43 percent to 39 percent.
The findings have important implications for women’s sexual and reproductive health and access to post-abortion care in Kenya. The report highlights that induced abortion remains a common experience for many women, with wide regional disparities.
Key Recommendations includestrengthening family planning and contraceptive service delivery, particularly at the primary health care level and in high-burden areas. Experts also recommend enhanced training and mentorship for health care providers involved in post-abortion care.
Additionally, the report recommends improvement of health facility readiness to manage abortion-related complications. Scale up comprehensive sexual and reproductive health education.
“Conduct further research into pregnancy wantedness and induced abortion . Mobilize additional resources to support advocacy for sexual and reproductive health and rights (SRHR),” read one of the key recommendations.
