Tag: #Abortion

Every year on 28 September, Uganda joins the global community in commemorating International Safe Abortion Day. This year’s theme, “Solidarity in Action: Advance Reproductive Justice and Urgently Strengthen Health Systems,” calls for the protection of human rights and the ability of women and girls to obtain timely, quality and dignified reproductive healthcare.

On this occasion, we, the Coalition to Stop Maternal Mortality due to Unsafe Abortion (CSMMUA), acknowledge the progress Uganda has made in reducing maternal mortality while drawing attention to the continuing burden of preventable death, illness and disability associated with unsafe abortion.

Uganda’s maternal mortality ratio declined from 336 deaths per 100,000 live births in 2016 to 189 per 100,000 live births in 2022. This represents important progress, but preventable maternal deaths remain a significant public health and human rights concern.

Globally, the World Health Organization (WHO) estimates that 45% of abortions are unsafe, with almost all unsafe abortions occurring in developing countries. WHO further estimates that between 4.7% and 13.2% of maternal deaths globally are attributable to unsafe abortion. Unsafe abortion therefore remains an important and preventable contributor to maternal morbidity and mortality.

The consequences are also borne by already constrained health systems. Available research has estimated that treating complications associated with unsafe abortion costs the health system approximately US$14 million annually. Beyond the financial cost to the health system are the costs borne by women, families and communities through illness, disability, lost productivity, household expenditure and, in the most serious cases, loss of life.

Persistent barriers to quality care

Women and girls experiencing unintended pregnancies or abortion-related complications continue to encounter multiple and intersecting barriers. These include uncertainty and limited awareness about the legal framework; stigma and discrimination; fear of criminal consequences; inadequate information; shortages of appropriately trained health workers; unequal availability of services, particularly for poor and rural populations; and gaps in referral, commodities and health-system capacity.

Uganda’s legal framework remains particularly important in this regard. The Penal Code Act criminalises the unlawful procurement of miscarriage, self-procurement of miscarriage and unlawful supply of drugs or other means intended to procure miscarriage. At the same time, Uganda’s legal and policy framework recognises circumstances in which pregnancy termination and, more broadly, post-abortion care may lawfully be provided.

The interaction between criminal law, clinical practice and reproductive health policy has nevertheless historically generated uncertainty among women, communities, health workers and law-enforcement actors. Greater legal and policy clarity is therefore important both for protecting women from unsafe practices and for enabling health professionals to provide lawful care without unnecessary fear or uncertainty.

– CSMMUA

Building on Uganda’s progress on post-abortion care

CSMMUA welcomes the Ministry of Health’s adoption of the Post-Abortion Care (PAC) Guidelines: Prevention and Management of Abortion Complications (2025) as an important step towards reducing preventable maternal morbidity and mortality.

The Guidelines recognise PAC as emergency healthcare and provide a comprehensive framework covering management of abortion-related complications, psychosocial support, counselling, post-abortion family planning, referral, confidentiality, respectful care, community engagement, monitoring and health-worker capacity development. The priority must now be to translate these standards into services that are consistently available across the country. Guidelines save lives when health facilities have trained and supported health workers, appropriate medicines and equipment, functioning referral systems, adequate financing, reliable data and communities that know where and when to seek care.

Strengthening post-abortion care should therefore form part of the wider effort to strengthen Uganda’s maternal and reproductive health system, including prevention of unintended pregnancy through voluntary family planning, comprehensive reproductive health information, timely emergency care and respectful, non-discriminatory services.

Uganda’s regional and international commitments

Uganda has ratified the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (Maputo Protocol). It calls upon States Parties to protect women’s reproductive rights by authorising medical abortion in cases of sexual assault, rape and incest, and where continued pregnancy endangers the mental or physical health of the woman or the life of the woman or fetus.

Uganda is also a State Party to the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). Article 12 requires States Parties to take appropriate measures to eliminate discrimination against women in healthcare and ensure access to healthcare services, including those related to family planning.

These commitments provide an important framework within which Uganda can continue examining its laws, policies and health-system arrangements to ensure that women and girls have equitable access to lawful, quality and respectful reproductive healthcare.

CSMMUA’s call for action

On this International Safe Abortion Day, CSMMUA calls upon the Government of Uganda, Parliament, the Ministry of Health, health professional bodies, development partners, civil society, communities and other stakeholders to sustain dialogue and action aimed at preventing maternal mortality and morbidity associated with unsafe abortion.

In particular, CSMMUA calls for:

1. Review of Uganda’s reservation to Article 14(2) of the Maputo Protocol.

The Government should undertake an inclusive review of the reservation, informed by Uganda’s maternal health realities, constitutional protections, public health evidence and regional human rights commitments, including consideration of its withdrawal.

2. Greater clarity and coherence in Uganda’s legal and policy framework on abortion care.

Relevant provisions of the Penal Code Act and reproductive health policies should be reviewed to remove ambiguity, clearly distinguish lawful healthcare from criminal conduct, and provide understandable guidance to women, healthcare providers, law-enforcement agencies and the wider public on the circumstances permitted by law.

3. Full implementation and financing of the 2025 Post-Abortion Care Guidelines.

The Ministry of Health and responsible authorities should ensure that the Guidelines are disseminated and operationalised throughout the health system, with adequate budget allocations, essential medicines and supplies, appropriate equipment, referral mechanisms, monitoring systems and quality-assurance measures.

4. Scale-up of health-worker training and mentorship.

Pre-service and in-service training should equip health workers with the clinical, ethical and legal knowledge required to provide quality post-abortion care. Training should emphasise confidentiality, informed consent, respectful care, patient autonomy, non-discrimination, appropriate referral and reduction of abortion-related stigma.

5. Strengthening of prevention strategies through reproductive health information.

Uganda should continue expanding equitable access to modern contraception, emergency contraception, accurate reproductive health information and counselling, particularly for adolescents, young people, rural populations and underserved communities. Preventing unintended pregnancy is an essential component of reducing unsafe abortion.

6. Improved efforts for community awareness and reduction of stigma.

Government, civil society, professional bodies, cultural and religious leaders, the media and communities should promote accurate information about post-abortion care, including that women experiencing abortion-related complications are entitled to timely emergency healthcare. No woman should delay seeking life-saving treatment because of fear, stigma or misinformation.

7. Strengthened data, research and accountability.

Uganda should strengthen routine collection and use of reliable, disaggregated data on post-abortion care, abortion-related morbidity and mortality, service availability and health-system costs. Better evidence is necessary for planning, budgeting, quality improvement and accountability for maternal health outcomes.

From solidarity to action

International Safe Abortion Day provides an opportunity to move beyond polarised debate and focus on a shared objective of preventing avoidable maternal deaths and ensuring that every woman and girl who needs reproductive healthcare is treated promptly, safely, respectfully and with dignity.

Uganda has demonstrated that progress in reducing maternal mortality is possible. The adoption of the 2025 Post-Abortion Care Guidelines provides another important foundation on which to build. The challenge before us is to ensure that laws, policies, financing, health workers, commodities, information and referral systems work together so that preventable complications do not become preventable deaths.

For CSMMUA, solidarity in action means translating commitments into functioning health systems, legal clarity, informed communities and quality care that reaches every woman who needs it. No woman should lose her life from a preventable pregnancy-related complication while giving birth.