A groundbreaking national study has unveiled significant shortcomings in Kenya’s capacity to provide adequate post-abortion care (PAC), highlighting the urgent need for comprehensive interventions to safeguard women’s health. The study, a collaborative effort between the Ministry of Health, the African Population and Health Research Center (APHRC), and the Guttmacher Institute, sheds light on the prevalence of induced abortions and the severity of related complications across the country.
The findings of the pivotal research were presented at a high-level launch event held at the Tamarind Tree Hotel in Langata, Nairobi, on Friday, May 2nd, 2025. The forum convened key stakeholders, including policymakers, reproductive health specialists, and researchers, to critically analyze the data and chart a course for strengthening PAC services nationwide.
Dr. Jeanne Patrick, the Deputy Head of the Division of Reproductive and Maternal Health at the Ministry of Health, underscored the gravity of the issue. “As a country, we need to know what is happening—what it costs for someone to lose a baby, what it costs for someone to go through that process. Because we know, any life we lose means we are losing something towards the development of this country.” Her words highlighted the profound human and societal impact of inadequate care.
The comprehensive study, drawing upon national survey data collected between 2023 and 2024, meticulously assessed the availability of PAC services, the state of healthcare infrastructure, the supply of essential medical commodities, and the lived experiences of Kenyan women who have undergone induced abortions and sought subsequent care.
The data paints a stark picture of the scale of induced abortions in Kenya. The study estimates that approximately 792,694 induced abortions occurred in the country in 2023. This translates to a rate of 57 abortions for every 1,000 women of reproductive age (15–49). While the study indicates a positive trend in the decline of unintended pregnancies, a concerning reality remains: more than half of these pregnancies still culminate in abortion.
Margaret Giorgio, a Senior Research Scientist at the Guttmacher Institute, provided critical context to the reasons behind women’s decisions to seek abortions. “Women choose to have abortions — sometimes it’s because they are unprepared to become a parent, but in many other cases, they’re already parents,” Giorgio explained. “The cost of raising children is very expensive, or they’ve already had the number of children they want.” Her insights challenge conventional understandings and underscore the complex socio-economic factors influencing these decisions.
Furthermore, the study’s findings dismantle prevailing assumptions about the demographics of women seeking abortions. “What we found was that women of all ages accessed both post-abortion care and also had abortions in Kenya, and the majority of women were ages 25 and older,” Giorgio emphasized. This revelation necessitates a re-evaluation of targeted interventions and service delivery models.
Despite the sobering statistics, the report offers a glimmer of hope, indicating improvements in the utilization of post-abortion care services, particularly for women experiencing mild complications. The data reveals that an increasing number of women are seeking timely care at public and lower-level health facilities. Moreover, there has been a notable decrease in the proportion of patients presenting with the most severe abortion-related complications over the past decade.
However, this progress is significantly undermined by the persistent and critical shortcomings within Kenya’s health system. The study’s findings expose a concerning lack of preparedness among healthcare facilities to deliver comprehensive PAC services. Alarmingly, only 18% of primary-level facilities and a mere 24% of referral-level facilities meet the minimum standards required to provide a full spectrum of PAC. Adding to the crisis, one in five health facilities that are expected to offer PAC services do not provide them at all.
The disparities are even more pronounced at lower levels of care. Among Level II facilities, only 14% possess the capacity to deliver all basic PAC components. This figure rises slightly to 31% for Level III facilities. Even at the referral level, where more comprehensive care should be available, only a quarter of facilities are equipped to provide essential services such as surgical interventions and blood transfusions, which are often critical in managing severe complications.
The functionality of these already under-equipped facilities is further jeopardized by the frequent stock-outs of essential medical supplies and contraceptives. This issue is particularly acute at the primary healthcare level, directly impacting the quality of care that can be provided to women in need.
Dr. Patrick acknowledged the existing challenges while highlighting the government’s ongoing commitment to strengthening the maternal healthcare system. “We are geared towards ensuring we provide quality services, quality maternal health services,” she affirmed. “We do provide post-abortion care. And, as I speak, a review is going on for that package to just ensure our women receive the services they deserve, especially during that hard time.” This statement suggests a recognition of the gaps and an active effort to address them.
The study also illuminated significant gaps in public awareness regarding the legal framework surrounding abortion in Kenya. Dr. Kenneth Juma, Senior Researcher at APHRC and the lead investigator for the project, pointed out a critical misunderstanding among many women. “Most women know why abortion is restricted but don’t know on what basis it is allowed,” he explained. This lack of clarity can lead to delays in seeking care or a failure to access legal and safe services.
Dr. Juma emphasized the counterproductive nature of restrictive abortion laws, asserting that they do not eliminate the procedure but rather drive it underground, increasing the risk to women’s health and lives. “Increasing access to safe abortion can reduce the number of unsafe abortions. Counties need to explore models that ensure such services are safe and accessible,” he urged.
Echoing this sentiment, Margaret Giorgio reiterated the global evidence on the ineffectiveness of legal restrictions in reducing abortion rates. “When abortion is legally restricted, it does not decrease the number of abortions that happen; it just decreases the number of safe abortions that happen,” she stated unequivocally.
In concluding the launch event, health officials issued a strong call for a coordinated, multi-sectoral response to address the deeply entrenched gaps in post-abortion care service delivery. The overarching goal is to ensure that all women of reproductive age in Kenya have access to safe, high-quality, and dignified care when they need it most.
The study’s findings pointed to an urgent need to improve women’s health services in Kenya. According to the report, the recommendations are expected to guide both policy and program changes aimed at strengthening the healthcare system’s ability to deliver comprehensive post-abortion care. These include upgrading primary health facilities to provide all basic services, improving the availability of essential medical supplies, and ensuring healthcare workers receive regular training.
The report further stresses the importance of establishing clear national guidelines for post-abortion care and building stronger referral systems to ensure timely access to appropriate care across all levels of the health system. Expanding access to family planning services was also identified as a key strategy to reduce unintended pregnancies and, as a result, lower the number of abortions.
The study highlights the value of community-level outreach, particularly through health promoters, in raising awareness and helping prevent repeat abortions. Researchers noted that the collaborative nature of the study—bringing together government, research institutions, and global partners—reflects a shared commitment to advancing reproductive health for all women in Kenya.
