IN the past two editions we delved into the legal framework of abortion in Africa with Zambia, Kenya and Uganda as models.
Today’s subject looks at the reasons why Africa should remove sanctions on victims and providers of abortion services.
Preventing maternal mortality and morbidity from unsafe abortion is a sound public health policy.
However, studies have shown that restrictive abortion laws which penalise those seeking the service and healthcare providers contribute to high rates of maternal mortality.
Decriminalising abortion saves lives and promotes health
The challenge of unsafe abortions stems from various aspects that include age of sexual debut for females, teenage pregnancies, early marriages, premarital sexual practices, sexual violence against women, media influence, and unmet needs of family.
Meanwhile, Zambian women and girls continue to face a challenge to access safe and legal abortions due to provider bias, limited information among women and girls about the Termination of Pregnancy Act, and legal requirements.
More opt for unsafe abortion at the hands of untrained people in unsanitary conditions because of limited number of sites that perform the procedure, and social and religious sentiments against abortion.
With the stiff punishment that is associated to illegal abortion in Zambia and many other African countries, more and more cases of unsafe abortion continue to resurface.
According to the Africa Coalition for Safe Abortions (ACSA), decriminalising abortion will enable countries to meet the targets under goal 3 of the Sustainable Development Goals (SDG) to reduce the maternal mortality ration to less than 70 percent per 100, 000 live births.
The World Health Organisation (WHO) also outlines that where legislation allows abortion under broad legal grounds, cases of complications arising from unsafe abortions are generally lower than where abortion is legally restricted.
Sixty-two per cent of all deaths due to unsafe abortions occur in Africa where abortion laws are more restrictive compared to other parts of the world.
Decriminalising abortion promotes human rights
Countries have an obligation to make safe abortion available and accessible to women and girls to the full extent of the law.
Various United Nations (UN) treaty bodies recognize that laws restricting abortion may violate women’s rights including the right to life, right to non-discrimination, right to the highest attainable standard of health, right to free from cruel, inhumane and degrading treatment, right to privacy, confidentiality, information and education.
The UN bodies have recommended to a number of states including Zimbabwe, Namibia and Ivory Coast to consider reviewing restrictive laws on abortion.
In 2015, the African Commission on Human and People’s rights further recommended to the Nigerian government to revise its abortion laws to bring it in line with the Maputo Protocol and the International human rights standards.
Decriminalising abortion enhances quality and empowers women and girls
Criminal abortion laws perpetuate inequality.  In places where abortion is a crime, women who are young, poor, uneducated and facing unwanted pregnancies are at greater risk of resorting to illegal and unsafe abortion.
Consequently, they are also at highest risk of being harassed, investigated, arrested, prosecuted and jailed. In contrast, women who are older, educated or have financial resources can seek services from a private provider to obtain safe abortion without the risk of arrest.
In Africa, young women below the age of 24 years account for nearly two-thirds of all unsafe abortions carried out on the continent.
Thirty  per cent of all maternal deaths in Zambia are caused by unsafe abortions.
The 2009 Ministry of Health’s Standards and Guidelines for reducing unsafe abortion morbidity and mortality in Zambia highlighted that 25 percent of maternal deaths due to induced abortions are in girls younger than 18 years.
Decriminalisation removes stigma on abortion services
Criminal abortion laws stigmatise a safe and common medical procedure, discouraging women from seeking abortion related services including emergency post abortion care. These laws also have a chilling effect on healthcare providers.
The fact that abortion is highly stigmatised, simply being accused of an abortion related offence can negatively impact a woman’s relationship with her family, community, or employer.
Health workers providing abortion services may also be subject to stigma, which negatively impacts their professional and personal lives.
Decriminalising abortion makes economic sense
Safe abortion is cost serving. Unsafe abortion is costly to the individual, family, community, and nation at large. The cost to the health system is overwhelming for many countries in Africa.
Professor Bellingtone Vwalika, Head of Department of Obstetrics and Gynaecology at the University Teaching Hospital (UTH), and University of Zambia (UNZA), estimates that the Zambia Zambia would save $13.43 per case (i.e. up to $611,046 per year) if each woman treated for a complication of unsafe abortion had instead accessed services for safe abortion
Zambian healthcare system spends 2.5 times more treating complications arising from unsafe abortion than would be spent on providing safe abortion for these cases
The health system spends up to $2.4 million per year on treatment for complications of unsafe induced abortions.

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