Unsafe abortion related complications drain the public health budget as government spends at least K300 million annually to provide services to the victims.
This amount, confirmed by the Ministry of Health, is roughly 0.6 percent of the K48.7 billion budget allocation to the health, sanitation and HIV and Aids sector in the 2012/13 fiscal year.
A Ministry of Health study says it costs an average of $23 (about K8 500 at current exchange rate) to treat a woman who has unsafe abortion complications. The country has 70 000 reported cases of unsafe abortion annually. Out of these, it is 31 000 that are life threatening and, therefore, treated in public health facilities, leading to the roughly K300 million cost.
Bwaila Hospital alone handles up to 800 cases of abortions in a month, according to district health officer for Lilongwe, Dr Mwai Mwale.
Malawi’s current law regulating abortion is a vestige of the antiquated British Offences against the Person Act of 1861, which allows abortion only for preservation of a woman’s life.
National coordinator for Coalition for Prevention of Unsafe Abortion (Copua), Chrispin Sibande, said in an interview on Tuesday that the problem in Malawi was that the law is restrictive and prevents most women from walking into hospitals and demand the abortion service.
Said Sibande: “As a result, we have a chaotic situation, free for all and unregulated process of unsafe abortion. Women are using cassava sticks, hangars, soap powders, bicycle spokes, wood, bottles, tumblers, herbals to access abortion as they cannot access the services in hospitals.
“Then they get injured most of the times with heavy bleeding then infections and, in some situations, death. If women were accessing abortion services in hospitals then the method could have been safe, less costly and no woman can die as it is done by skilled people,” he said.
Copua is a network of NGOs, professionals, institutions and individuals working on research and advocacy on issues of unsafe abortion in Malawi.
Sibande said abortion was legalised under Section 243 of the Penal Code, but that the country was failing to make that piece of legislation more liberal and expand it to the access to abortion.
He attributed the status quo to lack of information on the magnitude of the problem and possible solutions, failure to follow World Health Organisation guidelines and arguments pertaining to cultural, religious and traditional beliefs.
He said apart from the cost of providing post abortion care, abortions contribute 30 to 40 percent of all admissions in gynaecological wards and result in two to three women dying every day due to complications of unsafe abortion.
Said Sibande: “We are spending huge resources in hospitals treating complications of unsafe abortion every day. We are saying there are no drugs in hospitals when we could have avoided and prevented some illnesses such as unsafe abortion.
“If we provide safe abortion, we could be spending much less on time of doctors to treat patients, theatre to operate on patients, bed space. As a country, we are having some problems on maternal health, but some issues such as abortion have solutions,” he said.
Sibande said of the maternal mortality rate of 675 women per 100 000 pregnant women, 17 percent are due to unsafe abortion. He added that the most involved age group is in the 15-44 range.
Ministry of Health spokesperson Henry Chimbali confirmed that the report released in 2011 revealed that despite the law that restricts abortion to women whose lives are endangered because of the pregnancy, women continue to seek abortion services for various other reasons clandestinely.
Chimbali said it was estimated that 70 474 induced abortions occurred in Malawi in 2009.