Unsafe Abortion is an important global public health issue. Every year, 20 million unsafe abortions take place globally, with predominance in developing countries (WHO, 2007). In Kenya complications of unsafe abortion contribute 30 – 40% of all maternal deaths, far more than the worldwide average of 13% - making unsafe abortion a significant cause of maternal mortality in the country which stands at 486/100,000 live births (KDHS, 2009). According to a study carried out by Ipas on the magnitude of unsafe abortion in Kenya, every year, at least 2,600 women die from unsafe abortion in Kenya; 21,000 more women are hospitalised annually with complications from incomplete and unsafe abortion.
At the International Conference on Population and Development (ICPD) in Cairo in 1994 representatives of 179 countries agreed that “all Governments and relevant intergovernmental and NGOs to strengthen their commitment to women‘s health, to deal with the health impact of unsafe abortion as a major public health concern and to reduce the recourse of abortion through expanded and improved family-planning services”.
Abortion as a subject to Kenyans is regarded with much taboo, stigma, misinformation and fear with many including the youth, health care providers, community leaders, e.t.c. battling with the issue of its legality and morality or lack thereof. In the recent years discussions around this area has taken centre stage within Kenyans politics with the Anti Choice groups leading the onslaught at the pulpits mostly to have Life defined as beginning from conception and expressly criminalising any form of abortion. On the other hand the pro choice groups lead by FHOK has fuelled discussion around the public health, developmental and social burden of unsafe abortion and the lack of access to contraception with access to comprehensive SRH information and services including safe abortion and contraception mitigating these burdens. This lead to the promulgation of a more pro choice Kenyan constitution in September 2010 that highlights access to Reproductive Health as a right to all Kenyans, and access to Safe Abortion through the opinion of a trained health professional that include mid level health providers as opposed to the previous case of a medical doctor in consultation with 2 other senior colleagues.
FHOK has been playing an important role in the provision of comprehensive abortion care (CAC) services in Kenya offering PAC from 2005 in all of its clinics and CAC from 2009 in all its clinics. FHOK partnered with DFID through the GPAF project, SAAF and GCACI to value clarify the community and service providers in particular to remove stigma on abortion, capacity build staff and clinics with knowledge and equipment to perform CAC services within the confines of the Kenyan law, offer contraceptive services to the population as a way to prevent unwanted pregnancies and increase uptake of post abortion contraception, and building the capacity of community leaders to raise awareness on the legal changes that allow for CAC, public health and developmental benefits of access to safe abortion services. It has also participated actively in abortion advocacy and most notably in the just concluded civic education and sensitisation on abortion as well as in other advocacy for policy change as a member of the reproductive health and rights alliance.
FHOKs growth to the status of lead agency in SRH provision in Kenya can greatly be attributed to its knack for identifying present day challenges as opportunities to remain relevant tomorrow within a very dynamic community.
The projects aimed at serving The Poor and Marginalised including youth, sex workers, people living with HIV/AIDS and people living in slum areas that form a target of FHOK clientele.
The success is attributed to the following projects and partners;
