On Inclusion Of Comprehensive Abortion Care Services Into NHIS

Report by Joseph Kobla Wemakor

it is indeed unimaginable for anyone living in a sound frame of mind to overlook the nightmare Ghanaian women go through in everyday life trying terminate an unwanted pregnancy. In total desperation women resort to crude devices of getting rid of such unwanted pregnancies which often caused them infection, other health complications or even death. The unfortunate situation which has contributed significantly to higher maternal mortality rates militating against Ghana’s effort in achieving the Millennium Development Goals for the year 2015.

In Ghana women face a lot of challenges including the criminalization of abortion by the PNDC law 102(1985) with the exception of rape, defilement, incest, health of mother and child; cost of abortion, transportation cost to health Centre, stigma from both the community and health personal leading them to resort to life threatening methods such as using hairpins, knitting needles and herbs to terminate unwanted pregnancies however, health facilities offering Comprehensive Abortion Care (CAC) services are severely inadequate especially in rural areas; as a result there is a great mismatch between the number of abortion seekers and certified providers and centres.

Even instruments used for providing unsafe abortions are usually not sterilized, and hence become a source of introducing infections into the mother’s womb. Furthermore, women who have been through a prior unsafe abortion usually present symptoms of heavy bleeding, infections or injuries to body organs such as uterus or bowels.

According to Dr. Gloria Quansah Asare, Deputy Director General of Ghana Health Service, these infections if not treated early could spread through the blood stream, causing multi-organ failures, bareness and even result to death.

Health experts believe there will be about 126,000 abortions in Ghana in 2014 and that majority of those will be unsafe procedures done outside of registered clinics and hospitals however, it is very difficult to obtain recent reliable national abortion figures in Africa and Ghana particular. Moreover the World Health Organization estimates that, in Western Africa, there are 28 procedures per 1,000 women each year in Ghana, in 2007, there were at least 15 induced abortions per every 1,000 women of reproductive age(between the ages of 15 and 44).

According to the World Health Organization, nearly 42 million women faced with unintended pregnancies have abortions, of which 20 million are unsafe, mostly in countries where abortion is illegal. Further reports have also indicated that in developed regions, nearly all abortions 92% are safe, whereas in developing countries, more than half 55% are unsafe. Unsafe abortion accounts for 13% of global maternal mortality and is responsible for one in eight maternal deaths.

As part of efforts to address the challenges of unsafe or illegal abortion practices which is a major cause of maternal deaths in Ghana and to achieve the Millennium Development Goals (MDG 4&5) by the year 2015, Save -Ghana, a Non-Governmental Organization working with a rural and deprived community in Upper West Region with a focus on promoting quality delivery of basic social services including education, health, women empowerment, sustainable livelihoods for all as well as safe-guarding the rights of women and children in deprived communities is implementing partnership with Safe Abortion Action Fund (SAAF) in the Western and Upper West Regions of Ghana aimed at advocating against unsafe abortions having come out with realities of unsafe abortions on the ground and have expressed sorrow for Ghanaian situation.

According to Kingsley Kanton, leader of the Save-Ghana team, “Government’s effort at reducing maternal mortality in Ghana through the free maternal policy among others is not encouraging”, however, despite all these interventions put in place, “yet the sad reality is that many more women are still dying on daily basis and the stressing the achievement of the MDGs 4 and 5 are out of reach.”

He therefore called on the government to as a matter of urgency accelerate the execution of the adolescent reproductive health policy which encompasses the Comprehensive Abortion Care (CAC) model

At a forum dubbed the ‘Action Forum’ held in Accra on the 29th September, 2014 on the day set aside to raise awareness on the need for the government to accelerate the implementation of the adolescent reproductive health policy which involves the Comprehensive Abortion Care (CAC) model and equally to mark the global day of action for access to safe and legal abortion, Kingsley Kanton , Team Leader of Save-Ghana assured Journalists that his outfit is committed to sensitizing the public on the dangers of unsafe abortion. “We are poised to deliver on our promises and we will leave no stone unturned to see to it that safe abortion becomes accessible and legalized in Ghana” he emphasized.

He urge the Ghana Health Service as well as other stakeholders on board as partners to demonstrate loyalty, commitment and support the efforts of Save-Ghana into complete realization of its 3 years project aimed at sensitizing the public on dangers of unsafe abortion.

“The next three years, we will continue to sensitize the public on the dangers of unsafe abortion in partnership with our traditional authorities (queen mothers and chiefs) as well as build on the training given to midwives in partnership with Ghana Health service on Comprehensive Abortion Care (CAC) for them to adopt a positive attitude in their work therefore we call on GHS and other stakeholders to support us.” Kingsley announced.

He observed Government’s role is critical; including the implementation of the 2000 adolescent reproductive health policy which talks about the right to services and information, however, indicated the inclusion of comprehensive abortion care services in the National Health Insurance Scheme would push a notch further, adding it is in line with Article 16 of the Convention on the Elimination of all forms of discrimination against women for which Ghana is signatory.

He appealed to the Ghana Education Service to help intensify education on sexual reproductive health as well as sensitize teenagers in both basic and second cycle schools.

He also advised parents to play an active role in engaging their wards in sex education and call for the collaborative effort of teachers to complement the decision of intensifying education on sexual reproductive health, maintaining, it is the responsibility of both parties as a way of contributing their quota towards effective development and raising of teenagers.

Meanwhile, Save-Ghana has also utilized the day to issue a communiqué to the President through the minister of health petitioning government to consider safe abortion care legalized and accessible to all women.

Save-Ghana believes “Access to safe and legal abortion isn’t just a healthcare issue but a human right issue therefore no one should come between a woman and her bodily autonomy”