Disparities in access to abortion care among women in Nairobi

Margaret Giorgio, Guttmacher Institute
Onikepe Owolabi, Vital Strategies
Moussa Zan, ISSP
Kenneth Juma, African Population and Health Research Center (APHRC)
Isaiah Akuku, African Population and Health Research Center
Ramatou Ouedraogo, African Population and Health Research Center (APHRC)
Caron Kim, World Health Organization
Clementine Rossier, University of Geneva

Restrictive abortion laws expose all pregnant people to the risk of poor-quality abortion services and/or unsafe abortion. That said, it is likely that the burden of this risk is disproportionately shouldered by more marginalized individuals; social and economic injustice systematically predispose some people to a greater risk of unintended pregnancies and may also deny them access to high quality care. Kenya has a relatively high incidence of induced abortion and a restrictive law the prevents women from easily obtaining safe abortions within the formal health system. Few studies have collected data to examine inequities in access to safe abortions from a representative population in Kenya or sub-Saharan Africa. Our analysis compares results from two studies that used respondent-driven sampling (RDS) to sample and recruit women living in Nairobi who have had a recent abortion. One study was designed to sample the general population of women in Nairobi, while the other was conducted in two lower income informal settlements within the city. While the results of this work reveal that all women in Nairobi are experiencing barriers to accessing safe abortion services, women living in informal settlements are shouldering a disproportionate burden of the negative outcomes associated with this limited access.

Keywords: Sexual and Reproductive Health and Rights, Social network methods, Family Planning and Contraception

See extended abstract.