NOMSA NKANA, Lusaka
UNSAFE abortions in Zambia have reduced from 30 percent to 7 percent due to interventions implemented by the University Teaching Hospitals (UTH).
Unsafe abortion is “a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both”.
President of Zambia Association of Gynaecologists and Obstetricians (ZAGO), Swebby Macha, said in an interview that the measures are aimed at reducing maternal deaths and illnesses due to unsafe abortions.
“We have applied a four-pronged approach to safe abortion which is primary, secondary, tertiary and quaternary,” Dr Macha said.
He said primary prevention refers to preventing unwanted/ unintended pregnancy. This can be done through comprehensive sexuality education, including information on abstinence, counselling on contraceptive services, improving access to contraceptive services and prevention of rape and incest, among others.
Dr Macha said secondary prevention involves early detection of unintended pregnancy and the provision of safe and comprehensive abortion services in order to prevent recourse to unsafe abortion.
“The services include woman-centred counselling, termination of pregnancy to the full extent allowed by the law and provision of antenatal, among others,” he said.
Dr Macha said the third approach is tertiary prevention, which deals with complications of abortion, including from unsafe abortion by offering post-abortion care (PAC).
He said this level of care aims at preventing permanent disability and death in patients who already have complications either from spontaneous or induced abortion.
Dr Macha said the fourth is quaternary prevention where the hospital offers family planning services to women who have had an abortion so that they don’t repeat the action.
“Zambia allows legal termination of pregnancy under the Termination of Pregnancy (TOP) Act of 1972. The TOP Act permits an abortion to be performed by a registered medical practitioner, and two other registered practitioners, if the pregnancy is a risk to the life of the pregnant woman and a risk of injury to the physical or mental health of the pregnant woman, among other reasons,” he said.
NOMSA NKANA, Lusaka