Debates and discussions by health stakeholders on how to reduce maternal mortality and morbidity in Tanzania have been continuing, reflecting at the toll of unsafe abortion and related maternal mortality.
Despite some promising progress recorded so far, reduction of maternal mortality and morbidity in Tanzania is still a challenge. Key findings of the 2015-16 Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) shows that the estimated mortality and morbidity rate (MMR) of 556 deaths is “lower” than that recorded in the 2004-05 TDHS (578), but is higher than the ratios reported in the 2010 TDHS (454) and in the 2012 Population and Housing Census (432).
The 2013 research by Tanzania National Institute for Medical Research and Guttmacher Institute shows unsafe abortion accounts for one-quarter of maternal death in Tanzania. According to the research, some 405,000 Tanzanian women performed unsafe abortion in 2013.
About 40 per cent result in complications that require medical treatment and 60 per cent of them do not receive needed medical.
Speaking during her presentation at a recent stakeholders meeting in Dar es Salaam, a representative from the Association of Gynaecologists and Obstetricians of Tanzania (Agota), Dr Belinda Balandya, says maternal mortality and post abortion care is still a challenge as it is the second leading cause of maternal death.
According to Agota, gathered statistics show that the Lake Zone is leading in unsafe abortion cases as 51 out 1,000 women perform unsafe abortion.
Dar es Salaam Regional Medical Officer Yudas Ndugire says it is very important to have stakeholders’ meeting often so as to discuss on how to reduce maternal mortality and morbidity.
He urges health stakeholders and service providers to help in reducing the problem by establishing good communication with their customers and ensure that the society has full information on abortion, understand its effects and ways to reduce abortion cases.
“Discussion like this helps to reduce the effects of maternal mortality in Tanzania,” he adds.
Unsafe abortion is still a critical problem in Tanzania. Despite being criminalized, unsafe abortion is still practiced widely and secretly.
The Penal Code, Chapter 16 of the Laws Principal Legislation [Revised Edition of 2002], Sections 150-152, and 219 criminalises abortion while section 230 gives a slight room only for preservation of the mother’s life if the performance of the operation is reasonable.
The Maputo protocol
Advocate Kelvin Bateyunga from Levee Attorneys, is of the opinion that the law on abortion should give a room for termination of pregnancy in certain circumstances.
“Just imagine if the pregnancy is a result of rape by a close family member. How could the impregnated woman live in peace” says Kelvin.
Kelvin says the current law also does not allow abortion unless is performed to save the life of the mother.
“In that situation, most women and girls would opt for unsafe means to terminate the pregnancy because they know medical doctors will refuse to do abortion,” he says.
He urges relevant authorities to fully comply and implement the Maputo Protocol, especially Article 14, which clearly articulates the reproductive rights of women.
“The Maputo Protocol was the first human rights instrument that explicitly provide for the right to abortion in specific instances, such as rape, incest or in circumstances where the pregnancy endangers the life of the mother,” he says.
On the other hand, the advocate says it is high time health stakeholders to fill the gaps by helping to reduce stigma in post care abortion and save women lives.
Speaking after the discussion, the Regional Coordinator of Women‘s Global Network for Reproductive Right Africa (WGNRR Africa), Nondo Raymond says people have to change and come together to reduce maternal mortality and Morbidity in Tanzania.
A gynaecologist from Sinza - Palestina Hospital in Dar es Salaam, Dr Andreas Mgaya, says policy review as well as amendment of the law to allow abortion in certain circumstances than only to safe mother’s life will provide a smooth way forward in curbing unsafe abortion hence reducing maternal mortality.
“As long as safe abortion will not be fully recognised as a standard health service, then unsafe abortions will continue to cost the lives of hundreds and thousands of our women and girls,” he says.