Access to safe abortion services in Kibera informal settlements, Nairobi city county, Kenya
Abstract
This thesis focused on access to safe abortion services in Kibera informal settlements in Nairobi
City County. The main objective of the study was to explore the factors influencing access to
safe abortion services in Kibera informal settlements. The specific objectives were to investigate
the women’s understanding of the abortion provisions in the Kenyan constitution; to determine
the availability and accessibility of safe abortion services in Kibera informal settlements and to
examine how women’s attitudes influence their access to available abortion services in Kibera
informal settlements.
The study design was cross-sectional, combining both qualitative and quantitative methods of
data collection. The qualitative methods that were used included case studies, focused group
discussions and key informants interviews. Quantitative data was collected in a survey using a
semi-structured questionnaire. Non-probability sampling methods were used to draw the study
participants. A total of 50 women of reproductive age (15-49 years) were sampled to participate
in the study using convenience sampling technique. These women participated in the survey.
Three (3) FGDs were conducted with a sub-sample of the women who had participated in the
survey. The focus group participants were conveniently selected on the basis of who had time to
participate in the discussion. Key informants were selected purposively and case studies were
drawn using the snow-ball technique. Data were analyzed using different techniques. Qualitative
data was analyzed using content analysis whereby; data was read and re-read to identify the main
themes related to the study objectives. Narrative and verbatim quotations were used to explain
the trends exhaustively. Quantitative data was analyzed by SPSS version 21.
The findings suggested that majority of the women in Kibera (80%) were not aware of what the
constitution says about abortion in Kenya. All they said was that abortion was illegal from both
the state and religious perspectives. The study found out that lack of adequate health facilities
that offered safe abortion services and the high cost of safe abortion in Kibera drove women to
procure unsafe abortions from unqualified providers. The study also revealed that women’s
attitudes towards abortion influenced their practices; women who viewed abortion as a sin were
against abortion (safe or unsafe abortion). For others, the stigma that is associated with abortions
in Kibera made them to procure unsafe abortions from backstreet providers. Women who
suffered a lot of pain from unsafe abortions reported that they would only procure abortions from
safe providers in the future.
It is concluded at that lack of knowledge on the provisions of the constitution on abortion in
Kenya is a barrier for most women and girls in Kibera who want to terminate their pregnancies
safely. Few healthcare providers are knowledgeable on the full content of the law and most
women remain unaware of provisions of the law. A lack of clarity about legal access to abortion
has produced widespread misinformation among women, adolescents, and medical providers. In
addition, women’s access to safe abortion is determined largely by their ability to afford the
procedure and to identify and reach a provider who offers safe abortion services.
This study recommends that there is need to create more awareness among public on what the
constitution says about abortion and especially women need to be educated on their rights and
the legal issues around abortion. The government should ensure that there are sufficient facilities
that offer safe abortion services to women (both public and private) and to ensure that the cost of
safe abortion is affordable to women.
Publisher
University of Nairobi