• Edna N. Bosire MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • W.Onyango- Ouma )Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya


Background: Abortion remains a critical determinant of maternal morbidity and mortality in Kenya. Recent studies on induced abortion estimated an annual abortion incidence of 48 abortions per 1,000 women of reproductive age, which is higher than other East African countries. In 2010, the Kenyan Constitution widened the provisions under which women qualified for safe abortions. However, majority of women still seek abortion services from unqualified providers. Using an interpretive, meaning-centered approach, this study aims to explore the barriers to safe abortion services in Kibera informal settlements, Nairobi Kenya.

Subjects and Method: This was a cross-sectional study encompassing both qualitative and quantitative research methods. We used different sampling techniques (convenient, purposive and snow ball methods) to recruit our study participants (n=55). Quantitative data was collected using a survey questionnaire and data was analyzed by SPSS version 21. Qualitatively, data was collected using Focus Group Discussions (FGDs), Key Informant interviews and case study narratives. This involved note taking and audio recordings, which were transcribed verbatim and thematically analyzed using QSR Nvivo 21 software.

Results: This study revealed that women


Cameron C (2005). In the world of Dolly, when does a human embryo acquire respect?. Journal of Medical Ethics, 31(4): 215

Centre for Reproductive Rights (2010) In Harm

Daily Nation (2018). Unsafe abortions kill seven Kenyans daily.

Gleeson R, Forde E, Bates E, Powell S, EadonJones E, Draper H (2008). Medical students

Grimes DA, Benson J, Sigh H, Romero M, Ganatra B, Okonofua FE, Shah IH (2006). Unsafe abortion: The preventable pandemic. The Lancet Sexual and Reproductive Health Series, 368(9550): 1908

Hord C, Wolf M (2004). Breaking the cycle of unsafe abortions in Africa. African Journal of Reproductive Health, 8(1): 29

Hussain R (2012). Abortion and unintended pregnancy in Kenya. Issues Brief (Alan Guttmacher Inst).

Ikamari L, Izugbara C, Ochako R (2013). Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy and Childbirth. 13(1).

Izugbara C, Ochako R (2011). Unwanted pregnancy and pregnancy termination among women in Nairobi, Kenya. Policy Brief, Nairobi, Kenya: African Population and Health Research Centre.

Izugbara CO, Egesa CP, Kabiru CW, Sidze EM (2017). Providers, Unmarried Young Women, and PostAbortion Care in Kenya. Studies in Family Planning, 48(4): 343

Izugbara CO, Egesa COR (2015). High profile health facilities can add to your trouble: Women, stigma and un/safe abortion in Kenya. Soc Sci Med. 141: 9

Jackson M (1996). Things As They Are: New directions in Phenomenological Anthropology. Indiana University Press: Bloomington.

Jayaweera RT, Ngui FM, Hall KS, Gerdts C (2018). Women

Kenya National Bureau of Statistics (KNBS), ICF M (2010). Kenya Demographic and Health Survey 200809. Calverton, Maryland: KNBS and ICF Macro.

Kumar A, Hessini L, Mitchell EMH (2009). Conceptualising Abortion Stigma. Culture, Health and Sexuality, 11:(6).

Lee P (2004). The ProLife Argument from Substantial Identity: A Defence. Biothics 18:3: 249-26.

Lopez R (2012). Perspectives on Abortion: ProChoice, ProLife, and What Lies in between. European Journal of Social Sciences, 27(4): 511

Marlow HM, Wamugi S, Yegon E, Fetters T, Wanaswa L, MsipaNdebele S (2014). Women

Mayi Tsonga S, Assoumou P, Ol

Mitchell EM, Halpern CT, Kamathi EM, Owino S (2006). Social scripts and stark realities: Kenyan adolescents

Muzeyen R, Ayichiluhm M, Manyazewal T (2017). Legal rights to safe abortion: knowledge and attitude of women in NorthWest Ethiopia toward the current Ethiopian abortion law

National Coordinating Agency for Population and Development (2010). Maternal deaths on the rise in Kenya: A call to save women

National Council for Law Reporting (2010). Constitution of Kenya. Nairobi, Kenya: NCLR with Authority of the Attorney General.

Ndunyu L (2013). Women

Sai F (2004). International commitments and guidance on unsafe abortion. African Journal of Reproductive Health, 8(1): 16

Sawicki N (2011). Abortion Informed Consent Debate: More Light, Less Heat, The Cornell JL & Pub. Pol

ScheperHughes N, Lock MM (1987). The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. Medical Anthropology Quarterly, 1(1): 6

Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B (2016). Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet. 388(10041): 258

Shellenberg KM, Moore AM, Bankole A, Juarez F, Omideyi AK, Palomino N, et al. (2011). Social stigma and disclosure about induced abortion: results from an exploratory study. Glob Public Health. 6(): S111

Siegel RB (2014). Abortion and the


Ziraba AK, Izugbara C, Levandowski B, Gebreselassie H, Mutua M, Mohamed SF, Egesa C, Kimani Murage EW (2015). Unsafe abortion in Kenya: Acrosssectional study of abortion complication severity and associated factors. BMC Pregnancy and Childbirth, 15(1):34.




How to Cite

Bosire, E. N., & Ouma, W.-. (2019). Journal of Maternal and Child Health, 4(2), 97–109. Retrieved from