Civil Society angry at Kenya government’s attempt to develop a Health Act

Posted on | september 12, 2012 | No Comments

A committee in Kenya’s Ministry of Public Health and Sanitation charged with drafting the Heath Bill has come under scathing attack from members of the civil society for being autocratic and failing to take alternative views from the technical people working outside government circles.

At a recent meeting of the CSOs, the groups proposed the amendment to the Bill and called for removal of clauses that seem to create barriers to reproductive health rights of women.

These CSOs were in agreement that it was necessary to have a health law in place to help the realization of the right to health for Kenyans as provided for in the Kenyan Constitution, 2010.

However, they were quick to point out that the health Bill should give direction on how the right to health and the underlying determinants of health will be realized by all Kenyans including the vulnerable and marginalized people.

The Health Rights Advocacy Forum, a Nairobi-based NGO says the Taskforce on the Implementation of the Constitution in the Health Sector received inputs and comments from Stakeholders in the month of March 2012 and according to sources from the Ministry, they have been working on them to date.

Unfortunately, says an officer at the HERAF, there has been no communication on the progress of the same to stakeholders and at some point civil society has had the impression that the process had stalled or the task force working on the Bill is doing it alone.

Further, the source adds, there have been concerns on stakeholder’s engagement in the development of the Bill. The Bill was drafted by a consultant and stakeholders have only been called upon to give comments on the already developed Bill. “Moreover, despite giving their comments, there has been no feedback from the taskforce on whether their inputs are relevant, have or have not been considered,” adds the source.

According to Prof Joseph Karanja of the University of Nairobi, the 67-page Bill has good intentions but it also has some contentious issues that the committee has included. The worst bit of it, says Prof Karanja is the refusal by the committee members to ignore objections and proposals from other stakeholders working outside the government. “Although they are few, but they have wider implications,” said Prof Karanja.

He said the bill is generally aims to establishing structures for improving Kenya’s health systems and not to manage certain health conditions.

He singled out some section early in the bill that talks of family planning and tries to name abortion as a method of family planning.

“The Bill is singling out abortion as a method of family planning but leaves out all other health conditions. “It looks as if there is an ulterior motive to create barriers against abortion. This is contrary to the new constitution.

He said the way the Bill is put, it implies Kenyans will be denied the right given by Article 26 of the constitution and stigmatises abortion. Yet the ministry health guidelines on family planning don’t cite abortion as a method of family planning.

Article 26 (4) of the constitution permits abortion except when in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.

The CSOs also hit out attempts by the Bill drafters to say that abortion is notifiable disease condition like cholera, ebola, tryphoid and TB. “This is quite wrong,” said Prof Karanja.

The CSO members have called for the deleting the section that brings in the issue of abortion in the Bill.

The way out, says Prof Karanja is for the committee to wait for the proposed Termination of Pregnancy Bill which aims to shed light into how abortion is to be managed. This is in line with the way how all other medical conditions have been treated.

As it reads, say health experts, the proposed Health Act negates Article 26(4, 43(1) and (2) as it adds another obstacle of licensing.

The committee working on the Bill is composed of some technocrats at the ministry of health and it is said to ignore comments from the professional societies such the Nurses’ Council of Kenya, the Kenya Medical Association, and others.

Prof Karanja says that the process of selecting them was selective and brings together only a few people with like-minds who ignore others with opposed views.

The CSOs say the entire Bill has been developed with little consultation and comments, recommendations and proposals from professional bodies are ignored.

But the Minister for Medical Services, Prof Anyang Nyong told members of the civil society not to be worried.

He said the Bill is still under vey early stage of drafting.

He adds that after the drafting, the Bill will be sent to the Committee on Implementation of the Constitution which is required by law to provide a minimum of 30 days to allow public comments and additions.

“It is at this stage that members of the civil society will be needed to bring in their recommendations and memoranda,” he said.

Kenya has an estimated 360,000 abortions every year, 20,000 of these end up in admissions with complications which in turn result in 2,000 maternal deaths

According to studies by the International Planned Parenthood Federation, for every woman who dies, six others are left with complications which can be severe leading to loss of reproductive organs like uterus.

Experts now say with broad interpretation of Section 26 of the Constitution, there is no longer any reason a woman should die of pregnancy-related deaths. “The provision of the constitution now negates the notion that abortion is illegal in Kenya,” say experts.

According to experts, while all African countries have post abortion services, none ever asks questions on unsafe abortion.

Most abortion laws in Africa are inherited from former colonial masters but most have either been amended or are in the process of being amended as they were originally meant to save women from abuse by the medics 200 years ago.

While Kenyan official line still appears against abortion, some countries like Ethiopia, Zambia and Ghana seem to have some lax approach to abortion.

In Ethiopia for example, the law allows abortion on medical, mental, age (below 18 years) and is allowed without any other requirements. In Ghana, the law allows abortions for rape, incest.

In Zambia, abortion can be procured on socio-economic grounds. South Africa offers abortion on demand. It is only in Lesotho and Swaziland where abortion is still prohibited.

But the irony is, says an expert at IPPF, all over Africa, post-abortion care is provided for in government hospital facilities yet no one asks where abortion is initially done. This, says the source is a misnomer. “Post abortion is more costly compared to attempts to provide safe abortion.”

According to IPPF, there are estimated 210 million pregnancies every year. 46 million of these pregnancies are either spontaneously aborted or induced. 20 million pregnancies that are aborted are classified as unsafe. Of these, 4.3m occur in sub-Saharan Africa where 90% of abortions are considered unsafe.

Studies also show that by making abortion legal, you don’t increase the number of abortion.

In many studies, the number will increase initially…but this is explained by the fact that many women will not opt to go for the official healthcare facilities to procure abortion. But in the long-run the number drops due to the added family planning services.

AUTHOR: Henry Neondo
URL: http:// www.africasciencenews.org
E-MAIL: neondohenry [at] yahoo.com