Abstract
IntroductionAbortion in Zimbabwe is allowed to preserve the physical health of the woman, or in cases of rape, incest, or fetal impairment. Access even under these conditions is difficult and rare. We aimed to understand knowledge of the abortion law and attitudes towards abortion amongst health care providers’ and abortion experts in Zimbabwe as these can hinder access to safe legal abortion.MethodsIn 2016, we conducted a Health Facility Survey (HFS) (n=227) among health care providers’ knowledgeable about abortion services in their facility in a census of facilities offering Post Abortion Care (PAC), and a Health Professionals Survey (HPS) among 118 abortion experts.ResultsTwenty-five percent of providers and 47% of experts knew all four reasons under which abortion is legal in Zimbabwe. Amongst providers and experts, 31% and 50% respectively were misinformed about one or more legal criteria. Most providers and experts were in support of expanding the legal provision of abortion to cases when the woman’s mental health is at risk (65% and 79%, respectively) and if the woman is mentally incapacitated (66% amongst all). Seventy-one percent of experts recommend liberalizing the abortion law in order to reduce unsafe abortions.ConclusionThere is incomplete and sometimes inaccurate knowledge on the legal provisions for performing abortions in Zimbabwe amongst both health care providers and abortion experts. Incomplete knowledge of the law may be further reducing abortion access, highlighting the urgent need for educating health care providers on the legal status of abortion.
Highlights
Zimbabwe has a restrictive abortion law, with legal abortion limited to preserve the physical health of the woman, rape, incest, or cases of fetal impairment [1]
Knowledge and attitudes towards abortion were assessed using a Health Facility Survey (HFS) which was conducted with health care providers in charge of units offering postabortion care (PAC) at all public, private and Non-Governmental Organization (NGO) health facilities that had the capacity to provide PAC
71% of health care providers and 79% of abortion experts were aware that abortion is allowed in cases of physical risk to the woman’s health
Summary
Zimbabwe has a restrictive abortion law, with legal abortion limited to preserve the physical health of the woman, rape, incest, or cases of fetal impairment [1]. Abortion providers and experts knowledgeable about abortion are gate keepers for women’s access to safe abortion. It is helpful to understand their knowledge and perceptions of abortion in order to inform our understanding of the barriers to women’s access to safe, legal abortion in Zimbabwe. We aimed to understand providers’ and experts’ knowledge and misperceptions of the current abortion law, the extent to which they are in agreement with the current law, grounds under which they feel abortion should be provided and their recommendations for reducing unsafe abortion. Limited work has been conducted on attitudes of health care providers towards abortion in Zimbabwe. This paper improves on prior work by surveying health care providers in all facilities providing PAC nationwide and including experts on abortion
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