Abstract
Young women and girls in Kenya face challenges in access to abortion care services. Using in‐depth and focus group interviews, we explored providers’ constructions of these challenges. In general, providers considered abortion to be commonplace in Kenya; reported being regularly approached to offer abortion‐related care and services; and articulated the structural, contextual, and personal challenges they faced in serving young post‐abortion care (PAC) patients. They also considered induced abortion among young unmarried girls to be especially objectionable; stressed premarital fertility and out‐of‐union sexual activity among unmarried young girls as transgressive of respectable femininity and proper adolescence; blamed young women and girls for the challenges they reported in obtaining PAC services; and linked these challenges to young women's efforts to conceal their failures related to gender and adolescence, exemplified by pre‐marital pregnancy and abortion. This study shows how providers’ distinctive emphasis that young abortion care‐seekers are to blame for their own difficulties in accessing PAC may add to the ongoing crisis of post‐abortion care for young women and adolescent girls in Kenya.
Highlights
Young women and girls in Kenya face challenges in access to abortion care services
G lobally, adolescents disproportionately experience the adverse effects of unsafe abortion
About 60 percent of unsafe abortions in Africa occur among young women and girls under age 25 (World Health Organization 2011)
Summary
Young women and girls in Kenya face challenges in access to abortion care services. Using in-depth and focus group interviews, we explored providers’ constructions of these challenges. Structural factors, including lack of training in post-abortion care (PAC), lack of PAC equipment, and legal barriers, impede providers’ ability to effectively serve abortion patients (APHRC et al 2013, 2015; Payne, Debbink et al 2013) Within this context, doubts have been expressed, about providers’ appreciation of the challenges young women face in relation to abortion services and about their capacity to offer empathic and quality unprejudiced care to young abortion patients (Steele and Chiarotti 2004; Evens, Otieno-Masaba et al 2014; Izugbara, Egesa, and Okelo 2015). A focus on providers’ relationships with young abortion patients is key to understanding their challenges in serving patients; plugging gaps and disparities in reproductive health outcomes among young people; furnishing evidence for youth sexual and reproductive health (SRH) policy formulation and implementation; and informing strategies for addressing barriers to abortion patients’ access to respectful services worldwide
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