Legal but Stringent: Abortions in Zambia
Like many countries in Southern and East Africa, abortion legality in the context of Zambia is quite stringent. Unlike many of its neighbouring countries, such as Zimbabwe and Angola, Zambia has a more liberal abortion legislation. It also has a a unique stipulation  that allows for abortion upon request. As is evident in many countries where abortion upon request is allowed, access to the service is affected by much more than legislation. Lack of healthcare facilities that offer this service as well as stigma equally contribute to the inability to undergo safe abortions for many women. In this blog, we hope to highlight the legislative framework under which abortions in Zambia exist as well as shed light on the ways in which one can access the service.
Abortion laws date back to pre-colonial times
The Termination of Pregnancy Act of Zambia dates back to 1972 and allows abortion under specific conditions, namely; if the health of the pregnant person is at risk, both physical and mental, or the health of the fetus is at risk. Abortion is also allowed under socio-economic grounds. If the pregnant person can justify that the pregnancy would impact their socioeconomic situation, an abortion is allowed. Previously, this stipulation required the approval of three healthcare providers, but reports from the ground reflect that this requirement is no longer implemented religiously.
Despite this somewhat liberal abortion law, women in Zambia still struggle with accessing safe abortions. Proper estimates of how many women actually seek out the service are hard to quantify given the immense stigma and number of unsafe abortions that occur. This number is at around 39 abortions per 1000 women. In addition, the incidence of women admitted for abortion related complications (including induced abortions) was 10,000 in 2008, a sharp increase from the 5600 in 2003. 
Stigma is one of the greatest forces to inhibit abortion access
These numbers can largely be attributed to the stigma associated with abortions in the region: although the service is available, many women worry about the shame that comes with seeking the service. Furthermore, in Zambia, there are about 2 doctors per 10,000 people, which means there are even less opportunities for women to access the service. 
Although these numbers paint a fraught image of the situation on the ground, they also highlight the high number of women who are making the decision to terminate a pregnancy. The fact of the matter is that abortions have been occuring and will continue to occur, for multiple reasons, each diverse but each equally justified. As such, it is imperative that we re-examine the stigma we have become so accustomed to in the region and more generally, across the globe. Navigating fertility for periods up to 20 years can be challenging, and women reserve the right to make decisions that honor their lived experience.
Despite the restrictions, great strides are being made to increase abortion access
In recent years, there have been many strides made to increase access to the service, whether intentional or not. Many teaching hospitals as well as the Marie Stopes in Zambia offer abortion services, and there are new methodologies for adminstering the service, such as Manual Vacuum Aspiration that have become available for women in Zambia . A recent conversation I had with a Zambian woman also revealed that the stipulation that three doctors have to approve the service is largely not implemented, and you can walk into a clinic, state that you seek to have an abortion and in most cases, if the facilities are present, you will receive one.
There are two main types of abortion options
There are two routes you can take if you seek to end a pregnancy. Medical Abortion, which involves the administering of either one pill, misoprostol, or two pills, misoporostol and mifepristone. This method can be conducted at home and is viable up to 9 weeks of gestational age. The second option is Manual Vacuum or Electrical Vacuum Aspiration. This method is done in-clinic and takes about one hour in total, and you can resume normal activities once it is completed in the clinic. It involves a mild sedation around the cervix, followed by the use of an aspirator to remove the products of conception. This method is viable up to 12 weeks of gestation.
Both options are viable, the decision simply rests on what works best for you and your situation. Now, although I have provided some technical guidance on how to access an abortion, it would be thoughtless of me to not mention that stigma still stands in many of the institutions that ought to provide the service, and navigating that can be incredibly difficult. Our counselors at safe2choose.org can help in preparing you or talking you through what it would look like to seek the service, but what is always important to remember is that you yourself are the best advocate for your body, and the decision to terminate a pregnancy does not have to be approved by those around you, only yourself. Here, you can read more about the stories of the many women who have sought out the service, or watch a testimonial of a woman who made this brave choice in South Africa.
To find out more about what options are available to you, you can learn more about the legislation and context in which abortion exists in Zambia here. As I have already mentioned, our team of multilingual counsellors can also walk you through everything, or offer a helping hand. And for those simply reading this to learn more, I hope this has shed light on abortions in Zambia and perhaps in the future, this information can help you or someone who might need it.
About the author: Marie-Simone Kadurira is a Reproductive Health consultant in Southern Africa. She is also the founder of Vasikana Vedu. It is a not for profit organisation which combats period poverty in the region.
- Termination of Pregnancy Act. National Assembly of Zambia. Accessed July 2021. https://www.parliament.gov.zm/node/1263
- Unsafe Abortion In Zambia. The Guttmacher Institute. Accessed July 2021. https://www.guttmacher.org/sites/default/files/report_pdf/ib-unsafe-abortion-zambia.pdf
- Moving from legality to reality: how medical abortion methods were introduced with implementation science in Zambia. Reproductive Health. Accessed July 2021. https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-017-0289-2
COVID-19 cases worries Health Minister
THE Ministry of health says it has seen an increase in the number of COVID-19 daily cases, test positivity and the spread of disease across the country.
Minister of health Sylvia Masabo said that in the last 24 hours the country recorded 311 new COVID-19 cases and three deaths.
She said two of the three deaths are COVID-19 deaths saying the individuals died due to complications directly attributed to COVID-19.
Ms Masabo said in a statement that the cumulative number of confirmed cases recorded in the country is 336649 with 330658 (98%) recoveries.
“We currently have 1948 active cases, 29 of whom are admitted to hospital,eight of these being new admissions in the last 24 hours. Of those admitted, nine are on oxygen therapy and three are now in critical condition,”she said.
She also said that the current prevailing COVID 19 cases are reportedly driven by a sub-variant of the Omicron virus which is now called XBB.
Ms Masabo said the COVID-19 virus keeps generating new forms of itself as it continues to multiply across the globe.
She said similar to the Omicron virus, the XBB is said to have a high ability to pass from one person to another and here in Zambia we have confirmed that the current increase in the number of cases we are seeing is driven by this XBB.
Ms Masabo said the Ministry and other stakeholders have instituted measures to protect people from getting COVID-19.
She said some of the interventions were strengthened community and facility surveillance to ensure prompt identification and reporting of cases and intensified testing among other measures.
Ms Masabo also urged the public to be conscious of cholera and other diarrheal diseases.
She said every person must manage their waste saying the state of cities, markets, bus stops and community gathering places must be improved
(Mwebantu, Friday, 13th January, 2023)
Polio virus detected in sewer samples in Kitwe’s Mindolo Township
MINISTER of Health Sylvia Masebo has announced that Zambia has recorded a confirmed isolate case of polio virus from sewer samples taken from Mindolo Sewer treatment pond in Kitwe.
Addressing the media, Ms Masebo said the samples were done through the country’s surveillance system led by Zambia National Public Health Institute.
“The sample was collected in October this year and after a series of laboratory analysis, the results have been confirmed,” she said.
Ms Masebe said although the virus has not been detected in humans, it is important that correct measures are taken to prevent it from spreading.
She said so far the ministry has conducted four rounds of vaccine, further urging parents to take their children for vaccination against the virus.
southern Africa has seen a resurgence of polio outbreaks, with Malawi and Mozambique having recorded cases of the virus.
Polio, is a disabling and life-threatening disease caused by the poliovirus.The virus spreads from person to person and can infect a person’s spinal cord, causing paralysis.
(Mwebantu, Friday, 11th November, 2022)
Ministry of Health dismisses drug shortage claims
THE Ministry of Health says there is no shortage of Anti-retroviral drugs in Zambia.
Permanent Secretary for Technical Services, Professor Lackson Kasonka however explains that due to the world shortage of old ARV drug called Zidovudine, some people who have not transitioned to the new drugs have been affected.
Professor Kasonka clarified that shortage of Zidovudine is as result of its poor side effect profile hence increasing its low demand thereby disturbing its global supply chain and leading to its erratic supply in the last two years.
He however said in the quest to provide safer and more efficacious drugs, the optimization of antiretroviral therapy has since started.
“To this effect, 98.5 per cent of the 1,229,781 receiving ARVs are now receiving the newer, safer, easier to take and more efficacious dolutegravir containing ARV combinations called Tenofovir disoproxil fumarate/ Lamivudine/ Dolutegravir commonly referred to as TLD or Tenofovir alafenamide / Emtricitabine/ Dolutegravir commonly referred to as TAFED. These drugs are fixed into a tablet and given as one tablet per day,” he said.
Professor Kasonka said the newer combinations were introduced in Zambia in 2018 and have since led to over 96% of Zambian People Living with HIV receiving ARVs to have the virus suppressed resulting in a healthier and more productive population.
He however said there still remain about 6,000 individuals who are taking old ARV drug called Zidovudine which the Ministry of Health has been transitioning from to TLD or TAFED.
“To this effect, the Ministry of Health in consultation with the Civil Society Organizations representing People Living with HIV and implementing partners has made a decision to accelerate the transition of individuals on this drug to better, safer and easier-to-take ARVs,” he said.
Professor Kasonka said government remains committed to ensuring people living with HIV in Zambia have adequate access to quality and efficacious anti-retroviral drugs, for a longer healthier life.
He said guidance has been provided to health workers to fast-track the transition from Zidovudine-containing ARV combinations to TLD or TAFED in view of new developments, based on scientific evidence generated from the African continent including Zambia.
He said a further reminder is given to dispense a six-month supply of anti-retroviral drugs as per standard guidance.
(Mwebantu, Thursday, 15th September, 2022)