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
8,000 lives lost to cancer every year in Zambia
MINISTER of Health Sylvia Masebo has revealed that nearly 8,000 cancer patients succumb to the disease each year in Zambia.
Speaking in the Parliament yesterday , Ms. Masebo highlighted that over 70 percent of the fatalities occur in stages three and four, which are deemed incurable but could still offer a good quality of life with appropriate treatment.
The minister disclosed that alongside the 8,000 deaths, Zambia records more than 13,000 new cancer cases annually.
She said government is, however actively working to enhance the Cancer Diseases Hospital (CDH), a critical healthcare facility in the country.
Ms Masebo further informed the House that significant progress has been made in revitalising CDH, with additional efforts directed towards expanding cancer treatment services.
She said new cancer centers have been established in Livingstone and on the Copperbelt in Ndola, with the latter expected to be operational by June next year.
Responding to an urgent question from Nakonde Member of Parliament Luka Simumba, Ms. Masebo stressed the commitment of the government to address the challenges posed by the rising cancer cases.
“Madam Speaker, The House may wish to note that Zambia today confirms 13,852 new cancer cases per year, and nearly 8,000 patients die per year because more than 70 percent of these cancer patients are in stage three and four, which are incurable, but can still have a good quality of life with adequate treatment,” she said.
Ms. Masebo said CDH attends to 3,000 patients annually, with 1,800 requiring radiotherapy treatment.
She expressed concern that the diagnostic and radiation treatment machines, installed by Siemens in 2006, have become obsolete and were scheduled for replacement between 2016 and 2019.
“The New Dawn Administration under the able leadership of His Excellency Mr Hakainde Hichilema the President of the Republic of Zambia, measures by allocating money K12 million for repair of the two CT scanners and the MRI in 2022 and in the 2023 Budgets allocation of K300 million to revamp the operations of the facility has been done,” she said.
(Mwebantu, Saturday, 11th November, 2023)
Anthrax outbreak: 335 cases and four deaths reported across six provinces
MINISTRY of Health has disclosed that 335 cases of Anthrax and four deaths have been recorded in six provinces.
The affected provinces are Southern with 269 cases, Western 19, Eastern 30, Lusaka 13, North Western 1 and Muchinga with 3 cases.
Minister of Health Sylvia Masebo said a 12-year-old boy from Muchinga is among the victims that have succumbed to the disease.
Ms Masebo said this when she gave an update on the events threatening the public health security in the country.
“A cumulative 335 cases and four deaths have been reported across the country in the following provinces Southern, Western, Eastern, Lusaka, North Western and Muchinga,” the minister said.
Ms Masebo warned the public against consuming meat from unknown sources.
She said meat should be bought from designated butcheries to prevent the spread of the disease.
Ms Masebo said the ministry has also implemented measures to contain and prevent the spread of Anthrax.
She said reorientation of staff on disease identification and management to ensure early diagnosis and treatment among other measures.
(Mwebantu, Wednesday, 1st November, 2023)
26 cholera cases recorded in Lusaka, with 2 deaths.
MINISTER of Health Sylvia Masebo has told parliament that 26 confirmed cases of cholera have been recorded in Lusaka.
Ms Masebo said the ministry has also recorded two cholera deaths.
She explained that on August 18 the public was informed that a case of cholera was reported in Kanyama area.
Ms Masebo said as of October 25 health facilities noted a few more cholera cases in Lusaka.
She said this in a ministerial statement on the cholera outbreak situation in Zambia.
“To date there have been 26 confirmed cases of cholera in Lusaka and we are deeply saddened to report that two lives, one which occurred in the community, have been lost as a result of this outbreak. Our heartfelt condolences go out to the families affected by this,” the minister said.
She said health workers are working in the community to ensure that cases are identified and managed on time.
Ms Masebo said the Government is also distributing chlorine for household use and environmental decontamination among other measures to prevent the spread of the outbreak.
(Mwebantu, Friday, 27th October, 2023)