During the last decade, women in Africa have made progress in achieving greater gender equality, financial security and access to health care. Women have assumed positions of leadership and governance in international forums, national offices and at community levels. Young African women and men have grown more vocal in their support for women’s equality.

But throughout the region, women and girls are still denied the ability to control their reproductive lives. In many places, reproductive health care, including safe abortion care, is inaccessible—particularly for young, rural, poor, displaced and uneducated women—for a variety of reasons including legal restrictions, cost and cultural stigma. This stigma extends to health care providers who may not provide abortion care as a result.

In Africa, more than eight million women have abortions each year, many of them unsafe. Each year, about 1.6 million women are treated for complications from unsafe abortion, and thousands more suffer complications but do not receive the treatment they need. Because so many abortions in the region are unsafe, roughly 16,000 maternal deaths annually are due to unsafe abortion. The consequences of unsafe abortion for women and their families, and for society as a whole, are significant and enduring.

Approximately 90% of African women of childbearing age live in countries with restrictive abortion laws. Even where the law allows abortion under certain circumstances, few women, including survivors of sexual violence, are able to navigate the processes required to access a safe and legal procedure.

There has been progress in the last decade, and progress continues to be made. Some African nations are working to reform their abortion laws. The body of credible research has grown, and we know more about the magnitude and consequences of unsafe abortion. We know more about women’s and adolescents’ pathways to abortion, and attitudes and stigma around abortion. And we know more about the costs of unsafe abortion to women and their families and to health care systems, and the cost savings associated with safe and comprehensive abortion and contraceptive care.

We—more than 260 researchers, advocates, policymakers and donors—commit ourselves and call on others to build, share and act on the evidence. Furthermore, remaining gaps in evidence must be filled. Our agenda for research and action in Africa going forward will focus on:

CONTINUES

[printable page]