Abortion is the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to 28 weeks of amenorrhea. Uganda's laws and policies addressing abortion are unclear, confusing, and often contradictory. Consequently, although abortion is legal to preserve the life or mental or physical health of a woman and in cases of sexual assault, many people, including health care professionals, are under the impression that abortion is illegal. Current legislation.
The current legal and policy framework offers ample opportunities for increasing access to safe abortion services. The Ugandan Constitution does not prohibit abortion. Article 22(2), which states that “no person has the right to terminate the life of an unborn child except as may be authorised by law,” does not preclude access to termination of pregnancy; it simply requires a legal framework to do so. The Ugandan Constitution allows abortion if the procedure is authorized by the law, but does not state the exact circumstances, leaving room for legal provisions and interpretations. Several regional treaties ratified by Uganda—the African Charter on Human and Peoples’ Rights (African Charter), the African Charter on the Rights and Welfare of the Child (African Charter on Children),and the African Charter’s Protocol on the Rights of Women in Africa (Maputo Protocol)—provide important protections for the rights of women and girls in Uganda. The African Charter guarantees the right to life, while Article 16 recognizes the right to enjoy the best attainable state of physical and mental health and obligates states parties to take necessary measures to ensure the health of their people. Furthermore, according to the 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights, pregnancy termination is permissible in cases of fetal anomaly, rape and incest, or if the woman has HIV. Under these guidelines, mid-level providers can offer termination of pregnancy and post-abortion care services. The 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights provide for access to abortion services in the following cases: * severe maternal illnesses threatening the health of a pregnant woman e.g. severe cardiac disease, renal disease, severe pre-eclampsia and eclampsia: * severe foetal abnormalities which are not compatible with extra-uterine life e.g. molar pregnancy,anencephaly; * cancer of the cervix;
* HIV-positive women requesting for termination;
* Rape, incest and defilement.
Although these documents do not have the force of law, they do have evidentiary value and could be persuasive evidence in a court of law of the government’s understanding of the abortion law. However, the laws and policies are not clearly detailed in legislation, and because interpretations of the law are ambiguous, medical providers may be reluctant to perform abortion for any reason for fear of legal consequences, even though the penalties do not apply to the provision of legal abortions. Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly when access to legal abortion is restricted. They may attempt to self-abort or rely on another person who does not have proper medical training or access to proper facilities. This has a tendency to lead to severe complications, such as incomplete abortion, sepsis, hemorrhage, and damage to internal organs.
In December 2009, the Ministry of Health published the Patients’ Charter. The Charter invokes objective XX of the Constitution of Uganda, which provides that the state “shall take all practical measures to ensure the provision of basic medical services to the population,” and frames the Charter as part of an effort to “progressively realize the right to Health. The Charter provisions demonstrate that health care professionals with the requisite skills are obligated, at a minimum, to offer...