Kenyan courts issued a series of landmark rulings affirming abortion as a fundamental right, yet advocates warn that institutional stigma and administrative barriers continue to fuel a deadly national health crisis.
According to a 2025 report by the Ministry of Health and the African Population and Health Research Center (APHRC), an estimated 792,694 induced abortions occurred in Kenya in 2023. During that same year, there were 1.436 million unintended pregnancies, a figure that experts say reflects a significant unmet need for contraception and safe medical services.
The Human Cost of Restrictions
The legal battle for reproductive access has been defined by the “human cost” of government restrictions. In a landmark 2019 decision, the High Court of Kenya ruled that the Ministry of Health violated the constitution when it withdrew national standards and guidelines for safe abortion in 2014.
The case centered on JMM, a 14-year-old survivor of sexual violence who died from complications of an unsafe abortion after being unable to access legal services. The court found that the government’s withdrawal of guidelines and the ban on the medication Medabon created a “chilling effect” and a practical gap that effectively prevented access to safe and legal care.
Further legal clarity arrived in March 2022, when the High Court in Malindi strongly affirmed that abortion is a fundamental right under the Constitution of Kenya. The court ruled that while Article 26(4) of the Constitution protects the right to life, it permits abortion when a trained health professional determines it necessary for emergency treatment or to save the life or health of the mother.
Cases of Unlawful Prosecution
The Malindi decision arose from the 2019 arrest of PAK, a 16-year-old girl who sought emergency post-abortion care at a clinic in Kilifi County. Despite her constitutional right to emergency treatment, plainclothes police officers stormed the clinic, arrested PAK from her hospital bed, and detained her for two nights without further medical care. The court later declared the prosecution of PAK and her healthcare provider, Salim Mohammed, to be unlawful.
Despite these victories, reproductive health providers continue to face institutional pushback. In 2018, the Kenya Film Classification Board (KFCB) and the Medical Practitioners and Dentists Board (KMPDB) banned Marie Stopes Kenya (MSK) from running public awareness campaigns regarding unsafe abortion. Advocacy groups successfully challenged these bans, and the High Court subsequently ruled that survivors of sexual violence have an explicit right to access safe abortion in line with the Constitution.
Regional Advocacy and Economic Pressures
The struggle for reproductive justice extends across the region. In Nigeria, the Reproductive Justice Initiative Foundation (RJIF) filed a 2023 case seeking to clarify access for survivors of sexual violence. The case relies on the Maputo Protocol, a regional human rights law incorporated into Nigerian law that recognizes the right to reproductive health.
Adding to these legal hurdles is a growing economic burden on health services. In neighboring Uganda, the Uganda Bureau of Statistics (UBOS) reported that annual health inflation rose to 4.3 percent in December 2025, up from 3.8 percent in November. The rising cost of services, particularly in regions like Masaka where health inflation hit 7.2 percent, poses an additional barrier for vulnerable women and girls seeking essential care.
