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Zambia
ABORTION POLICY
Grounds on which abortion is permitted:
To save the life of the woman
To preserve physical health
To preserve mental health
Rape or incest
Foetal impairment
Economic or social reasons
Available on request
Yes
Yes
Yes
No
Yes
Yes
No
Additional requirements:
An abortion requires the consent of three physicians, one of whom must be a specialist in the branch of
medicine related to the woman’s reason for seeking an abortion. However, the requirement may be waived if
the abortion is immediately necessary to save the life or prevent grave permanent injury to the physical or
mental health of the woman. A legal abortion must be performed by a registered physician in a government
hospital or other approved institution unless the patient’s life is in danger.
REPRODUCTIVE HEALTH CONTEXT
Government view on fertility level:
Too high
Government intervention concerning fertility level:
To lower
Government policy on contraceptive use:
Direct support provided
Percentage of currently married women using
modern contraception (aged 15-49, 1996):
14
Total fertility rate (1995-2000):
5.6
Age-specific fertility rate (per 1,000 women aged 15-19, 1995-2000):
134
Government has expressed particular concern about:
Morbidity and mortality resulting from induced abortion
Complications of childbearing and childbirth
Yes
Yes
Maternal mortality ratio (per 100,000 live births, 1990):
National
Eastern Africa
940
1 060
Female life expectancy at birth (1995-2000):
40.6
Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations
Secretariat. For additional sources, see list of references.
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Zambia
BACKGROUND
Zambia has one of the most liberal abortion laws in sub-Saharan Africa, allowing abortions to be carried
out on broad health, as well as socioeconomic grounds. The Termination of Pregnancy Act of 1972 permits an
abortion to be performed if three registered medical practitioners are of the opinion formed in good faith that
(a) continuation of the pregnancy would involve risk to the life or of injury to the physical or mental health of
the pregnant woman, or of injury to the physical or mental health of any existing children of the pregnant
woman, greater than if the pregnancy were terminated; or (b) that there is substantial risk that if the child
should be born, it would suffer from such physical or mental abnormalities as to be severely handicapped. In
determining whether (a) above exists, account may be taken of the pregnant woman’s actual or reasonably
foreseeable environment or age.
A person who performs an abortion in violation of the provisions of the Act is subject to the punishments
prescribed in the Penal Code of 1 November 1931 for the performance of an illegal abortion. The penalty is
fourteen years’ imprisonment for a person who, with intent to procure a miscarriage, unlawfully administers a
noxious thing or uses any means. A woman who undertakes the same act with respect to herself or consents to
such an act is subject to seven years’ imprisonment.
A legal abortion must be performed by a registered medical practitioner in a hospital. One of the three
physicians consenting to an abortion must be a specialist in the branch of medicine in which the patient is
specifically required to be examined. Thus, a woman seeking an abortion for mental health reasons must be
examined by a psychiatrist, while one with a specific medical condition must be examined by a specialist in
that area of medicine. In the case of an emergency, an abortion need not be performed in a hospital and only
one physician need consent to its performance.
Complicated procedural requirements and inadequate services limit the number of legal abortions
performed in Zambia. Thus, despite the liberal nature of its abortion law, there are continuing obstacles to
obtaining a legal abortion and therefore a continued reliance on illegal abortion. For example, the University
Teaching Hospital is the only facility at Lusaka where a legal abortion can be obtained. Moreover, such
facilities are almost non-existent in the rest of the country because of a scarcity of gynaecologists at provincial
hospitals. The requirement that three physicians consent to the abortion is also difficult to satisfy because many
hospitals do not have three physicians. Moreover, some physicians are reluctant to sign the forms for religious
and personal reasons, and crowded hospitals make it difficult to obtain timely appointments with physicians.
These obstacles force many women to induce their own abortion and then proceed to a hospital for emergency
medical treatment. In 1976, a total of 173 legal abortions were performed at the University Teaching Hospital
at Lusaka, whereas 1,000 cases of illegally induced abortions were admitted to the same hospital.
The Government has expressed concern about the high incidence of illegal abortion in Zambia. Many
studies have also shown that illegal abortion is one of the major causes of the high rate of maternal mortality in
the country (940 deaths per 100,000 live births in 1990). A study conducted at the University Teaching
Hospital between 1982 and 1983 found that 18 per cent of all maternal deaths were due to complications from
incomplete induced abortions. Zambia also has one of the highest proportions of orphaned children in the
world, with 23 per cent of children under 15 missing one or both parents.
Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations
Secretariat. For additional sources, see list of references.
187
Zambia
Attitudes towards population growth rates and fertility among Zambian leaders have ranged until recently
from pronatalist to laissez-faire. While knowledge of contraception is high in Zambia, the use of modern
methods of contraception is low but increasing from 9 per cent of women in 1992 to 14 per cent in 1996. The
formulation of a population policy was not a priority in the decade following independence because it was felt
that the country was relatively large (about 750,000 square kilometres) in relation to its population size (8.4
million in 1990). In the mid-1980s, however, two major developments forced the Government to change its
attitude towards population policy. The first was the release of the 1980 census, which provided evidence of
high fertility and rapid population growth. The other factor was a stagnating economy. Although Zambia had
been experiencing a series of economic problems since the mid-1970s, they became more severe during the
1980s. Indeed, per capita income in the 1980s was lower than it had been at the time of independence in 1964.
Following these developments, the National Commission for Development Planning drafted a national
population policy in 1986, which was ultimately adopted in 1989.
The overall objective of the Government’s population policy was to improve the health and quality of life
of all Zambians as well as slow the rate of population growth. The policy called for sustained measures to
reduce the total fertility rate from 7.2 in 1975 to 4.0 by the year 2015 and to reduce the population growth rate
from 3.7 to 2.5 per cent per annum during the same period. The Government sought to provide family planning
services to at least 30 per cent of all adults in need of them by the end of the century. The total fertility rate did
indeed drop to 5.6 children per woman by 2000. The population growth rate for the period 1995-2000 was
estimated at 2.3 per cent.
Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations
Secretariat. For additional sources, see list of references.
188