USAID’s Impact on Abortion Access in Kenya
By Joyce Onana Mfege, PBI-USA Solidarity Fellow
Reproductive rights remains a multifaceted global issue that informs the way women’s human rights defenders operate worldwide. In the United States, the long fight for abortion rights had a huge turning point in the overturning of Roe v. Wade in the 2022 Supreme Court Dobbs v. Jackson Women’s Health Organization decision that ended the federal constitutional right to abortion. As a result, reproductive human rights infringements followed throughout the U.S. in the form of abortion bans, bans on the prescription, administering, or shipping of abortion medication, defunding of clinics, and bounty laws that risk the freedom of people seeking to leave anti-abortion states for reproductive care elsewhere. The U.S.’s increasing restrictions regarding reproductive healthcare access also has an impact outside our borders through the parameters for aid set by the U.S. government.
In the U.S., the bans on abortion place serious mental and physical risks on all those capable of bearing children. Bans increase maternal mortality and infant deaths, and increase the likelihood of poverty.
Countries that are forced to rely on western aid are subject to adopting similar or mirroring policies around substantive social issues. This brings us to consider the U.S.’s role in shaping access to adequate reproductive healthcare and abortion through their bilateral health agreement with Kenya.
Kenya, a country in East Africa, has one of the highest abortion rates in the world yet the treatment of abortion rights as a public health and human rights issue remains volatile because of U.S. colonial impact and gendered violence in the nation. Kenya’s reproductive health system is being pulled in two separate directions as they contemplate the needs at home and the implications of U.S. policy regarding reproductive healthcare. At home, Kenyan courts keep reversing themselves on the constitutional rights of abortion, resulting in a population that continues to seek abortion care and a health care workforce exposed to prosecution for treating them - similar to the situation in the U.S. Their similar landscapes regarding the polarity between social reality and the law becomes part of the larger conversation of the U.S. as Kenya’s largest health donor.
In recent months, under the Trump administration, the U.S. withheld health funding from Kenya, only offering it back with the requirement that the Kenyan government hand over its citizens’ health data. This has caused much outrage among human rights defenders, particularly those that are concerned with how this will disproportionately impact Kenya, a country with high abortion rates, potentially increasing dangerous, illegal abortion practices.
The human toll of the uncertain Kenyan abortion laws are not just structural. They materialize through the deaths of Kenyan people and the dangerous ways people are seeking to terminate pregnancies without the safe tools to do so. The prevalence of abortion combined with the social and political taboo that exists in Kenya can be detrimental to the health of women and girls, as each year over 300,000 people in Kenya seek out risky backdoor ways of aborting. The Center for Reproductive Rights estimates that around 2,600 women die every year in Kenya from unsafe abortions, with another 21,000 hospitalized from complications.
PBI Kenya has intentionally built relationships with women’s human rights defenders since its founding and developed a toolkit to assist them in their fight for women’s, sexuality, and gendered justice in Kenya. Learn more about the Women’s Human Rights Defenders Toolkit Organizers here.
One of those toolkit organizers is Kenyan human rights defender Editar Ochieng. Editar is a survivor of sexual violence who shares her story in order to empower others. A snippet of her story is below. Read the full version here.
“When I was 16 years old I was gang raped. When I realized that I was pregnant, I hid it and went for an unsafe abortion; I did not share my story, not even with my best friend. It was more than 20 years after the first time I got raped that I told my family about it.”
A 2023 national study conducted by the African Population and Health Research Center (APHRC), in partnership with the Guttmacher Institute, estimated about 792,694 induced abortions that year based on clinic data and interviews with over 2,000 women who had an abortion within the last five years. This research serves a grounding point for the impact abortion access has on people in the country. The findings from both studies were contested by government officials and although the Ministry of Health has acknowledged and approved of the study, there have been no official comments beyond broad statements about developing post abortion care guidelines for workers and an investment in “family planning” programs that would reduce the number of unwanted pregnancies and abortions.
Though these studies helped to legitimize governmental policies around abortion, the Kenyan government-aligned, anti-abortion lobby disputes the APHRC study’s findings. Another major influence on the abortion-related discussions in Kenya is the USAID stop-work order Kenya received in 2025. The abrupt suspension of an estimated $500 million in funding to Kenya targeted products like contraceptive supplies. NPR reported that the administration’s 2027 global health budget justification explicitly listed “providing condoms and contraception in Kenya” among the foreign programs it wanted to eliminate, on the stated view that the United States should not fund reproductive care abroad.
To regain at least partial funding, Kenya has become the first African country to sign one of the Trump administration’s new bilateral health agreements. The deal commits Kenya to share health data and physical pathogen specimens with the U.S. government. Kenya’s reliance on USAID thus becomes an obstacle to abortion reform as first, the United States does not provide funding to “entities that provide abortions” and second, with the requirement to share Kenyan health data, there are now international safety risks to abortion.
Organizations like the Reproductive Health Network Kenya (RHNK) have expressed concerns that the Kenyan government is making its decisions according to U.S. contexts and others have argued that the public was never consulted over the plans to transfer their data overseas.
The people of Kenya are now being forced to risk their privacy and reproductive health in order to access abortion care, unsure of the legal trouble that could follow from Kenyan officials or international western powers. This has the potential to increase abortion related deaths and potentially arrests in Kenya.
About the Author: Joyce Onana Mfege (she/her) is a masters student in the department of Gender, Sexuality, and Women’s Studies at the University of Florida. She graduated from Spelman College, where she received her Bachelor’s degree in Comparative Women’s Studies with a self-designed focus in Feminist Socio-legal Studies and served as a Social Justice Fellow and co-founder of Project Reproductive Justice. She is passionate about sexual violence prevention, reproductive justice, and global women’s and sexuality rights struggles. Her thematic focus in the protection of Women’s Human Rights Defenders is derived of those very interests in the political, social, economic, and cultural autonomy of women, girls, and sexualized minorities. She hopes to pursue both an academic and nonprofit career in global human rights protection, using advocacy as a tool to create equitable communities among all.