Knowledge of and preference for abortion legality in Kenya: A National Cross- Sectional Survey

Abstract Background Inadequate knowledge of abortion laws implies those seeking care cannot know their legal entitlements, service providers cannot practice with legal protection, and governments can escape legal responsibility for the adverse effects of their laws. There is limited understanding of the public’s views of abortion in Kenya. This study assessed the knowledge and preference for abortion legality in Kenya. Methods We conducted a nationwide cross-sectional survey using mobile telephones to collect data from adults 18 or older. The sample was drawn from a database owned by a mobile-survey provider with over 12 million telephone numbers across Kenya. We used a random digit dialing approach to select and recruit participants. Trained research assistants administered telephonic interviews using a structured questionnaires that had questions assessing knowledge of conditions for legally sanctioned abortion and their preferences for conditions the law should permit. We summarized continuous variables into means with standard deviations while categorical variables into proportions. Multivariate analyses were performed to assess associations between knowledge of abortion laws and independent variables. Results Of the 8942 respondents, 76%, 74%, and 33% correctly knew that the Kenyan law allows abortion when a woman's life and health are at risk and when the pregnancy results from rape, respectively. Being female (AOR = 1.22 [95% CI: 1.09–1.38]; p < 0.001), age group 25–34 (1.21 [1.03–1.43]; 0.024) and having university education (2.57; [1.79–3.70]; <0.001) were associated with higher knowledge of abortion laws. Majority of respondents preferred that the law allow abortion when a woman’s life (72%) or health (65%) or mental health (43%) is at risk. One-quarter wanted abortions allowed for rape (29%) and incest (28%) while only 15% approved abortion if the pregnant was unwanted. The latent class analysis characterized that most respondents were conditional supporters of abortion legalization (43%), whereas individuals opposed to abortion legalization in all/most circumstances represented 29% of respondents. Conclusion Information on abortion legality preferences offers insights into public acceptability and opportunities for abortion legal and policy reforms. There is need for comprehensive dissemination of the Kenya abortion law, focusing specifically on groups and communities that typically struggle to access information and services.