Girls pay price as post-abortion guidelines stay unamended

More than 180 days after the High Court ordered the Ministry of Health to amend Malawi’s post-abortion care guidelines, the revised rules are yet to be finalised.

For girls, especially survivors of sexual violence, the delay is not just procedural but also a barrier to healthcare.

Malawi’s current laws and outdated clinical guidelines do not adequately protect survivors of sexual violence seeking reproductive healthcare.

In response, the High Court, on October 28, 2025, ordered the Ministry of Health to review and amend the post-abortion care guidelines within 180 days. That deadline has since elapsed.

Stakeholders in the health sector have expressed concern over the failure by the Ministry of Health to adhere to the court ruling.

Chairperson for the Parliamentary Committee on Health, Anthony Masamba, said the committee notes with concern that the 180-day period set by the High Court elapsed without the Ministry of Health finalising the revised post-abortion care guidelines.

“This constitutes non-compliance with a binding judicial directive,” Masamba said.

He said, under Section 108 of the Constitution of Malawi, decisions of the High Court are binding on all persons and authorities.

He added that the principle of constitutional supremacy under Section 5 requires that any law or conduct inconsistent with the Constitution be regarded as invalid.

“Failure to comply with a High Court order undermines the rule of law and violates the government’s duty to respect judicial authority.

“The Judicature Act reinforces the binding nature of court orders, while the Public Health Act places a statutory obligation on the Ministry of Health to ensure [the] delivery of health services [that are] consistent with prevailing legal standards,” he said.

Masamba further noted that the Child Care, Protection and Justice Act obliges the State to protect minors, including survivors of sexual violence, whose access to lawful reproductive healthcare is directly affected by the delay.

According to Masamba, Parliament has a constitutional duty to ensure that judgments of the courts are respected and implemented.

The role is exercised through legislative authority, the power to demand accountability from the Executive, and the responsibility to safeguard constitutional rights.

“We intend to raise the issue in Parliament either through Standing Order 14 on a Matter of Urgent National Importance [or other means].

“In addition, the committee may request that the Minister of Health to present a Ministerial Statement under Standing Order 71 to clarify the reasons for the delay,” Masamba said.

He said the committee is “deeply concerned” that the delay continues to affect access to lawful reproductive health services, particularly for minors who are survivors of sexual violence.

Masamba said the committee remains committed to ensuring that the High Court judgement is respected, that survivors of sexual violence are protected, and that Parliament fulfils its oversight mandate in a manner that is both constitutionally sound and socially sensitive.

Meanwhile, civil society organisations have said the impact is being felt on the ground.

Nyale Institute Executive Director Godfrey Kangaude expressed concern that nothing much has been done on the matter.

“Since that time, we haven’t heard anything else and, further to that, it is our experience that when children who have been defiled go to seek services, they are being turned away and one of the reasons the health providers are providing is that they do not have guidelines,” Kangaude said.

He said what the court had ordered as a corrective measure to the violation of the rights of minors is not being complied with and that young girls are still facing problems.

“We are disappointed that, up to now, more than 180 days have passed and the court order appears to not have been complied with,” he said.

Kangaude said the Executive is using its power to prevent young girls from accessing the services.

“What we, as civil society, are planning to do is to facilitate a meeting between the two arms of the government—the Legislature and the Executive—because the Legislature represents the people and the people are those who are being frustrated from accessing the services by the Executive,” Kangaude said.

Health rights activist Maziko Matemba said the guidelines are critical and need to be looked into as the court has ordered.

“We would want to see that these guidelines are updated so that the court judgement is respected,” he said.

Matemba said updating the guidelines would go a long way in protecting the right of girls and women.

“We believe that the ministry will do the needful so that when victims go to seek post-abortion care services, they should be assisted without any other restrictions,” he said.

He said Malawi is one of the countries with high maternal mortality rates, such that the judgement will help improve the lives of women, mostly on their sexual health.

Attempts to get a response from the Ministry of Health were unsuccessful.

Minister of Health, Madalitso Baloyi, referred us to her public relations officer, who referred us to the Attorney General.

The Attorney General did not respond to questions we sent.

Meanwhile, the ministry’s public relations officer Benedicto Mbewe has asked for ample time before he can comment on the issue.

The delay also has implications for Malawi’s commitments under the Sustainable Development Goals, notably 3, which seeks to ensure healthy lives and promote the wellbeing of people of all ages, while SDG 5 targets gender equality and the elimination of all forms of violence against women and girls.

Access to comprehensive post-abortion care is recognised as key to reducing maternal deaths and protecting the health rights of girls.

Statistics show the urgency. Over 4,000 teenage pregnancies were recorded in Mchinji in the first quarter of 2026. Kasungu registered more than 5,000 pregnancies among girls aged between 10 and 19 in just five months.

Nationally, the teenage pregnancy prevalence rate has risen to 32 percent.

For now, health providers, girls and advocates are waiting.

Until the guidelines are amended, many survivors of sexual violence will continue to be turned away from facilities that should be helping them heal.