More than six months after a court-ordered deadline expired, government’s perceived silence on the review of Malawi’s national clinical post-abortion care (PAC) guidelines has attracted accusations that the process is not being handled transparently.
The High Court directed that the guidelines be reviewed within 180 days of its October 28 ruling last year, but the deadline lapsed on April 26 without the revised guidelines being published.
But Attorney General (AG) Frank Mbeta said on Thursday a consultant engaged to review the guidelines is still working on the document, adding that a validation meeting is expected to take place soon.
However, sexual and reproductive health and rights expert Dr Godfrey Kangaude faulted the Office of the Attorney General and the Ministry of Health and Sanitation for what he described as political rhetoric and a lack of communication on the matter.
“The challenge is that those responsible for the process are either silent or speaking politically,” said Kangaude, who is also a commissioner of the Malawi Human Rights Commission (MHRC).
The review was necessitated by a High Court ruling arising from a case brought by a 16-year-old girl who challenged a clinician’s decision at Chileka Health Centre in Blantyre to deny her a pregnancy termination.
The minor was defiled by her 60-year-old neighbour when she was 13 years old. She subsequently sued Blantyre City Council, the Malawi Human Rights Commission and the Attorney General.
In his judgment, High Court Judge Mike Tembo held that Malawi’s legal framework, including the Gender Equality Act, permits access to safe abortion for minors who become pregnant as a result of sexual violence. The judge consequently ordered that the national clinical PAC guidelines be revised to reflect that legal position.
Speaking in an interview on Thursday, Mbeta said government officials met the consultant on Tuesday and were assured that the validation process would commence soon.
“We met the consultant on Tuesday and were assured that the validation meeting will take place soon,” he said.
The prolonged delay has already triggered legal threats. On July 16 this year, the minor, through her lawyers, Mlauzi Legal Solutions, notified authorities of her intention to commence contempt of court proceedings against the Minister of Health and Sanitation and the ministry’s Principal Secretary.
In the notice, she argues that the delay is frustrating implementation of a judgment intended to protect vulnerable children and uphold their constitutional rights.
Kangaude, however, urged caution against immediately pursuing contempt proceedings, saying dialogue should first be exhausted.
He said: “Pursuing contempt proceedings may not solve our problem. For now, that is my position, although others may hold a different view..”
Ministry of Health and Sanitation spokesperson Benedicto Mbewe referred queries to the AG.
The most recent available data compiled by Ipas shows that Malawi remains among countries with highest numbers of girls and women who seek illegal abortions and subsequently approach public health facilities for post-abortion care.
The data, published in a policy brief titled ‘Unintended Pregnancies, Unsafe Abortion and its Implications on Women of Reproductive Age in Malawi’, says 3 395 girls and women induced unsafe abortions in 2022 alone and they sought post-abortion care treatment in public health facilities.
Authored by Jane Mangwana, Judith Pangani, Doris Omao and Kenneth Juma, the policy paper notes that the increase in the number of those seeking post-abortion treatment was observed in Blantyre and Lilongwe.
“While health facilities in Blantyre provided post-abortion care to 665 women in 2020, the number rose to 1 144 in 2021 and further to 3 395 in 2022,” reads the policy paper, published by the African Population and Health Research Centre.
“A similar trend is observed in Lilongwe, which recorded 1 098 cases in 2020, 4 711 cases in 2021, and 7 851 cases in 2022. The trend is also present in rural districts such as Rumphi, which recorded 327 post-abortion cases in 2020, 448 cases in 2021 and 569 cases in 2022.”
A 2024 report by Nyale Institute and Centre for Human Rights and Rehabilitation stated that at the time, the government was spending nearly K326 million yearly on post-abortion care services.
A nationwide perception survey by Afrobarometer published on September 22 this year says 50 percent of Malawians think abortion happens often, marking the highest proportion of 38 surveyed countries between January 2024 and September 2025.
