Government has been called to expedite implementation of the amended post-abortion care guidelines to remove legal uncertainty for clinicians to safeguard women’s and girls’ access to sexual and reproductive healthcare.
The calls follow a review of the post-abortion care guidelines, a move that was compelled by an October 28 2025 High Court of Malawi ruling.
The ruling emanated from a court case a 16-year-old minor pursued, challenging the decision by a clinician at Chileka Health Centre, who declined to assist in terminating her pregnancy.
The Blantyre-based minor was defiled by her 60-year-old neighbour when she was just 13 years old, and she sued Blantyre City Council, Malawi Human Rights Commission (MHRC) and the Attorney General.
And in his ruling, High Court of Malawi Judge Michael Mtambo directed that the Attorney General works with the Ministry of Health in amending the guidelines, making it explicit that girls who become pregnant due to defilement have the right to decide whether to carry the pregnancy or not.
Health and Rights Education Programme executive director Maziko Matemba said in an interview during the week that prolonged implementation delays will continue having severe health and human rights implications.
Matemba said the situation leaves vulnerable women and girls in legal and medical jeopardy. He said the bureaucratic delays transform a landmark legal victory into a lingering systemic crisis.
“The High Court of Malawi explicitly highlighted that the existing guidelines are vague. Because the Penal Code penalises unlawful abortion with up to 14 years of imprisonment, clinicians operate under extreme fear of prosecution,” he said.
“Without the ordered amendments, frontline health workers will continue to broadly deny legal terminations and even delay life-saving post-abortion care. Clinicians cannot distinguish between a criminal act and protected health service without updated clinical guidance.”
Matemba said the prolonged delays will also perpetuate the trauma that victims of rape and defilement experience; hence, the status quo will continue violating women’s and girls’ fundamental right to dignity and bodily autonomy under the Gender Equality Act.
He further said with Malawi being a party to international treaties, including the Maputo Protocol and other United Nations Conventions which guarantee access to sexual and reproductive healthcare, the country’s standing will be compromised.
The Maputo Protocol, as embedded in the Gender Equality Act, guarantees comprehensive sexual and reproductive health and rights services.
Matemba said: “The situation signals a failure to uphold the principle of progressive realization of health rights, demonstrating a regressive step where a right recognized by the Judiciary is denied in practice by the Executive.”
According to Matemba, further delays also translates to zero accountability for health facilities that turn women and girls away when seeking post-abortion care services.
He added that in such instances, victims have no administrative avenues for immediate redress, therefore, translating that their right to health only exists on paper.
According to the High Court of Malawi’s ruling, the Ministry of Health was also directed to train designated healthcare providers countrywide and set up accountability measures and remedies for girls and women that are turned away at public health facilities when seeking post-abortion care.
The ruling also clarified that the risk to life includes both mental and physical health, and further tasked MHRC to ensure that healthcare workers are guided on the revised guidelines.
Parliamentary Committee on Health chairperson Anthony Masamba said in a separate interview last month that while the committee is aware of the court ruling, they await Ministry of Health consultation on progress made.
He said: “Generally, we haven’t been consulted on the next steps. Suffice to say that the committee is mandated by the Constitution and standing orders to provide oversight roles, and we continue to do so.”
Attorney General Frank Farouk Mbeta in a brief written response said consultations on the matter have been finalised.
He said draft guidelines are now in place which are awaiting other formalities.
Mbeta said: “The consultation process has been completed and we have some draft guidelines. At the moment, we are just waiting for vetting and other formalities.”
Following recommendations of the court ruling, a committee comprising lawyers from the Attorney General’s office and medical experts was formed to come up with regulations.
In an earlier interview, Mbeta said the idea is to have regulations that are balanced in terms of applicable laws while at the same time maintaining appropriate medical standards.
Under the current laws, abortion in Malawi is only accepted when it is deemed necessary to save a woman’s life.
Currently, a contentious Termination of Pregnancy Bill, which legislators blocked in 2021, continues to gather dust. If passed into law, the Bill would, among others, allow women and girls to access safe abortion whenever they feel like not keeping the pregnancy.
