By Daniel Chigundu
Health sector stakeholders have welcomed the development of regulations and clinical guidelines to clarify the implementation of Zimbabwe’s Termination of Pregnancy Act, saying the move could help end inconsistent practices and delays in providing services permitted under the law.
The Termination of Pregnancy Act, enacted in 1977, provides for lawful termination of pregnancy in specific circumstances, including rape, incest, serious foetal abnormalities and situations where continuing the pregnancy poses a risk to the life of the pregnant woman.
However, implementation of the law has long been complicated by the absence of clear operational regulations and standardised procedures, resulting in differences in how health institutions interpret and implement its provisions.
The Ministry of Health and Child Care has now begun drafting regulations aimed at addressing some of these gaps. The process is expected to clarify the medical criteria used to determine threats to life and serious foetal abnormalities, standardise approval processes and timelines for applications, and strengthen protections around privacy and informed consent.
The regulations are currently at the Ministry’s internal consultation stage, with further consultations expected with the Attorney-General’s Office, the Medical and Dental Professions Council of Zimbabwe and other relevant stakeholders.
Speaking during a media sensitisation workshop organised by Women and Law in Southern Africa (WLSA), Maceline Mukwamba, Director of the Adult Rape Clinic (ARC), welcomed the development, saying clearer regulations would help both healthcare providers and patients understand how the law should be applied.
Mukwamba said the regulations and clinical guidelines would not change the grounds under which termination of pregnancy is currently lawful, but would provide a clearer framework for implementing the existing law.
“So, when we are looking at clinical guidelines, these are no longer the Acts per se. These are just documents that direct how people are going to be offering the services,” she said.
She said the absence of such guidance had contributed to uncertainty among both healthcare providers and patients, with some women struggling to establish where they should seek services or how their cases should be processed.
The regulations, she said, would provide a binding framework for implementation and help address the different interpretations of the law that have emerged across health institutions.
“We’ve got one Bible, and from the same Bible, we’ve got different interpretations of the various verses. The same happens with the Acts,” Mukwamba said.
“We interpret them differently, so the practice is not standardised. By having regulations, now we will have binding subsidiary rules within the powers given by the Act.”
Mukwamba also rejected concerns that the development of the regulations amounted to an attempt to liberalise abortion, arguing that the objective was instead to ensure that people who already qualify under the existing law can access the services to which they are entitled.
“The major concern that has been coming through is we are now trying to liberalise abortion, but that’s not the truth,” she said.
Instead, she said, the regulations should ensure that when a person who qualifies for a lawful termination presents at a health facility, providers have clear procedures to assess the case, provide counselling, document the process and safeguard the patient’s rights.
She also called for individual health institutions to develop their own local protocols based on the national guidelines.
“What happens at Parirenyatwa will be different from what will happen at United Bulawayo Hospitals and other institutions,” she said, arguing that locally adapted protocols would help healthcare workers understand their responsibilities and improve accountability.
Mukwamba said the absence of clear timelines could also contribute to unnecessary delays, leaving healthcare workers and patients uncertain about how quickly cases should be handled.
She said the ultimate goal should be to translate Zimbabwe’s existing legal provisions into services that are “consistent, competent, compassionate, and timely”.
Training, she added, would be critical because differences in how the law is interpreted can also arise from variations in the training and experience of healthcare workers.
The government’s broader response also includes efforts to strengthen clinical guidance and provider capacity, with the Ministry revising national guidelines and training health workers at district and provincial hospitals on the legal grounds for termination of pregnancy.
The Ministry is also seeking to bring services closer to communities by decentralising post-abortion care and lawful termination services to more health facilities. The move is intended to reduce the need for women to travel to central hospitals and to ensure that facilities have the skills and resources needed to provide timely care.
Alongside service expansion, the Ministry plans to work with civil society organisations and community health workers to improve public awareness of the existing law. Officials say many women remain unaware of the circumstances under which termination of pregnancy is lawful, potentially leaving them unable to seek appropriate services when they qualify.
Partnerships with organisations including UNFPA and Population Services Zimbabwe are also expected to strengthen service delivery, particularly for survivors of sexual violence who may face additional barriers, stigma and delays in accessing lawful services.
The Ministry has further committed to continued dialogue with Parliament, civil society and other stakeholders on possible reforms while remaining within the existing legal framework.
According to Health and Child Care Minister Douglas Mombeshora, the government is also examining the administrative barriers that can delay access to lawful services, including documentation requirements imposed by health institutions.
The Ministry is working with the Ministry of Justice and the Ministry of Home Affairs to assess what can be done within the current law to simplify service delivery and reduce unnecessary delays for people who qualify for termination of pregnancy.
