Assessing Legal barriers to safe abortion services hindering sexual and reproductive health rights awareness access and public health outcome in Mtandire

Unsafe abortion remains a major public health and human rights concern in Malawi, largely driven by restrictive legal frameworks that limit access to safe abortion services. This study assesses the legal barriers to safe abortion services and their effects on Sexual and Reproductive Health and Rights (SRHR) awareness, access, and public health outcomes in Mtandile, an informal settlement in Lilongwe. Malawi’s abortion law permits termination only when a woman’s life is at risk, a restriction that has contributed to widespread unsafe abortions and accounts for approximately 18% of maternal deaths nationally. Using a mixed‑methods research design, the study collected quantitative data through structured questionnaires and qualitative data through in‑depth interviews and focus group discussions involving women of reproductive age, healthcare providers, and community leaders. Findings reveal significant gaps in legal knowledge, pervasive stigma, and strong socio‑cultural and religious influences that discourage women from seeking formal healthcare services. As a result, many women rely on informal networks, traditional practices, or unregulated use of abortion pills, leading to severe health complications such as hemorrhage, infection, infertility, psychological trauma, and death. The study further highlights the strain placed on the health system due to the high cost of managing preventable post‑abortion complications. The research concludes that restrictive abortion laws, combined with low SRHR awareness and community stigma, significantly undermine women’s health and rights. It recommends legal reform, strengthened SRHR education, stigma reduction initiatives, and improved access to comprehensive post‑abortion care to reduce maternal morbidity and mortality in Mtandile and similar settings in Malawi.