Conscientious objection as a colonial inheritance: rethinking abortion access through an Africentric Reproductive Justice framework

Despite liberal abortion legislation in some African countries, access to safe and legal abortion across the continent remains constrained. This paper conducted a critical literature review and policy analysis to examine how the practice of conscientious objection by healthcare providers continues to obstruct meaningful access to abortion in Zambia, South Africa, and Tunisia. Arguing for a decolonial reorientation, the paper situates reproductive justice within an Africentric philosophy that centres African experiences, epistemologies, and historical contexts. Applied to abortion governance, this framework shifts analysis from narrowly legalistic understandings of conscientious objection towards the historical and structural conditions that shape provider discretion and the practice of conscientious objection. In doing so, it reveals how colonial and neocolonial moral and legal logics continue to structure abortion governance, particularly through the weak regulation of conscientious objection. It also reorients attention towards contextually grounded accountability mechanisms informed by African social and institutional realities. Key recommendations include the development of enforceable guidelines on conscientious objection, the integration of Africentric reproductive justice principles into healthcare education and training, and the prioritisation of African-led initiatives for the realisation of sexual and reproductive health and rights.