Denial? Government responds to teenage pregnancy
We meet Maria, not her real name, while she is carrying her baby in Korogocho, an informal settlement in Nairobi.
She explained that her five-month-old baby had been feeling unwell and that she had planned to take her to a nearby health clinic for check-ups. That is why she missed her classes that particular day.
At her age, Maria knows about the role of contraceptives—to prevent pregnancy. The information about the contraceptives came from her peers. However, the knowledge from the girls was far from reliable and accurate.
“I wanted to be on a family planning method even before I became pregnant and continue my education uninterrupted, but I feared that I might not get a baby in the future because of its effects,” Maria said.
The teenager said she had persuaded her partner, who is also a teenager, to use condoms. When she experienced an itch, the teenagers abandoned the method altogether.
According to a recent study released by the African Population and Health Research Centre (APHRC), Miss Koch Kenya, and the Nairobi County Directorate of Children’s Services, the majority of girls (73.7%) had their first sex while still in school, and 56.2% did not use condoms the first time they had sex.
According to the report, 76.7% of pregnant and parenting adolescent girls in Korogocho had unintended pregnancies, 72% of those who became pregnant for the first time were single, and 49% were still in school.
The report highlights a lack of contraceptive knowledge as one of the factors associated with early and unintended pregnancy. Other factors include ignorance, family breakdown/conflict, limited parental support, a lack of provisioning and supervision, poverty, sexual violence, and COVID-19-related school closures.
According to Judith Ochieng’, program director at Women United for Social Transformation in Korogocho, some minors in the area lack supportive parents and are forced to fend for themselves. Some are already cohabiting during the process, and abstinence is impractical for them, and one problem is leading to the other.
“When we talk about unwanted adolescent pregnancies, they already have one child, which is difficult to manage. We are looking for other possible preventive interventions to help them avoid another unexpected pregnancy,” she tells Nairobi News.
In 2020, the number of teenagers falling pregnant, contracting HIV, and experiencing sexual abuse rose so rapidly in Kenya that then-President Uhuru Kenyatta directed the National Crime Research Centre to interrogate the reasons for the increase. Studies from public health specialists listed numerous solutions: increasing health education among teenagers so they can make responsible health decisions and training healthcare workers to offer sexual reproductive health services to young people after providing adequate information. When it was the government’s turn to put all the counsel into action, the Ministry of Health’s National Reproductive Health Policy 2022-2032 stated that the government would prioritize abstinence because teenagers would reach “full cognitive competence on matters of sexuality and reproduction at the age of 21”.
Judith calls on policy makers to revisit the policy.
“We are trying to lobby for awareness creation. We are also trying to bring on stakeholders to make them understand the importance of allowing these girls to use contraceptives,” she says.
Speaking during the launch of a study that revealed challenges facing pregnant and parenting adolescents in Korogocho last week, Mark Keya, Directorate of Children Services, Assistant Director, appealed to children stakeholders to start a conversation on programming that will see interventions attending to the available statistics.
“Even if you want to look at them (policy) as regulations and even laws later on, it will start from research findings and how we can take advantage of these findings and start another conversation on how that develops to another policy,” he said.
Mr. Keya added that society must remember that policies involving children rely on the Children Act 2022, effected in July of last year, and prioritizes the child’s best interests and rights.
“In order for them to access contraceptives they have also a right therefore to access appropriate information on health matters,” he said.
In their 2022 World Population Report, the United Nations Population Fund stated that young people engage in sex without protection due to misinformation. Young people, like Maria, believe modern contraception jeopardizes future fertility, results in problems conceiving, causes birth defects, makes women promiscuous, is “un-African,” and denies couples their sexual freedom, the UNFPA report stated.
Abstinence has not worked for teenagers like Maria, who are part of the numbers that contribute to the Triple Threat: HIV infections, gender-based violence, and teenage pregnancy. In June, the National Syndemic Diseases Control Council (NSDCC) Chief Executive Officer, Dr. Ruth Laibon, said that between January and May 2023, more than 6,000 girls aged between 10 and 14 years accessed antenatal services at clinics in Kenya. In 2021, NSDCC also reported that two in every five cases (more than 40 per cent) of gender-based violence reports were adolescents aged between 10 and 17. The council also reported that 5,294 new HIV infections were among teenagers in the 10-19 age bracket.
Public health specialists have experienced opposition whenever they recommend providing contraceptives as a measure to tackle HIV infections and pregnancies among teenagers. Most reasons for resistance are moral and religious, while some are legitimate.
Benard Ratemo, a clinician at Family Access Medical Centre in Kasarani in Nairobi, said some contraceptives are appropriate for more mature women, while there are others more appropriate for teenagers. Experienced healthcare workers would recommend the most appropriate if the teenager attends healthcare in health facilities that are friendly to the youth.
“If given the wrong contraceptive, a girl who has been getting her periods monthly will start getting them twice or three times a month, or it will continue throughout the month,” Dr. Ratemo told Nairobi News.
Ratemo said condoms are a safe form of protection for teenagers.
“Despite the availability of condom dispensers in various health facilities and free condoms in public hospitals, not many young people know that,” Ratemo said.
With the support of her mother, Maria said she sought care from a public healthcare facility where she got a family planning method that was appropriate for her.
Women who do not access family planning get pregnant. According to UNFPA, more than 60 per cent of unintended pregnancies end in abortion. 800 women die of unsafe abortion every day. Those who survive unsafe abortions cost the healthcare system an estimated $553 million per year in post-abortion treatment costs alone.
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