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January 21, 2019

No one left behind: Why countries must expand access to contraception

Vivian Onano, a Kenyan delegate and one of the organisers of the Women Deliver conference that took place May 16-19 this year IN Copenhagen, Denmark.
Vivian Onano, a Kenyan delegate and one of the organisers of the Women Deliver conference that took place May 16-19 this year IN Copenhagen, Denmark.

In the recent Women Deliver conference in Copenhagen, Denmark, one message stood out: no meaningful development can ever be attained when nations do not invest in the youth, adolescents and women.

This means issues affecting the youth, including education, sexual and reproductive health, family planning and general healthcare, can no longer be ignored if Sustainable Development Goals are to be realised. 

“We live in extraordinary times, which calls for the upholding and safeguarding of the rights of young people,” says Anandita Philipose, a representative of UNFPA who participated in the Copenhagen meeting.

Philipose reiterates the need to invest in sexual and reproductive health initiatives, saying the move remains central to development.

“Investing in education on sexual and reproductive health, especially for young women and girls, benefits not only the individual woman, but also her family, her community and her nation,” adds Klaus Brill, the Vice President of Global Healthcare Programmes at Bayer’s Pharmaceuticals Division.

Brill calls for a joint responsibility towards understanding sexual and reproductive health and empowering women. “We cannot afford to give up; new generations (of youth) are coming up and they need the information,” he says.

The pharmaceutical company has since launched an initiative dubbed My Life, My Rights, My Future: Young People and Contraception. It aims at reaching out to young people and directly involving them in ‘youth-to-youth’ awareness-raising activities on topics such as sexuality and contraception.

“Fostering awareness of reproductive health issues has always been part of our engagement. Access, availability and affordability are crucial for family planning. But, in addition, we also need education,” Brill says.

While leaders are busy grappling with modes of transmission of sexual and reproductive health information to the public, a section of the intended target is yet to receive its first, full session of the all-important subject.

“Although am not yet sexually active, I would love to know the options that are available for me, so that am well informed when I decide to go out,” a first year public university student, (name withheld) says.

The 19-year old, who lives with her grandmother, is an example of many girls who are growing up knowing that sexual topic and/or literature is taboo in the homestead.

“My younger sister was forced to drop out of (primary) school after her teacher impregnated her. Nothing was done to him; he was only transferred to another school in a bid to save his face,” a pensive but stern communications student says.  

Admitting the daunting responsibility ahead, Brill says the challenge of addressing reproductive health is a task that no individual, company, aid organisation, government or research institute can manage alone. “However, through networking with strong partners, it is possible to make a real difference.” 

Although Kenya is making strides in demystifying sexuality among youth, the subject remains emotive, with more school-going population barely having in-depth knowledge on the subject, save for only names of the body parts.

“There is need for enhanced mentorship, sponsorship and access to networks for us to address this challenge; it’s everybody’s issue,” says Vivian Onano, a Kenyan delegate and one of the organisers of the Women Deliver conference that took place May 16-19 this year.

Onano urges the government to adopt activism for girls and women’s empowerment to be realised.

Though the introduction of free primary education has increased number of girls in learning centres, they are still grappling with among others, unwanted pregnancies, access to sanitary towels, coerced female genital mutilation, gender-based violence and early marriage.

“We need to reach young people in urban and rural communities and remove restrictions that limit access and choice. We can achieve this by creating an enabling environment for young people to access contraceptives,” the vice president, strategy and development at Marie Stopes International, Megan Elliot says.

“Giving access to contraception for girls is not the right thing to do; it’s the smart thing to do,” Elliot says, adding that for demographic dividend - a boost to economic growth - to be achieved, the youth have to be accorded sexual and reproductive health rights.

“It is especially important to give teenagers and young adults a comprehensive sexual health education; this can initiate changes in society regarding the right of girls and young women to take self-determined decisions in family planning,” Philipose says.

Currently, Kenya has 21per cent unmet need for family planning, a drop from the previous 43 per cent. Despite the national percentage portraying an optimistic picture, the distribution remains highly disproportionate.

While towns and cities continue to record high contraception uptake, the situation remains dire in most rural communities, where myths and misconceptions, coupled with cases of gender imbalance, remain high.

“We need to create an empathetic environment towards youth when they come to access information on contraception. We need to treat them with respect and expand options for them,” says Prof Maria Abalos, a member of the Global Care Group.

Abalos says globally, more than 70 per cent of all women hospitalised for unsafe abortions are aged below 20 years. The situation is no different in Kenya where cases of back street termination of unwanted pregnancies continue to be perpetrated.

Abortion is illegal in Kenya, except upon recommendation by a medic, when the mother’s life is in danger.

Although some private health caregivers and politicians have voiced reservations on illegality of abortion, their concerns have been met with stiff resistance, especially from religious organisations.

Due to legal ramifications that medics may be slapped with if found culpable of engaging in the practice, more women and girls continue to expose themselves to the grave dangers of unsafe abortion, a pointer to desperate times calling for desperate measures.

“Young people need to be empowered to make informed decisions about contraception and their future life. There is need to engage young adults in dialogue. It is through conversation that we can give them information that makes them confident, hence making them want to access contraception information,” Abalos says. 

He says healthcare providers are partly to blame for continued myths and misconceptions that push away majority of the population in need of services.

“We need to train good health professionals who can communicate and provide accurate messages,” she says, adding that healthcare givers remain the most trusted to provide information globally. 

As the debate rages on, the loud voice being echoed is in unison - there is need to bring on board men, religious leaders, teachers, politicians and teachers, if any meaningful impact is to be felt. 

“We need an all-inclusive approach; a shared responsibility for family planning so as to ensure its success. This will help demystify the contraception information so that it is not a woman thing, but information for the whole society,” Brill says. 






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