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September 26, 2017

Step up support for sexual and reproductive health

AMREF director general Teguest Guerma charts with UNFPA chief of Sexual reproductive health Dr Laura Laski after they signed a Memorandum of Understanding yesterday photo/PATRICK VIDIJA
AMREF director general Teguest Guerma charts with UNFPA chief of Sexual reproductive health Dr Laura Laski after they signed a Memorandum of Understanding yesterday photo/PATRICK VIDIJA

More investments in sexual and reproductive health are needed to realise global health and development goals in the next 13 years.

Health experts have identified universal access to sexual and reproductive healthcare services and the fulfilment of reproductive rights as integral to overall development goals related to healthy lives and achieving gender equality.

An updated analysis from UNFPA Kenya documents that by fully providing women with sexual and reproductive health services, we would prevent thousands of unintended pregnancies and save thousands of lives.

The key areas we should focus more on include contraceptive services; pregnancy, delivery and newborn care; services and medicines for pregnant women living with HIV; and treatment for four other common STIs.

Although maternal and infant deaths and new HIV infection have declined, progress has been uneven.

According to the Kenya Demographic Health Survey 2014, almost half of all women of reproductive age are at risk of pregnancy and want to avoid one in the next two years or longer. One-fourth of these women do not use contraception or use traditional methods such as withdrawal or periodic abstinence.

These women are at high risk of a number of negative health consequences due to unintended pregnancy.

Every year, millions of unintended pregnancies occur in Kenya, which lead to an estimated 500,000 abortions. The vast majority of these (81 per cent) occur among women with an unmet need for contraception.

Four in 10 women do not go for the minimum four antenatal visits recommended by WHO (KDHS 2014). Moreover, even when they do make those visits, they do not receive all of the services they need. About one-third of women across the country do not deliver their babies in a health facility. This problem is particularly common in most rural areas.

Failing to meet women’s contraceptive and maternal health care needs leads to pregnancy and abortion-related deaths. Nearly all of these deaths among women and infants could be prevented with adequate medical care

Out of the over 15 million women of reproductive age, an estimated two million are at high risk of STIs, including HIV, and need prevention information, education and services. Out of the 1.5 million people living with HIV, more than half are women of reproductive age (National Aids Control Council).

When women’s needs are met, we stand to reap tremendous returns. If all women with unmet need for modern contraception were to use contraception, unintended pregnancies would drop by 70 per cent and unsafe abortions by 74 per cent, leading to large and immediate health gains.

Fully providing contraceptive care and maternal and newborn healthcare services, including to HIV mothers and their babies, would mean: Maternal deaths would drop by two-thirds; newborn deaths would drop by three-fourths; the burden of disability related to pregnancy and delivery experienced by women and newborns would drop by three-fourths; and mother-to-newborn HIV transmission would be nearly eliminated (Guttmacher Policy Review).

UNFPA Kenya projects that when women’s needs are met, women and children are more likely to stay get an education, which in turn will have a positive impact on their future labour force participation and earnings.

For every additional dollar invested in contraceptive services, $1.47 is saved in pregnancy related and newborn healthcare. Policymakers must heed this overwhelming evidence that investing in sexual and reproductive health is effective and cost-effective.

Fundamentally, women want and acutely need sexual and reproductive health services to lead healthy sexual lives, have the number of children they want, when they want them, deliver their babies safely and ensure their newborns thrive.

Both the county and national governments have a responsibility to ramp up investment and support for sexual and reproductive health and rights. All have a stake in the cascade of benefits that accrue to women, children, families, communities, countries and the planet.

NAYA Kenya youth advocate

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