“We cannot always build the future for our youth, but we can build our youth for the future.” —President Franklin D Roosevelt. What duty do we owe our youth? They deserve accurate, age-appropriate information at all stages to enable them sustainably survive in the future. Though we live in an information age, it saddens to acknowledge that our youth are least informed, even on their own health, and denied access to pertinent information on their sexual and reproductive health. This leads to needless deaths and loss of potential.
A Lancet study on global patterns of mortality in young people reported that 2·6 million deaths occurred in people aged 10–24 in 2004. Some 2·56 million (97 per cent) of these deaths were in low-income and middle-income countries, and almost two thirds (1·67 million) were in sub-Saharan Africa and southeast Asia. Pronounced rises in mortality rates were recorded from early adolescence (10–14 years) to young adulthood (20–24 years), but reasons varied by region and sex. Maternal conditions were a leading cause of female deaths at 15 per cent.
The teenage pregnancy rate in Kenya stands at 18 per cent. This implies that one in every five girls under the age of 20 has begun childbearing. Pregnancy is the leading cause of school dropouts or delayed education.
According to the latest report on teenage pregnancies by the United Nations Population Fund, some 378,397 adolescent girls in Kenya aged 10-19 became pregnant between July 2016 and June 2017. Of these, 28,932 were aged 10-14.
Many factors are associated with adolescent pregnancies; lack of reproductive healthcare information and services for teens stand out.
During last year's national exams, media reported alarming cases of girls who sat the papers in delivery rooms or went into labour in the exam room. Yet when Marie Stopes Kenya conducted an educational tour on sexual and reproductive health at a Catholic-sponsored school in Kitui, there was an uproar. A group petitioned the Health ministry to revoke their licence. Clearly a classic example of blind criticism devoid of facts.
These statistics show the need for urgent action and awareness to enable the youth to manage their sexual and reproductive health. Estimates from developing countries indicate that pregnancy and delivery complications, including unsafe abortions, are the second leading causes of death for girls below 20 years.
What, then, is the role of the state, non-state actors, and citizens within the law to avoid these distressful statistics? The 2010 Constitution, under Article 43(1)(a), provides that every person has the right to the highest attainable standard of health, including reproductive healthcare services. Article 35(1)(b) further provides that every citizen has the right to information held by another person and required for the exercise or protection of any right or fundamental freedom.
The Health Act Section 6(1)(a) provides that every person has a right to reproductive healthcare, which includes the right of men and women of reproductive age to be informed, and have access to reproductive health services including safe, effective, affordable and acceptable family planning services.
The laws and policies thus require state, non-state actors and citizens to provide information and services of sexual reproductive health to youths who are of reproductive age as a right.
We commend the Health ministry for implementing the Kenya National Adolescent SRH Policy 2015, whose goal is to enhance equitable access to high quality, efficient and effective adolescent friendly reproductive health information and services.
The SRH policy acknowledges that exercise of control over one’s sexual and reproductive health is linked to human rights. This includes the right to reproductive health throughout the life cycle for both men and women; and, equality and equity to enable individuals make free and informed choices in all spheres of life free from discrimination based on gender.
Therefore, comprehensive sexual reproductive health and rights must not be subjected to tunnel vision, but rather exercised per our own national laws, policies, and in line with international standards.
We must progressively pay to the youth what we owe them - a better life, which starts with a simple step of providing access to information and services, and respecting their sexual and reproductive health and rights.
Director, Ipas Africa Alliance.