The Kenya Demographic and Health Survey, 2014 reveals that 23 per cent of adolescent girls aged 15–19 have an unmet family planning need. This means the girls would like to delay or stop childbearing but are unable to access the necessary information, supplies and services. World Population Day, which will be marked tomorrow, provides us with an opportunity to boldly speak about the elephant in the room — teenage pregnancy.
Recent data from the District Health Information System showed 7,182 girls aged between 10-19 were pregnant in Nairobi county between January last year and March. At this age, your typical girl is usually in upper primary or secondary school. Imagine how many classrooms those girls would fill.
In a public school with an average of 50 students per classroom, those are about 144 classes filled to capacity. That would further translate to six primary schools with three streams per class. Interestingly, these are only the numbers captured within the public health system. There still remains many unreported cases. A significant number of cases are handled by private providers. Our biggest fear is that many adolescent girls resort to seeking help from backstreet quacks and the result is unsafe abortions. The question is, are we doing anything to address this ticking time bomb? If so, is it enough?
An unexpected pregnancy changes the trajectory of a girl’s life with long-lasting physical, socioeconomic and psychological ramifications. Studies show maternal mortality rates are twice as high in girls aged 15-19 as those among adult women. The girls’ bodies are not yet ready for pregnancy. Consequently, complications in pregnancy and childbirth are the leading cause of death within this age group, according to UN data.
Despite the commendable return-to-school policy, which allows pregnant girls to stay in or go back to school after delivery, more must be done to stem the flow of teenage girls into the family way. Living in denial and burying our heads in the sand will not cut it.
Kenya has no shortage of policies and commitments to address reproductive health and family planning needs. The Constitution undertakes to promote every person’s right to the highest attainable standard of health, which includes the right to healthcare, including reproductive care.
The National Adolescent Sexual Reproductive Health Policy 2015 intends to enhance the sexual reproductive health status of adolescents and contribute towards realisation of their full potential in national development. It intends to, among others, enhance equitable access to high quality, efficient and effective adolescent friendly ASRH information and services.
Kenya is also a signatory to diverse regional and international instruments and commitments on adolescents, girls and women and reproductive health. These include the Maputo Protocol, Family Planning 2020 (FP2020 ) and the Sustainable Development Goals.
Under FP2020 pledges last year, the country committed to expand youth-friendly services with a focus on adolescent girls, with a view to increase contraceptive prevalence rate among adolescents from 40 to 50 per cent and reduce teen pregnancy from 18 to 12 per cent by 2020.
Despite this robust policy and legal framework, the reality — as far as implementation is concerned — is much less encouraging. The government has to the talk by ensuring adolescent girls have access to quality family planning products and services. Research shows when this happens, girls are able to keep healthy, stay longer in school and contribute to economic development. In this regard, investing a dollar in family planning makes an equivalent of $4 in socioeconomic returns. It is not only a right for women and girls but also a smart thing to do.
As we mark World Population Day, it is important to make sure no girl is left behind due to teenage pregnancy. By providing age appropriate comprehensive sexuality education, youth-friendly services, accessible and quality reproductive health services, we can ensure girls plan their lives and make informed decisions on their future.
Kenya cannot achieve Vision 2030 nor reap from the demographic dividend if it ignores them. Investing in family planning now will have impacts long into the future.
Evidence for Action Mama Ye, Kenya Country Lead