The heart of a woman, they say, is like a deep ocean, concealing secrets that man will never find.
That is especially true with some Somali women in Kamukunji constituency, Nairobi county, who are taking contraceptives without the knowledge of their husbands.
The practice is done covertly to save them from marital conflict and preserve their health.
For Halima Ahmed* (not her real name), the decision was a choice between life and death.
The mother of six looks heavily yoked with the secret she has been holding for four years now.
“I bled excessively during the birth of my last child, and I was bedridden for a long time,” she says.
“My blood pressure also shot up but my husband would hear nothing about family planning.
“He said he wanted many children until Allah says stop.”
The mother of six says a conversation with a community health promoter at a salon got her the idea of taking family planning secretly.
Unlike other women who carry their clinic books home, Ahmed leaves hers at the clinic.
She has also mastered her husband’s pattern of work and takes advantage of his absence to get her doses.
“After every three months, a health official calls me to remind me of my injection,” Ahmed says.
“I arrive at the clinic when everything is set. I don’t have to wait in the queue.”
Sarah Abdi* (not her real name), on the other hand, says she is on pills. Unlike Ahmed, she has a bubbly character and even laughs at the fact that her husband does not know she is on contraceptives.
“He has tried to get me pregnant in vain. He just thinks that I have a medical problem,” she says.
Abdi, a bhajia seller, says she has been taking the pills religiously for three years and leaves them at her shop.
“Taking the pills has become part of my life. I must take them, however tired I am,” the mother of six says.
“I sought family planning services because I was giving birth after every year. This became physically and economically hard because I strain to provide for the children.”
I sought family planning services because I was giving birth after every year. This became physically and economically hard because I strain to provide for the children
SALON SAVIOUR
Grace, a salon owner who is assisting the women to take family planning, says the initiative started after hearing a lot of cries from the women.
“I serve very many Somali women in this salon, and I used to think that they were okay with having many children until they started sharing their plights,” she says.
“Amidst our conversations, I started with one woman, and the numbers slowly built to about 20 women.”
Grace says most of the women prefer oral contraceptives because they view other methods like IUD and implants as haram.
“Their argument is that when they die, their bodies will be found with foreign objects, which in Islam are regarded as haram,” Grace says.
When the contraceptives are in high supply, she administers them to some of the women in her salon. But when the supply is very low, she has to accompany the women to the clinics for safety.
“This is to avoid any form of suspicion or altercation when the women run into their husbands and if the husbands happen to notice them, they will say they were accompanying me to the hospital,” Grace says.
A study conducted by Kenyatta University lecturer Eliphas Gitonga last year found many Somali women take contraceptives secretly due to cultural and religious barriers.
It says most Somali women are not allowed to make decisions about their bodies without the consent of the man.
According to the research, women use the market and the salon as excuses to leave the house to take contraceptives.
“Some of these salon owners are also community health volunteers who are very knowledgeable on contraceptives,” the research says.
“These salonists mostly provide oral contraceptives for the women, who are afraid of keeping them in their homes.”
Other unconventional places the women hide the contraceptives are in cooking flour or inside their husbands’ pillows.
Some keep them in their neighbours' houses or the salon, the research says.
Gitonga says the move has, however, backfired on some women. Some of them have experienced excessive bleeding due to the side-effects of the hormonal contraceptives.
The tide masters, the men, are also not completely blindsided, he says.
“During the town hall meetings, they said, they will know if their wives are on family planning when they suddenly grow thin,” he said during an interview with the Star.
EXPERT, CLERICAL VIEWS
Dr John Ong’ech, a gynaecologist, says it is important to seek professional advice before making a decision to take family planning.
He says family planning methods react differently on people.
“The professional, before prescribing family planning, should have your medical history,” Ong’ech says.
“Medical conditions like blood pressure should be made known to the medic before a prescription is given.”
Sheikh Omar Barisa, an Imam from Biafra slums in Kamukunji, says Islam as a religion is not against family planning.
He says the religion opposes contraception only when it puts the life of the mother, the husband or the children who will be conceived in future, in danger.
“If you read the Quran well, you will find that Prophet Muhammad is not against the use of contraception,” Barisa says.
“Those opposing it are just hiding behind religion. Suffice to say, Somalis who are against contraception are more bent towards culture and not religion.”
Islam is not the only religion that is believed to be at loggerheads with family planning. Some Christian faiths, such as the Catholic Church and deliverance churches, are opposed to contraception.
“Go ye and multiply” is a Bible verse churches use to oppose family planning.
Gitonga says for Somali men, the higher the number of children, the more the praise they get from their peers.
POLITICISED NUMBERS
The National Reproductive Health Policy 2022-32 policy seeks to decentralise family planning service delivery at all levels of healthcare.
The policy supports informed initiation, correct use, refills and community distribution of self-care family planning methods.
These methods include pills, vaginal rings, patches, condoms, fertility awareness and self-injectable contraceptives.
The 2019 census by the Kenya National Bureau of Statistics puts the Somali population at 2.7 million.
The numbers were, however, disputed by politicians from the Somali community, who said they were more.
They argued it is not statistically possible that the community’s population increased by only 400,000 from 2.3 million in the 2009 census.
The Kenya Demographic Health Survey 2022 says Kenya has an unmet need of family planning of 14 per cent.
It says six out of 10 women are currently using different methods of contraception.
According to the survey, contraception uptake is highest among women with higher education and lowest among women with no education.
It says seven out 10 women with higher education are on contraception compared to two out of 10 women with no education.
The World Health Organisation says use of contraception prevents pregnancy-related health risks for women, especially for adolescent girls.
When expressed in terms of interbirth intervals, children born within a two-year interval have a 60 per cent increased risk of infant death.
Those born within an interval of three years have a 10 per cent increased risk.
Contraception also offers a range of potential non-health benefits that encompass expanded education opportunities and empowerment for women.
WHO says not all types of contraception are appropriate for all situations.
The most appropriate method of family planning depends on an individual’s overall health, age, frequency of sexual activity, number of sexual partners and desire to have children in future.
WHO says ensuring access for all people to their preferred contraceptive method advances several human rights, including the right to life and freedom of expression.
Meanwhile, Ahmed has called for intense family planning sensitisation programmes in her community.
She hopes that with time, the community, especially the men, will understand the importance of family planning and help lift the heavy yokes they are carrying.
