Barriers at the Clinic: Parental consent policies fuel teen pregnancies and HIV risks- Report

The overbearing need for parental consent by adolescent girls before accessing contraceptives is to blame for the increasing rate of teen pregnancies and sexually related infections, a new report has said. 

The report by the Kenya Legal and Ethical Issues Network on HIV and Aids said this comes amid rising early sexual exposure among the young demographics. 

The health rights lobby based in Nairobi cited a case in which 17-year-old AO walked into a local health centre in Kisii county asking for contraceptives. She was turned away. 

The nurse, though kind, insisted she needed parental consent to access any reproductive health services. AO never returned, but became a young mother a few later. 

“I couldn’t tell my mother. She would think I’m immoral,” the daughter of a staunch SDA congregant told researchers who were compiling a report on access to contraceptives by adolescents in the country. 

AO is among the 15 per cent of teenage girls aged 15–19 who have experienced pregnancy, according to the 2022 Kenya Demographic and Health Survey (KDHS). 

Her story echoes many across Kenya, where adolescents and young people seeking reproductive health services face rigid policies. 

The report by Kelin takes issue with the National Reproductive Health Policy 2022-2032, Section 3.4, which excludes particularly young women and girls below the age of 21 from accessing or receiving critical reproductive health care services or information. 

This policy imposes unreasonable requirements on parental consent prior to the provision of reproductive health services, imposing additional barriers for adolescents and young people attaining the highest standard of health.

"This is despite evidence that points to an increasingly sexually active young population with the Kenya Demographic and Health Survey 2014 reporting more men aged 15–24 had their sexual debut before the age of 15, similar to the KDHS 2022 report where eight per cent of women and 19 per cent of men aged 15–24 had their first sexual intercourse before age 15. 

“KDHS 2022 notes that the percentage of women aged 15–19 who have ever been pregnant increases with age, from 3 per cent among those aged 15 to 31 per cent among those aged 19. Fifteen percent of women aged 15–19 have ever been pregnant; 12 per cent have had a live birth, 1 per cent have had a pregnancy loss, and 3% are currently pregnant," it reads. 

But it is not just adolescents facing barriers. Persons with disabilities are also systematically excluded from vital reproductive health services. 

“Persons with disabilities also miss out on the crucial reproductive health services and information despite constituting 2.2 per cent (0.9 million) of Kenya’s population, with women making up 57% (523,883), of all persons with disabilities.

The report adds that about 80 percent of PWDs do not access quality medical services, compared to 50 per cent of the general population. 

As for HIV awareness, the picture is no less grim, showing that a sizeable population has no knowledge of their HIV status but are sexually active. 

“There is also a glaring gap in knowledge on HIV prevention among youth aged 15–34. 41 per cent of women and 39 per cent of men had no knowledge on HIV prevention. In 2021, an estimated 66.7 per cent (23,051) of all new HIV infections occurred among women and girls,” it said. 

“Women and girls tended to become infected at a much earlier age than men and boys of the same age with 8 out of every 10 new HIV infections occurring among adolescent girls and young women aged 15–24.” 

Even more worrying are the challenges faced by populations already stigmatised, criminalised and pushed to the margins. 

“Finally, key populations (sex workers, gay men and men who have sex with men, transgender people, people who inject drugs, people in prisons and other enclosed settings who are disproportionately affected by HIV) also have inequitable access to safe, effective and quality HIV services and face disproportionate levels of stigma, discrimination, violence, human rights violations and criminalisation. 

“Significant barriers, such as police harassment, societal discrimination and insufficient community-based services prevent them from getting the care they need. In 2021, key populations accounted for 70 percent of new HIV infections.” 

While policies meant to protect children are rooted in good intentions, Kelin and other health advocates argue that they are harming the very people they aim to safeguard. 

They are calling for urgent reforms that put adolescent health first—by eliminating the need for parental consent and expanding access to comprehensive, non-judgmental reproductive care. For girls like AO, it could mean the difference between a life shaped by choice or derailed by silence.

Instant Analysis

Rigid consent policies continue to block access to reproductive health services, worsening teen pregnancy and HIV infections in Kenya’s most vulnerable youth.