Silent revolution: How Kibra girls are using tech to solve SRH challenges

In the heart of the bustling Kibera slum, where access to education and healthcare resources is limited, a quiet revolution is taking place.

The revolution, how adolescent girls are using technology to solve their sexual reproductive health challenges, is one of a kind.

Through the Agape Woman and Child Empowerment Foundation in Kibra, they have come up with the Tiko App by Triggerise.

The app provides them with access to health products and services from a participating clinic or pharmacy in their communities.

The beneficiaries of AWOCHE have a story to tell. 

A story of how they have easy access to sanitary products and family planning, hence, taking charge of their lives.

Sylvia is among adolescent girls in Kibera who are positively using technology to take charge of their daily sexual reproductive health challenges. She uses the Tiko app

When I join her at AWOCHE, she is attending one of their Saturday sessions.

She tells me at just 17 years old, she gave birth to her first child and was not on any family planning.

"Initially, I was abstaining but when I got into a relationship, I stopped and that is when I fell pregnant and now my not-so-little baby is two years old," she says.

"After realising that I was pregnant, I had all sorts of weird thoughts but having an abortion is what crossed my mind more often. I was scared as I had disappointed my parents."

Sylvia says she even knew all the facilities where she could procure an abortion but was conflicted as she couldn't understand why she wanted to harm her unborn baby.

The 19-year-old says when she couldn't decide on what to do, she ran away from home and even broke up with her boyfriend. 

"I escaped because I knew my mum could take me to jail. After escaping, I went to a friend at one of the universities. However, I couldn't stay past one week because my friend used to party a lot. Therefore, I decided to call my dad who came to pick me up," she says.

Sylvia says her father never realised she was pregnant even when he came to pick her up and only found out when she gave birth.

TURNING POINT

Sylvia says immediately after she gave birth, she had to rethink her life choices to avoid getting pregnant a second time and that is when she learnt about AWOCHE Foundation.

She heard about the foundation from her friends and decided to join them, finally forming a club of adolescent girls and naming it after the app.

"My son was my saviour. I have put a lot of hard work into everything that I do and I would not want to mess up again. I have also realised time is very precious. Hold everything you do dearly," she says.

Sylvia aspires to pursue photography as she has already pursued a sales and marketing course.

"I love photography. I will pursue it as a career to enable me to help my son so that he doesn't depend on anyone. I now stay with my mum and my child feels at home," she says.

BRIDGING THE DIGITAL DIVIDE

Sylvia and other girls are using Tiko app to solve their sexual reproductive health needs.

"I am now on family planning, I consulted a doctor and I decided on the contraceptive to use," she says.

"The Tiko app has also been very helpful because, through it, I can always find a doctor to speak to privately."

Together with her three friends, they use the app to access family planning and also monitor their periods.

However, two of the adolescent girls say they are yet to decide on what family planning methods to use but with the app, they are sure of making the right choices.

Just like Sylvia, Kalsum is also on family planning.

"Before this app, I never knew anything to do with family planning. I used to think it was meant for those in marriage but thanks to technology. I am now an adult and able to learn the importance of family planning," she says.

Kalsum says her parents are aware that she is on family planning and they are comfortable with it.

"With knowledge of family planning, the number of teenage pregnancies will reduce and girls will become more aware of what is best for their bodies," she says.

Kalsum says she is grateful that at AWOCHE Foundation, she was introduced to the app and in the process, got a counsellor who was able to guide her through.

"The counsellor was friendly and embraced me like she would her daughter," she says.

Sophie, another beneficiary of the Tiko app, says she is not on any family planning method but she would not be scared to try it in future because she has more knowledge on what to do and what to go for.

"There were myths that one could get barren due to the different family planning methods but I have since learnt that it is not always the case and we were taught what causes barrenness," she says.

"I am not on any family planning yet but when I am ready, I will go for what suits me after speaking to a doctor. For now, I use the app to monitor my periods. I would also urge parents to support their adolescent girls when in need of contraceptives and more advice on family planning." 

Charity, another beneficiary, also says she is not using family planning but has ideas and is more knowledgeable about what to do in case she needs to use contraceptives.

She says thanks to Tiko app she has access to a counsellor with whom she can always discuss her sexual reproductive health needs and monitor her periods.

The girls say misinformation has been a challenge but they have not been victims because they know what is right and what not to do when making decisions to do with family planning.

"We come from the slum and sometimes there are those who misadvise others but we want to share our knowledge on family planning," Charity says.

"Due to lack of data as our parents cannot afford to put food on the table and at the same time buy us bundles, AWOCHE foundation helps us by ensuring we have free Wi-Fi at the organisation."

TIKO APP

AWOCHE founder Evelyn Bowa says the Tiko app by Triggerise has been very helpful because the girls have now taken charge of their sexual reproductive health.

She says they have also formed a club named after the app and they offer programmes that respond to reducing the number of teenage pregnancies and accessing information on sexual reproductive health services.

Cases of adolescent pregnancies in Kibera have been rampant due to lack of empowerment and sex education.

Bowa says they meet during weekends and hold sessions with the girls, where they educate them on sexual reproductive health and engage them in activities such as making reusable sanitary towels, going through lessons in their Tiko Club where they have a handbook and even speaking to counsellors.

"We have different approaches that we use to increase access to information on several regular services," she says.

"Through the app, the girls also get information on periods, how to handle period cramps, access counsellors freely in case of any hygiene challenges and even connect you to a gynaecologist."

Bowa also explains how they use technology to help adolescent girls solve daily sexual reproductive health challenges.

"The programme supports girls to access SRH information services, counselling services, family planning and HIV services. We have community mobilisers who work in the community, and when they work, they reach out to adolescent girls to help them access family planning services, so they enrol them using a phone," she says.

"When enrolled, a code is sent to them and they will use it to access information on family planning."

Bowa says that those who don't have access to smartphones have what they call Rafikis, where their mobilisers enrol them using cards.

"Most of our programmes target all girls in Kibra, and, it's open for everyone," she says.

Bowa acknowledges that most girls also face challenges to do with a lack of bundles.

To handle that, she says, their office space has internet which can always help them access these apps.

The 2022 Kenya Demographic and Health Survey report shows that among sexually active unmarried women aged 15–49, 70 per cent use contraceptive methods, and 59 per cent of these women use a modern method.

Data shows the use of traditional methods is more common among sexually active unmarried women than among currently married women (11 per cent and 6 per cent, respectively).

Among sexually active unmarried women, male condoms are the most commonly used contraceptive method (20 per cent), followed by injectables (16 per cent) and implants (11 per cent). 

GIVING BIRTH BY CHOICE

Dr Fredric Ochenge, a general practitioner and director of AntHill Medical Clinic and Pharmacy in Kibra, says they offer different types of family planning methods.

He says the methods include pills, intrauterine devices (IUDs), injections and oral contraceptive pills (combined pill and progestogen-only pill) among others.

Ochenge says they also advise adolescent girls to use condoms.

"Family planning is a safe way of preventing unwanted pregnancies. When the girls visit our clinic, we first advise them on everything that involves family planning. They are safe if administered by a qualified doc and if adolescents use them well, they offer 100 per cent protection," he says.

"Giving birth is by choice not by chance. When you use family planning, it doesn't mean you will give birth to abnormal children, as there is no scientific proof."

Ochenge says before advising the girls on family planning methods, they consider factors such as blood pressure and the family tree to check if any of their family members have a history of hypertension, weight or any medical condition.

"We also discuss the side effects with them such as excessive bleeding which happens for more than three days, spotting, gaining and losing weight, severe abdominal or back pain, nausea and vomiting."

Ochenge says after a one-on-one session with the girls, they now discuss which family planning method best suits them.

"When the girls come to our facility, we also try to be as confidential as we can. We have a doctor's room where they come in and speak to a specialist without any other second party knowing they have come to seek family planning methods," he says.

"After that is said and done, we advise the girls to come for a review. Some come every three weeks and some every three months."

Dr Ochenge says they also encourage the girls to use the Tiko app to access the family planning services in case they feel uncomfortable physically visiting the health facilities.

EFFORTS BY GOVERNMENT, NGOs 

Marie Stopes Gender, Youth and Inclusion programmes manager Salima Mohammed says there are some youth-friendly clinics and health centres where adolescents can access confidential and non-judgmental reproductive health services, including contraception methods.

Mohammed also says some of the technologies being used to promote family planning include local radio stations and telemedicine services, which enable young people to consult healthcare providers remotely, allowing them to discuss contraceptive options and receive guidance without having to visit a clinic in person.

"For example at Marie Stopes, we have a contact centre with a toll-free phone number and agents who offer free advice and refer clients for services at different health facilities across the country," she says.

"The government and organisations also use social media platforms and online forums to disseminate information about family planning and engage with young people, addressing their concerns and questions."

She says adolescents can play a crucial role in advocating family planning in their communities by educating their peers about the importance of contraceptives, dispelling myths and misconceptions, and promoting the use of contraceptives through peer-to-peer interactions.

"Adolescents can organise and participate in community campaigns to raise awareness about contraceptives, organise workshops and engage with community leaders to address cultural and social barriers," Mohammed says.

SUPPORT GIVEN TO ADOLESCENTS 

Mohammed says adolescents benefit from life skills education largely provided by NGOs and other stakeholders teaching them various health topics.

The programme officer says they have peer education where the adolescents can educate their peers about the importance of contraceptives, dispel myths and misconceptions, and promote the use of contraceptives through peer-to-peer interactions.

"Adolescents can organise and participate in community campaigns to raise awareness about contraceptives, organise workshops and engage with the community to address cultural and social barriers," Mohammed says.

"Adolescents can join or form youth-led advocacy groups that focus on reproductive health and contraceptives. These groups can advocate for policy changes, engage with policymakers, and amplify the voices of young people.”

She says there are also youth-friendly health centres and clinics that offer counselling services to adolescents seeking contraceptives.

The programmes officer says trained healthcare providers also provide guidance, answer questions and address concerns related to contraception.

"They are also informed about the different options available and can choose the method that suits them best," she says.

"However, there is a need to allow for age-appropriate, culturally sensitive, comprehensive sexuality education that will equip adolescents with more information about their sexuality and also the use of contraceptives."