We all deserve healthy lives. But, unfortunately, your ethnicity and where you born affect your chances of living a long, healthy life.
This means Kenya’s geography matters in what you become in life.
The United Nations Population Fund calls this the “ugly truth”.
Its 2024 State of World Population report released last week shows that many women have not benefited from sweeping global gains in sexual and reproductive health and rights over the last 30 years, simply because of their tribe and where they were born.
It shows that between 2000 and 2020, global maternal mortality declined by 34 per cent, a success story that can be credited largely to better access to skilled and emergency obstetric care.
But women and girls in Kenya’s remote areas do not enjoy many of these benefits.
For instance, Kenya’s maternal mortality rate declined from 564 deaths in every 100,000 women in 2000 to 362 in 2023, according to the Kenya Demographic and Health Survey.
But mortality in Mandera county is still the highest at 3,795 deaths per 100,000 live births, followed by Wajir and Turkana, which have maternal mortality ratios of 1,683 and 1,594, respectively, according to the National Council for Population and Development.
“The data are damning. Women and girls who are poor, belong to ethnic, racial and indigenous minority groups, or are trapped in conflict settings, are more likely to die because they lack access to timely health care,” UNFPA says in the report, titled “Interwoven lives, threads of hope: Ending inequalities in sexual and reproductive health and rights”.
“Women from indigenous ethnic groups are more likely to die of causes related to pregnancy and childbirth,” UNFPA adds in a statement, released alongside the report.
The report also highlights the role racism, sexism and other forms of discrimination continue to play in blocking broad gains in sexual and reproductive health for women and girls globally.
It indicates that from 1990 to 2021, the number of women using modern contraception doubled globally.
In Kenya, the uptake of modern contraception is 57 per cent nationally. In counties with high concentrations of Somali tribes, notably Garissa, Mandera and Wajir, the percentage of married women using modern contraception ranged from two per cent to 11 per cent, according to the 2022 Kenya Demographic and Health Survey.
“Use of modern methods of contraception was lower among non-refugee and refugee Somali women compared to the national average,” said Eliphas Gitonga from Kenyatta University and a scholar from America’s Tulane University. Their analysis of the 2022 KDHS was published in the Frontiers Global Women’s journal in January.
UNFPA noted that globally, improvements in health care access have primarily benefited wealthier women and those who belong to ethnic groups that already had better access to health care.
The report notes women and girls with disability, migrants and refugees, ethnic minorities, LGBTQIA+ people, those living with HIV and disadvantaged castes all face greater sexual and reproductive health risks and unequal access to sexual and reproductive health care.
Their vulnerability is further compounded by powerful forces such as climate change, humanitarian crises and mass migration, which often have a disproportionate impact on women at the margins of society.
“Inequalities within our societies and health systems are widening and we have not adequately prioritised reaching those furthest behind. Our work is incomplete but not impossible with sustained investment and global solidarity," UNFPA’s executive director Dr Natalia Kanem said.
