While population growth projections are based on simple models they can be imprecise. For example, it was projected that Kenya’s population would surpass the 50 million mark by 2017. But according to the 2019 census, there were 47.6 million Kenyans.
So here we go again for what it is worth. Kenya’s population is projected to reach about 92 million by 2050. It is also projected that by 2050 Kenya’s median age will be about 25 years. Just five years older than the current median age of 20 years. Hence, we will for the next 30 years be in a powerful vortex of reproductive momentum. Tens of millions of young Kenyans will either be planning families or having children.
The pace of demographic change, as well as the quality of life from the cradle to end of life matters. Human population, along climate change and biodiversity loss, in synergistic ways, will determine critical thresholds or tipping points that will define the fate of our kind. Hence, sexual and reproductive health is and will continue to be a crucial national conversation.
Kenya, like many sub-Saharan African countries, experiences very high rates of unintended pregnancies and unsafe abortions. Moreover, the Covid-19 pandemic has and will continue to slow progress toward equitable universal access to safe contraceptive services. A recent study shows that about 14 per cent of non-contraceptive users in Kenya identified Covid-related reasons for non-use.
Fear of contracting Covid-19 at health facilities was the most frequently reported reason. Loss of income owing to the impact of Covid-19 on key sectors of the economy was also a major reason affecting continuation of use of contraception.
Gains in contraceptive use remain fragile, easily reversible. Covid-19 underlines the complex impact of a disease pandemic and the associated economic shocks on fertility and contraceptive behaviour among reproductively active populations. Hence, it is important that public health messaging in times of crisis is precise and coherent.
Moreover, it is critical to ensure that public information achieves the right balance between accurate information on the public health threats of a global pandemic and how individuals should seek care, especially sexual and reproductive health services. There is urgent need therefore, to empower and support young adults to manage their own health through self-care initiatives.
The Covid-19 pandemic has laid bare the limits of medicalised and facility-based care. Arthur Kleinman’s book, Patients and Healers in the Context of Culture has been hugely influential in advancing the self-care for sexual and reproductive health through peer support and exchange, and counselling to enable informed decision making by youth.
The personal nature of sexual and reproductive health means that self-care can empower and give agency to women to manage their health needs. More importantly, we need to develop novel population health approaches for information exchange and dialogue that bridge taboos and other social barriers.
Moreover, building and sustaining partnerships between communities and healthcare systems around self-care models will be critical to ensuring enhanced and sustainable implementation of sexual and reproductive health interventions.
