Addressing teen pregnancy in Kilifi County requires more effort

Teenagers 18

Kenya’s population is rapidly growing at a rate of 2.9% per annum with an estimated 25 percent of the population[1] being youthful. Statistics show that Adolescent Sexual Reproductive Health and Rights (ASRHR) remains a priority need in Kenya, with a teenage pregnancy rate of 18 percent, and an unmet need of family planning —as measured by the contraceptive prevalence rate among sexually active, unmarried girls aged 15–19 years—of 49 percent[2]. It is estimated that about 13,000 girls drop out of school annually due to early and unintended pregnancy[3] with some Counties such as Kilifi emerging as hotspots.

Kilifi County is largely a rural area on the Kenyan Coast with a population of 1,453,787 as of 2019, with majority (71%) being below the age of 30[4]. Issues such as religious and cultural beliefs in the County largely affects its Sexual and Reproductive Health and Rights (SRHR) outcomes. This in turn affects the rate of access to and use of modern contraception methods especially among young people.

Looking at the data on teenage pregnancies as per the Kenya Health Information System (KHIS), Kilifi recorded 4,909 pregnancies among 15-19-year-old girls between January 2021 to August 2021. These pregnancies were as a result of: harmful cultural practices such as early marriages, high poverty levels in the region leading to transactional sex, low levels of education that contributed to limited knowledge on SRHR, and poor parenting[5].

 

In efforts to address this worrying trend, the County has included the reduction of teenage pregnancies in the Kilifi County Adolescent and Young People Sexual and Reproductive Health and HIV strategy (2021-2025) so as to inform, design, plan, implement and evaluate all Sexual Reproductive Health /HIV programs in the region. The County Government continues to support all its departments to implement the strategy and calls upon all Partners to align their programming to the same.  

 

However, this is not enough. The National Government and the Kilifi County Government in collaboration with other key development partners in the region can do more to meet the family planning needs of its adolescents and young people. A good place to begin would be to continuously strengthen its Human Resources for Health Capacity. The doctor-patient ratio in Kilifi County stands at 10:100,000 against the recommended World Health Organisation (WHO) standard of 36:100,000[6]. The county experiences shortage of health workers with skills to respond to adolescents and young people’s SRH needs. Through strengthened capacity, the health workers will be qualified, trusted and more responsive to young peoples’ sexual and reproductive health including provision of contraception services. Additionally, they get motivated and retained in hard to reach areas, thus ensuring that they adequately meet the SRHR needs of population in the County who are of reproductive age.  

Garnering political support for improved health care infrastructure and increased health care funding can have favourable outcomes on issues such as contraceptives supply management. This will ultimately address stock outs experienced in the County. If there are several contraception options that are readily and easily accessible to young people, particularly the long acting methods, unwanted teenage pregnancies can be greatly reduced as well as unsafe abortions and deaths resulting from pregnancy related complications.

Working closely with the young people, their communities and partners in both the public and private sector to increase access to factual Adolescent Sexual Reproductive Health and Rights information will help the County to generate tailor made solutions that work, and at the same time equip young people with adequate knowledge that will guide them in making better decisions on sexuality matters. A practical example of this is what the Faya Project –a partnership with Amref Health Africa in Kenya, Kenya Muslim Youth Development Organisation and Straight Talk Foundation Kenya- is doing through use of Human Centred Design approaches targeting adolescents aged 15-19 years old in Kilifi, Mombasa, Siaya and Homa Bay Counties with Sexual Reproductive Health and Rights information and linking to services. The project through its County approved Life Skills Education toolkit ‘Together into the Future’ is increasing the adolescents’ knowledge on SRHR issues such as Teenage pregnancy, HIV/AIDS, Self-Awareness and Sexual and Gender Based Violence among others.  Faya project engages local peer educators who have been trained to deliver this information through four delivery channels: Print Comics, Religion, Digital and Edu-sports.

Lastly, parents should also be empowered to be confident enough to discuss sexuality issues with their children. By them being the first point through which their children access such information, the adolescents are less likely to give into peer pressure which might lead them to experiment on things that will negatively affect their future.

 

The writer is Leila the Executive Director at Youth Voices Action Initiative (YVAI), the President of Kilifi’s Youth Advisory Council and the Secretary of the Faya Project Youth Advisory Board.

[1]  KNBS (2019) Kenya Population and Housing Census Results

[2] Kenya MOH. National Guidelines for provision of adolescent and youth friendly Services in Kenya, second edition. Nairobi: MOH; 2016.

[3] Muganda-Onyando R, Omondi M. Down the drain: counting the costs of teenage pregnancy and school drop out in Kenya: Centre for the Study of adolescence; 2008.

National AIDS Control Council, Kenya’s Fast-track Plan To End HIV and AIDS Among Adolescents and Young People

[4] 2019 Kenya Population and Housing Census: Volume I

[5] https://maarifa.cog.go.ke/assets/file/06177118-kilifi-county-mitigates-high-prevale.pdf

[6] Kilifi County Incentive framework for attraction and retention of health workforce, August 2018

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