Teenage Pregnancy in Kenya: A Crisis of Health, Education and Opportunity

Education CS Amina Mohamed chats with form four candidates of Mama Ngina Secondary School a few minutes before KCSE exams. Credit: Standard

By Siddharth Chatterjee
NAIROBI, Kenya, Nov 19 2018 (IPS)

That almost one in five Kenyan teenage girls is a mother represents not only a huge cost to the health sector, but also a betrayal of potential on a shocking scale.

November 20, 2018 marks International Children’s Day. Perhaps a day we should use to reflect on a national crisis of underage pregnancies that confronts us.

Recent media reports of the high number of girls failing to sit their final secondary school examinations (KSCE) only reveal the extent to which we have continued to sweep under the carpet candid discussions about adolescent sexuality.

Kenya’s Education Cabinet Secretary, Amina Mohamed said that the country must confront this worrying trend. “We must have this conversation. We cannot bury our heads in the sand. It is happening to our children, our sisters, and even our young brothers. We will deal with it or it will not go away”. No doubt CS Mohamed has a tough job ahead.

Consider this. Statistics from the United Nations Population Fund (UNFPA) indicate that between June 2016 and July 2017, 378,397 adolescents in Kenya aged 10 to 19 got pregnant.

The carpet’s edges are now too frayed to conceal our failure to act; we no longer can afford the blissful pretence about sexual activity among our teenagers. Nor can the responsibility for decisive solutions be shunted around.

Numerous studies have documented the fact that a high number of teens are already sexually active. These young girls are part of the four in ten women in Kenya aged between 15 and 49 who have unintended pregnancies. There can be no illusions about what they need: accurate, up-to-date information and access to effective contraception.

It is time to take a wholesome picture of the social and economic price society is paying when 15 percent of its teenage girls become pregnant. For virtually all of them – and statistics say majority are from poor families – it means an end to any dreams of coming out of poverty because they cannot continue with education.

Complications during pregnancy are the second cause of death for 15 to 19-year-old girls, therefore it means their already poor families have additional health care costs to meet. Children born to such young mothers are more prone to physical and cognitive development.

The overall effect is a perpetuation of the cycle of poverty that brings personal catastrophe while weakening social and economic development and adding strain to already stretched medical services.

In reproductive health, as in most things, knowledge is power. But across sub-Saharan Africa too many teenage girls lack knowledge of their bodies, their contraceptive options, and their rights. The notion of rights is central.

As the UNFPA report The Power of Choice states, in countries where rights to health, education and opportunity prevail, fertility rates tend to be lower. Through exercising their wider rights, people exercise choice about the timing and number of their children.

The 2014 Kenya Demographic and Health Survey of 2014 that shows girls who have completed secondary education have an average of three children in their lifetimes compared to an average 6.5 for those with no education. Additionally, around 60% of girls who have completed primary and secondary school use some form of modern contraception compared to only 15% of those with no education.

That almost one in five Kenyan teenage girls is a mother represents not only a huge cost to the health sector, but also a betrayal of potential on a shocking scale.

“The girl child in this country is under threat from all manner of vices, including early pregnancy and female genital mutilation and many other kinds of nonsense that affect our communities. These things have no basis for the development of our country” said the Deputy President of Kenya, William Ruto.

The underlying drivers of teenage pregnancy are complex and include gender inequality, child marriage, poverty, sexual violence, and poor education and job opportunities. To be successful, efforts to reduce the incidence of teenage pregnancy must address all these elements through comprehensive programmes of behaviour change, social and economic development, health and sex education, reproductive rights, and gender equality.

Crucially, such efforts must also include boys and men, whose attitude to girls and women underpin many pervasive social problems in Kenya and across the world.

Reproductive rights and health are also central to achieving the Sustainable Development Goals, particularly Goal 3 on ensuring healthy lives and promoting the well-being for all ages.

As the UN family in Kenya we are working in partnership with government, civil society, religious and youth groups to extend access to sexual and reproductive health information, counselling and services for young people. We intend to step this up.

Three years ago, Kenya launched the Adolescent Sexual and Reproductive Health Policy. Unless bold decisions are made to implement that policy, pregnancies among our youth will continue to be a wrecking ball to the national development agenda particularly the Big Four and the SDGs.

In order for every girl to achieve her full human potential, how can the entire country be engaged to initiate a change in mindset in Kenya? How can a national conversation on this subject be leveraged into national action?

Stopping History from Repeating Itself

Students at Umbili Girls concrete during class; they are some of the over 200 girls attending the school. Photo: O. Headon/IOM 2018

By International Organization for Migration
South Sudan, Nov 19 2018 (IOM)

When Deputy Principal Rose was a student, there was a week every month that she dreaded: the period every twenty-eight days or so when she had her period. A keen student with an innate love of learning, she loathed this forced truancy.

Without menstrual management support, Rose could see no other option but to wait out her period at home.

From her office in the school, Deputy Principal Rose explains how she saw history repeating itself across generations when it came to menstrual management. Photo: O. Headon/IOM 2018

Two thousand and five — the year the war for independence from Sudan ended — was the year Rose finished her studies. She graduated from university in Khartoum and returned to her hometown of Wau, now in South Sudan. There, she became a teacher and later the Deputy Principal of the 200-pupil strong Mbili Girls Secondary School, known locally as “Umbili Girls”.

Many of the girls in Rose’s school face the same issues she did back in her own schooldays.

Geography class at Umbili Girls, where IOM water, sanitation and hygiene teams support students. Photo: O. Headon/IOM

One student at the school said that when she starts menstruating, she would “ask the teacher for permission to go home.” And then, she would stay put for a day or so until her period was no longer so heavy, making it possible to go back to school.

“When I’m at home, I cannot read or study because I have domestic work to do,” said another girl student. She continued on to say that if she asks for time off from household chores, then she will not be given money for candles, further hindering her studies. All her classmates agreed that when they have access to basic hygiene products like pads, soap and buckets, they can stay in school during their periods.

One of the over 200 girl students at Umbili Girls in Wau, South Sudan. Photo: O. Headon/IOM 2018

“Before, there was no proper place to wash pads, so the teachers and I would have to send girls home,” said Deputy Principal Rose. A non-governmental organization (NGO) constructed a private room at the school for girl students to wash or change their sanitary products.

With training and support from the International Organization for Migration (IOM), the school set up a student hygiene club. The club helps students promote simple but vital hygiene practices throughout the school. As part of its activities, IOM held menstrual management training for girl students and distributed dignity kits. The kits included reusable pads, underwear, soap, a kanga (multi-purpose material, typically used as clothing), and a solar torch to help the girls easily read at night.

“There is more awareness today and teachers can offer help,” said Rose, more optimistic about the current situation for girls, who experience their periods at school. Such kits not only help girls stay in school but go through their monthly cycle with more dignity.

Deputy Principal Rose is optimistic for the future but knows her girls have many challenges ahead of them. Photo: O. Headon/IOM 2018

Another challenge the students were facing was the lack of latrines. There was only one functioning latrine at the school.

Umbili Girls was originally a girls’ school with 207 students but, due to the lack of teachers in Wau, two or three schools were temporarily combined for Senior Four (the final stage of secondary school) classes. Umbili Girls was the largest and most strategically located of the schools, which means that, for the moment, boys are part of the student body. This made the latrine situation for the pupils even worse; now boy and girl students and men and women teachers were relying on one latrine during school hours. Many of the girls were not comfortable with this arrangement.

Earlier this year, IOM’s water, sanitation and hygiene (WASH) team assessed the sanitation situation in multiple schools in Wau, comparing the state of each school’s latrines and the number of people who used them. Umbili Girls was deemed to a priority with far more than 200 people with access to only one functioning latrine. The WASH team verified with Wau’s Directorate for Education to ensure that no other organization had plans to support the school in this way, avoiding duplication of work.

Assistant Engineer Grace Keji speaks with labourers as they work on the latrine rehabilitation. Photo: O. Headon/IOM 2018

Employing local labourers, IOM engineers oversaw the rehabilitation of a block of latrines (eight stances), which had fallen into disrepair, forcing the school population to share what was meant to be the teachers’ latrine.

“During our assessment, we made sure that the existing latrines could be rehabilitated; we checked that the pits were ok and how many metres were left before they would become full,” said Grace Keji, IOM South Sudan Assistant WASH Engineer. “Then, we used the assessment report to prepare a Bills of Quantity (BoQ), which is a list detailing the materials, like cement, needed for the rehabilitation. Following procurement of the materials, we got to work fixing the floors, walls, roof and ventilation. We also constructed three handwashing facilities, which are vital, as good handwashing practices play a key role in reducing diarrhoeal diseases,” added Keji.

Assistant Engineer Grace Keji explains how the privacy wall is being constructed. Photo: O. Headon/IOM 2018

The team also constructed a privacy wall around the teachers’ latrine, as everyone was using it during the rehabilitation works. Now, there is a specific latrine stance for people living with disabilities, one for women teachers and six for girl students — all in the rehabilitated block. And there is another existing stance located away from the girls and women’s latrines, used only by men teachers and boy students. This is a temporary arrangement until more teachers can be hired in the boma [administrative division] and the boys can go back to their own school. But while they are attending Umbili Girls, the hygiene club has capitalized on their presence and engaged them in activities.

The latrines and handwashing facilities were completed in September and officially handed over to the community. Representatives from IOM, Wau’s Directorate for Education, the school administration and school hygiene club attended the handover ceremony. IOM also supplied the school with cleaning supplies.

The completed rehabilitation of Umbili Girls latrines. Photo: O. Headon/IOM 2018

Following, the completion of the latrines, IOM turned its attention to the school’s inadequate borehole. During the following month of October, IOM finished the rehabilitation of the borehole, ensuring there was access to clean and safe water at the school.

According to UNICEF, the “current trend in female enrolment [in South Sudan] is particularly disconcerting with the Gender Parity Index (GPI) going from 0.75 at primary to 0.57 at the secondary level.” GPI is a socioeconomic index measuring the relative access to education of girls and boys.

Helping young girls feel comfortable enough to stay in school is extremely important.

As one of the students said, “We must study to become independent because there are certain things you must do for yourself,” and as another said, “School is very important because it makes you mentally happy. When you study, life becomes easier; you can work hard for what you want.”

Girls take a break in between lessons at Umbili Girls. Photo: O. Headon/IOM 2018

IOM’s support to Umbili Girls in Wau was funded by the US Agency for International Development (USAID) as part of the “Water, Sanitation and Hygiene (WASH) Response and Prevention of Gender Based Violence (GBV)” project.