Implication of teenage pregnancies to Kenya’s maternal health index

NAIROBI, KENYA: Kenya could see more maternal deaths if trends of teenage pregnancies are not checked and curbed.

And this is reinforced by the National Adolescent Sexual and Reproductive Health Policy 2015 which states that estimates from developing countries indicate that pregnancy and delivery complications, including unsafe abortion, are the second leading causes of death for girls below 20 years.

It comes as no surprise therefore that reports of teenage pregnancy seem to be on the rise. And it is also not lost that President Uhuru Kenyatta faced a barrage of attacks when he launched what has now come to be dubbed 'condom for school children' in February last year.

Earlier this month, reports of 20 school girls of Chelebei Secondary School in Mt Elgon, Bungoma County, being pregnant emerged in the media.

This comes barely a year after the government launched the policy document meant to help in reduction of such cases. It should be remembered that it is in the same area, at Chepkurkur Primary School, where 18 girls were confirmed pregnant at about two years ago.

While the incident might be looked at in isolation, it is part of a bigger nationwide problem that parents, teachers and the country at large have to grapple with.

The Kenya Demographic and Health Survey 2014 found that fertility rates in rural Kenya is higher with one in ten girls between the ages of 15 and 19 being fertile. This is in comparison to girls of the same age in urban areas.

The fertility rate of women generally has been falling of the years from an average of eight children per woman as recorded in the 1977-1978 survey to about four children in the 2014 survey.

Focus is now shifting on what could be the reason for more girls to get pregnant even after the government launched the policy document.

The policy looks at the sexual reproductive health status of adolescents in Kenya; the country has for a long time struggled to contain cases of early sexual debut, unplanned pregnancies, abortions and diseases including HIV.

Cheptais district education officer Jacob Wanyama says that reversing the trend requires a spirited sensitization campaign that will target parents and learners to mitigate cases of sexual engagement.

Wanyama says, "Among the measures include establishing more boarding schools and discouraging late night activities that may make the conditions thrive."

The latest pregnancy reports from Mt Elgon therefore come as no surprise that the students were aged between 14 and 18 years. KDHS 2014 notes that 15 out of every 100 women between 15 and 19 years have already given birth

On the same note one in every five women of similar age have begun bearing children or pregnant with the first child. Also the percentage of women bearing children increased significantly between 15 and 19 years.

But why would this worrying trend occur despite there being good policies on paper to address such issues among the youth?

While the policies look good on paper, stakeholders say that failure has been at the implementation stage.

Albert Obuyyi, the executive director of Centre for the Study of Adolescence (CSA) which trains young people on sexual and reproductive health says that despite there being a policy, the government is yet to invest in its full implementation. And he goes further to castigate the school system for not doing enough as well.

"The school system is not responsive to the needs of the youth and has failed to provide information in a time-tabled manner to learners," says Obbuyi.

Obbuyi also blames the traditional societal structure which he says has made it difficult for education of the youth on matters of sexual and reproductive health. With this lack of information and insufficient implementation, the field becomes free for all leaving adolescents to their own devices.

The government is clear that no person should be denied contraception services if they so need especially the sexually active youth, the health sector should have systems to make this possible without any glitches.

The policy on adolescents justifies the need to focus on the youth stating thus: Adolescents face greater adverse complications during pregnancy because they are not fully physiologically and biologically prepared for pregnancy due to among other factors gynecological immaturity and incomplete pelvic growth.

This tends to be a justification for the need of more education and if need be the use of contraception to stop unintended pregnancies that could also lead to abortion.

But Wanyama disagrees arguing that what is needed is information first so that learners can make informed choices. He says religious organisations and civil society organisations can come in handy and offer information services to learners.

He further argues that parents also need to discourage the problem by reporting because this will deter people who may target learners for sex.

He says, "Were it not for the media we would not have known because the parents would not have come to report so that legal action could be taken against them."