Pauline, 18, delivered a baby girl at the Mrima Maternity Hospital in Likoni, Mombasa County, early October.
She got pregnant after marriage last year at 17 and this is her first baby, delivered through caesarean section. Pauline is an example of rampant early marriages, teenage pregnancies and poor contraceptive reach in the seaside county. Statistics show that 13,000 girls in Kenya drop out of school each year due to early pregnancies.
Early sexual debut and early marriages continue unabated in the area: between June and September this year Mrima alone recorded 167 pregnancies of girls aged between 15 and 19. In the same period, 96 girls of similar age group sought contraception services. Officials at the hospital argue that the number could decrease if the teenagers received proper information on reproductive health and services.
The World Health Organisation notes that underage mothers may suffer numerous pregnancy-related complications including high risk of eclampsia, puerperal endometritis and systemic infections. But there are fears that more young girls could be delivering without skilled care thus duplicating the inherent danger.
One in 10
Rukia Shosi, the medic in charge of Mrima says while one out of 10 antenatal care visits are by teens, some could be delivering under the care of traditional birth attendants. “While we do not discriminate the girls who come to deliver here, we consider them high risk due to the fact that they are still young,” says Ms Shosi.
Shosi says teenage pregnancies remain a problem due to poor reception of sexual education by the community. “Religion plays a key role in this region and the community is not willing to fully accept that family planning is important; this has exposed many girls and women to unplanned pregnancies among other reproductive health conditions,” says Shosi. The situation is no different in Nyali and Kisauni sub-counties. Kisauni has 64,619 women of reproductive age while the number of teenagers reached by family planning services last year was only 121.
In neighbouring Nyali, one out of 25 women seeking family planning services are aged between 10 and 19 years. But Victoria Kapune, a reproductive health coordinator says there is an unmet need for family planning.
“Missed opportunities opportunity occurs when a woman who could need family planning services fails because of one reason or the other like lack of information and has contributed immensely to teenage pregnancies but we have a strategy to counter this by training all hospital workers to educate all women seeking health services about family planning,” explains Kapune.
This is a programme that the sub county is undertaking in partnership with with DSW Kenya, Family Health Options Kenya.
DSW Kenya for instance has come up with youth friendly centres where young people van information on reproductive health.
In one such centre is Mikindani where young people from the surrounding area get information on sexuality matters and if need be get referred.
Kezziah Olooh, a 26-year-old youth champion at the centre says the issue of need for contraception among young people cannot be wished away.
Early sexual debut means that young people are bound to meet consequences that come with sexual engagement.
Olooh says, “Lifestyle in the surrounding slum areas like Jomvu pushes young girls to begin sexual engagement and this is promoted by peer pressure.”
She adds that she has dealt with a 12-year old who walked in seeking contraceptive services. Olooh also says that without services these young girls are likely to procure unsafe abortions which is one of the leading contributors of maternal deaths.
This in itself poses a challenge requiring a mental shift. Collins Baswony of DSW opines that in such cases there is a need for mental shift even among service providers that deal with these young people.
“We urge that young people be viewed as clients by health service providers so as to create objectivity in the way they will receive critical services without judgement or impediment,” states Baswony.