Only a proper policy on unsafe abortion will save Kenyan girls from dying

Many teenagers are getting pregnant and contracting sexually transmitted diseases due to lack of information.Picture:Thomas Bwire
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When Cabinet Secretary James Macharia launched the National Adolescent Sexual and Reproductive Health Policy 2015, it was clear that things were not very good with the youth as in matters sexuality.

Though many engage in early sex which is often unprotected, reproductive health services continue to exclude them, and where offered, they are largely unfriendly and discourage young people from seeking them.

Information to empower youth

It is within this context that Macharia said the ministries of Health and Education were working together to empower young people with appropriate information and skills to help them make informed choices about their sexuality.

In a speech read on his behalf by Principal Secretary Khadijah Kassachoon, Macharia said: “My ministry, together with the Ministry of Education are working to ensure that age-appropriate comprehensive sexuality education is implemented in all schools.”

He noted that adolescents who have access to sexual and reproductive health information and services are more likely to stay in school, giving them better opportunities to obtain a secure income and fully contribute to the country’s economic growth.
Earlier in 2014, Senator Judith Sijeny brought the Reproductive Health Care Bill to the floor of Senate noting that if passed into law, it would help reduce the rate of HIV infections and deal with rising cases of teenage pregnancies.

Sijeny said: “This Bill will provide a framework for protection and advancement of reproductive and health rights for women and children.”

The Bill, however, raised significant controversy with many unwilling to read and understand the spirit and letter in which it was brought forward.

Statistics speak

The Kenya Demographic Health Survey 2014 indicates that 18 percent of young women ages 15 to 19, who are basically just girls, have given birth or are pregnant with their first child.

Recent evidence suggests that the age of sexual debut gets lower depending with area of residence with girls in the informal settlements of Nairobi having had their first sexual encounter by age 12.

However, nobody wants to accept that girls this young are having sex at a stage in which they are least informed about contraceptives and risks of getting pregnant.

This early pregnancies are ultimately having significant implications on the lives of young girls who often have to drop out of school while their male counterparts continue with their education unaffected.

The National Adolescent Sexual and Reproductive Health Policy 2015 recognises that a number of factors have been associated with adolescent pregnancies. It notes that while many adolescents may choose to get pregnant, many pregnancies occur in the context of human rights violations such as child marriages, coerced sex or sexual abuse.

Unsafe abortion still a problem

But what happens when a girl gets an unwanted or unplanned for pregnancy? Most of the young girls will not keep the pregnancy but instead opt for abortion, and quite often it will be one that is not safe.

The Kenya Demographic Health Survey 2014 puts Kenya’s maternal mortality at 362 per 100,000 live births. Among the contributors to maternal mortality is unsafe abortion which accounts for 13 percent of all maternal deaths in Kenya.

According to IPAS Africa Alliance, thousands of women and girls end up with lifelong injuries or die from pregnancy related consequences. IPAS notes that four in every 10 women who die from unsafe abortion are adolescents aged between 15 and 19 years.

This is the elephant in the room that nobody wants to talk about as girls and young women continue to die from situations that they could have seen them saved.

A study dubbed Incidence and Complications of Unsafe Abortion in Kenya by IPAS estimates that due to delays in seeking care, more than three quarters of the women treated for post-abortion care suffered complications that included high fever, infection and some resulting in organ failure.

In September 2012, the Ministry of Health did address the problem of unsafe abortion, but this was shortlived as the National Standards and Guidelines for Reduction of Maternal Mortality from Unsafe

Abortion was arbitrarily withdrawn in 2013.

Unsafe abortion, therefore, remains an issue that needs to be addressed properly with right policies. It’s a major contributor to Kenya’s maternal mortality burden, which should be addressed before it happens instead of in post-abortion care where the government has prioritised dealing with unsafe abortion.

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