We are nearly half way through 2019, with only eleven more years until 2030– the year that all countries must achieve the 17 Sustainable Development Goals (SDGs).
But is Kenya on track to meet its commitments, especially for SDG 3, Good Health and Wellbeing? The statistics show that a lot more needs to be done.
Kenya is a relatively youthful country—where 24 percent of the population is between the ages of 10 and 29. A growing population of adolescents means we need to work faster to improve young people’s health, to reap the economic rewards of a demographic dividend.
Adding to these demographic pressures is the troubling situation with adolescent girls. One in five girls between the ages of 15 and 19 is a young mother, while about 13,000 girls drop out of school every year due to pregnancy. Adolescent girls are being prevented from fulfilling their potential, which compromises their health and the wellbeing of future generations.
Key drivers of adolescent pregnancy include female genital mutilation (FGM), the lack of age appropriate comprehensive sexuality education, early child marriage and early sexual debut. These issues can be compounded by poverty, unemployment, child abuse, and poor law enforcement, especially for vulnerable or orphaned children.
Kenya must address the barriers to adolescent girls’ SRHR if it wants to achieve SDG 3 or the goal of Universal Health Coverage—a key pillar of the country’s Big 4 Agenda.
Currently, adolescent sexual and reproductive health investments are not prioritized, with existing adolescent policies and programs being fragmented, with low coverage. Further, many policies and programs are not effectively implemented or adequately evaluated to build evidence on efficacy or cost effectiveness.
Despite laws governing harmful practices such as FGM, early marriage, and gender-based violence, enforcement of these legal frameworks is poor and ineffective. The translation of policies and commitments into implementation strategies that include young women and adolescents remains minimal with contradictions between sector policies, funding shortfalls and inadequate adolescent focused services. Religious and cultural barriers to age appropriate sexuality education and cultural practices that perpetuate ill health among adolescents still persist.
How will Kenya then achieve SDG 3 or its Universal Health Coverage pillar of the Big Four agenda if equity is not entrenched to include all age groups and ensure that No One is Left Behind? It’s time to listen to the voices of adolescent girls and women.
Last year, The White Ribbon Alliance Kenya, a key partner and Sexual reproductive thematic lead of the Deliver for Good Kenya Campaign, commissioned the What Women Want campaign, which sought to establish the key priorities for girls and women regarding their reproductive health needs. Over 1 million voices were heard globally, with over 127,000 responses collected across Kenya.
For adolescent girls and young women in Kenya, the issue was almost unanimous across counties and age groups. The demands are clear. Girls and women want more information and education on sexual and reproductive health and sexuality, more contraceptives, respectful and confidential treatment in health facilities, and more space to speak on their needs. Girls and women want to decide their sexual and reproductive health priorities and have their voices heard.
Through the Deliver for Good campaign, the White Ribbon Alliance Kenya has brought together key stakeholders to ensure successful dissemination and implementation of the Adolescent Sexual and Reproductive Health Policy, which has been in place since 2015. Political leaders including first ladies of some counties and members of county assemblies have lauded the efforts and called for multi-sectoral coordination and partnerships in addressing adolescent pregnancy and ensuring the policy’s full implementation.
The phrase “Nothing about us, without us” must hold true for women and girls seeking reproductive health care services. The gender lens must be integrated into health policies and programs for any significant change to take place. Until all women and girls-adolescents, women with disabilities and other needs have their sexual and reproductive health and rights addressed without prejudice or discrimination; Until communities can make a deliberate effort to end Female Genital Mutilation; Until men value their girls and give them education rather than marrying them off early for dowry; Until women have a say in the number of children they can have, and have meaningful conversations with their partners about family planning; Until both governments and leaders are conscientious about moving from political will into concrete action, then the narrative will continue.
Some county assembly members have promised to lobby for more budget allocation for adolescent sexual and reproductive health in their county health budgets. Reproductive Health departments in counties with high rates of adolescent pregnancy are considering shifting strategies from just engaging school going children to involving communities as well.
The policy is in place. We just need an implementation framework that responds to girls and women and puts their needs first. To Deliver for Good, let’s act on What Women Want. We won’t achieve the SDGs without it.