By HENRY OWINO (Senior Science Correspondent)
Teenage pregnancies are a global problem, occurring in high, middle and low-income countries. Around the world, however, such pregnancies are more common among marginalized communities, due to poverty, lack of education and unemployment.
Several factors contribute to teenage pregnancies and births. In many societies, girls are under pressure to marry and bear children early.In least developed countries, at least 39% of girls marry before they are 18 years of age, and 12% before the age of 15 years.
Often, in such societies, motherhood is valued and marriage or union and childbearing may be the best of the limited options available.
In Kenya, for example, the Kenya Demographic and Health Survey (KDHS)2014 statistics shows that 18% of young girls between ages of 15-19 years have either had a live birth or are pregnant with their first child.
The statistics implies that approximately one in every five teenage girls of same age brackets have either had a live birth or are pregnant. The rate increases rapidly with age from 3% among girls aged 15 years, to 40% among girls aged 19 years.
These data were released by National Council for Population and Development (NCPD) during a national dialogue on ending teenage pregnancy in Kenya. The meeting held early March 2020, in Nairobi, brought hundreds of teenagers, parents, teachers, religious leaders, county and national governments leaders, among other stakeholders.
Counties Burden of Teenage Pregnancy
The teenage pregnancy situation varies by County, with some counties being disproportionately affected than others. Narok County is the most affected at 40% of teenage girls being pregnant followed by Homabay at 33%. West Pokot comes third with 29% teenage pregnancy rate. Other counties featuring prominently in the list of shame include, according to the KDHS Tana River, Nyamira, Samburu, Migori, Kwale, Bomet, Transnzoia, Uasin Gishu, Kilifi, Busia, Kericho, Kajiado, Turkana, Meru, Kakamega, Isiolo, Laikipia, Kisii and Nakuru.
The KDHS report further indicates that teenage pregnancy and motherhood rates have remained unchanged since 2008, implying that many girls continue to drop out of school.
“Many girls continue to experience health related challenges, including mortality and morbidity due to birth related complications and unsafe abortion. Again many girls in some instances are forced into early marriages by cultural practices.”
The net effect of this is that, the prospect of girls securing descent economic opportunities is greatly compromised, and this in turn jeopardizes the country’s potential of reaping the demographic dividend.
Drivers of Teenage Pregnancy
Teenage pregnancy is driven by a number of factors, including lack of education (including sexual and reproductive health), poverty, early sexual initiation, harmful cultural practices (such as child marriages) sexual abuse/violence and barriers to access to sexual and reproductive health services.
According to the Director General of NCPD, Dr Mohamed Sheikh education is a social vaccine and is associated with positive health outcomes. He said studies have consistently shown that education attainment has a strong effect on health behaviors and attitudes.
“Teenage girls with no education or those with primary education only, are more likely to begin childbearing compared to those with secondary education and above,” Dr Sheikh noted.
Dr Sheikh clarified that KDHS’s 2014 report indicates that 33% of teenage girls 15-19 with no education had begun child bearing compared to 12% of girls with secondary or higher education.
The DG explained that schools equip adolescent s with basic information on sexual and reproductive health (SRH). Moreover, schools provide a safety net/protective environment to adolescents, thereby reducing their vulnerabilities to teenage pregnancy, early childbearing and other SRH risks.
Counties Lowest Secondary Enrolment
Poor school enrolment, retention, transition and completion rates compromise education attainment and can be attributed to high teenage pregnancy rates in some counties. Good examples are Narok, West Pokot, Tana River, Samburu and Turkana Counties, which have low transition rates from primary to secondary school.
An exception to this is North Eastern Counties that have fairly moderate rates of teenage pregnancy and motherhood, despite having low school enrolment and transition rates. Mandera, Turkana, Wajir, Garissa, Marsabit, Samburu, Tana River, West Pokot, Narok and Isiolo counties have lowest secondary net enrolment.
Whereas schools provide information on sexuality and sexual reproductive health, the information is inadequate and does not fully respond to contemporary challenges facing learners. Parents on the other hand, are not providing sufficient guidance to adolescents, leaving this important role to teachers, uninformed peers and the internet, according to the findings from the National Adolescent and Youth Survey Report (NAY) 2015, suggest that parents have been negligent and have failed to provide proper guidance to the adolescent.
Hon Pamela Odhiambo, Migori County Member of Parliament, said to end teenage pregnancy, parents must play their roles while leaders should walk the talk and stop blame games while hiding their heads in the sand. She emphasized the need to stop retrogressive cultural practices that expose young girls to unintended pregnancy and sexual violence.
“For instance, early marriages after initiations are being encouraged by parents in certain cultures in exchange for wealth hence promote early motherhood. This can stop if we talk to parents on the ground,” Hon Mrs Odhiambo said, adding “we need to stop talking in big hotels in town instead visit the counties where these things happens. Let’s go to the ground where the rubber meet the road and establish facts that could save our girls.”
Prof Richard Muga, Homa Bay County health executive, admitted challenges faced in the county but said efforts are in place to adjust. He attributed rampant teenage pregnancy and early marriages in the county to poverty..
“Poverty compromises school enrolment, retention, transition and completion thereby predisposing girls to early sexual relationship including early marriages,” Prof Muga said.
“Some girls are driven into sex to either meet their personal financial needs or those of their families. This is with fishermen, boda-boda riders, touts, teachers and some of the perpetrators are their own uncles or relatives for that matter,” he added.
In other counties school absenteeism contribute as girls are forced into child labor for lack of school fees, or are forced to remain at home during menstruation, for lack of sanitary pads. As a result, perpetrators would lure girls with money in exchange for unprotected sex.
So, parents, teachers, leaders and community at large should work together to make necessary investments to ensure girls transit from primary to secondary school and even beyond. Ensuring bursary programmes to poor or needy students from disadvantaged backgrounds benefit.
Health workers’ biasness and unwillingness to acknowledge and address adolescents’ sexual health needs must be addressed amicably.
Adolescents’ inability to access contraceptives should be helped not discriminated to help girls obtain sexual health needs. For example, restrictive laws and policies regarding provision of contraceptive based on age or marital status should be reviewed and amended where necessary.
Governments should also expand free sanitary pads programme to eliminate barriers to girl child education. Lastly, teenage girls who drop out of school due to pregnancy issues should be supported to go back to school in line with the government policy.