The rate of early unwanted pregnancy in Kenya is alarmingly high. Around every fifth girl between the ages of 15 and 19 has had children. In some areas it is worse than in others. For example, in Narok and Homa Bay counties, the rate is as high as two in five. Most of these pregnancies are unplanned and unintentional.
Getting pregnant at such a young age can affect a girl’s health and socio-economic well-being.
When girls become pregnant, they voluntarily or involuntarily drop out of school. Most of them never return to school and miss out on critical educational investments necessary to their qualification and profitability.
They also face stigma and social exclusion that contribute to their poor mental health. Some seek abortion in unsanitary environments, resulting in complications, disability, and death. Almost half of all unsafe abortion deaths in sub-Saharan Africa are among teenage girls.
Those who terminate the pregnancy are at greater risk of birth complications. This includes eclampsia (potentially life-threatening seizures), premature birth, and low birth weight of the baby.
Awareness of the dangers of early unwanted pregnancy and knowledge of contraceptives has increased. But many girls continue to get pregnant this early. My colleagues and I conducted a study to understand why.
We analyzed data from two Kenyan counties in Kenya that had the highest rate of adolescent children. A total of 1,840 adolescent girls, ages 15 to 19, were enrolled in the study, and 60.3% were sexually active. Of these sexually active individuals (1,110), 42% became pregnant, and eight in ten (77.1%) pregnancies were unintentional.
There were a number of reasons why these young women became unintentionally pregnant. We interviewed some of them in depth. They said that they were sometimes tricked into having sex and that they lacked proper knowledge of contraceptives and their side effects. Nor did they have trustworthy mentors to confide in on sexual matters.
Knowing these factors is a critical step in developing pregnancy prevention programs.
We drew our study data from the basic data of the “In Their Hands” program. The program, which was carried out in 18 Kenyan countries, aimed to improve the uptake of quality sexual and reproductive health services by young people.
The African Population and Health Center to which we are affiliated collected both quantitative and qualitative data as part of the program evaluation. Our analysis only included teenage girls who had sex.
Our statistical analysis found that only 46.4% of sexually active teenage girls had ever used contraception. We also found that of the sexually active girls, two fifths had unwanted pregnancies. Girls who had never used contraception were about twice as likely to have unwanted pregnancies as girls who were using contraception.
Current school attendance reduced the likelihood of unwanted pregnancy in adolescents by 66%. However, people living in rural areas were 64% more likely to have unwanted pregnancies than those living in urban areas.
Why they got pregnant
We interviewed 19 girls who had experienced unwanted pregnancy early to get their perspective on why they are vulnerable. They attributed their pregnancy to the fact that they were seduced into sex. Boys challenged them to prove their love by having sex with them, and they held on to maintaining their relationships and impressing their partners. When they became pregnant, the boys abandoned or rejected them.
Some said they lacked accurate information about contraception before starting sex.
Many said they could only prevent pregnancy if they were already pregnant. Neither their parents nor their teachers taught them methods to prevent unwanted pregnancies.
Some people who knew about birth control were misinformed about side effects. A 16-year-old respondent from Homa Bay County, who became pregnant and dropped out of school before age 15, said:
Yes, we were told, but we were told that if you want to use it, you must have a child first because if you just go free (with contraception) you may not be able to have a child.
The lack of trustworthy mentors to advise her on sexual matters, including preventing pregnancy, has been cited as a reason for her unwanted pregnancy. When asked why she did not consult older women, one respondent replied:
I don’t have an older woman to trust. If you tell them, they will know you are having sex and everyone will know soon.
Our findings suggest the need to prioritize two main proven interventions as policy makers reflect on effective strategies to terminate teenage pregnancy in Kenya.
First, comprehensive sex education is vital. This is sex education that gives students the right knowledge, attitudes and skills. A good program will improve their knowledge of sexually transmitted diseases, reduce unwanted pregnancies and unsafe abortions, increase contraceptive use, delay sexual debut, decrease the number of sexual partners, and improve women’s autonomy in deciding when, how, and with who to have sex with.
Therefore, it is important to fully implement sex education before boys and girls have sex. There is currently sex education in Kenya, but it is not comprehensive. For example, it mainly focuses on abstinence and HIV, neglecting contraception and how to access it. And teachers often provide incomplete and sometimes inaccurate information.
It is also important to complement comprehensive sex education with improved access to contraception in order to end an early unwanted pregnancy in Kenya. In contrast to countries like South Africa, there are no programs that target young people who are contraceptive. In South Africa, condoms are available in schools. While young people are given access to contraception in clinics, it is often not easy to do as providers may give judgment. There may also be data protection or cost issues. And some teens cannot consent to services without their parents.
Although the Kenyan government has committed to ending teenage births by 2030, cultural norms and values related to sex and religious dogmas prevent them from implementing what is known to work.
Overcoming obstacles such as cultural and religious norms will be crucial in ending an untimely unwanted pregnancy in the country.