One in four pregnant, half cannot read: New survey exposes crisis in Kenya's most vulnerable counties
A new survey by the International Centre for Research on Women Africa and KNBS reveals that 27.5 per cent of adolescent girls in Tana River County are currently pregnant.
What you need to know:
- Among sexually active girls, 81.3 per cent in Tana River have ever been pregnant.
- Among all adolescent girls surveyed in the county, 27.5 per cent were pregnant at the time of the survey.
More than one in four adolescent girls in Tana River County was pregnant between January and June this year, according to a new survey. Conducted by the International Centre for Research on Women Africa and the Kenya National Bureau of Statistics to generate evidence ahead of a new programme, the survey revealed that 27.5 per cent of adolescent girls in the county are currently pregnant.
Across Garissa, Homa Bay, Samburu, Tana River, and West Pokot, the findings paint a stark picture of adolescent girls navigating their sexual and reproductive health under conditions that make informed decision-making almost impossible, with consequences the data makes impossible to ignore.
The new programme, known as the Her Health Initiative, is a five-year system change effort co-led by the Reproductive Health Network Kenya (RHNK) and the Centre for Reproductive Rights, in partnership with the Ministry of Health and the National Council for Population and Development. It will be implemented in five of Kenya's most vulnerable counties: Garissa, Homa Bay, Samburu, Tana River, and West Pokot.
The findings, validated in Nairobi on Friday last week, revealed that only five in 10 (53 per cent) of girls in Tana River have ever attended school, while half (51 per cent) are illiterate. The average age at first sex in the county is 15.8 years.
"Among sexually active girls, 81.3 per cent in Tana River have ever been pregnant. Among all adolescent girls surveyed in the county, 27.5 per cent were pregnant at the time of the survey," the report revealed.
"These numbers are not independent of each other. They form a chain. Low school attendance limits literacy. Low literacy limits access to information. Limited information reduces contraceptive use. High pregnancy rates pull more girls out of school. The cycle repeats," said Nelly Munyasia, RHNK executive director.
The study also found that only 41.3 per cent of schools in Tana River offer sexual reproductive health (SRH) classes, the lowest of any county surveyed, and just 36.9 per cent of girls name a teacher as their primary source of sexuality information.
"Where teachers are absent, friends fill the gap. And where friends are the primary source of sexual information for adolescents without access to accurate education, the consequences are visible in the data, revealing why 81.3 per cent of sexually active girls in Tana River have ever been pregnant," the survey stated.
In West Pokot, 22.3 per cent of adolescent girls surveyed were currently pregnant, while Samburu recorded 21.7 per cent. In both counties, the situation is urgent, but the drivers are different, meaning the solutions must be different too.
In Samburu, girls are having sex at an average age of 15.5 years, the earliest of any county in the survey. Contraceptive knowledge is not the problem: 89.9 per cent of Samburu girls know about injectables, and 92 per cent know about condoms. However, more than four in five (82.8 per cent) want more SRH education than they are currently receiving.
In West Pokot, 34.4 per cent reported the highest rate of sexual activity of any county in the survey. School attendance stands at 88.6 per cent, better than Tana River but still insufficient. Youth-friendly contraceptive services are largely absent. "The cultural barriers limiting contraceptive use are real and documented," the survey noted, reflecting the high pregnancy rate.
Homa Bay County, however, presents the survey's most intriguing puzzle. School attendance there is 99.1 per cent, the highest of any county, with literacy at 98.7 per cent. Knowledge of injectables is 87.4 per cent, and knowledge of condoms is 87.7 per cent.
"Teachers are the primary source of sexuality information for 60.4 per cent of girls, with mothers a strong second at 26.4 per cent. Yet still, 36.4 per cent of sexually active girls in Homa Bay have ever been pregnant. Seven and a half per cent were currently pregnant at the time of the survey," the report said.
In Garissa County, only 1.3 per cent of girls report ever having had sex, the lowest of any county, and none were currently pregnant. The average age at first sex is 17 years, the highest among the five counties. But Garissa also has the lowest condom knowledge of any county surveyed, at just 27.2 per cent. Only 51.4 per cent of girls know about injectables. Additionally, just 53.2 per cent of schools offer SRH education, and among those girls who do receive sexuality information, 9.2 per cent cite social media as a primary source, the highest proportion of any county.
What runs through all five counties like a single thread is the most consequential finding of the entire survey: teachers are the primary source of sexual and reproductive health information for adolescent girls in Kenya.
In Samburu, 69 per cent of girls name their teacher as their primary SRH information source. In Homa Bay, it is 60.4 per cent. In Garissa, 53.9 per cent. In West Pokot, 52.3 per cent. Even in Tana River, where school attendance is just 53 per cent and only 41.3 per cent of schools offer SRH classes, teachers still lead as the primary information source at 36.9 per cent.
Mothers are the second most trusted source of sexual and reproductive health information for adolescent girls; at 34 per cent in Tana River and 26.4 per cent in Homa Bay. This reveals that the two most powerful channels for reaching adolescent girls with accurate sexual health information are already operating in every county. They are just doing it without adequate training, without sufficient curriculum support, and without the institutional backing that would enable them to do it well.
"Across every county, teachers are the single most important source of sexuality information, demonstrating the critical role schools play in adolescent SRH education. Mothers are the second most common source in most counties, hence the need to equip them with the necessary information to pass on to the girls," said Munyasia.
Kenya already runs a comprehensive sexuality education programme, but it is not funding it. According to the Ministry of Health's Policies, Standards and Guidelines for Reducing Maternal Morbidity and Mortality in Kenya, sex education in schools was intended as a strategy to reduce unplanned crisis pregnancies that lead to unsafe abortions, high maternal mortality, and serious illness in the country.
However, the debate on introducing sexual education in schools has in recent years generated considerable discussion among Kenyans, religious leaders, and health experts, who hold differing opinions.
Nelson Ilamoka, headteacher of Khayenga Primary School in Kakamega, noted that on average, the school records three pregnancies per year. But in 2025, after the girls were counselled and taken through comprehensive sexual education, none of them sat for their examinations while pregnant.
"I recommend that different organisations with this programme partner with the Kenya Institute for Curriculum Development so that aspects of sexual education can be infused into the learning areas. The topics can be tailored to suit different age groups. If we hide behind the fact that learners are not supposed to be taught, then we are lying to ourselves," said Ilamoka.
The Basic Education Act, 2013, provides the operational rules and regulations for assigning content and form of learning for every subject taught. The assumption is that whatever is being taught in school is age-relevant and content-specific, which in the first place motivates the grading of pupils in certain classes and categories and their graduation to subsequent levels.
Additionally, the Adolescent Reproductive Health Development Policy (2003) emphasises multisectoral and interdisciplinary approaches to provide integrated and quality reproductive health information to learners. The Education Sector Policy on HIV/AIDS (2013) stresses the need to provide age-appropriate and relevant information on HIV/AIDS, as well as alcohol and substance abuse, to prevent new HIV infections among all students at all levels.
The Ministry of Health, in its National Adolescent Sexual and Reproductive Health Policy (2015), advocates for comprehensive sex education for persons aged 10 to 19 years, including access to contraceptives.
In 2013, the government signed a declaration committing to scale up comprehensive rights-based sexuality education beginning in primary schools, a promise yet to be fulfilled.
Education sector policies in Kenya have largely promoted HIV education while focusing on abstinence, resulting in a limited scope of topics covered in schools. The Kenya Conference of Catholic Bishops and the National Council of Churches in Kenya have consistently rejected the proposal to introduce sexual education in schools.
Despite these restrictions and the rejection of the subject in Kenya, some countries such as South Africa, Rwanda, Zimbabwe, and Namibia are increasingly acknowledging the importance of equipping young people with the knowledge, skills, and attitudes needed to develop and sustain positive, healthy relationships and protect themselves from unsafe situations.
The World Health Organization's guidelines state that between the ages of five and eight, children should learn to "identify the critical parts of the internal and external genitals and describe their basic function" and "recognise that being curious about one's body, including the genitals, is completely normal."
