Taming teen pregnancies one conversation at a time

During a reproductive health session at a primary school in Kakamega County last July, a shy Grade Seven pupil aged 12 expressed her concerns.

She jotted them in a notebook: “If I don’t have sexual intercourse in the morning, I cannot concentrate in class.”

The note was read out loudly by Ms Beverlyn Polet, a health promotion officer at Kakamega General Hospital, who was conducting the session.

After the session, Ms Polet requested that the pupil follow her quietly so she could speak to her privately.

 During their conversation, the pupil confessed that she was struggling with sex addiction. She narrated that the addiction came from a boda boda rider who dropped her off to school every morning, having sex with her on the way. 

“This became a routine. Every morning she had to have sex with the rider and thereafter proceed for her lessons and on days when she did not, she could not concentrate in class,”Ms Polet revealed this to Healthy Nation. “Do you think this is a girl that we should turn our back to? Why should society expect that she continues with her education if sexuality experts don’t talk to her? The Kenyan society has long viewed sex talk as a taboo, but avoiding it leaves many girls under the risk of early pregnancies and early marriages. 

“This girl needed to have been guided and counselled, but when we assume that everything is okay, we continue losing a number of our children to such addiction. Our silence ruins their future,” Ms Polet added.

She noted that after the discussion, they became good friends. She would always check up on her, listen to her problems and through the guiding and counselling teacher, the girl can now concentrate on her studies. “I am glad that since this journey started, her performance and attendance in class have improved,” Ms Polet said.

However, Ms Polet is concerned that more pupils are suffering in silence since they have no one to talk to and no one to teach them about body changes, menstrual hygiene, relationships and even issues concerning their sexuality.

Ms Polet was part of a programme by the Reproductive Health Network Kenya, which identified that there was a high number of teenage pregnancies in Kakamega County. The programme brought together various stakeholders including the Ministry of Health, Teachers Service Commission, health care providers, religious leaders, teachers and learners.

The programme entails moving around schools and in the community identifying the gaps that are leading to the high rate of teen pregnancies.

Maureen Achieng and Euphrecia Musavi are representations of many girls who, without knowing what they are getting into, end up being mothers at a young age. The two were not lucky to have gone through the programme. They both dropped out of school in Standard Seven and Grade Four respectively.

 Speaking to Healthy Nation in Kakamega, Maureen and Euphrecia, who have since joined the programme as champions, said they would still be in school had they been taught about reproductive health in school.

Maureen’s curiosity led her to be a mother of a now 17-month-old child.  Her cousin introduced her to a man who would later break her virginity at the age of 17.  “One day after school, the boy requested me to pay him a visit at their home. I went but I did not give in to sex. I was afraid. But during my third visit, I gave in and I got pregnant,” she said. 

She added that it has been uncomfortable sharing details of her sexual escapades because she is ashamed. “I wish we could share sex education information that is relevant to every age group in schools. I would not be where I am now,” Maureen regrettably said.

Ms Polet noted that if sexuality counsellors don’t share the information with school-going children, they become more isolated. They tend to find out on their own and thus get themselves into risky behaviour.

After noticing that she was expectant, Maureen dropped out of school and the boy disappeared. “I was left with a deep psychological scar - taking care of a child in a struggling background and embarrassing my family.”

Maureen is now part of the programme, where she tells teenagers her story and encourages them to be better and avoid falling prey to irresponsible sexual advances.

For Euphrecia, she cannot vividly remember what happened before she conceived. She would occasionally visit the man, have sex and go back home until she got pregnant. “If I had the information I have gotten from the programme, I would not be a mother now. I blame my parents and teachers for not being open to us and telling us what we needed to know,” she says. 

Diana Muchalusi, a 16-year-old grade eight pupil, is lucky to have been part of the programme in school and she is confident that nothing will interfere with her education. “Given the teachings that we have been getting from the programme, I know a lot about my sexuality as a girl,” says Diana. 

She is among more than 100 girls who have since benefited from the programme. The Reproductive Health Network Kenya is planning to expand it to other sub-counties in Kakamega County. 

“We visited around 10 schools and in one of the schools, there was a dropout rate of 10 girls per term due to pregnancy. But after talking to the girls, from my assessment of the latest sexual reproductive health data, there is a reduction in teen pregnancy. In fact, no girl has fallen pregnant this term,” said Ms Polet.

She indicated that it is high time all the stakeholders realised that imposing their opinions and denying the learners the opportunity to get to understand sexuality so they can make informed decisions is not the right path.

Ms Nelly Munyasia, the executive director of Reproductive Health Network Kenya, told Healthy Nation that the programme was started given the worrying numbers of teenage pregnancies and gender based violence cases reported in Kakamega County. 

“Many times we have heard the government coming up with initiatives on how to reduce the worrying numbers of HIV new infections, early teen pregnancies and even gender-based violence. Looking at the numbers, it is the adolescents and youths who are majorly affected,” says Ms Munyasia. 

Through the programme, teachers were also taken through value-added transformation to enable them to address learners’ issues wholly by creating a favourable environment for teen girls in the community. “We also brought parents because we wanted them to play a critical role in providing the correct information,” she said.

According to the Kenya Demographic Health Survey 2022 statistics, teen pregnancy in Kakamega County stood at 15 per cent, which was equal to that of the national level, with GBV recording 17 per cent, way higher than the national rate which stands at 15 per cent. 

Data from Kenya Health Information Survey, Kakamega County indicated that last year, there was a drop in the number of pregnant teens from 12, 843 in 2022 to 9,048 in 2023.

For sub-counties, Malava is leading with 1,257 with a reduction of 239 pregnancies as compared to 1,496 in 2023 it is followed by Lurambi at 873, Navakholo 869, Lugari 820, Shinyalu 802, Matungu 795, Ikolomani 657, Butere 629, Likuyani 620, Mumias East 601, Mumias West 596 with Khwisero recording the least at 529 up from 701 in 2022.

“The numbers are decreasing but still we are not where we want to be. We are looking at a time when no teen will get pregnant while in school,” said Rose Muhanda, Kakamega County reproductive health expert.

Historically, the measure of a good sex education programme has been in the numbers - marked decreases in the rates of sexually transmitted diseases, teen pregnancies, and pregnancy-related drop-outs.

“It is about time that the Ministry of Education integrates the programme into the curriculum because learners require the information. It is only the teachers who are better placed to provide the information because they spend a lot of time with the learners,” Ms Munyasia said.

Mr Silas Wabuti, curriculum support officer with TSC in Kakamega County, indicated that the programme addressed sexual and reproductive health rights and services, especially to the young people in school and out of school.  

“In some schools, we have had about 50 girls getting pregnant at the same time. This affects the government agenda of retention and transition of learners. We need to engage extensively with various players so that we can collectively take responsibility for our children,” Mr Wabuti said.

 Ms Maureen Munyasia, human resource officer with the TSC Kakamega County, noted that teachers from Malaba, Kakamega East and Central were trained “and we are hoping that in future this will be done in all the sub-counties.” 

“While adhering to the policies, I think it is important for the programme to be incorporated in our curriculum. Learners should be taught so they make the right decisions about their sexuality,” she said.

She indicated that it is wrong to think that sexual education is all about teaching the learners to engage in sex as this denies them the opportunity to make informed decisions about their lives.

Pastor Patrick Muganda of Friends Church Namongo told Healthy Nation that one way to avoid teenage pregnancies is to provide teens with information and let them make the right decision. “Denying them means they are finding out for themselves in whichever risky way they can. “I teach these issues even in the pulpit and organise youths gathering. This is critical since we have no way out but to keep informing them,” Pastor Muganda said.

Mr Nelson Ilamoka, headteacher of Khayenga Primary, noted that on average, the school records three pregnancies per year but last year after the girls were talked to, none of them sat her examination while pregnant.  

“I recommend that the network partners with the Kenya Institute for Curriculum Development so that aspects of sexual education can be infused in the learning areas. The topics can be tailored to go with age. If we hide behind the fact that the learners are not supposed to be taught, then we are lying to ourselves.,” Mr Ilamoka indicated.

 The Basic Education Act, 2013 provides the operation rules for 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 grading pupils in certain classes and categories and graduating them to subsequent levels.

Also, the Adolescents 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 of 2013 stresses the need to provide age-appropriate and relevant information on HIV/Aids and alcohol and substance abuse to prevent new HIV infections among all students at all levels.

The Ministry of Health in its National Adolescents 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. 

The Education sector policies in Kenya have largely promoted HIV education while focusing on abstinence, resulting in a limited scope of topics in schools; with the Kenya Conference of Catholic Bishops and National Council of Churches in Kenya consistently rejecting the proposal of sexual education in schools.

Despite the restriction and 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 to develop and sustain positive, healthy relationships and protect themselves from unsafe situations.

The United Nations Educational, Scientific and Cultural Organization (Unesco) notes that with sexual education, learners can openly talk when they are confused about their bodies, relationships and values. “They learn to think about what is right and safe for them, how to avoid coercion, sexually transmitted infections including HIV and early and unintended pregnancy and where to go for help. They learn to identify what violence against children and women looks like, including sexual violence and to understand injustice based on gender. They learn to uphold universal values of equality, love and kindness.”

It advised that schools apply a learner-centred approach whereby sexual education is adapted to the age and developmental stage of the learner. Learners in lower grades are introduced to simple concepts such as family, respect and kindness, while older learners get to tackle more complex concepts such as gender-based violence, sexual consent, HIV testing, and pregnancy.

Unesco further notes that when delivered well and combined with access to necessary sexual and reproductive health services, comprehensive sexuality education empowers young people to make informed decisions about relationships and sexuality and navigate a world where gender-based violence, gender inequality, early and unintended pregnancies, HIV and other sexually transmitted infections still pose serious risks to their health and well-being. It also helps to keep children safe from abuse by teaching them about their bodies and how to change practices that lead girls to become pregnant before they are ready.

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.”

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