Sexual and Reproductive Health and Rights: Understanding the SRHR Landscape in Kenya
The United Nations Population Fund defines sexual and reproductive health as a “state of complete physical, mental, and social well-being in all matters relating to the reproductive system.” With access to sexual and reproductive health and rights (SRHR), people can have safe and satisfying sex lives and decide if and when they want to have children.
Access to sexual and reproductive health and rights is particularly important for people in their teens. For instance, approximately 289,000 adolescent girls will die in low- and middle-income countries from pregnancy and childbirth-related causes. In Kenya in particular, 18% of girls aged 15-19 have begun childbearing, which can often lead to complications unique to adolescent mothers. Teens who give birth are at a higher risk for a number of complications, including:
Obstructed labour and obstetric fistulas
Having a child also significantly impacts a girl’s life. It is estimated that in Kenya, 98% of girls who had begun childbearing by age 18 have dropped out of school, meaning that access to sexual and reproductive health and rights has significant impacts on young women’s socio-economic wellbeing. Adolescent pregnancy rates are also significantly higher in girls from lower income levels, implying that access to adequate contraception and sexual education is an issue of health equity.
Access to contraception, safe abortion, and sexual education for adolescents is often limited, especially for those in poor or rural areas. For instance, 53% of female adolescents and 34% of male adolescents in Kenya reported that they used a condom during their first experience with sexual intercourse. Lack of access to contraception has widespread impacts on couples’ abilities to space their children and on women’s abilities to be empowered to control their fertility.
Approximately 465,000 Kenyan women will undergo abortions every year, according to estimates by the Kenya Medical Association. And yet, abortion is not permitted under the constitution except in cases where “in the opinion of a trained health professional, there is a need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.” This means that approximately half of these women will undergo unsafe abortions using herbs, coat hangers, spoons, knitting needles, and other tools to terminate their pregnancy. As a result, many young women experience significant complications or must otherwise live with a pregnancy they were not prepared for, often trapping them in a cycle of poverty. Unsafe abortions are also the single leading cause of maternal death in Kenya, with 2,000 deaths per year being tracked to abortion complications.
Sexual education is effective in reducing risky sexual behavior in adolescents and subsequently lowering their risks of sexually transmitted diseases or infections (STDs/ STIs) including HIV and unplanned pregnancy. Access to accurate information can separate myths on sexuality and reproductive health from scientific evidence. However, a study conducted in 2015 found that only 2% of students involved were taught about all of the topics identified as constituting a comprehensive sexual health education programme. Furthermore, only 20% of students surveyed had learned about contraceptive methods. Comprehensive sexual education is a crucial component to ensuring that young people engage in safe sexual behaviour.
Issues of sexual education, contraception, and access to safe abortion are obviously intertwined. It is unsurprising that in 2012, 70% of women in Kenya who were treated for complications after unsafe abortions were not on contraceptives. This leaves young women who cannot access sexual education or contraception at a higher risk of developing life-threatening complications during pregnancy or undergoing unsafe abortions.
Sexual and reproductive health and rights encompasses a wide range of topics, including birth spacing and family planning, mental health and sexual- and gender-based violence, and education. Ability to access to sexual and reproductive health services is also largely determined by one’s education and income level, gender, sex, and race, since the most vulnerable often experience the most difficulties in reaching services. This article is not intended to explore all of these issues, but to give a brief background on the importance of SRHR for adolescents. Improving access to sexual and reproductive health and rights will have significant impacts on the health and empowerment of women and girls and could reduce neonatal and maternal mortality and morbidity, HIV/AIDs and STI rates. SRHR for adolescent girls, in particular, will prove crucial to achieving the Sustainable Development Goals (SDGs) in Kenya.
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