- In 2021, Homa Bay recorded the following statistics: 4.2% of pregnant women were between the ages of 10 and 14, 20.6% were between the ages of 15 and 19, and 24.8% of adolescents received their first antenatal care visit.
The fight against Homa Bay County’s alarming rates of Human Immunodeficiency Virus (HIV) prevalence, rising teenage pregnancies, and rampant sexual gender-based violence face a significant setback if the High Court approves the implementation of the National Reproductive Health Policy 2022-2032.
The battle over the policy was filled on September 11, 2022, against the then Cabinet Secretary Ministry of Health, Mutahi Kagwe, challenging its provisions that hinder access to the highest attainable healthcare for young women and girls.
Despite recognizing the triple threat, the policy sidelines adolescents' reproductive rights, pushing abstinence and delaying sexual debut while restricting crucial services. Worse still, it arbitrarily sets 21 as the age for full cognitive competency, leaving countless young people vulnerable.
The policy mandates that persons under 18 must obtain parental or guardian consent to access reproductive health services.
This restriction effectively strips teenagers of their right to make independent, informed decisions about their reproductive health, leaving them vulnerable to the very issues the policy aims to address.
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Moreover, the policy contradicts Article 43 of the 2010 Constitution, which guarantees every citizen the right to the highest attainable standard of healthcare, including sexual and reproductive health services.
Ngina Muyanga, an advocate of the High Court and the Sexual & Reproductive Health Rights Program Manager at Kenya Legal & Ethical Issues Network (KELIN), questioned the level of public participation that was done before the policy was put into law.
She lamented that the policy contradicts the Children Act 2022, which states that a child is someone below the age of 18, while the policy recognizes that a minor is anybody below 21 and needs to get consent from their parent to access reproductive health services.
“There was inadequate public participation in shaping this policy, as the decisions made fail to prioritize the reproductive health needs of the majority, ultimately undermining efforts to curb the triple threat in Kenya,” decried Muyanga.
Restricting a wide range of services, including family planning and contraceptives, goes against the law, which guarantees everyone the right to the highest attainable standard of healthcare.
While decisions concerning minors should prioritize their best interests, this policy risks denying them critical healthcare, potentially exacerbating the challenges of teenage pregnancies, unsafe abortions, a rise in unreported Sexual and Gender-Based Violence (SGBV) cases and the spread of sexually transmitted infections.
Homa Bay has ranked among the counties hardest hit by these interlinked crises, commonly called the “triple threat.”
Successive administrations have launched aggressive interventions to curb the worsening statistics. However, the gains made over the years now risk being undone, threatening to reverse progress and plunge the county more profoundly into a public health and social crisis.
According to the research conducted by the Kenya Demographic and Health Survey (KDHS), in 2022, Homa Bay County ranked sixth with a teenage pregnancy rate of 23%, registering a reduction from 33%.
In 2021, Homa Bay recorded the following statistics: 4.2% of pregnant women were between the ages of 10 and 14, 20.6% were between the ages of 15 and 19, and 24.8% of adolescents received their first antenatal care visit.
In 2022, the percentage of adolescents aged 10 to 14 who were expecting reduced to 1.8%, while the rate of pregnant adolescents aged 15 to 19 decreased to 19.2%. Additionally, the percentage of teenagers receiving their first antenatal care dropped to 21%.
However, in 2023, the county experienced a rise in teenage pregnancies. The figures stood at 2.4% for girls aged 10-14, 19.6% for girls aged 15-19, and 22% for girls aged 10-19 who were pregnant during their first antenatal care visit.
In Kenya, approximately 1.62 million people are living with HIV/AIDS, with Homa Bay County accounting for 138,932 cases, of which 33,343 are adolescents.
Furthermore, Kenya has an overall HIV prevalence rate of 4.5%, while Homa Bay County's prevalence rate is at 15.2%, nearly four times higher than the national average. Among those affected, 23.1% are girls, and 20.95% are boys between the ages of 10 and 24.
In 2023, the county also reported 7,618 cases of sexual gender-based violence among teenagers.
With the new policy in place, these alarming numbers could rise as teenagers may be denied essential reproductive health services due to parental consent requirements, leaving many without critical care.
Dr Brighton Odundo, a Sexual Reproductive Health expert from Rachuonyo North health facility in Homa Bay County, reiterated that the policy contradicts WHO guidelines that grant access to family planning to all women of reproductive age.
“We will witness a rise in teenage pregnancies without direct access to family planning for our young girls who have attained reproductive age. The policy makers should review the WHO protocol that demands access to family planning to adolescents,” Dr. Odundo reiterated.
Dr Odundo also shared that with the policy baring teenagers to access reproductive health services, teenagers with strict parents will have nowhere to turn to since the law prohibits health workers from offering these services to young girls without adult consent, which will lead to a rise in early pregnancy cases.
“Efforts laid to curb teenage pregnancies in the county have seen to it that we register lower numbers annually but the policy puts these efforts to the drain. The lawmakers should respect human rights and foresee the looming consequences of the policy,” The RH expert lamented.
Mercy Kwamboka, a youth advocate from the Social Services Department in Homa Bay County, shared her worry about the policy undermining Article 31 (c), which states that every person has a right to privacy, which includes the right to have information relating to their family and private affairs unnecessarily required or reveled.
Citing her experience at the department, Kwamboka confirmed that many youths and teenagers access reproductive services frequently because they are sexually active, and sharing their sexual experiences with their parents to ascend medical services deprives them of their privacy.
“We have sexually active teenagers and youth who rely on reproductive health services daily,” said Kwamboka.
“The department provides guidance, counseling, and referrals for contraceptives, family planning, and HIV testing to combat the triple threat. But if accessing these services requires teenagers to disclose their private sex lives to their parents, many will avoid seeking help altogether. This will only lead to more unprotected sex, silence, and a surge in triple threat cases.”
Despite this petition being supported by stakeholders to see to it that adolescents access the utmost attainable reproductive health services, some stakeholders support the policy, saying minors cannot make informed choices about their reproductive health.
Hellen Oromo, a Triple threat advocate and Program manager at Lake Region Community Development (LARCOD), expressed her support for the policy, citing that minors need appropriate guidance on sexual matters.
"Parents should have open talks about sexual matters with their children and teach them to prioritize abstinence over making rush decisions into sexual exploration that will put them in need of services like family planning," Oromo said.
The National Reproductive Health Policy 2022-2032 has faced legal challenges, with a petition currently in court. This reflects the grave concerns raised by stakeholders over its potential to worsen the triple threat crisis.
By restricting adolescents' access to essential reproductive health services, the policy risks driving up cases of HIV infections, teenage pregnancies, and sexual gender-based violence, undoing years of progress in public health interventions.
As the court deliberates on this petition, it is crucial to uphold the constitutional right to the highest attainable standard of healthcare for all, including adolescents.
If this policy can stand, it will push vulnerable young people further into secrecy and risk, exacerbating the issues it claims to address.
The fight against the Triple Threat cannot afford regressive policies. Instead, it requires inclusive, rights-based solutions that empower, rather than endanger, Kenya’s youth.
Only by guaranteeing access to comprehensive, youth-friendly reproductive health services can we hope to address these crises and ensure the well-being of future generations.
