Kenyan media exploded with a disturbing story last month: “Close to 4,000 school girls impregnated in Kenya during COVID-19 lockdown”, read one headline. “Alarm as 3,964 girls impregnated in Machakos County in five months”, stated another.
The articles all cited data from a recently released Kenya government health information survey, and most attributed the high pregnancy numbers to the COVID-19 lockdown. That seemed to make sense. Since the pandemic hit Kenya in mid-March, healthcare providers have been warning about its potential to increase rates of teenage pregnancies.
School closures have cut off girls from teachers who can sound the alarm in suspected cases of abuse at home, and students have been left idle and often unchaperoned by busy parents. Restrictions on movement have also made it harder for girls to access contraceptives and family planning services, and mandatory curfews have trapped girls in homes with predatory family members and neighbours.
But many of the articles published last month failed to put the numbers of teen pregnancies into context. In Kenya, high-risk early pregnancy has long been a societal challenge. Government demographic data from 2014, the latest available, show that 15 percent of girls aged 15-19 had already given birth, and another three percent were pregnant with their first child – the highest rates in East Africa.
Underpinning any COVID-19-related rise in teen pregnancies are other significant challenges, including insufficient funding for reproductive health services and a lack of comprehensive sex education in schools – which have contributed to Kenya’s alarming numbers.
COVID-19 makes it worse
Comprehensive national data on the impact of COVID-19 on teen pregnancy rates are not yet available. At least anecdotally, though, some healthcare providers suspect a coronavirus effect.
Last September, Ashley Okoth*, a high school student living in a remote village in western Kenya, boarded a public bus to travel to the nearest city to visit her aunt. She sat next to an older man, who seemed friendly and started chatting with her. By the end of the ride, Okoth had taken his number, and the two began texting.
Okoth was an eager student, who enjoyed physics, math, and geography and loved playing baseball and handball with her friends. She planned to attend university to become a teacher. So Okoth was devastated when COVID-19 closed her school in mid-March, and her days blurred into a mundane routine of doing chores and helping her mother at her job as a sand harvester.
With time on her hands, Okoth decided to visit the man from the bus, and they had sex. Just weeks later, Okoth realised she was pregnant. She says her father will prevent her from returning to school — a punishment for her pregnancy.
“I wish I had been going to school, because if I had been [occupied] going to school, this would have not happened,” Okoth told The New Humanitarian. “I feel bad because my dream has failed now just because of my pregnancy.”
“I feel bad because my dream has failed now just because of my pregnancy.”
Okoth is not alone.
Elizabeth Mariara is a nurse running a reproductive health clinic in rural Kenya. The number of pregnant 16-18 year olds coming to her clinic between April and June 2018 was four; then three in 2019. This year, that number jumped to 30 for the period.
Mariara said she is also seeing a rise in teenage girls who say they are pregnant from incest. She had never encountered an incest case before, she said, but this year she has already had two.
“You know everybody being at home, even the uncles and the family are not even working,” she told TNH. “They’re still at home. They take advantage of the girl child.”
Siddharth Chatterjee, the UN resident coordinator in Kenya, warned that individual, anecdotal cases should not be used to extrapolate a national pattern.
“Confirming the precise numbers at this moment is still quite complex,” he said. “It’s too early to say if there has been a rise in teenage pregnancy, or is it as per the current levels that are already there… Unintended teenage pregnancies have always been very, very high.”
But other factors could make young girls more vulnerable to any COVID-related pregnancy risks.
The US government has historically been a major contributor to Kenya’s healthcare budget. But since President Donald Trump reinstated and expanded the policy that prohibits funding to NGOs that offer counseling, referrals, or services related to abortion — often referred to as the Mexico City policy or the global gag rule — Kenyan reproductive health and family planning organisations have struggled with reduced financing. Some have had to close their doors, according to the NGO Family Health Options Kenya.
The global gag rule has “made it worse,” said Chatterjee. “The institutions that used to provide those services…[have] had to shut down… And therefore the opportunities of access to knowledge and reproductive health services have virtually diminished.”
The clinics that remain are more vulnerable and less resilient than they would have been had they received US donor funding, representatives of those facilities say, and it is difficult for them to provide critical health services much less offer counseling and contraceptives to teenage girls.
“The institutions that used to provide those services…[have] had to shut down… And therefore the opportunities of access to knowledge and reproductive health services have virtually diminished.”
The Reproductive Health Network Kenya (RHNK), a group of pro-choice health providers and advocacy organisations, purchases contraceptives and other healthcare items and distributes them to smaller providers across the country. The group has refused to adhere to the US policy limitations and no longer receives funds from Washington.
“The global gag rule has worsened the situation because if only we had continued to get the funds, it would have been easy for us to be able to quickly integrate COVID into the existing [sexual and reproductive health] programmes,” Nelly Munyasia, the head of RHNK, told TNH in April.
“Institutions that used to get the funds from the American government are now hit so much because they do not have budget lines to take care of COVID,” she added.
Lack of sex education
In 2013, the Kenyan government committed to scaling up sex education, beginning courses in primary schools. But efforts to make good on this promise have been met with fierce opposition from conservative and religious groups.
Currently, when sex education is taught at all, courses focus largely on HIV prevention and abstinence — which means students’ knowledge of reproductive and sexual health is often limited.
“Parents told us, ‘Those things are taught in school. We do not talk to our children about sex. That is a taboo. So we expect that the teachers should tell our children about sex and about how to protect themselves,’” said Mercy Chege, director of programmes at Plan International, an NGO advocating for children’s rights and girls’ equality.
She continued: “The teachers say, ‘It is the work of the parents to teach their children about sex’... So now you’ll find that the children will go back to the internet, they’ll go back to their friends and they’ll try to discover.”
It’s a situation familiar to Okoth, the high school student who is now pregnant. She said she learned the basics of human reproduction in school, but she never received a thorough sexual health education.
Kenya’s parliament is currently debating legislation mandating age-appropriate sex education in schools.
But religious leaders and cultural conservatives have launched an aggressive campaign against the bill, arguing that such a curriculum runs counter to Kenyan cultural values. They’ve taken to the airwaves and social media platforms to encourage a public backlash against the bill.
What it means for young girls
Pregnancy and childbirth complications are the leading cause of death among girls aged 15–19 years globally, according to the WHO. A 2017 Kenyan study into maternal deaths revealed that nine percent of women who died in the hospital were teenagers.
Of pregnant teenagers who survive childbirth, nearly 98 percent drop out of school, research conducted in Kenya last year by Plan International shows.
Of pregnant teenagers who survive childbirth, nearly 98 percent drop out of school.
Most, like Okoth, will never return. Chege says that without education, survival for many girls will mean turning to transactional sex or marriage to a man who can “keep” them and their children.
And, she warns, the legacy of high teenage pregnancy rates will almost certainly outlast the coronavirus in Kenya.
“For years we have been struggling to elevate the girl child,” Chege told TNH. “So when you talk about gender equality, when you talk about women’s empowerment, two, four, five, 10 years to come, it’s going to be affected by what is happening right now.”
“If you do not get the girls to go to school, how are we ever going to get them into hospitals as executives or even in parliament or senate as decision-makers or lawmakers?”
*Her name has been changed to protect her privacy