Three years after the Kenyan government began to promote emergency contraception as part of its family planning strategy, the “morning-after pill” remains as controversial as ever: critics argue that unless the public is better educated about its purpose, it risks undermining the messages of abstinence and protected sex, putting impressionable young people at risk of HIV.
"When you speak to young girls and the youth, they confide that unwanted pregnancy rings more in their minds than the possibility of contracting venereal diseases or HIV," said Anne Muisyo, coordinator of the Abstinence and Worth the Wait programme at Crisis Pregnancy Ministries. "It is the very reason I have qualms about a campaign telling people to relax because there is a pill they can run to after engaging in unprotected sex."
Muisyo's fears seemed borne out by students IRIN/PlusNews spoke to in the Kenyan capital, Nairobi. Jack*, a student at the Kenya Polytechnic University, says even though he fears HIV, he finds some reassurance in the existence of the pill.
"You know for us young people, we engage in quick and unplanned sex, for example at a party... You get a girl and you do not have a condom, what do you do? Let the opportunity pass by? No," he said. "Do it and give her some small money for a pill tomorrow."
Molly*, a student at the same university, said: "It's not that I do not use condoms at all with my partner, but the comfort you get when you realize there is a pill which is available cheaply is very tempting."
"You give yourself the belief that just once will not bring damage," she added.
The government is keen to stress that emergency contraception must not replace the condom.
Not a replacement for condoms
"I think it is important to note that we have been very consistent in our condom use promotion campaigns and we are not ready to change course because it prevents both pregnancies and HIV," said Shahnaaz Sharif, the director of public health at the Ministry of Public Health. "We have also been very consistent in saying that these pills do not in any way prevent one from contracting HIV."
Experts warn that unless the messages about emergency contraception are accompanied by further education on family planning and warnings about the dangers of unprotected sex, the government's campaign could backfire.
A study published in a recent edition of the East African Medical Journal found that just 15.8 percent of sexually active Kenyan university students said they used condoms every time they had sex, compared to 22.5 percent who reported never having used a condom.
Need for more education
"Various studies have shown that the sexual debut amongst the youth is happening very early," said Marsden Solomon, regional medical adviser for reproductive health NGO Family Health International. "Because a pregnancy has an immediate effect on them both psychosocially and economically, they would jump into anything that presents an opportunity to prevent it, and an emergency pill provides that opportunity for them."
"What they forget is that while they might have prevented an unwanted pregnancy, they have not done anything to protect themselves from HIV and any other sexually transmitted disease," he added. "I think the message to the youth should be abstinence, and for those who cannot, then dual protection methods like other long-term contraceptives together with a condom should be the most appropriate."
Solomon noted, however, that the emergency pill should not be dismissed altogether, noting that with proper education, it could form a useful tool in a much-needed national family planning push. According to the 2003 Kenya Demographic and Health Survey, nearly 20 percent of births in Kenya are unwanted and a further 25 percent happen at an unwanted time.
A study by social marketing group Population Services International - the government's partner in the national emergency contraception campaign - reported that the average age of women who use emergency pills regularly is 24.
(* not their real names)
ko/kr/oa/cb
"When you speak to young girls and the youth, they confide that unwanted pregnancy rings more in their minds than the possibility of contracting venereal diseases or HIV," said Anne Muisyo, coordinator of the Abstinence and Worth the Wait programme at Crisis Pregnancy Ministries. "It is the very reason I have qualms about a campaign telling people to relax because there is a pill they can run to after engaging in unprotected sex."
Muisyo's fears seemed borne out by students IRIN/PlusNews spoke to in the Kenyan capital, Nairobi. Jack*, a student at the Kenya Polytechnic University, says even though he fears HIV, he finds some reassurance in the existence of the pill.
"You know for us young people, we engage in quick and unplanned sex, for example at a party... You get a girl and you do not have a condom, what do you do? Let the opportunity pass by? No," he said. "Do it and give her some small money for a pill tomorrow."
Molly*, a student at the same university, said: "It's not that I do not use condoms at all with my partner, but the comfort you get when you realize there is a pill which is available cheaply is very tempting."
"You give yourself the belief that just once will not bring damage," she added.
The government is keen to stress that emergency contraception must not replace the condom.
Not a replacement for condoms
"I think it is important to note that we have been very consistent in our condom use promotion campaigns and we are not ready to change course because it prevents both pregnancies and HIV," said Shahnaaz Sharif, the director of public health at the Ministry of Public Health. "We have also been very consistent in saying that these pills do not in any way prevent one from contracting HIV."
Experts warn that unless the messages about emergency contraception are accompanied by further education on family planning and warnings about the dangers of unprotected sex, the government's campaign could backfire.
 You get a girl and you do not have a condom, what do you do? Let the opportunity pass by? No |
Need for more education
"Various studies have shown that the sexual debut amongst the youth is happening very early," said Marsden Solomon, regional medical adviser for reproductive health NGO Family Health International. "Because a pregnancy has an immediate effect on them both psychosocially and economically, they would jump into anything that presents an opportunity to prevent it, and an emergency pill provides that opportunity for them."
"What they forget is that while they might have prevented an unwanted pregnancy, they have not done anything to protect themselves from HIV and any other sexually transmitted disease," he added. "I think the message to the youth should be abstinence, and for those who cannot, then dual protection methods like other long-term contraceptives together with a condom should be the most appropriate."
Solomon noted, however, that the emergency pill should not be dismissed altogether, noting that with proper education, it could form a useful tool in a much-needed national family planning push. According to the 2003 Kenya Demographic and Health Survey, nearly 20 percent of births in Kenya are unwanted and a further 25 percent happen at an unwanted time.
A study by social marketing group Population Services International - the government's partner in the national emergency contraception campaign - reported that the average age of women who use emergency pills regularly is 24.
(* not their real names)
ko/kr/oa/cb
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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