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THE TRUTH ABOUT FAMILY PLANNING

By Jane Mwangi

The on-going and fully justified uproar regarding the large number of teenage pregnancies in Kenya (18 per cent of Kenyan teenage girls have already begun childbearing), now exacerbated by the lockdown brought on by COVID-19 crisis, has led to a vigorous debate as to how to tackle the problem and where Kenya stands in the battle against ‘unplanned’ pregnancies.

On a positive note Kenya has hit and surpassed the target of 58 per cent in the use of modern contraceptive methods and is on course to meet the goals set for growth in contraceptive use by next year, topping the East African region in the use of contraceptives among married women.

But what about the married and unmarried women, including teenagers, that are not using contraception?

Ironically, as far back as the 2014 Kenya Health Demographic Health Survey reported that contraception information is more accessible to mothers after delivery.

It is also the case that to a large extent Kenyan society frowns upon sexual activity and contraception outside of marriage, hence young adolescents, unmarried women and women without children do not have as much access to information about and methods of contraception.

The National Council for Population and Development recorded an average of 6,300 maternal deaths in 2015 citing unplanned pregnancies as the major cause of maternal deaths.

According to the World Health Organization complications arising during pregnancy and childbirth are the second cause of death for 15-19 year-old girls globally.

Have things changed since the surveys from 2014 and 2015? Pretty much not: surveys and studies going back to 2003 depressingly report the same figures, with over 18 per cent of girls and young women aged 15 to 19 being either mothers or getting pregnant every year.

As the chairperson of the department for obstetrics at Aga Khan University Hospital has said, “if they [adolescents] are already having sex, why not let them access family planning services?”

Family Planning is often misunderstood to be solely about contraception, however when viewed holistically it includes educational services, and medical or social activities which enable couples to determine freely the number and spacing of their children and to select the means by which this may be achieved.

Other aspects of family planning aside from contraception include sex education, prevention and management of sexually transmitted infections, pre-conception counselling and management.

The benefits of family planning for both individuals and nations are well recognized throughout the world.

A study conducted over several years in Bangladesh found that women who had the choice and opportunity of planning for the number of children they wanted and when to have them achieved earnings 40 per cent higher than women who did not have the same opportunity.

When women and their partners have access to contraception services, the socio-economic benefits accrue to the individuals concerned, their families and ultimately to the entire nation.

If couples can time and space births, both child and parents stand a much better chance of having better lives.

For a start mother and baby will be healthier.

The risk of death to both mother and child is higher during the first birth, mainly because it occurs at younger ages. Pre-pubescent or pubescent girls are also more likely to experience birth complications due to incomplete pelvic development.

Those mothers who thereafter have multiple births with only short spacing intervals in between and those with multiple children are also at increased risk.

There is empirical evidence showing that eliminating births among high-risk groups could eliminate between 20 to 25 per cent of maternal deaths.

Central to the future well being of the mother and her first child, and that of subsequent children if she decides to have any more, is the educational opportunity afforded by finishing her schooling before giving birth and all that flows from it in the form of higher income, better health and better education for her own children.

Early and unintended pregnancies are reckoned to contribute to one-in-four of girls who drop-out of school. But if girls stay in school and complete their secondary education they can look forward to achieving 40 per cent higher earnings to support her family compared to their compatriots who left school early to become young mothers.

Spacing subsequent births means households can invest more in each child’s nutrition, health and education – meaning happier, healthier and better educated children.

Family planning is a delicate and disquieting subject for some but we should not be afraid of it. We should be very afraid of the consequences arising from the ongoing pandemic of teenage pregnancies in Kenya.

Jane Mwangi is a Human Resources consultant

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