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Youth reproductive health in focus as maternal deaths rise

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Kenya has made progress in the uptake of modern birth control measures, but the number of teenage maternal deaths paints a grim picture — a reason for deeper focus on the youth to improve their awareness of all available contraceptives and enable them to make informed choices on their sexual and reproductive health.

Hundreds of thousands of young people fall pregnant each year but maternal deaths claim hundreds of them, partly due to lack of information on preventive measures such as use of contraceptives.

Statistics by the United Nations Population Fund (UNFPA) for instance showed that some 378,397 adolescent girls aged between 10 and 19 years became pregnant between July 2016 and June 2017.

But more disturbing is that in 2017 alone there were 827 maternal deaths registered among young mothers aged between 10 to 19 years, an increase from 772 registered in 2016. Many of these deaths could have been prevented through the use of contraception that prevent unwanted pregnancies minimising the chances of procuring often unsafe abortions.

Kenya has shown overall progress in the use of modern birth control methods from the prevalence rate of 36.5 per cent in 2012 to 44.8 per cent in 2017. Contraceptives use is even higher among married women at a prevalence rate of 61 per cent women in 2017 from 49.7 per cent in 2012.

About 5,322,000 women used modern methods of contraception in 2017, according to Family Planning 2020 report, jointly authored by UKAid, Bill & Melida Gates Foundation, USAID and the UNFPA.

According to the report, 1,472,000 unintended pregnancies were prevented in 2017 as a result of contraceptive use, while 438,000 unsafe abortions and 5,000 maternal deaths were averted in the same year.

Kenya Action For Acceleration report on modern contraceptive mix has shown that significant number of women have adopted modern contraceptives, indicating that injection accounts for 47.9 per cent, implants (18.2 per cent), pills (14.1 per cent), male condoms (7.9 per cent), Intrauterine Device (IUD) contraception (5.9 per cent) and female sterilisation (5.6 per cent).

However, the Family Planning 2020 report, which supports the rights of women and girls to decide -freely and for themselves-whether, when, and how many children they want to have, indicate that 17.2 per cent of women in Kenya have unmet need in the modern method of contraception. This is a slight improvement from 17.7 per cent in 2016.

Implants remain the fastest growing birth control method in Kenya, especially driven by the low cost supplies in public dispensaries and hospitals.

The use of birth control implants is highest among poor and uneducated women who are taking advantage of free facilities in public health centres, a new recent survey the Performance Monitoring and Accountability (PMA 2020) revealed.

About 53.3 per cent of women using implants in Kenya are uneducated while 41 per cent fall within the lowest wealth quantile. “A higher proportion of implant users compared to all modern contraceptive users are married, live in rural areas, are less educated, poor, obtain their services from public health facilities and receive their method for free,” the PMA 2020 report showed.

The uptake of implants, however, remains low among educated working-class women who mainly visited private hospitals where the cost of such services are still prohibitive and are not covered by their various health insurance packages. The report states that among all the modern contraceptive methods, implants account for 33.4 per cent

It costs an average of Sh7,000- Sh15,000 to obtain implant services in private hospitals — a possible reason as to why their popularity is low among the middle-class women visiting private hospitals.

The use of contraceptives by women is highest in Central Kenya, the PMA 2020 report further showed with an estimated 73 per cent of women in the region using birth control devices and drugs. The region is followed by Eastern at 70 per cent and Nairobi with 63 per cent, Rift Valley at 53 per cent and Coast at 44 per cent while it is lowest among women in North Eastern at three per cent.

In terms of individual counties, Kirinyaga tops countrywide at 81 per cent against a national average of 58 per cent. Others with high rates are Makueni (80 per cent), Meru (78 per cent), Machakos (76 per cent), Tharaka Nithi (74 per cent) and Kiambu (74 per cent).

There is markedly low use of contraceptives in pastoral counties with Mandera and Wajir both registering a usage of just two per cent. Others are Garissa (6 per cent), Turkana (10 per cent), Marsabit (12 per cent) and West Pokot (14 per cent).