Is religious influence fueling the teen pregnancy crisis in Kenya?

Pregnant teens come to Helen’s clinic on a daily basis. As a private practice offering reproductive health services, she tells them it costs about 5,000 Kenyan shillings ($43) for an abortion. They often leave her office, unable to cobble together the funds, and resort to visiting a “quack” instead who might tell them to drink chlorine or bleach or put leaves inside their vaginal canal. They then come back to her, infected, either still pregnant or with an incomplete abortion, where the fetus hasn’t left the body.

“If you don't help her, her uterus is going to get so infected,” she said.

Helen works in a rural district in Kenya. Her clinic lies in an area where most families survive on subsistence farming and poverty levels are high. She asked to go by a false name, due to the ongoing harassment she faces for her work.

Kenya’s Ministry of Health reported 45,724 pregnancies among girls aged 10 to 19 in January and February 2022 — averaging about 775 a day.

“The statistics are mind-blowing,” said Stephanie Musho, a Nairobi-based expert in reproductive justice and a human rights lawyer.

There are myriad reasons — some consensual and some driven by poverty and exploitation — why adolescents become pregnant, according to experts, but one of the strongest driving forces is the lack of comprehensive sexual education in schools — with the Catholic Church leading the opposition.

The Kenyan government has also created a confusing environment for health care providers who are working to provide reproductive health care to adolescents. Guidelines are absent and policies are misinterpreted, leading to harassment of providers and patients, as well as denial of services.

Church says ‘moral fiber’ of Kenya at stake

Helen’s Catholic priest told her she forfeited a chance at eternal life by providing family planning.

“I told him: ‘I know my God is just and he sees what I'm doing. He will not just judge me,” she said. “Family planning with Catholics is a no-go zone.”

Comprehensive sexuality education is an embattled issue. In 2013, Kenya committed to scaling up this type of education in its schools through the Eastern and Southern Africa Ministerial Commitment on Comprehensive Sexuality Education. That was supposed to improve education in schools ​​— but it didn't, experts told Devex. Last December, the government did not recommit to the regional document, Musho said.

According to the American College of Obstetricians and Gynecologists, studies have demonstrated that comprehensive sexuality education programs reduce the rates of adolescent pregnancy.

Contraception, consent, sexual orientation, and abortion are not part of the school curriculum ​​— and schools are often faith-based. “Life skills” are offered instead, which includes messaging around abstinence, the consequences of having sex, HIV, and drug abuse.

“The lack of information greatly contributes to adolescents not making informed choices,” said Ritah Anindo, youth coordinator at Reproductive Health Network Kenya.

The Kenya Conference of Catholic Bishops said comprehensive sexuality education “promotes harmful gender identity ideology, sexual promiscuity and abortion.”

“If you look at the [comprehensive sexuality education], it is so dirty that if we go that way, we are going to destroy the moral fiber of our country,” wrote Bishop Paul Njiru Kariuki, local ordinary of Kenya’s Embu diocese in 2020.

“The Catholic Church has a lot of influence in terms of policy," Anindo said.

It is well-funded, participates in drafting and reviewing policies, and many health facilities are faith-based, Musho said. “The Catholic Church has been very vocal on issues having to do with sexual and reproductive health rights. They become kind of like the authority for the opposition.”

Politicians, in turn, are heavily influenced by religion, which trickles into policymaking, she said.

Beyond the Catholic Church, other faiths have been “up in arms” against the teaching of sex education in schools, said Winfred Osimbo Lichuma, who is a lawyer, gender specialist, and former chair of Kenya’s National Gender and Equality Commission. She added that religious leaders can have immense sway in communities.

There are also faith-based crisis pregnancy centers that work to prevent girls from accessing safe abortions, but then “leave them to their own devices” to care for the child, Musho said.

And in the void, many parents fail to pick up the slack, Lichuma said. Instead, children learn about sex from the internet — which also connects them to predators. One girl Lichuma met, met a man on Facebook, and traveled 200 kilometers (124.3 miles) to meet him. He impregnated her.

While some of the sex is consensual, some girls are forced into prostitution, child marriage, or assaulted in other ways.

A threat without a response

The government deemed reducing adolescent pregnancy a priority and one of the “triple threats” facing girls, along with HIV infection and gender-based violence. But its efforts have not matched its rhetoric, experts said.

Dr. Stephen Kaliti, head of the maternal and reproductive division at the Ministry of Health, said in April that giving contraceptives to adolescents is a criminal offense punishable by up to 20 years in jail.

“This is not a true representative of the existing legal and policy framework,” Musho said. “In his erroneous statement that pointed to a draft policy that is yet to be passed, the ministry official misled millions of Kenyans.”

A national reproductive health bill was thrown out meaning that 12 years after the country received a new constitution, this area of health “continues to operate without a comprehensive legal and policy framework,” Musho said. “Policies continue to be drafted, and withdrawn at the whim of Ministry of Health officials, leaving Kenyans at the mercy of individuals and their biases.”  

But a regional bill could provide relief. The East African Community Sexual and Reproductive Health Bill 2021 is up for public participation this month and then will go for a vote. This bill is anchored to a regional treaty that will require Kenya to integrate sexual and reproductive health efforts into its efforts toward universal health coverage.

When they do become pregnant, adolescents don’t always know about or have access to safe abortions.

The Kenyan Constitution allows abortion when it endangers the life of the mother. The health provider can provide an abortion if the mental health of the patient is harmed by the unintended pregnancy. For example, if the teenage girl is suicidal.

If a guardian is not there, the health care provider can give consent. But this largely remains on paper, and the government gives conflicting information, which leads to harassment of providers and patients, Musho said. “Service providers out of fear refuse to provide these services to adolescents contrary to legal and policy positions,” she said. 

Standards and guidelines were developed to guide medical practitioners on how to administer safe medical abortion, in compliance with the law. But the government withdrew these guidelines in 2013. A court ruled in 2019 that the Ministry of Health violated the rights of Kenyan women and girls in withdrawing these guidelines. But the ministry has yet to reinstate them.

This ambiguity creates a climate where health professionals are harassed.

And if they keep the child, many girls drop out of school because nobody can care for the baby. Pregnancy, child marriage, and parenting account for nearly 50% of girls that don’t graduate secondary school in Kenya. “For the majority of the girls, once you deliver that is the end of the road for her education,” Lichuma said, adding that formal adoption is not common in Kenya.

“Pregnancy denies girls a myriad of rights: The right to be children. The right to go to school. They are forced into motherhood at an early stage,” Lichuma said. “Let children be given an opportunity to grow as children.”

Devex, with support from our partner GHR Foundation, is exploring the intersection between faith and development. Visit the Focus on: Faith and Development page for more. Disclaimer: The views in this article do not necessarily represent the views of GHR Foundation.