Celebrate World Population Day; the Role of Research in Preventing Unintended Pregnancy among Adolescents
By Caroline Kabiru, Research Scientist
July 11, 2013
In the last few months, two condom adverts have been at the center stage of our national discourse and the subject of heated debate around family planning and contraceptive use. The direction the conversations took – with many calling for banning of the adverts – is an excellent illustration of what is wrong with public discussion on health and science issues in Kenya — scientific evidence was missing from the conversation entirely which meant that debate generated a lot of heat but very little light.
Recent studies by researchers at the African Population and Health Research Center among adolescents living in Korogocho and Viwandani slums found that 40% of teenagers between the ages of 15 and 19 living in slums were sexually experienced. Sexual activity among this group starts early, sometimes as early as 9 years of age. For boys, sexual activity may stem from the need to prove to peers that they have come of age or in the words of one of the respondents, to “show that you are man enough.” Indeed, peer pressure cuts across genders with girls also needing to have boyfriends in order to “fit in”. However, sexual violence and the need to engage in sex for survival are also realities for many young people who live in poverty.
Although a large proportion of adolescents are sexually-active, the use of contraceptives is remarkably low. We found that modern contraception was shrouded with half-truths and outright myths. Respondents told researchers that they were often scared to use condoms because the ‘oil’ in the condoms would cause ‘stomach growth.’ Even when respondents used contraceptives, they would often be used wrongly and thus never had any effect in preventing STIs and unintended adolescent pregnancy.
It is important to point out that previous studies in Kenya have shown that whilst 42% of young people aged 15 to 19 years have had sex, only 11% of them ever used any form of contraceptive. The low use of contraceptives means that many young people are at risk for sexually transmitted infections and unplanned pregnancy.
The burden of unplanned pregnancy weighs heavily on girls. Apart from the social stigma, many female respondents in the study told researchers of the lengths they would go to procure an abortion. Unsafe abortion methods such as drinking detergent solution or having abortions performed by herbalists were frequently mentioned. Many respondents could also not envision returning to school after giving birth which meant exposure to a life of poverty and dependence.
This and similar studies of adolescents show that unintended pregnancy is a far bigger problem than anything banning a condom ad could solve. To cite the example of the thousands of young girls who get pregnant as a result of rape or who go into transactional sex as a means of survival, the debate on whether we should or should not ban condom adverts on national media is perhaps irrelevant.
The 2013 World Population Day focuses on adolescent pregnancy. The problem of unintended pregnancy among adolescents is multi-faceted. As we celebrate the World Population Day, it is useful to have constructive conversation based on quality evidence about teenage pregnancy in Kenya.The solution does not lie in bumper sticker slogans and public grandstanding about national morality. The solution lies in a comprehensive understanding of the factors that lead teenagers to have sex and a careful testing of interventions to improve young people’s health and wellbeing.
Dr. Kabiru is a research scientist at the African Population and Health Research Center. She holds a PhD in Health Promotion and Behavior from the University of Georgia, USA. This article was co-authored by Martin Njaga. This research quoted on this article was titled Strengthening Evidence for Programming on Unintended Pregnancy (Step Up).