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WHAT WE SHOULD BE TALKING ABOUT; BUT WE NOT

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WHAT WE SHOULD BE TALKING ABOUT; BUT WE NOT

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Category : Naya Blog

 

By Michael Oliech Okunson (@MikeOkunson)

Image Courtesy: afromum.com

Abortion is a medical process of ending a pregnancy and is also known as termination of pregnancy. It is estimated that 1 in 3 women in the world will have an abortion in her life time.

There are two types of abortion; safe abortion is the termination of pregnancy by a well-trained, recognized, professional and licensed person/doctor at a medical facility while unsafe abortion is the termination of pregnancy by unskilled person or in an environment that does not conform to minimal medical standards.

It is estimated that 42 million women and young girls worldwide with unintended pregnancy choose to have abortions and half of all these abortions are unsafe. Furthermore 68,000 women die of unsafe abortion annually in the world making unsafe abortion as one of the leading causes of maternal deaths. Most of these deaths occur in sub-Sahara Africa Kenya included. Moreover, according to the World Health Organization, every 9 minutes in a developing country, a woman will die due to complications arising from unsafe abortion.

In Kenya some of the unsafe abortion methods include drinking toxic fluids such as detergents, inserting sticks and hangers in the vagina or cervix and inserting inappropriate medication in the vagina. Quacks also perform unhygienic abortion hence causing infection in the womb.

Restrictive laws against abortion and lack of access to contraception services and information are some of the factors that has contributed to the high cases of unsafe abortion. In Kenya Abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law (Article 26 of the Kenya constitution).  Furthermore 70% of all pregnancies in Kenya occur to women who are not using any form of contraception.

If we are to achieve the sustainable development goal number 3 which recommends to ensure healthy lives and promote well-being for all at all ages, then we must end unsafe abortion. Unsafe abortion is easiest preventable cause of maternal deaths.

Preventing unintended pregnancies should be a priority for Kenya if we are to end cases of unsafe abortion. This can be done through both the national and county governments investing more in comprehensive sexual and reproductive health services and information. When people have access to correct, accurate, affordable and quality sexual and reproductive health information and services, they are more likely to delay their first pregnancy. Also providing women with better access to affordable and quality safe abortion services can help reduce maternal deaths caused by unsafe abortion.

Amending laws that are against abortion can also help reduce abortion mortality. By amending the law to only allow skilled practitioners to practice safe abortion services will discourage people from going to quacks.

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Let’s Implement Adolescent Sexual and Reproductive Health Policy

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By Michael Oliech Okunson (@MikeOkunson)

 

Adolescent account for 24% of the Kenyan population. They face severe challenges to their lives particularly in relation to their sexual and reproductive health as they transition to adult hood. High cases of HIV infection and unintended pregnancies are some of the main problems young people face in Kenya.

According to the National Aids Control Council, one in five young people aged 15 to 24 years reported sexual debut before the age of 15 years. New HIV infection among girls between the age of 15 to 19 years stands at 70% and for young boys in the same age group it stands at 30%. 13,000 new cases of HIV infection are among children below the age of 14 years. Comprehensive Knowledge on HIV prevention is very low among the adolescents. Moreover AIDS is the leading cause of morbidity and mortality among the adolescents and young people in Kenya. In 2014 alone 9,720 adolescents and young people died of AIDS.

In addition, according the Kenya Demographic Health Survey 2014 one in five girls aged 15 to 19 years have begun child bearing and 47% of these pregnancies are usually unintended leading to school dropout, unsafe abortion and serious health complication which may lead to maternal death. Maternal mortality is the leading cause of death among adolescent girls and young women in Kenya. Furthermore Adolescent girls and young women account for 70% of all pregnancies in Kenya.

Number don’t lie at all. The Kenya National Examination Council released data of young people in secondary schools and majority of these young people are between the age brackets of 15 to 19 years. This means one of the most vulnerable group in Kenya and are found in secondary schools.

We need age appropriate comprehensive Sexuality education in our school. When young people have correct, accurate and the right information about sexual and reproductive health, they will be able to make informed choices on their sexual behavior, delay sex, reduce multiple sex partners, use a condom during sex hence preventing STIs and unintended pregnancies, and choose whom to have sex with and when to have sex. Comprehensive sexuality education is the key to ending new cases of HIV infection and unintended pregnancy among young people. Knowledge is power.

Comprehensive sexual and reproductive health education is a human right and everyone is entitled to it. Article 35 of the Kenyan Constitution states that every citizen has the right of access to information held by the State and information held by another person and required for the exercise or protection of any right or fundamental freedom. Every person has the right to the correction or deletion of untrue or misleading information that affects the person.

One of the key objective of the National Adolescent Sexual and Reproductive Health Policy that was launched by the ministry of health in 2015 was to increase access to adolescent sexual and reproductive health information and age appropriate sexuality education. We Call upon both the national and county government to implement this policy to the latter.

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Adolescents are Too Important To Be Ignored

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By Michael Oliech Okunson (@MikeOkunson)

Over 9 million Kenyans are adolescents aged 10 to 19 years. In Kenya adolescents face many sexual and reproductive health challenges such as early pregnancies, STIs and HIV. According to the Kenya Demographic Health Survey 2014, 11% of girls and 20% of boys aged 15 to 19 years started to have sex before the age of 15 years. The unmet needs of contraception among young girls between the age of 15 to 19 years stands at 20%. Furthermore 20% of girls in this same age group have begun child bearing and most of these pregnancies are usually unintended. New HIV infection among boys and girls between the age of 15 to 19 years stands at 70% for girls and 30% for boys. Moreover 23% of adolescents aged 15-to 19 years know their HIV status and out of those aged 10 to 19 years, 105,680 are in need of ART. Comprehensive knowledge of HIV among the adolescents is very low.

Inadequate access to Comprehensive sexuality education and access to quality, affordable, youth friendly and stigma free sexual and reproductive health information and services has contributed to the rising cases of unintended pregnancies and new case of HIV infection.

Comprehensive sexuality education empowers young people to make healthy choices and decision about their sexual behavior. Global evidence shows that this program helps young people abstain or delay sex, reduce the frequency of unprotected sex and the number of sexual partners which helps reduce the spread of HIV. Moreover Comprehensive Sexuality Education increases the use of contraception among young people to prevent unintended pregnancies, sexually transmitted infections and helps delay that first birth to ensure a healthier mother and a safer pregnancy in future.

In addition to education access to youth friendly health services are very important to young people because they help young people address a range of sexual and reproductive health needs. The services should always be available, accessible and affordable so that young people can use these services. They should also be acceptable to all youth and the staff in these facilities should be well trained to provide services with privacy, confidentiality and respect.

On the 3rd of September 2015 the ministry of health launched the Revised National Adolescent Sexual and Reproductive Health Policy to reaffirm its commitment to ensure that adolescent have access to comprehensive sexuality and reproductive health services and education/ information. The objective of the policy are: to promote adolescent sexual and reproductive health and rights, increase access to adolescent sexual and reproductive health information and age appropriate comprehensive sexuality education, reduce STIs and HIV, reduce unintended and early pregnancies, reduce harmful traditional practices, reduce drug and substance abuse and to address the needs of marginalized and vulnerable adolescents.

County and national government need to prioritize implementation of the policy by allocating resources  to strengthen capacities of institutions, service providers and communities to provide appropriate information and services.

Reproductive health is a crucial part of general health and a central feature of human development. Just like a tree adolescents go through many transition as they mature to adulthood. Investing in their sexual and reproductive health will enable them stay healthy. When right policies and programs are implemented to the later, we will ensure that young people live successful lives and ensure social and economic development.

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Implement Comprehensive Sexuality Education To Tackle Teenage Pregnancy

By Michael Oliech Okunson (@MikeOkunson)

Nyalenda slums in Kisumu County houses a lot of teenage mothers. Achieng was brave enough to share her story with me.

 

“I wanted to finish school and become a hair dresser but my wishes never came true. I got pregnant at the age of 13 and I was forced to drop out of school to look after my baby. 5 minutes of unprotected sex had ruined my life and dreams completely. I wish I could reverse time to that moment. I could have asked him to use a condom. I wish I had the information on sexual reproductive health and rights, I could have made the right decision. Right now I could be in school working hard to achieve my dreams but all that is gone. I usually feel so bad when I see my friends going to school and reading books that I can’t even read.”

 

She is not alone. According to the Kenya Demographic health survey 2014, teenage pregnancy is highest in Nyanza region followed by Rift valley and the Coast. They say number don’t lie. According to the KDHS 2014 15% of women age 15-19 have already had a birth while 18% have begun child bearing.

There is a need to stop teenage pregnancy before the situation gets out of hand. Teenage pregnancy is not just a health issue but it is a developmental issue too. The price of teenage pregnancy is characterized with lost potential, foreshortened education, lack of opportunities, poverty, and constrained life options.

I believe that every young person must be empowered to decide how many children to have and when to have them. This can be done by introducing Comprehensive sexuality education in schools. Evidence has shown that where young people’s lack of access to critical information about their sexual and reproductive health, we are more likely to see increased cases of teenage pregnancy.

Comprehensive sexuality education provides young people with opportunities to explore their values and attitudes and build skills so they can make safe decisions and reduce their risk of getting diseases such as ‪HIV and getting pregnant

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Child Marriage is a Killer of Dreams

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Image Courtesy: Voice of America

By Michael Oliech Okunson (@MikeOkunson)

Adhiambo Monica’s marriage at age 15 in East seme ward Kisumu County destroyed her hopes of becoming a lawyer. “I wanted to work hard and become a lawyer but now I have no more hopes.” All is lost. It hurts when I see lawyers on TV. I wish it was me acting as the defense council of the accused in the court of law.”

“I faced a lot of problems in my marriage. I was young and didn’t know what being a good wife entailed. Life became more difficult especially when I was pregnant as I had to care for my husband, do the house chores, work in the farm, and walk to the clinic under the scorching sun”

Globally, marriage is often idealized as ushering in love, happiness and joy. However it’s not the same case for Adhiambo Monica and many other girls in rural Kenya who are often married off at a very young age. According to them marriage is among the worst things that could ever happen to them. It is estimated that one in three girls in developing countries Kenya included is married before age 18 and one in nine before turning age 15.

Early marriage/child marriage has dire lifelong consequences. It leads to school dropout, marital rape, risk of experiencing domestic violence, risk of HIV transmission, and a range of health problems due to early childbearing

For Kenya to achieve the UN sustainable Development Goals adopted in September 2015 which includes eliminating child marriage as the key target by 2030 for advancing gender equality, the government should; Empower young girls with information and choices; Ensure girls access quality education; Engage and educate parents and community members about child marriage; Establish and implement stronger legal framework against child marriage and lastly Ensure true coordination across various sectors including education, health, justice and economic development to fight child marriage.

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Why Men In Nyanza Fear Getting Involved In Family Planning

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PHOTO Mr Okello, FP Male Champion, Migori

By Michael Oliech Okunson (@MikeOkunson)

Male involvement in family planning has been met with great resistance in Nyanza region more so in rural areas. Most men in this region are totally opposed to family planning because of the following reasons.

Majority of men in Nyanza believe that family planning threatens their gender roles in the family. In Nyanza a man is expected to be dominant, authoritarian and capable to provide for his family. Men involved in family planning are usually seen as overpowered and controlled by their wives and unable to provide for the family and to function sexually. They are usually gossiped about all the time. If a man is seen accompanying his wife to the clinic or hospital, people will gossip that he has been over powered by the wife No man would want that so it forces them not to be involved in family planning.

Men in this region desire to have large families. Many of them desire to have a lot of male children to continue with their legacy when they are dead. Majority of them argue that if they have few children, they are afraid that they will be seen as avoiding their male tribal duties to have many children and embracing the western culture. Others fear that death could rob them their children so there is need to have many children to replace the dead ones so there is no need of family planning since it controls birth.

Apart from that men also believe that family planning use causes low libido in women. This will force them to find other partners exposing them and the family to the risk of HIV infections. Others believe that family planning increases libido and promiscuity in women. They argue that since a woman knows she cannot get pregnant and get HIV she can go out and sleep with other men. Some men also associate family planning with diseases such as cancer and blood pressure. Other say that family planning causes early menopause, infertility, child defects and miscarriages

Men in this region fear family planning providers. They fear family planning providers would coerce them to use vasectomy, abandon polygamy and to disclose their HIV status and extra marital sexual activities to their wives. They are usually uncomfortable with discussing sexuality with wives. A lot of traditions in Nyanza communities are not open to discussing issues of sex especially between spouses.

Overt male family planning acceptance is highly stigmatized in Nyanza. Men in rural Nyanza need more family planning education. Male outreach workers and village elders can be used to promote family planning among men and help to correct misconceptions and reduce stigma.

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The article was also published in the Standard Digital Portal, 2/2/2016

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Let’s Remember Bali

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By Michael Oliech Okunson (@MikeOkunson)

Three years ago hundreds of youth, civil society organizations and member states, descended into Bali, Indonesia for the Global Youth Forum to identify and discuss issues and priorities facing today and tomorrow’s generation of young people within the context of population and development so as to influence global agenda going forward.

The question that lingers however is whether we have realized the strides that we committed to?

On creating enabling environment for adolescents and youths, the government has actually done very little. A lot of young people still lack access to comprehensive affordable health services that are free from stigma, violence, coercion and discrimination. The sexual rights of young people are not fully protected. Young people are still forced into early marriages and female genital mutilation. Cases of gender based violence in the country is on the rise. We still have LGBTQI discriminated in the country and attacked. Minors and teenagers are being defiled and raped and the perpetrators walk scot free. The killings of sex workers is on the rise in the country. Youth participation in the country is not taken so seriously. Top down development approach is the order of the day. Youths voices are never heard.

Health education to adolescents and young people in the country is not actually reaching all the young people. Majority of the adolescents and young people don’t know their rights to staying healthy and yet It was agreed that the government was to provide non-discriminatory, non-judgmental, rights-based, age appropriate, gender-sensitive health education including youth-friendly, evidence based comprehensive sexuality education that is context specific.

We have less youth friendly services in the country more so in rural areas. In the conference it was agreed that Governments must provide, monitor and evaluate universal access to a basic package of youth-friendly health services (including mental healthcare and sexual and reproductive health services) that are high quality, integrated, equitable, comprehensive, affordable, needs and rights based, accessible, acceptable, confidential and free of stigma and discrimination for all young people but this is not happening at all.

On universal education, quality education, relevant education and inclusive education, we are still lagging behind. We still have young people still learning under a tree and in the burning sun. Education is not actually completely free in the country. We still have a lot of persons living with disability not going to school.

The financing of sexual and reproductive and health rights policies and programs in the country are not usually prioritized for budgetary allocation. Most of the county governments have not implemented the SRHR policies and programs due to the lack of political and financial commitment.

Although we have made some gains on gender equality in the country, Gender inequality is still rampant in the country. Women in the same profession as men are being paid less than men. This is rampant in the informal sector which is a hotbed of many women here in Kenya. We still have not yet achieved the one third gender rule. We can see men fighting women in making sure that this bill is eliminated. We still have women not going to school at all.

I call upon the government to be accountable and when it comes to matters that concern young people. We are the future of this country and we need to be treated with care.

Young people you need to get up and speak out now for a better tomorrow. We have a right to quality education and health care services. Reproductive health is a human right and we deserve to have it. We have a right to take part In public participation, ask questions and access information.we have a right to be protected from harmful practices. Stand up and speak out for a better tomorrow.

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Institutions of Higher Learning Need to Invest in Youth Friendly Services

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By Michael Oliech Okunson (@MikeOkunson)

Despite the loud silence on issues abortion, incidences of unsafe abortion continue to rise, more so in institutions of higher learning. This is actually contrary to what most people think. Aren’t they supposed to be more learned and thus averse to risky sexual behavior that would make them require unsafe abortions? Aren’t they more aware of the effects of unsafe abortions such as bleeding, damage to organs, sterility and even death?

Truth is students in institutions of higher learning still do not have adequate access to comprehensive sexuality information and sexual and reproductive health services.

I was in Maseno University the other day for a dialogue on unsafe abortion and the statistics and testimonies were pretty shocking.

More than 50 girls had undergone unsafe abortion. Some of the incidences had been procured by medical students, many others by quacks on the outskirts of the university and yet others swallowed bitter concoction of tea leaves and concentrated juices to get rid of their pregnancies.

Although there were no cases of mortalities that the meeting heard, the psychological and physical effects of unsafe abortion demands that the strongest proponents and the strongest opposition agree on fundamentals of taking the agenda forward.

Now more than ever, we need youth friendly services in our institutions of higher learning. In most of our universities we only have hospitals and majority of its staff are old men and women whom the youths do not feel free to confide in. I am very sure that there are plenty of well-trained young doctors out there the government can employ in the university hospitals to attract more youths to visit such facilities for guidance and assistance. We also need to equip these hospitals with all the equipment and tools necessary for providing the highest standards of health including reproductive health care.

There is also need for more reproductive health programs that will help in creating awareness among the young people to practice safe sex at all times. Most of our young men and women in these learning institutions believe in sex myths.

Parents also need to have a sex talk with their sons and daughters. It has been proven that parent youth communication on sexual and reproductive health and rights actually saves lives. Yet most of the parents shy away when it comes to sex talk.

Young people are among the most vulnerable groups in the country and deliberate steps must be taken to ensure they are healthy and ready to play their part in contributing to Vision 2030 and other local, regional and global development agenda.

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Letter To The President

Category : Naya Blog

By Michael Oliech Okunson (@MikeOkunson)

Happy New Year Mr. President,

On behalf of young people in Kenya, we take this opportunity to wish you a great 2016, to remind you of your earlier promises and to bring to your attention our needs as young people.

On 20 October 2015, the Mashujaa day, the day set aside to honour our heroes, you gave a moving speech at Kasarani stadium. Your speech filled us with optimism and made us believe that it was not all lost for us as young people living in Kenya today.

Specifically on the fight against HIV/AIDS and maternal mortality, you said

“We have increased access of ARVs from 600,000 people in 2013 to 850,000 people today. Our target is to ensure that we cover an additional 600,000 people meaning 90% of Kenyans living with HIV will be given treatment. Our free maternity programme has also bone fruits. When we came to office 44% of women gave birth in medical facilities. At present 68% of our mothers are attending hospitals for child birth. In 2013 maternal mortality was at 488 per 100,000, this has declined to 310 per 100,000. Likewise the child mortality rate has declined from 72 per 1000 to 52 per 1000 today.”

Mr. President although there is a slight improvement, more still needs to be done. The supreme laws of our land guarantees all individuals the right to access the highest standard of health including reproductive healthcare. The number of Kenyan mothers and children who died due to pregnancy and childbirth related complications last year were just too much. The figures Mr. President, were totally unacceptable for a country like Kenya who prides itself in being a regionally giant. But the bigger question will be if we will let others die from preventable causes this year? Will it be the same narrative again? Few facilities and human power? Poor infrastructure? Poor budgetary allocation to health? Health workers Strikes? Stock outs?

We hope definitely not.

Access to life saving ARVs by persons living with HIV/AIDS including the forgotten populations like adolescents and young people and communities in rural areas is crucially important in improving the quality of life. Inadequate access thus limits enjoyment of human rights as stipulated in the constitution and other international, regional and national commitments.

Mr. President a healthy nation is a prosperous nation and is more likely to develop at a faster rate.

We call upon you to be a champion of health and prioritize the sexual and reproductive health and rights of young people. We call upon you to lubricate your words with action and improve the health of our people; not just as a human right but so that we can be able to contribute to realization of Vision 2030.

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Society Must be Objective in the Abortion Debate

Category : Naya Blog

By Michael Oliech Okunson (@MikeOkunson)

It’s quite ironical that we men are the loudest wen it comes to what women do with their bodies, reproductive system and all other women’s sphere of life. Key among them whether or not women should give birth, whether or not they need to use contraceptives, how many kids they should have, how they should dress and of course the controversial debate around access to safe abortion.

Interestingly, views on access to safe abortion change depending on which side of the fence the men are. You remember Nerea from Nerea by Sauti Sol?

Sometimes the chorus sang by men  is that  abortion is a crime yet they wont hesitate to order the same girls to seek these services should they be the ones responsible and they don’t feel ready to take full responsibility.

Let stop for a second and ask ourselves the hard questions.

Men play a big role in contributing to the astounding figures of  unsafe abortion in Kenya. Some refuse to use a condom in the name of sex is sweeter without a condom, others lie to their women and make empty promises that they will stick with them through thick and thin, after winning their trust, most proceed to unleash the coveted three letter sentence  “I LOVE YOU” just to seal the deal.

When the woman gets pregnant she becomes a stranger to their erstwhile lovers. Deny! Deny! Deny!  becomes the infamous slogan.

We men refuse to take responsibilities and all we can do is tell the woman to terminate it. At that point we are willing to give them any amount just to go and get rid of the pregnancy. We use the so called love to justify our action.

“if you really love me go get rid of that pregnancy”

We don’t even care on where she is going to acquire these services, all we care about is the termination of the pregnancy. The woman goes and procures unsafe abortion from a quack and it is here where things do go wrong for the woman.

Aren’t men then the enablers of unsafe abortion?

We may not be on the same side in this discourse but at least we need to agree on three things.

  1. That we need to be honest and true in this debate.
  2.  That unsafe abortion hurts and kills our women.
  3. That access to safe and legal abortion as provided for under the constitution will severely reduce complications, morbidity and mortality from unsafe abortions

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WE CALL UPON the Government of Kenya to immediately release, disseminate, popularize and resource the National Standards and Guidelines for The Reduction of Maternal Mortality and Morbidity that provide clinical guidance to health care providers on the skills and indications for provision of safe abortion care in accordance with the Kenyan Constitution. {Excerpt  from Alternative Report on Kenya- Reproductive Health and the Maputo Protocol }

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