TEENAGE PREGNANCIES IN THE WAKE OF COVID -19 WITHIN HOMABAY COUNTY.
RAPID ASSESSMENT
JUNE 2020
By Kennedy Nyamura & Benedict Ochieng
INTRODUCTION
Teenage pregnancy is one of the development related challenges that denies the youthful population in Kenya from realizing their growth aspirations of being productive citizens to themselves and their communities at large. Incidences of teenage pregnancies are triggered by factors such as social and cultural attributes, weakness in enforcement of existing policies and laws by those in authority, effects of poverty, economic constraints, lack of responsibility from those entrusted to ensure safety of teenagers, and peer influence. The risk factors in many occasions have led to school dropout, early marriages, stigma and discrimination against adolescent pregnant girls, and difficulties in accessing reproductive health services; with girls from poor backgrounds affected most. This explains the disparities that exist between boys and girls.
To respond to the causes and effects of teenage pregnancy, programs, projects, policies, laws and plans have been implemented by different stakeholders; both public, private and civil society actors. This is in an effort to change the trends, address injustices perpetuated to the girls, and ensure equity and equality in accessing socio-economic opportunities to all without discrimination despite one’s given status. Despite the progress made, the Covid-19 pandemic seems to be reversing the gains achieved so far.
Recent media reports[1] have brought to light a rise in cases of teenage pregnancies across the country. Homa Bay has ranked second with 5,932[2] teenage pregnancy cases. The teenage pregnancies crisis is said to be linked to the mini-lockdown as a result of Covid-19[3]. The government officials however refuted these numbers calling for a need to verify the validity and source of the information. According to the various media reports, teenage pregnancies are being fueled by rape, defilement, poverty, early marriages, peer influence, drug abuse, and lack of youth- friendly health services. It is estimated that teenagers in poor households are more likely to experience teenage pregnancies compared to teenagers in wealthier households.
When a girl becomes pregnant, her life can change radically. Her education may end, and her job prospects diminish. She becomes more vulnerable to poverty and exclusion, and her health often suffers. EACHRights- in an effort to continue the advocacy work around teenage pregnancies in Homa Bay-embarked on this research activity to determine the actual figures on the cases of teenage pregnancies within Homa Bay County and to determine whether there is a correlation between Covid-19 pandemic and the rise in teenage pregnancies cases. The findings will be useful in contributing to the discussion around the teenage pregnancies crisis as well as devising possible solutions; particularly support to ensure that girls’ education isn’t adversely affected.
Objectives of the Study
The overall objective of the study is to determine the status of teenage pregnancies in Homa Bay County in the wake of Covid-19 and to utilize the findings to contribute to the discussion around the teenage pregnancies crisis as well as devising possible solutions; particularly support to ensure that girls’ education isn’t adversely affected. The specific objectives of the study are:
- To determine the trend of teenage pregnancies in the 8 sub counties of Homa bay County from 2017-2020.
- To determine whether there is a correlation between the Covid-19 pandemic and the rise in teenage pregnancies.
- To identify causes of teenage pregnancies in the county.
- To understand the challenges hindering interventions to reduce teenage pregnancy cases in the county and obtain proposed solutions.
Research Questions
This research study sought to answer the following questions:
- What is the number of teenage pregnancy cases in Homa Bay County between January – May 2020 segregated per sub-county?
- What is the number of teenage pregnancy cases in Homa Bay County between 2017-2019?
- Is there a correlation between Covid-19 pandemic and the anticipated rise in the number of teenage pregnancies?
- What are the major causes of teenage pregnancy in Homa-Bay County?
- Who is responsible for the teenage pregnancies?
- Where are the teenage girls who are pregnant now?
- What actions have been taken by the relevant authorities on cases of defilement?
- What are some of the perceived actions / solutions to curb teenage pregnancies in Homa Bay county?
LITERATURE REVIEW
The World Health Organization defines teenage pregnancy as pregnancy of a female aged 10-19 years old (Rosen, 2010). Mothiba looks at adolescent pregnancy as the pregnancy of a woman younger than 19 years (Mothiba & Maputle, 2012), while Katamoyo defines teenage pregnancy as pregnancy of a girl aged between 13 and 19 years (Katayamoyo, 2010). Although occurrences of pregnancies within this age are minimal, the latter definition precludes pregnancies to girls under 13-who fall under adolescents. Tewodoros defines teenage pregnancy as a condition where a woman has given live birth before the age of 20 years (Tewodros Alemayehu, 2010).This implies that a woman who becomes pregnant at age 19 but gives birth at age 20 is not defined as an adolescent birth. This research study adopts the WHO definition of adolescent pregnancy as any pregnancy in a girl aged 10-19 years considering that this is the globally recognized standard when it comes to reporting cases related to teenage pregnancies by different developed and developing states.
Kenya Data and Health Survey report (KDHS, 2014) shows that 1 in every 5 girls between 15-19 years is either pregnant or already a mother. As of 2019 latest statistics from the Global Childhood Kenya has the third-highest[1] teen pregnancy rates with 82 births per 1,000 births. According to the United Nations Population Fund Report, Kenya has recorded 378, 397 adolescent and teenage pregnancies for girls aged 10-19 years between July 2016 and June 2017, specifically, 28, 932 girls aged 10-14 and 349,465 girls aged 15-19 became pregnant. 13,000 teenage girls drop out of school every year due to pregnancy (KDHS 2014).
The situation in Homa Bay County varied over time. According to a study conducted in 2016 through the STEP UP project (strengthening evidence for programming on unintended pregnancy) by the Population Council, HomaBay County experiences acute trends and has the second highest levels of teenage child bearing in the country at 33% and is characterized by high intended teenage pregnancy and female school dropout rate. Add info from pop council report
Research Methodology
Design
The study adopted a qualitative research methodology to enable the participants in the study to describe their experiences, thoughts, feelings and ideas about teenage pregnancy in the county without being directed so much by the researcher’s assistants.
Respondents
The study engaged respondents through face to face interviews and phone calls. Respondents included the County director of children services, Sub- county children officers, chiefs, and the health records officer; considering the nature of their work on child welfare and development. Pregnant adolescents were also targeted considering that they are beneficiaries of interventions by state and non-state agencies on adolescent sexual and reproductive health initiatives. Their involvement was to understand their feelings, perceptions, needs, experience, and the challenges they undergo during such periods. This is further broken down in the table below:
| Category of Respondents | Numbers | Respondent codes |
| County children coordinator | 1 | RI |
| Sub-county children director | 1 | |
| SCO Homa B ay/Rangwe. | 1 | R2 |
| SCO Ndhiwa | 1 | R3 |
| SCO Rachuonyo | 1 | R4 |
| County Health records officer | 1 | R5 |
| Development partner (USAID;Tupime county project planning and learning specialist ) | 1 | R6 |
| County Gender Based Violence (TWG) | 1 | R7 |
| Chief arujo | 1 | R8 |
| Chief Gem west | 1 | R9 |
| Chief Kanyamwa | 1 | R10 |
| Chief Kanam | 1 | R11 |
| Parent HomaBay. | 1 | R12 |
| Parent Kendu-Bay | 1 | R13 |
| Parent Kadongo. | 1 | R14 |
| Parent Sindo. | 1 | R15 |
| Parent Luanda Mbita. | 1 | R16 |
| Parent Kosele Oyugis. | 1 | R17 |
| Parent Kobondo. | 1 | R18 |
| Parent Ndiru kagan. | 1 | R19 |
| Police Deputy OCS | 1 | R20 |
| Community paralegal Homa-Bay | 1 | R21 |
| Total Respondents | 22 |
Data collection methods
Data collection was done through interviews. 22 interviews were conducted; some in person and others on phone with different respondents through use of an interview guide that was administered to the different respondents.
Key Findings: Status of teenage pregnancy in Homa Bay County.
- The number of teenage pregnancy cases in Homa Bay County between 2017-2019
An increase in cases of teenage pregnancies was registered in 2017 (14,646) & 2018 (14,733) among adolescent girls aged 10-19 yrs. Interviews with R5 and R6 brought out an increase in cases of teenage pregnancies in 2018 with 14,733 cases compared to 14,646 cases in 2017, however in 2019 the cases were reduced slightly to 13,644. This data was provided by R 5.
| Year | Number of Recorded Teenage Pregnancies |
| 2017 | 14, 646 |
| 2018 | 14,733 |
| 2019 | 13,644 |
The Decline in the number of teenage pregnancies in 2019 was attributed to integrated interventions cited by different respondents who were interviewed. R8, R9, R10, R11 talked of regular awareness sessions / Barraza’s held in different locations on the dangers of teen pregnancies and the role of parents and other stakeholders in child protection. R1, R2, R3, R4 linked the decline to Prosecution of perpetrators, provision of social protection grants to care-givers and establishment of child rescue centers in Makongeni area. R7 cited provision of sanitary towels to girls from vulnerable families. The following charts outline the above figures.
Figure 1: Adolescents (10-14 years) presenting with pregnancy trends, 2017-2019[2]
Figure 2: Adolescent pregnancies Trend, 15-19
- Cases in Homa Bay County between January – May 2020 segregated per sub-county
A total number of 5,962 cases of teenage pregnancies were reported to various health facilities, police stations and children department offices between early January and end of May 2020. This is outlined below:
| Period | Sub counties | adolescents (15-19 years) presenting with pregnancy | Adolescents (10-14 years) presenting with pregnancy | Cumulative Adolescents Pregnancies |
| 2020 | Homa Bay Town Sub County | 710 | 32 | 742 |
| 2020 | Kabondo Kasipul Sub County | 716 | 72 | 788 |
| 2020 | Karachuonyo Sub County | 851 | 39 | 890 |
| 2020 | Mbita Sub County | 450 | 26 | 476 |
| 2020 | Ndhiwa Sub County | 1028 | 95 | 1123 |
| 2020 | Rachuonyo South Sub County | 434 | 57 | 491 |
| 2020 | Rangwe Sub County | 659 | 71 | 730 |
| 2020 | Suba South Sub County | 664 | 60 | 724 |
| 2020 | County | 5512 | 452 | 5964 |
The following charts present the number of teenage pregnancy cases among adolescent girls (10-19 yrs) in Homa Bay County between January – May 2020 segregated per sub-county. These were outlined by R5 and R6.
Figure 3: Adolescents (10-14 years) pregnancies trend in 2020
Figure 4: Adolescents (15-19 years) pregnancies trends in 2020
R 1, R3, R7 and R 20 during the county area advisory council meeting raised concerns on the impact of Covid -19 in accessing essential health services due to movement restrictions , curfew and fear of being arrested. The majority of teenage pregnancy cases haven’t been reported so far; posing health risks among teenage pregnant girls.
Trends of teenage pregnancies segregated in the sub counties show that Ndhiwa has the high number of cases .
Figure 5: Teenage pregnancies segregated by sub-county
Phone call to R 5 indicated that all the teenage pregnancy cases reported between January – May 2020 were all new cases as per DHS being the primary source of health data.
- Causes of teenage pregnancy in Homa-Bay County
| Interviews with parents | ||
| Respondent Codes | Causes of teenage pregnancies | Explanations/examples |
| R12,R 15,R17 | Lack of information and knowledge on adolescent sexual and reproductive health. | Demonstrated lack of knowledge on how to deal with the changes adolescents face during adolescence. R17 was shy to comment on when issues of sex and sexuality; this tells the magnitude of challenges that then their teens are likely to face. |
| R13 | Poverty | Low income levels among some vulnerable families is a predisposing risk factor to the girls who are unable to afford sanitary towels during menstruation; resorting to seek favors from others who end up abusing them. |
| R19 | Sex and gender- based violence | Mentioned a case of a girl defiled by a relative and currently pregnant. T he matter is being handled by the children’s department. |
| R14 & R16 | Communication barrier between parents and teenagers | Some of the parents are not comfortable, and fear discussing issues of sex and sexuality because culture prohibits such discussions. |
| R12 also indicated that it’s the role of women to discuss such matters with their daughters. | ||
| Peer pressure | Teenagers tend to get influenced by what their fellow peers do and they believe that is the right thing without putting into consideration the risks. | |
| Beach influence | ‘Jaboya system’ fish for sex .Vulnerable girls staying with sick parents/those with low income would be forced to start engaging trade for fish and considering their age, with no start-up capital they get favors from boat owners who take advantage of them. | |
| Interview with Key informants (Government) | ||
| Respondent code | Causes of teenage pregnancies | Explanations/examples |
| R1 | Poor parenting | Some parents have abandoned their responsibility of taking care and providing for their families. |
| R1 | Neglect | Some parents don’t even bother to know what is happening around their children, who their peers are, and where they spend their time. |
| R3 & R10 | Community events /ceremonies | Disco matanga night dances in the rural areas put girls at risk because they are confronted in the night; and given that they can’t resist pressure from their counterparts and other adults, they end up being defiled , raped and engage in unprotected sexual intercourse that leads to pregnancies and infections. |
| R1 | Early marriages | Some families use their girls as sources of wealth by proposing marriages and making choices for them. Most girl then get married at an early age when they aren’t able to make choices on safe sex relationships. |
| R2 | Social media influence | Through information and materials available in different social media platforms, y oung people get lured to what they see and ultimately have a feeling of experiencing the same. |
- Who is responsible for the pregnancies?
| Those responsible | Description |
| Teenage relationship | Early sexual relationships among peers with little access to ASRH information and services hence predisposing girls to succumb to teenage pregnancy. |
| Boda-Boda | Economic related challenges among girls from poor backgrounds to access ASRH products like sanitary pads hence falling prey in the hands of such individuals who take advantage of their economic power. |
| Fisher Folk | Teens engaged in fish trading as a means of supporting their families in the process they get lured into unprotected sexual activities that end up in pregnancies. |
| Relatives | Poor social and sexual orientation among family members. Orphaned teenage girls suffering in the hands of guardians who end up coercing them into sexual relations. |
| Church members | Church activities that promote late out meetings among youths. |
N/b this % are purely perceived rating given by respondents not from any study so far.
- Where are the teenage girls who are pregnant now?
- In an interview with R1 and R7 their response was that all the reported cases presented at various health facilities are with their families and caregivers.
- R 20 lamented that people don’t report cases of child defilement.
- R 12 and R13 cited that some parents are very harsh in the event they find out that their daughters are pregnant, and some end up seeking refuge from relatives and friends.
- Challenges occasioned by Covid -19 towards case management;
- Low number of teenagers and adults attending health facilities seeking varied health services. This implied that some cases were never reported.
- Fear by the majority of stakeholders to report cases to the police with the feeling that they might be arrested for either having no mask or being victimized of being a possible carrier of Covid.
- Negotiation by parents to kill cases and resolve them locally without considering the situation of the victim and harm created.
- Dealing with stigma and discrimination among community members associated with teenage pregnancies.
- Proposed actions /solution by the respondents towards curbing teenage pregnancies in the county?
- Strengthen reporting procedures of cases so as to attain 100% reported cases to different authorities.
- Address prevention of teenage pregnancies from a multi-sector al approach as opposed to individual interventions which may not have greater impacts.
- Conduct regular sensitization and awareness through media, churches, existing forums and community group meetings with messages on child rights, protection and prevention of teenage pregnancies targeting beach management units, boda-boda, media practitioners , Faith based leaders, girls, boys, parents/guardians, policy makers, and elected leaders.
- Support access to legal aid services for under privileged families to access justices.
- Capacity building for community change champions i.e volunteer children Officers, community health volunteers, cultural leaders, chiefs and opinion shapers on teenage pregnancy prevention measures, rights & legal aid awareness and child protection strategies and reporting processes.
- Come up with sustainable support interventions for the teenage girl s i.e on access to sanitary pads and economic stimulus packages for vulnerable families.
- Promoting implementation of school re-entry policy.
- Are there cases of defilement if so what are the interventions
R7 in his quarterly report in the area advisory council meeting on case load in the county mentioned a total of 56 cases of defilement were reported; Interventions so far include medical examinations and treatment of the survivors, investigation and litigation of cases where R7 represents the state before court, safety of the minors during the litigation process by R1, follow up of cases and minors well-being during and after cases, legal and rights outreach session by 21.
Conclusion and Recommendations
This study offers an opportunity for all the stakeholders in the county to interact with the findings and think of designing and implementing programs, activities and consider some of the mentioned actions by different groups to curb trends of teenage pregnancies which is quite alarming. The findings will trigger completion of Sexual and reproductive health policy and laws in the county which as lead researchers we are recommending that Civil society organizations and relevant authorities need to initiate an engagement process to fast track the process and have the policy aligned to the proposals in current Reproductive health Amendment “Bill” 2019.
We do hope everyone will find this study relevant and interesting to engage with and team up will leaders within Homa Bay County in the fight against this menace that has a lot of impact into the life of our future generation.
The following recommendations outline actionable points going forward:
- County government to fasten completion of Sexual and reproductive health policy and have it implemented.
- Different sectors to integrate adolescent- related concerns and challenges into their programs and plans.
- During this period of Covid-19, guidance and counselling will be key and parents should be equipped with skills on how to talk to and advis e their children.
- Strengthening of guidance and counselling among adolescents in schools when schools resume.
- Involvement of boys in discussions of teenage pregnancy considering that they are contributors.
- The teachers, particularly class advisors should act as second parents, especially to those teenagers who need parental guidance.
References
Study by James E Rosen position paper on mainstreaming adolescent pregnancy in efforts to make pregnancy safer.
KDH 2014 https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf.
https://www.popcouncil.org/uploads/pdfs/2016STEPUP_AdolMothersKenya.pdf.
https://www.researchgate.net/scientific-contributions/2008703199_Tewodros_Alemayehu.
Athar, S. (2017), The Silent Truth of Teenage Pregnancies-Birth to Twenty Cohort’s next generation-NCBI-NIH. Journal of Teen Reproductive Health. Retrieved from: https://www.ncbi.nlm.nih.gov/…
National Survey of Family Growth (NSFG 2017), Key Statistics from the National Survey of Family. Retrieved from: https://www.cdc.gov/…/nsfg/key-statistics.
National Council for Population and Development (2018), State of Kenya Population and Adolescents and Youth Survey Reports 21081
UNFPA (2017), Adolescent Pregnancy and Development. Journal of Development and adolescent health. Retrieved from: https://www.unfpa.org/…/…
Zadeh Mohammadi A. et al. (2018), Risk Taking Behaviors Among Adolscents: The Strategies to Predict Crimes Commitment. Retrieved from: https://www.dnl.tebyan.n
Acknowledgement
The outcomes of this report were made possible because of the commitment and dedication of the data collection clerks, who navigated the encountered challenges and demonstrated a high level of professionalism.
We also want to recognize and appreciate all the respondents who willingly accepted to take part in the interviews despite their busy schedule.
Finally, our gratitude goes to the Education Support Programme team at EACHRights for providing the technical and financial support that enabled the execution of this study in Homa-Bay. We believe that such gestures need to be sustained as we strive towards bringing about change into the lives of the underserved community groups in our midst.
[1] Daily Nation. 2020. https://www.nation.co.ke/kenya/news/crisis-as-nearly-380-000-kenyan-teenagers-become-mothers–256690 Accessed on 09th July 2020.
[2] Ibid
[3] Relief Web. 2020. https://reliefweb.int/report/kenya/covid-19-lockdown-linked-high-number-unintended-teen-pregnancies-kenya. Accessed on 09th July 2020
In the world?
Perhaps we want to reflect on the slight increase for the age group 10- 14; and the drastic decrease for the age group 15- 19
