by Esther Aoko
Background to this article:
Kenya’s recently launched ten-year National Reproductive Health Policy 2022-2023 has been the focus of criticism by civil society organisations, human rights organisations, and professional bodies such as the Kenya Obstetrical Gynaecological Society (KOGS). After months of repeated requests for meaningful engagement in the policy development and review process, including an attempt to launch the policy on March 23 that was suspended after civil society and women’s rights defenders caused an uproar over the lack of public participation in the development process, the launch on July 5 2022 was boycotted by these same actors in protest at the lack of meaningful consultation and lack of transparency on the part of the Ministry of Health.
It is not only the process that is controversial. The policy itself recognises the so-called ‘triple threat’ of adolescent pregnancy, gender based violence and rising rates of HIV among adolescent girls and young women. However, rather than upholding the sexual and reproductive health and rights (SRHR) of adolescent girls and young women and facilitating their access to SRH services and commodities, the new ten-year policy determines that people attain ‘full cognitive competence on matters of sexuality and reproduction at the age of 21’, and prioritises ‘abstinence and delayed sexual debut for persons yet to attain full cognitive competency.’ It introduces new requirements enforcing parental consent for SRH services, and fails to adequately address critical issues such as teenage pregnancy, and high maternal mortality rates from unsafe abortions. Importantly, while the policy talks about ‘Mainstreaming special RH-related needs of people with disabilities, the elderly, people in humanitarian settings and fragile contexts’, it does not similarly promote mainstreaming of the SRH needs of adolescent girls and young women, people living with HIV, LGBTQI people, sex workers or people who use drugs. The policy provides for ‘adequate age-appropriate RH information and awareness for all persons including adolescents and young people’, which leaves the concept of comprehensive sexuality education open to redefinition.
The National Reproductive Health Policy is complementary to existing policies on Reproductive Health, and shall be the primary reference document on matters concerning Reproductive Health in Kenya. This means it takes precedence over any existing policies and strategies on SRH and related areas that may have more progressive provisions.
In this piece, Esther Aoko describes reactions to the new policy by young women in Kenya.
Until when will we have to fight for our Sexual and Reproductive Health and Rights?
by Esther Aoko
Imagine if you didn’t have a say over when, for what or how your body was used. How would that feel? How would you react? This is the sad reality for many women and girls in Kenya.
It is an amusing idea to many, this audacious notion that women should be able to move through the world as freely and enjoy the same inalienable rights and bodily autonomy as men. Women’s bodies continue to be objectified and controlled by society and this takes away their rights and prevents them from taking charge of their bodies. When I was growing up, the community made me believe that everyone had a right to my body, everyone except me. I was supposed to work hard and make sure that I take care of my body to please my community.
This idea was constantly fed into my mind and I began to believe that I was incapable of making decisions about my body since I didn’t own it in the first place.
The right to bodily autonomy means that we must have the power and agency to make choices, without fear of violence or coercion, or having someone else decide for us. But often, these decisions are made or influenced by others, partners, families, societies and governments. Across diverse sociocultural contexts, women’s partners and families control most if not all aspects of their lives. From a woman’s access to contraceptives, to how she dresses, to whether or not she is allowed to work or even step out of the house unaccompanied.
The rights to bodily autonomy and integrity are recognised in the Universal Declaration of Human Rights. Nonetheless, women are still denied their rights. In some cases, retrogressive laws and systems are to blame as they let traditional and modern norms coexist in spite of their incompatibility. A good example is the recently launched National Reproductive Health Policy which does not reflect the sexual and reproductive health needs of women and girls in Kenya. The most unfortunate bit is, the policy was launched at a time when Kenya is facing a triple threat which is a rise in teenage pregnancies, new cases of HIV among adolescents, and gender-based violence.
During the National Council for Population and Development National Dialogue, the Ministry of Health revealed that between January and February 2022, they handled 45,724 cases of pregnant adolescents aged between 10 and 19 years. They further revealed that 2,196 cases of Sexual and Gender Based Violence were registered among adolescents aged between 12 and 17 years. It does not end there – the Ministry of Health added that every week 98 girls aged between 10 and 19 years acquire HIV due to Sexual and Gender based Violence. Worrying statistics, right? But again what are we doing about it? Because launching a policy that further strips women and girls of their bodily autonomy will clearly cause more harm.
The enforcement of parental consent in the reproductive health policy puts adolescents under the age of 18 at a great loss. This means that the views of adolescents regarding their sexual and reproductive health are not valid in the eyes of the government. Denying adolescents crucial health services like contraception will not only lead to more teenage pregnancies, but it will expose them to gender based violence which in turn might result in an increase in new cases of HIV. The mere fact that comprehensive sexuality education is still being frowned upon by the Kenyan government means that adolescents will be left without access to sexual and reproductive health information and services. All these roadblocks are intentionally going to expose adolescent girls to negative reproductive health outcomes such us teenage pregnancies and unsafe abortions.
The little or no effort that is put in by society to advance women’s bodily autonomy and integrity is attributed to the fact that it is seen as a women’s issue. Any concern affecting the welfare of half of humanity cannot be dismissed as a ‘women’s issue’. It is important to realise that every individual should be empowered to claim their bodily autonomy and integrity.
A person’s ability to choose what they do with their body is critical to their ability to live a fulfilling life with dignity and to be a productive member of their society. When it should be obvious that the enjoyment of bodily autonomy and bodily integrity is critical to the realisation of the full range of human rights and should therefore be guaranteed for everybody, the sad reality is that for many women and girls, bodily autonomy and bodily integrity remains elusive. Because bodily integrity and autonomy influence so many aspects of health as well as a decent, dignified life, progress in realising them will lead not just to achieving sexual and reproductive health and the sustainable development goal on gender equality, but many other goals as well.
I believe that the rights to bodily autonomy and integrity are core principles that can mobilise and unite diverse efforts to address the social and structural determinants of health, addressing gender inequality, and advancing sexual and reproductive rights. I want to live in a world where I am respected and valued. A world where I am seen as an expert. A world where my gender is not a barrier. And finally a world where I am viewed as an important part of society. I am hopeful for a better future for girls and women, but I know that I must not relent in my efforts to ensure these dreams become a reality in my lifetime.
Written by: Esther Aoko
Peer reviewed by: Fiona Hale, Luisa Orza, Martha Tholanah, Anne Mugo
Follow Esther on Twitter @esther_aoko
If you’d like to reference this article, please use the following suggested citation:
Aoko, E. (2022) The Kenya National Reproductive Health Policy 2022-2032: Until when will we have to fight for our Sexual and Reproductive Health and Rights? Making Waves. Available at: https://makingwaves.network/2022/08/05/kenyas-new-national-reproductive-health-policy-2022-2032/