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Contraception & Family Planning in Kenya - Thoughts and Stuff

Contraception & Family Planning in Kenya


Every week I come across something that leaves my heart broken, partly because it touches on an area I am passionate about, and partly because there is so much that could have been done about it. This week it was about the sentencing of a nurse in Gachie to death. The man was accused of the murder of a lady and her baby as he tried to assist in abortion. Here’s a link to the article and this of the wife who now must be widowed and left to take care of a little baby. The lady who died in the process of abortion also left one other child who now will never see the mother again. We all have a rough idea of how that orphan will grow up. Right there, we have a child who will grow up without a Father, and one who is an orphan.

Now, to make it a little more graphic, 43% of all children born in Kenya in the five years preceding and including 2008 were out of unwanted (I prefer to call them unplanned) pregnancies according to the Ministry of Health. This is not to count the number of children aborted, standing at 460 000 for the year 2012 only, with 120,000 women seeking medical attention due to abortion complications in the same year. Fertility rate in Kenya is still at 5 children per mother, about twice the world’s average. This is after concerted efforts by the government brought the fertility rate from 8 children per mother at independence until late 90’s.

Now, if you are around my age and up, family planning must be one of the things you heard about every day as a little boy or girl on TV, on Radio, and in each Baraza. I can even sing several of those funny songs they used to advertise family planning with. Now, I am not talking about Femiplan adverts, I am talking about government sponsored civic education on family planning. They would talk about the advantages of having a small family, the advantages of delaying the first child for a woman, and of course spacing your children. This too was part of home science in upper primary school. Had this campaign persisted, it is estimated that fertility rate in Kenya would be around 2-3 children per mother.

Unfortunately the campaign did not persist, and we have our overzealous religious leaders and myopic politicians to thank for the mess.

Several months ago, I came across a Time magazine news feed marking the 50th Anniversary of the Pill. The article was titled The Pill at 50: Sex, Freedom and Paradox. Paradoxically, the pill’s main inventor was a conservative Catholic who was looking for a treatment for infertility. It was of course rejected by the church immediately, and contraception has remained one of those dark areas for the church.

In 1999 The Economist named the pill the most important scientific invention of the 20th century. With all the accusations levelled against it (and birth control in general), it is certain that it has done much good for women (and the men who love them). A semi humorous statement in the article puts it this way ‘The Pill became the means by which women untied their aprons, scooped up their ambitions and marched eagerly into the new age.’ And for sure a lot of women in Kenyan rural areas need that – to be empowered to decide how many children they want and when they want them (without being unduly made to feel guilty). I strongly believe that each pregnancy should be planned, and no child should be unwanted. Each child should be eagerly expected and planned for; else, that child will grow scared.

I know I have not stirred murky waters yet, but I am headed there now. Earlier on I blamed our religious leaders and politicians for hindering family planning. I do not want to dwell on politicians much… we all know they ask women to have many children so that “our tribe” can grow. We even know politicians in Central and Coast who bribe women to get pregnant. These politicians sometimes take the moral high ground and oppose what they term as evil “reproductive health legislation”, but we know where they get their cue from so let me head there.

Earlier this year, little known Senator Judith Achieng sponsored a Reproductive Health Bill that, among other things, recommended access to contraception by students. Hell broke loose. The bill was still born. It was opposed by the ministry of education, by the church, by parents, and of course our politicians know how to read the public mood and support the safe side.

If you ask me, each Kenyan of reproductive age must be educated on and have access to contraception. Every Christian I know will tell me that that is giving our young people license for promiscuity.  They will insist that what we should teach our young people is abstinence, and that’s it. To that, I have three points to make.

I appreciate the moral complexity of telling your teenager that they can use contraception so that they don’t get pregnant or a condom so that they don’t catch HIV. However, I sometimes feel like we misinterpret the concept of sin. To not sin because we have never been tempted is very different from to not sin because we have developed the character to resist sin. And I think God is looking for the latter sort of people. If the only reason we have not sinned is because we have not had the opportunity, then we must be very poor Christians. It is like having a spouse who never cheated on you only because you locked them in the house. Much as we try to shield our children from opportunities for evil, they will find these opportunities in every corner. Our best bet is help them develop a character that can identify and avoid pitfalls. If we do not build their character, keeping contraception from them does not mean they will not have sex, it only means they are more likely to catch an STD and an unplanned pregnancy.

The preceding paragraph assumes that we are all Christians (Christians in the sense that we uphold the teachings of Christ) in Kenya, or at least are all religious, and thus identify sex outside marriage as sinful. As absurd as this may sound, a very big proportion of Kenyans care nothing about Christian values. If they care nothing about Christian values, we sure cannot force upon them the Christian notion of chastity. As zealous as we may be as Christian, we must appreciate Kenya is a secular nation that separates religion from state. Our religious convictions do not form a law for other people, and we really have no say on their reproductive health. Before you lose your temper on me, as a Christian, imagine how you would feel if another religion you cared nothing about insisted you observe their rules. Good, do unto others as you would have them do to you.

To highlight my third point, I wish to borrow a small description from my all-time favourite author.

“So many people cannot be brought to realize that when B is better than C, A may be even better than B. They like thinking in terms of good and bad, not of good, better, and best, or bad, worse and worst. They ask what you think of fighting. If you reply that it is far better to forgive a man than to fight with him, but that even a fight might be better than a lifelong enmity which expresses itself in secret efforts to “do the man down,” they think you are being evasive and go away complaining that you would not give them a straight answer.” ~ C S Lewis (Book – Mere Christianity).

Let us revisit the issue of the lady who bled to death in the process of abortion. Most Christian discussions around the whole issue will revolve around the good – observing chastity, and the bad – that sin leads to death. I agree it is best if the young girl had observed chastity and never had the need to worry about an unexpected pregnancy. However, I must also concede it is better for the lady to have used contraception even in the sex outside marriage and lived to take care of her other child, and probably come to God later, than to have died. We must realize that our linear black and white thinking has very little application in a practical world. It leaves enough gaps for our young Kenyans to fall through in truck loads and perish.

Bill and Melinda Gates, my favourite couple, are doing a lot of great work in this area. Melinda Gates, who is a practicing Catholic, has faced a lot of criticism in what she has called a Legacy project at their foundation: a $4.3 billion project to provide birth control for an additional 120 million women in some of the world’s poorest countries. For her, she believes it is more important to save a woman’s life than to win a religious argument. In this article, she says:

“I use contraceptives. I believe in contraceptives, my friends use contraceptives. And so if I believe in this for myself – and for my daughters and other women – I said to myself, ‘how could I not speak out about this for all the millions?’”

In this other article on Foreign Policy, Melinda quotes an ongoing study in Bangladesh for the past 35 years, that proves that people who have access to and education about contraceptives have a higher quality of life in almost every conceivable way than those who don’t. They are healthier, less likely to die in childbirth, and less likely to have children who die. They are better educated, with sons and daughters who have more schooling. And they are more prosperous: Their households have more total assets, including land, livestock, and savings. On an even larger scale, economists have argued convincingly that the so-called East Asian economic miracle of the 1980s was due in large part to parents in the region deciding to have fewer children.

She regrets, however, that any occasion when contraceptives and public policy overlap seems to be an excuse to fight about other issues – abortion or the meaning of religious freedom. It seems as Christians we have to sneak in weightier, more controversial issues to strengthen our unreasonable positions.

As Christians, we are not just called to talk the convenient truths. We are also called to tackle the hard issues affecting our society. We have the choice of sticking to our moral high ground or encourage our government to combine our hard efforts to bring up upright youngsters with robust policies that safe-net them if worse comes to worst.

Little Footprints in the sand

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