COVID-19: A Precarious Time for Sexual and Reproductive Health in Kenya – By Sasha Masabanda
A noted side effect of the COVID-19 pandemic across contexts has been how it has intensified existing structural and historic inequalities and made them glaringly obvious. People already made vulnerable by these inequalities have been facing greater challenges in meeting their basic needs and are more likely to slip through the cracks of systems supposed to protect them. This has been painfully visible within Kenya.
An area in which these inequalities have been perpetuated is that of sexual and reproductive health (SRH). SRH refers to the right of individuals to have a safe and satisfying sex life, the capacity to reproduce and the freedom to decide if, when, and how often they will do so. This includes the ability to protect oneself from sexually transmitted infections, to manage menstrual hygiene, to be informed about and access family planning, and to have access to services which enable safe pregnancy and childbirth.
Sexual and reproductive health rights were already weak in Kenya, especially for young women and girls, however significant gains had been made in key areas such as teenage pregnancies and access to education. Nevertheless, the pandemic will likely contribute to devastating setbacks for the health rights of women and girls in the country. As is typically the case in times of crisis, women and girls are often those affected most disproportionately. This COVID-19 pandemic has been no different.
Rates of HIV, unsafe abortions, and underage pregnancies have been predicted by activists to drastically increase in Kenya. A shocking statistic is the fact that over a period of three months of quarantine there has been a 40% increase in Kenya’s monthly average of teenage pregnancies. 1These girls will be unlikely to return to school should they reopen. This is especially concerning because this can be expected to contribute to the widening of a gender gap in education, and thereby the labour market. It should be understood that sexual and reproductive health is not only a private issue but that it should be given necessary public attention and response, especially during an ongoing health crisis.
This surge in teenage pregnancies is indicative of an ongoing vicious cycle. Adolescents are experiencing limited access to crucial sexual and reproductive health resources, services and information, as their key points of access – schools, safe houses and shelters – have been shut down as part of the government response to COVID. Meanwhile, confinement has contributed to a rise in domestic violence, including sexual abuse and rape. I avoid using the legal term for rape in Kenya, “defilement,” as it perpetuates stereotypical and harmful notions of the loss of ‘purity’ of the victim which places more focus on their sexual history rather than the actions of the abuser, as critiqued by Evelyne Opondo in this compelling op-ed in The Star.
This is a time when an appropriate and thoughtful government response to this public health crisis could alleviate the struggle of those made vulnerable. As criticized by researchers on the effects of COVID on the health and socioeconomic security of sex workers in Nairobi, the Kenyan government’s approach to limiting the spread of the virus has largely involved severely limiting social and economic freedoms, which has disproportionately burdened the urban poor.2 This has included a harshly enforced daily curfew, whereby people caught breaking the curfew were arrested and placed in quarantine centres, in many cases in poor conditions and requiring to pay substantial fees to be released. 3
To be clear – this is not to criticize the idea of social isolation itself, as it is a crucial emergency response to this virus pandemic. However, given that it has been imposed in a punitive and draconian manner, with limited support provided to those most compromised by quarantine, it has contributed to burdens on people’s health and security. Moreover, there is a significant amount of the population in Kenya for whom the government’s hardline social isolation policies simply aren’t realistic and who aren’t being adequately taken into consideration. These include the many that live in informal settlements, and those who pursue livelihoods through commercial sex work.
Sex workers, who are already heavily stigmatized in Kenya, face aggressive targeting and treatment at the hands of law enforcement enforcing curfew. This is problematic given that they are simultaneously being exposed to increased violence from clients, as they are forced to work within their own homes or client’s homes due to brothels being closed. This limits protection from abusive customers. As stated by the regional coordinator for the African Sex Workers Alliance, Grace Kamau, in this Reuter’s article (https://fr.reuters.com/article/BigStory10/idUSKBN23B0CS.): “Sex workers are an easy target in a time of crisis. Clients feel they can take advantage of them, and law enforcement think they can use them to show that they are implementing COVID-19 measures.” Harshly targeting and criminalizing sex workers only further contributes to suffering in a context where there are limited social safety nets and people are increasingly at the point of financial desperation.
The increasing danger of being involved in commercial sex work in Kenya is especially concerning given the loss of livelihoods so many are facing. As pointed out in a conversation with Hellen Gathogo, founder of Laikipia-based child rights organization, One More Day for Children , the sexual exploitation of children is a miserable side effect of this. The exchange of sex for food or children being pushed by desperate families into sex work is being increasingly observed throughout the pandemic. Even despite lockdowns, child trafficking has continued to flourish in East Africa, as highlighted by child rights organization Terre des Hommes. 4 Given that the government has also closed refuges and safe houses such as One More Day for Children in their response to the pandemic, this has removed a significant means of protection from abuse and point of access for sexual and reproductive health resources.
It is clear that many are facing increased vulnerabilities as a result of this ongoing pandemic. This is worsened by an uncoordinated government response which has overlooked the needs of many and will likely contribute to a loss of gains made in children’s rights in Kenya. As Hellen lamented, how can this be the same government who promised that by 2022, there would be no more female genital mutilation (FGM)? 5 She urges for the government to take measures such as cautioning and educating families about child exploitation, providing options for alternative livelihoods or at least cash transfers, and addressing sexual and reproductive health by improving access to key items such as menstrual hygiene products, contraceptives, and condoms. Additionally, implementing justice mechanisms such as making pro-bono legal counselling accessible to the many victims of domestic violence.
Many comparisons have been made to the past Ebola epidemic of West Africa and there are certainly some lessons that can be learned. The effects of the crisis on sexual and reproductive health rights were mostly sidelined in response and recovery planning until Ebola itself was under control, but by then harmful social and health effects for women and girls had already been set in motion. It’s already apparent that vulnerable communities in Kenya, and elsewhere in the world, are experiencing a disproportionate amount of the collateral damage from COVID. In the context of sexual and reproductive health in Kenya, this will have long-term consequences which government policy and the NGO sector cannot afford to overlook, at the expense of the lives and wellbeing of several generations.
A key element of the African Institute of Children Studies’ (AICS) mandate is the promotion of the sexual and reproductive health rights of Kenyan youth. These efforts include a pilot program in development which seeks to support sustainable withdrawal of underage sex workers from commercial sexual exploitation (CSE) in the Mlolongo area of Nairobi. To read more about model interventions such as these by AICS, click here (https://institutechildstudies.org/srhr/)
1 Sophie Partridge-Hicks, “Rise in Teenage Pregnancies in Kenya Linked to COVID-19 Lockdown,” Global Citizen, August 19, 2020.
2 Kimani et al.(2020) The effects of COVID-19 on the health and socio-economic security of sex workers in Nairobi, Kenya: Emerging intersections with HIV, Global Public Health, 15:7, 1073-1082, DOI: 10.1080/17441692.2020.1770831
3 Abdi Latif Dahir, “Kenyans Held for Weeks in Quarantine Were Told to Pay to Get Out,” The New York Times, May 8, 2020.
5 Also referred to as ‘female circumcision” in some communities in Kenya.