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A profound silence enveloped the room as Nelly Munyasia, Executive Director of the Reproductive Health Network in Kenya (RHNK), took to the podium at the recently concluded seventh RHNK Adolescent and Youth Sexual and Reproductive Health and Rights Scientific Conference in Mombasa. 

Her voice, a blend of determination and sorrow, carried the weight of untold stories, suffocated by a lack of access to crucial health services. Her eyes welled up as she recounted the harrowing tale of a 13-year-old girl in a remote part of Uganda.

Married off and living in dire poverty with her ailing grandmother, this child is thrust into transactional sex to sustain her family. “Whenever she seeks a healthcare provider, she’s met with a cold refusal—‘No, I cannot help you without consent,’” Munyasia’s voice trembled with emotion.

 The teenager, driven by desperation, found herself entangled in risky, unprotected sex with boda boda operators, the only lifeline she could grasp to support her bedridden grandmother.

 “We must ask ourselves, where are we placing the lives of our adolescents and youth? Who will consent for them? Government and policymakers in this room, how do we navigate these treacherous waters to ensure they receive the information and services they desperately need?” 

Munyasia’s impassioned plea hung in the air.

In Kajiado county, a similar story unfolded—a 15-year-old girl, forced into marriage and subjected to the brutal rite of female genital cutting, initiated into motherhood far too soon. “She had no choice,” Munyasia lamented.

 “Her older husband dictates their sexual encounters and the number of children she must bear each year. She is denied the chance to grow as a young girl.”

As Mercy Mugesha, a youth advocate at RHNK explains, such are the issues the young people in Africa are grappling with in what is famously known as the “triple threat”, which includes new HIV infections, teenage pregnancies and Sexual and Gender-Based Violence (SGBV). 

“Young people are dying everyday as a result of unsafe abortions, at the same time a big number of adolescent girls are dropping out of school because of lack of clear policies on how to re-join schools after they deliver their babies as a result of teenage pregnancies. If we do not educate our youth and talk about how to address our immediate needs then we can see we are in a deep crisis,” explained Mugesha.

 Remote parts

While acknowledging the efforts made by various organisations to involve the youth in sexual reproductive health sensitisation campaigns, she is of the opinion that there are still a bigger percentage of young people predominantly in the remote parts of the country who miss out on the basics as they are not reached.

 “For instance yesterday when our caravan stopped at Mtito Andei to engage the youth, we were so surprised to realise that there is still a big percentage of youth who don’t have any idea about the most basic information such as how to use a condom for contraception and HIV prevention. We still have a long way to go for sure.”

The above stories are the everyday reality Munyasia confronts in her work.

Kenya plans to put an end to the triple threat by the end of 2027.

In 2023, a total of 254,753 pregnancies were reported among adolescents aged between 10 to 19 years. Despite a slight decrease as compared to previous years, the National Syndemic Disease Control Council (NSDCC) has identified sexually gender-based violence and teenage pregnancy as indicators of heightened HIV infection risks. This is a clear indication that the risk that the triple threat presents is still high in the country.

Against this backdrop, the government is calling for more robust support programs to guide adolescents and youth through the intricate landscape of sexual and reproductive health. 

Dr Edward Serem, Head of Maternal and Reproductive Health at the Ministry of Health, acknowledged the ongoing interventions against HIV, gender-based violence, and teenage pregnancy but emphasised that much more remains to be done.

“Teenage pregnancy is a significant issue. When a young girl becomes pregnant, the Ministry of Education tracks how many return to school after childbirth. However, comprehensive support is crucial to ensure these young mothers can thrive and continue their education,” said Dr Serem, who represented Acting Director General Dr Patrick Amoth.

Child marriages   

 Director General of the National Council for Population and Development, Dr   Mohamed Sheikh, highlighted the heightened risks faced by girls who become pregnant, driven by poverty into child marriage and other adversities.

 “We must address dependency. Programs are needed for both girls and boys to help them complete their education. As our nation transitions from an agricultural to an urbanised society, challenges like inadequate housing and slum settlements deeply affect children,” he stated.

Dr Sheikh stressed the necessity of innovative ideas and robust systems, noting, “No single agency can implement these interventions alone.”

 “We must involve parents, leaders, and partners to support each girl and boy. By 2030, we aim to eliminate these threats and achieve a zero-teenage-pregnancy rate.”

His words underscored the need for comprehensive, collaborative efforts to tackle the multifaceted challenges faced by adolescents and youth.

Adding a note of technological hope, Felicity Nneoma of Youth Focal Point, FP2020 Nigeria, shared how cutting-edge technology is being deployed in her home country to address pressing issues.

 “We are utilising mobile platforms to develop safety apps, including an Android app that provides young people with accurate information on FBI, HIV, and family planning.  As many young people now have smartphones and use social media, these tools are vital for accessing and using information effectively. We also developed a WhatsApp chatbot to address confidentiality concerns, allowing young people to ask questions anonymously. The chatbot provides information on the nearest service points,” Nneoma explained.

As the conference drew to a close, the collective resolve to navigate these treacherous waters and carve a path towards a brighter, healthier future for the youth of Africa resonated in every heart present.