Bigger picture in each Kenya Demographic Health Survey data

Health survey data

From Left: KNBS Board Chairman Stephen Wainaina, PS Economic Planning James Muhati with United Nations Resident Coordinator in Kenya Stephen Jackson during the launch of the 2022 Kenya Demographic and Health Survey at the Kenyatta International Confrence Centre on January 17, 2023.

Photo credit: Diana Ngila I Nation Media Group

You may have heard the adage that numbers don't lie. You may have also heard the argument that numbers tell a story.

Data informs policy interventions, guides budgetary allocations and on rare occasions, triggers a change in archaic, oppressive laws.

The findings of the Kenya Demographic Health Survey (KDHS) 2022 are out and the numbers therein are telling a story. This story has partial successes, disappointments, frustrations as well as concerns.

The successes are in areas such as child and maternal deaths which have gradually lowered since the first data collection in 1989 with under five mortality lowering from 90 to 41 deaths per 1,000 live births.

Incidences of Female Genital Mutilation (FGM) have also lowered gradually from 38 percent in 1998 to 21 percent in 2014 to 15 percent in 2022.

Women are now attending pre-natal clinics more, with 89 percent of them going through childbirth in hospitals and under the care of a skilled birth attendant.

This is a huge success compared to previous years where the percentages ranged from 52 percent in1989 to 66 percent in 2014.

Skilled assistance in childbirth means higher chances of live births and quicker detection of complications.

The data is reassuring that less women will die while giving life.

Fertility trends have also decreased from an average 6.7 children in 1989 to about 3.4 children per household in 2022. This provides a greater chance of healthier children enjoying a quality life while not competing for scarce resources.

Indeed, this is the era of children by choice, not by chance. 80 percent of the children are fully vaccinated and more than 57 percent of married women are using a modern method of family planning!

But in this celebration there are equally a few areas of concern from the data. Only one in four Kenyans has access to health insurance.  

Most of those with access reside in urban areas and dependency on a barely functional NHIF remains at its peak. Whereas Universal Health Coverage was flagged off as the most desirable way of reducing out of pocket expenses, with four pilot counties in 2018, there may be need to interrogate the revival of that project.

Additionally, sexual and gender-based violence is still rife and the new data is curious on two fronts.

First, boys between 15-19yrs are experiencing more physical violence than girls (29 percent vs 20 percent) and married women in their 40s are equally the highest survivors of both physical and sexual violence (42 percent).

I am yet to form an accurate hypothesis on the boys and would invite well-seasoned researchers such as the African Population Health and Research Centre (APHRC) to unpack this data a little further.

The latter data, however, seems familiar from my past experiences at Fida Kenya. In a society that has consistently frowned upon divorce and safe transition from abusive relationships, one can almost predict why this data is off the roof.

It behooves the Ministry of Gender to emphasize a family protection policy that offers safety, reassurance and economic support for women who wish to exit abusive relationships.

Data on teenage pregnancies is equally at its peak of worst performing indicators. Ideally, there shouldn't be any data on this indicator because girls between 15-19 years should be, in my unsolicited view, flourishing in academics and living their dreams of graduation, internship and contributing to the growth of the nation.

Yet, Samburu, Homabay, Migori and Kajiado counties are crippling those dreams with cases of teen pregnancy ranging between 22 percent to 50 percent!

There is also data that still reinforces a status-quo that has been there since time immemorial. Men own more agricultural land. 31 percent as compared to 25 percent women.

My work experiences with widows living with HIV at KELIN offered insights on the deep connection between land, health and women empowerment.

In its simplest explainer, he who controls the land dictates the economic activity, who lives on it, ability to use it as collateral for loans etc.

Negotiating power rests with the title holder. Data says that our property ownership and inheritance norms are still patriarchal.

Lastly, it is important to flag that while KDHS data reveals stories of women’s progress, gaps and areas of concern, the same has very little data specific to Men’s health issues.

Most indicators on HIV, violence, property ownership are in comparison to women. Indicators focused on male specific health challenges such as prostate cancer, male circumcision etc might call for more nuanced indicators specifically addressing this in the next ten year mark.

Tabitha Saoyo is an award winning Health Policy Advisor and Human Rights lawyer. She draws inspiration for this article from her own past experiences working on the complexities of teenage pregnancy, maternal mortality and Gender Based Violence at Fida Kenya and KELIN. She currently sits as an Amnesty International (Kenya) Board Member.