West Pokot’s solution to teen pregnancies is surprisingly effective

n the year 2023, we still confess that three in every 20 adolescents are currently pregnant or have ever been pregnant. This figure only speaks to those who are aged between 15 and 19.

In the same cohort, in Samburu County, the figure changes to one in every two! This basically means that in every household, half the girls are mothers. West Pokot isn’t faring any better, with a statistic of two in every five. The situation is only slightly better in Marsabit, Narok, Meru, Homa Bay, Migori and Kajiado.

Public debate with regard to adolescent pregnancy has tended to point a finger at poverty, decaying societal morals, and undue exposure to inappropriate media content. However, a closer look at the counties will indicate that the only universal causes of teenage pregnancy in Kenya, are poverty and lack of education.

An adolescent in the lowest wealth quintile in Kenya has a 21 percent chance of getting pregnant, compared to seven percent in the highest wealth quintile. Education is an even more powerful determinant; where those with no education at all, have a 38 percent chance of being pregnant before 20. This drops significantly to less than five percent for those with post-secondary school education.

While this may be the case across our borders, it may not be the driving force in some regions. I had the pleasure of visiting West Pokot County recently and I got a rapid re-education on my social studies. While the rest of Kenya is dealing with mainstream issues, this neglected and mostly misrepresented county, the true Wild West, has to deal with a totally different ballgame.

The first thing that threw me off was the hospitality of the people! The Pokot South and West Pokot sub-counties are rather deceptive; with great road networks and beautiful, lush green hills glistening in the April rains. The situation further up in Pokot North and Pokot Central is astonishingly different.

The sudden transformation into an arid and semi-arid land will catch you by surprise.
So is the transition in their health indicators. The sharp increase in the number of adolescent pregnancies is testimony to a people still held far back by a mix of tradition and poverty. This is a county where education has taken a back seat with almost 40 percent of the population still fully illiterate.

Girls are counted as commodities and the father cannot wait to marry off soon enough, so as to receive the bride price, valued in cows and goats. As the girl is seen as a temporary liability that is converted to credit, there is no motivation to invest in her. This fuels the illiteracy among girls in the community.

Further, since the girl is not tied down to a specific objective such as school, the age of marriage has continued to progressively reduce; with young girls as 13 being married off as soon as possible. There being no other distracting business to be attended to after marriage, the next step is to embark on the motherhood journey.

Though human physiology may permit this young girl to conceive, it does not make up for the fact that at this young age, she is ill-equipped to safely carry the pregnancy or deliver the baby. Obstructed labour and genital tract fistula remain rampant in the region.

Considering the very high cost of marrying in the animal currency, it is imperative to note that older men have the capacity to afford the bride price. It means that while younger men are striving to raid enough animals or waiting for a family fundraiser, the economically empowered older Pokot man will go on to marry multiple wives, including their potential future wives, creating a repeated cycle of men having to marry down with regard to age; a perfect set up for power imbalance in the community.

This practice is further distorted by the prevailing harmful cultural practice of the female genital cut as an initiation into the marital eligibility cohort. While initiation happens to the boys when they are legally adult men; the commercialisation of the practice of marriage has resulted in the lowering of the age for girls from early adulthood to as young as 10 years.

From these observations, it is clear that in West Pokot, their arsenal for addressing adolescent pregnancy is vastly different from many other counties. The solutions that have worked elsewhere are not applicable in this setting.

The entire county leadership is in agreement about the way forward — education! This has been earmarked as the single most successful intervention that is bound to bear fruit. Education has been shown to empower girls, opening their minds to the possibility of what lies beyond the undulating hills and building a desire to do things in a different manner.

This creates a ripple effect, nudging their even more listless male counterparts to lay down their weapons and head to class. It is astonishing to see grown men in school uniform leaving their wives and children at home and heading to school, motivated by the need to read their M-Pesa messages to avoid being conned in this era of mobile banking.

Wherever the motivation is coming from is irrelevant, the solution has been presented. A multisectoral approach to handling the impact of culture, poverty, food security, illiteracy, and insecurity, is the first step to implementing this solution.

The County Government of West Pokot has already demonstrated goodwill. Every child in school from a needy and vulnerable background is eligible for an education bursary, whether attending a boarding school or a day school. This has seen a sharp rise in the number of admissions into schools, with many young adolescent mothers returning to school to get an education.

West Pokot County understood the power of education, long before the KDHS 2022 spoke to us. Keeping girls in school is a sure bet to reducing adolescent pregnancy. This is not just a health issue; it is a multisectoral issue!

Dr Bosire is an obstetrician/ gynaecologist