Whereas adolescents are defined as persons aged 10-19, the World Health Organization (WHO)

defines the youth as persons aged 10-24 years. According to the 1999 Population and Housing
Census, youth so defined constitute about 36 per cent and the adolescents 25.9 percent of Kenya’s
population. The World Health Organization states that reproductive health (RH) is a state of
complete physical, mental and social well being, and not merely the absence of disease or infirmity,
in all matters relating to the reproductive system, its functions and processes. Fertility levels have
remained high among Kenya’s adolescents despite declines experienced among other age groups.
Sexual activity among Kenyan young people begins early. It is, moreover, often characterized by
what might be called serial monogamy - one partner after another. Adolescent liaisons are usually
brief and easily replaced, so that by the time a person is ready to consider settling into marriage they
have already experienced many partners. Despite this multiplicity of partners, sexual activity is
usually unprotected, giving rise to early pregnancy and unsafe abortion, school dropout, STIs
including HIV/AIDS, and economic hardship. According to KDHS 1998, 44 per cent of girls aged 15-19
years have had sexual intercourse and 19 per cent are sexually active. The median age at first sex for
men is 16.8 years, compared with 16.7 years for women. Although men enter into sexual unions on
average five years later than women, they start sexual activity at about the same age.

In spite of high fertility and early sexual debut, contraceptive use among adolescents is relatively
low. Only 6.6 per cent of persons aged 15-19 were using any method of family planning in 1998. Of
these, only 4 per cent were using modern methods. Among 20-24-year-olds, only 27 per cent were
using any method while 19.9 per cent were using modern methods.

Although government, private and NGO sectors provide RH services, most are not designed to take
into account the special needs of young people. Where services exist, providers lack capacity to deal
effectively with adolescent reproductive health issues and the range of services provided is also
limited. Consequently, the majority of adolescents are hesitant to use them.

Laws and regulations governing gender

Gender is defined as the division of roles by sex, determined by any given society and dictated by
cultural, religious or other values that have little to do with the anatomy or genetic construct of a
person.

“gender’’ means the social definition of women and men among different communities and cultures,
classes, ages. “gender mainstreaming” means ensuring that the concerns of women and men form
an integral dimension of the design of all policies, laws and administrative procedures including
budgeting and budget implementation, and the monitoring and evaluation of programmes
implementing such policies, laws and administrative procedures in all political, economic and
societal spheres; so as to ensure that women and men benefit equally, and that inequality is not
perpetuated.

Expectations about what it means to be a man or a woman, which are an integral part of the
socialization process, leave many youth and adults ill prepared to deal with their sexuality or protect
their health. Gender influences sexual behaviour, especially when stereotypical assumptions are
considered.

Stereotypes of submissive females and powerful males restrict access to health information, hinder
communication between young couples, and encourage risky behaviour among young women and
men in different, but equally dangerous, ways. Ultimately, these gender disparities increase
adolescents' vulnerability to sexual health threats such as violence, sexual exploitation, unplanned
pregnancy, unsafe abortion and sexually transmitted infections (STIs) including HIV/AIDS. The power
imbalances between men and women can sometimes make it difficult for adolescent girls to refuse
unwanted or unprotected sex, negotiate condom use, or use contraception against a partner's or
husband's wishes.

The right to health is provided for under Article 43 of the Constitution. This includes the right to
reproductive health care. It also provides that a person shall not be denied the right to emergency
health care. In the Kenyan context, a major barrier for women to the achievement of the highest
attainable standard of health is inequality, inaccessibility, unacceptability and unaffordability of
quality health services both between men and women and among women in different geographical
regions, social classes and indigenous and ethnic groups.

Key issues

 Maternal mortality remains high in Kenya, but has shown a decline from 488 deaths per
100,000 live births in 2008 to 362 deaths per 100,000 live births in 2014 nationwide with
regional disparities.
 The proportion of registered medical personnel per thousand population rose to 368 in 2018
from 355 in 2017 which is below the WHO recommended levels
 Women are still burdened with preventable diseases, such as HIV/AIDS, malaria and
tuberculosis (TB);
 Outdated cultural practices such as ‘wife inheritance’, which exacerbate the spread of
HIV/AIDS;
 Expectant mothers are prone to malaria due to poverty and limited access to sleeping nets;
 Women have borne the greatest brunt of TB infections 7 and maternal mortality is still high.
 Mental health as an aspect of health, which is not given as much emphasis as other health
conditions, and yet ‘there is no health without mental health’. There are specific links
between mental health and women’s reproductive health and sexual and gender-based
violence
 Remove gender bias in the school curriculum, educational materials and practices, improve
teacher attitude and classroom interactions.
 Increased sensitisation and capacity building of the National Police Service, strengthening of
the Gender Desks at Police stations to facilitate reporting of sexual gender based violence.
 Improve Government support in providing support services such as shelters for GBV
survivors;
 Engage with women and men engaged in sex work and Injecting Drug Users (IDUs) to
minimise vulnerability to GBV;
 Provide a Minimum Benefits Package under Universal Health Care to enable GBV survivors
to get health services; and,
 Research on SGBV to identify underlying and systemic causes and the best ways of
addressing them.

Policy Goal

The overall goal of this policy is to achieve gender equality by creating a just society where women,
men, boys and girls have equal access to opportunities in the political, economic, cultural and social
spheres of life.”

Objectives of the Policy are to:

a) Facilitate implementation of the Constitution and domesticate the international and regional
obligations and commitments that promote gender equality and freedom from discrimination;
b) Provide a framework to integrate and mainstream gender into the National and County
Government development planning and budgeting as well as resultant policies, programmes and
plans including those of non-state actors;

c) Promote and support the rights-based approach when dealing with gender related matters;

d) Define institutional framework and performance indicators for effective tracking, monitoring,
evaluation and reporting implementation of gender equality and women empowerment.

Guiding Principles include

a) Sharing and devolution of power;

b) Equality, equity and non-discrimination;

c) Recognition of differences, diversities and inequalities among women and men;

d) Respect of the rule of law;

e) The inseparability of public and private spheres of life;

f) Inter-sectionalist and multiple discrimination;

g) Public participation, consultation and co-operation;

h) Transparency and accountability;

i) Sustainable development and inclusive growth;

j) Protection, inclusion and integration of the marginalized and special interest groups.

Policy Approach includes:

a) Gender mainstreaming and integration in all planned interventions; b) Affirmative Action to

c) Empowerment of women, men, boys and girls to facilitate equality, equity and non-discrimination;

d) Involvement of men in addressing gender issues;

e) Institutional and human capacity building;

f) Gender responsive development planning budgeting;

g) Generating data and indicators that are disaggregated by sex, age and disability.

Policy Outcomes anticipated are:

a) Equality and economic empowerment will be achieved;

b) Diversity of all Kenyans will be acknowledged and respected;

c) Women men, boys and girls will have equal rights and access to education, health, housing,
employment, and other services and resources;

d) Women and men will have equality of opportunity to participate in decision making and to
contribute to the political, social, economic and cultural development agenda;
e) Promotion of equal rights at the time of, during and on the dissolution of the marriage for
spouses.

f) Sexual and Gender based Violence will abate and men, women, boys and girls will live with dignity.

Cat 2 Discuss Post-Abortion care.

Maternal mortality rate has reduced from 488/100,000 (KDHS 2009) to 362/100,000 (KDHS 2014).

Abortion is the loss of a pregnancy whether spontaneously of by induction before viability outside
the mother’s womb. It can be complete with expulsion of all products of conception (POCs) or
incomplete with residual POCs or missed where the Embryo dies without a miscarriage happening or
a septic abortion with infection of POCs or unsafe where the abortion is performed by persons
lacking the skill or in an environment that is not in conformity with medical standards or both.

Post abortion care (PAC) is defined as the medical, social, psychological, spiritual care and support
given to a person after an abortion. For PAC the cervix should be open plus or minus products of
conception.