John Karanja attempted suicide three times before realising that his life, after all, had meaning. Karanja, who was born Dorcas Wangui in 1993, did not notice his body was different until he was eleven years old when he began puberty. However, in order to understand Karanja’s journey, we must first understand Dorcas Wangui.
Wangui was born and raised in Gatundu South, the last of 12 siblings. The attending physician observed that the new-born possessed both female and male genitalia. He assured the parents that the child’s visible male genitalia would “disappear” as she approached puberty. The doctor was describing some of the characteristics of an intersex person.
The report of the Taskforce on Policy, Legal, Institutional and Administrative Reforms on Intersex Persons in Kenya describes intersex persons as those who have ambiguous genitalia, both internal and external, and do not fit into the binary categories of male or female. The ambiguity could be anatomical (i.e. a bodily structure like the vagina, penis, or breasts), hormonal (e.g. oestrogen, testosterone), gonadal (i.e. reproductive organs like the ovaries and testes), or chromosomal (i.e. genetic makeup, e.g. XX, XY). In essence, each intersex person is one-of-a-kind. According to the UN Office of Human Rights, 1.7 per cent of the world’s population is born with intersex characteristics.
There are more than 46 variations of intersex conditions, according to Dr Milton Diamond, a renowned American professor of anatomy and reproductive biology. These variations can be detected at various stages, including pregnancy screening, birth, childhood, puberty, and adulthood; a person can have multiple variations.
Wangui’s parents returned home, overjoyed to have a daughter. They kept their worries to themselves and did not follow up with the doctor. After all, having an intersex child was and is still not openly discussed, let alone acknowledged.
Wangui’s body began to change during her adolescence, as is typical. She began to notice physical changes when she started secondary school in 2009. She was perplexed at the age of 16 as to why she had never had menstruation. Her voice was also beginning to deepen, something she only observed with her male age-mates. Wangui’s parents had never explained that she was born different from her siblings, so she had no idea how to interpret the ambiguous anatomical changes.
During this period of confusion and ridicule from peers, Wangui attempted to commit suicide but failed. She dropped out of school the following year and fled to Nairobi, leaving her family and friends in the dark.
Intersex people face discrimination from the moment they are born because they are labelled as either male or female. They face discrimination as they grow because their sex characteristics do not correspond to the gender assigned to them by medical doctors and their parents.
Consider the case of an intersex student attending an all-male school who, instead of breaking his voice, begins to develop breasts! Because there is rarely a support structure in schools—or in society in general—for intersex students, many choose to drop out. The psychological stress and pressure are enormous, and many people consider suicide as a means of escaping their situation.
Most intersex children are assumed to be female due to the biological formation of a child in the womb. Typically, the first organs to develop are female, followed by male genitalia. When a child reaches puberty, hormones begin to assign themselves in accordance with what is dominant. Intersex people have health predispositions that are uncommon in males and females, according to Dr Paul Laigong, a paediatrics endocrinology lecturer at the University of Nairobi. “These are conditions such as electrolyte imbalance, delayed puberty, infertility, sexual dysfunction (difficulty in having or enjoying sex) and gender identity crises,” he says. The latter—gender identity crisis—in particular, was what Wangui was experiencing.
Wangui was accommodated in the big city by her older sister, who lived in Kariobangi. Wangui was surprised to see so many girls and women wearing trousers, which was unusual in Gatundu, her rural home. Wangui had never worn trousers before, preferring to dress in skirts and dresses as dictated by her parents, who considered her a girl.
When a child reaches puberty, hormones begin to assign themselves in accordance with what is dominant.
Wangui’s physical appearance continued to change after she arrived in the city. People in the neighbourhood began to wonder why a “boy” was wearing dresses and skirts. As a result of her growing dissatisfaction with her body, she attempted suicide twice more. It wasn’t until 2012 that she decided to finally confide in her sister, and then their mother, both of whom were extremely supportive. Wangui also changed her name to John Karanja at this point, hoping to make it official as soon as possible.
According to the task force report, intersex is not a new phenomenon or concept. While the existence of intersex people has long been recognised in Kenya, talking about sex is frowned upon, and even mentioning the more unusual sex statuses such as intersex is still unthinkable. As a result, most communities either lacked proper names to describe them or used euphemisms to refer to them. These terms are rarely used in public discourse.
Robert Edgerton, an American anthropologist, conducted research on the cultural beliefs and perspectives on intersex people among the Pokot in 1964. According to the study, an intersex child was viewed as an unfortunate occurrence and a freak, with some members of the community stating that if they had such a child, they would kill it. Others saw the killing of intersex children as a cultural and religious obligation.
Retrogressive beliefs continue to endanger intersex children and cases of infanticide (the intentional killing of children under the age of twelve months) continue to be reported in some places, such as Western Kenya, a crime under Kenyan law.
Because of a history of shame and stigma, parents are coerced into subjecting their intersex children to unnecessary surgical procedures in order to “normalise” them and make them fit into binary stereotypes. Jedidah Wakonyo Waruhiu, a former commissioner at the Kenya National Commission on Human Rights (KNCHR) and former member of the Intersex Persons Taskforce, believes that the right to health of intersex people should be guaranteed before birth.
According to Jedidah, “assigning a gender to intersex children causes problems in their natural biological and social lives.” “It becomes more problematic when parents force their children to undergo gender normalising surgeries, even if the sex development disorders do not pose a health risk,” she adds.
This is what happened to *Zuri, who was forced by her family to have surgery at the age of 16. Zuri, now in her 30s, had not realised her body was different until she was eight years old. Her parents were aware of her intersex status from birth and even had an endocrinologist (a doctor who specialises in diagnosing and treating hormone-related diseases and conditions) confirm it. Despite the ambiguity, they chose to raise Zuri as a girl and stuck to their decision, even as male characteristics emerged over time.
The doctor advised them not to operate on Zuri because there was no danger to her health. Ignoring the doctor’s advice, Zuri was subjected to the surgery that would transform her into the daughter they had always wanted, assuming her health was not jeopardised.
What followed was hormone replacement therapy and chronic depression. Her academic performance suffered as a result, and she attempted suicide on several occasions. “The mental anguish and physical problems I’ve had as a result will most likely never be resolved,” she says. Sadly, being intersex comes with stigma. Many times, Zuri, a freelance web developer and graphic designer, has potential clients cancel their projects based solely on the sound of her voice. “Traditional 9 to 5 jobs don’t work for me because I don’t “fit” in hierarchical structures,” Zuri explains.
Ignoring the doctor’s advice, Zuri was subjected to the surgery that would transform her into the daughter they had always wanted, assuming her health was not jeopardised.
Kenya became the first country in the world to count intersex people as a stand-alone group during the 2019 Population and Housing Census. Conversations about intersex people were rare on public platforms prior to 2007, and have been gradually peaking since then. The first case involving the rights of people with intersex conditions in Kenya was presented in court that year, prompting an increase in media coverage.
Unlike Karanja, Zuri has never had trouble obtaining official documents because her birth certificate and all related documents show that she is female. She has never been denied services.
Karanja, on the other hand, has faced a slew of difficulties. In 2012, he went to Milimani Law Courts to have his name legally changed so that he could change his academic records and resume school. He was a bright student who hoped to return to school, either all-male or mixed, where his gender ambiguity would not be an issue. Karanja and his family requested that the Kenya National Examinations Council (KNEC) change the name on his primary school examination records because no school would admit him. It was difficult to follow up on the case because they couldn’t afford a lawyer.
Karanja met a benefactor during this time who assisted him with the medical process of testing and, later, surgery. Between 2013 and 2017, he underwent four successful surgeries. In 2015, the benefactor helped him enrol in an all-boys school in Kisumu. Except for the principal, no one knew he was intersex. Karanja, however, was unable to take his national examination at that school because his official name remained “Dorcas Wangui.” He enrolled in a mixed school to take his final exam, where he had to present an affidavit proving his gender identity.
Karanja believes that if he had been identified as intersex at birth, access to basic human rights such as education would be the reality rather than a pipe dream. He is unable to enrol for higher education because his image and the names on his documents are contradictory. Years later, he is still attempting to persuade the Kenya National Examinations Council to change the name. According to the task force report, the majority of intersex people of school-going age have limited access to education, with only about 10 per cent completing tertiary education.
The Taskforce Report made a key recommendation that the relevant agencies expedite the provision of birth certificates, identification documents, passports, and other official personal documentation that include provisions for the intersex (I) marker. This would be accomplished through the amendment of the Births and Deaths Registration Act (Cap. 149), the Registration of Persons Act (Cap. 107), the Interpretation of General Provisions Act (Cap. 2), the Kenya Citizenship and Immigration Act, (Cap 172), and the Children Act, 2001.
The Kenyan government established an Intersex Persons Implementation Coordination Committee (IPICC) in 2019 with the mandate of assisting the government to implement the recommendations of the Intersex Persons Taskforce Report. According to Veronica Mwangi, IPICC’s Head of Secretariat, the IPICC is in the process of developing a database for intersex people that will ensure centralized data for all intersex children and adults in Kenya to help the government make decisions.
Kenya became the first country in the world to count intersex people as a stand-alone group during the 2019 Population and Housing Census.
Veronica points out that Kenya made big strides by becoming the first country globally to count intersex people as a stand-alone group in the 2019 Population and Housing Census. “This has paved the way for the inclusion of an intersex sex marker in key government systems such as Chanjo (the COVID-19 vaccination portal), the Kenya National Commission on Human Rights (KNCHR) complaints management system and the Independent Policing Oversight Authority (IPOA),” she says.
In 2021, the secretariat was joined by a member from the civil registration services, a move that is critical in ensuring children born intersex have a right to a name and that name change services are simplified. Veronica also mentions that IPICC has been collaborating with the Kenya Law Reform Commission, the Office of the Attorney General and legal practitioners to develop a comprehensive law amendment that will address the concerns of intersex people.
Inconsistent Intersex Data
Karanja is one of 1,524 intersex people counted in the 2019 census, out of a total population of approximately 47.6 million. The census was conducted from 24 to 31 August 2019, with a follow-up exercise on 1 and 2 September to cover those who were not counted during the seven-day period.
A year earlier, the Intersex Taskforce had published a report in which they estimated that the population of intersex persons in Kenya was 779,414. The taskforce had conducted a field survey in each of the 47 counties from June to October 2018. To supplement the research, data collected by the Kenya National Commission on Human Rights between October 2016 and April 2017, as well as data from various state and non-state institutions, were used. This was Kenya’s first survey specifically targeting intersex people.
The discrepancy in the intersex data collected is astounding. According to former commissioner Jedidah Waruhiu, a follow-up by the KNCHR after the census revealed that while the enumerators had received intersex training, certain cultural factors came into play during the data collection process. For example, the mostly-young enumerators felt awkward asking elderly people gender and sex-related questions. Similarly, those who were not explicitly asked the gender marker question found it difficult to raise the issue, fearing that the revelation would stigmatise them in the community. “Many families were not comfortable answering the sex question as the majority of enumerators were locals in the areas where they were collecting data,” says Jedidah.
In other cases, the enumerators would simply look at a person and, without asking a question, indicate on the form the gender of the person they were interviewing based on their outward appearance, such as mode of dress. This was done so that they could quickly finish the questionnaire and move on to the next person. As a result, many intersex people were left out of the count.
Other than the census, the Kenya National Bureau of Statistics (KNBS) has not included intersex persons in any other of its reports. Despite accounting for less than 1 per cent of the population, intersex persons are important contributors to the economic growth of the country, according to the KNBS research. According to the census report, at least 41 per cent of intersex people were in the labour force.
Despite global progress in recognising intersex peoples’ rights, the Sustainable Development Goals (SDGs) do not include intersex people. SDG 5 addresses gender equality, but the emphasis is on women and girls. However, an indirect reference is made to SDG 10, which deals with reducing inequalities within and between countries. By 2030, one of the SDG targets is to empower and promote the social, economic, and political inclusion of all people, regardless of age, gender, disability, race, ethnicity, origin, religion, or economic or other status.
This also applies to SDG 16, which aims to promote “peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable, and inclusive institutions at all levels.” SDG 16 includes goals such as “providing legal identity for all, including birth registration,” and “promoting and enforcing non-discriminatory laws and policies for sustainable development.”
Despite global progress in recognising intersex peoples’ rights, the Sustainable Development Goals (SDGs) do not include intersex people.
While the SDGs do not include direct targets for intersex people, policymakers and stakeholders in participating states have a responsibility to provide them with equal opportunities because they are bound by international and regional legislative and human rights frameworks.
The Universal Declaration of Human Rights (UDHR), for example, recognises all people’s inherent dignity and worth, stating unequivocally that “all human beings are born free and equal in dignity and rights”. Another important framework is the International Covenant on Economic, Social, and Cultural Rights (ICESCR), which guarantees the right to self-determination and the enjoyment of all other ICESCR rights to all without regard to gender, birth, or other status.
In Kenya, granting intersex people the right to documentation, which unlocks many of their rights and freedoms, is key to enabling intersex people to contribute to the economy.
Richard Muasya, an intersex person, filed a case in court in 2010 alleging violation of his constitutional rights. Muasya had been charged with the capital offence of robbery with violence a few years before, arrested, and imprisoned in Kitui. Following the discovery of Muasya’s intersex status during a routine physical search, the Kitui Magistrates Court ordered that he be remanded in isolation at the Kitui Police Station pending trial.
Muasya was later convicted, sentenced to death, and transferred to Kamiti Maximum Prison, a male-only prison for death row convicts. Muasya was initially forced to share cells and facilities with male inmates, but was later held in solitary confinement. Because of his condition, he was allegedly subjected to invasive body searches, mockery, and abuse while in prison.
Muasya argued in court that he should have been detained in a separate facility with specially trained staff rather than being placed in a male prison. The court acknowledged that the petitioner’s situation was unique and had not been anticipated by the legislature, but determined that creating a prison specifically for him would be impractical.
In Kenya, granting intersex people the right to documentation, which unlocks many of their rights and freedoms, is key to enabling intersex people to contribute to the economy.
The court ruled that neither the Prisons Act nor the Prisons Rules discriminated against intersex people. It dismissed Muasya’s claim that he was unconstitutionally detained in the police station while his trial was pending, and ruled that the petitioner’s social stigma was not a legal issue. Further, the three-judge panel ruled that there was no empirical data that could lead the court to conclude that intersex people require recognition. The court, however, awarded Muasya KSh500,000 in compensation for the inhuman and degrading treatment he endured.
Regardless, the Prisons Act did not (and still does not) specify where intersex people should be detained.
Advocacy for issues affecting intersex people was low-key at the time. Kenya was undergoing constitutional reform at the time Muasya’s case was dismissed. According to former KNCHR commissioner Jedidah Waruhiu, this was a missed opportunity to incorporate intersex issues into the constitution.
Three years later, a petition for Baby A, an intersex baby born at Kenyatta National Hospital, was filed in court. The hospital included a question mark in the column for indicating the person’s gender in the birth notification document. The baby’s mother claimed that the use of a question mark to indicate the baby’s gender was a violation of the child’s rights to legal recognition, dignity, and freedom from inhuman and degrading treatment. In addition, the petitioner claimed that the failure of legislation such as the Registration of Births and Deaths Act to recognize children with intersex conditions violated various children’s rights guaranteed by the constitution as well as various international human rights treaties.
This was the second case to be decided in the Kenyan courts concerning the rights of persons with intersex conditions. In a much more progressive ruling, the court ruled that while Baby A’s rights were not violated, the Attorney General (AG) was ordered to bring before the court information related to the organ, agency, or institution responsible for collecting and keeping data related to persons with intersex conditions. Further, the AG was ordered to file a report identifying the status of a statute regulating intersex as a sex category, and guidelines and regulations for any corrective surgery for persons with intersex conditions. Finally, the Court ordered that Baby A’s mother move to make an application for the registration of Baby A by the Registrar of Births and Deaths.
In Kenya, only a handful of laws have been changed to accommodate intersex people. According to the 2014 Persons Deprived of Liberty Act, while a body search of any person must be carried out by a person of the same sex, an intersex person has the right to choose the sex of the person conducting the search.
The Registration of Persons (Amendment) Bill, 2019 is currently pending in the Senate. Once approved, the Intersex sex marker will be concretised as a third sex marker in law.
Misinformation/sensationalisation about intersex people
Being intersex is a gender marker, just like being male or female, and is usually assigned at birth based on sex characteristics. Being intersex is frequently misunderstood as a description of one’s sexual orientation or gender identity (the personal sense of one’s own gender, which may differ from the assigned sex in some cases). It is frequently lumped into the LGBTQIA category, and as a result, people are dismissive of intersex people’s plight.
Granted, much of the societal apathy stems from how the media, both local and international, covers stories about intersex people. For a long time, they were referred to as “hermaphrodites”, implying that they are both fully male and fully female. That is not only deceptive but also stigmatising. While they are now referred to as “intersex people”, reports about them are still sensationalised, which is usually a ploy to attract more readers.
When ratings and readership come first, no matter how accurate the information, the news often becomes a mere source of entertainment. It cannot be overstated how damaging sensationalisation of such issues is to society. People’s perceptions of even the most mundane things are shaped by the news. Reports on intersex people, on the other hand, must be approached with the utmost professionalism and respect if we are to change the narrative about them.
Kenya could possibly borrow best practices on reporting from the Australian Human Rights Commission. Their reporting guidelines for people born with sex differences advise journalists to always begin by asking the interviewee about their preferred terms or descriptors, and to avoid making assumptions about the terms a person may use.
It is important to note that unless an intersex person has volunteered that information, asking them questions about their bodies or genitals is inappropriate. Additionally, the interviewer should not mix up Intersex issues with sexual orientation, gender identity, or LGBTQI identities.
When ratings and readership come first, no matter how accurate the information, the news often becomes a mere source of entertainment.
Not to be overlooked is how a lack of data contributes to a fair share of misinformation and stigmatisation of intersex people, both past and present. In the absence of hard evidence on intersex people, retrogressive cultural beliefs that lead to infanticide or abandonment of intersex children who are perceived to be a curse, as well as misinterpretations of religious canons, are used to frame the narrative.
Intersex people face discrimination at school, work, and in social settings as a result of misinformation and stigma. This has an impact economic wellbeing due to a lack of job opportunities and, in some cases, a lack of education. Overall, the impact on their mental health is immeasurable from a young age.
Greater intentionality is required to make intersex people more visible and heard, which requires continuous data collection and their inclusion in all country statistics. Hopefully, this will lead to more accurate and more nuanced discussions about intersex people.
Need for sensitisation
Jedidah contends that introducing the Intersex “I” marker will allow medical professionals and parents to follow up on children since birth, raise them as intersex, and biologically monitor them. “This fixing of male or female is what is causing problems for the children as they grow in their natural biological life, as well as in their social life,” she adds.
There is an urgent need to educate healthcare workers across the country about the needs and rights of intersex people. This awareness should be achieved both during and after training. According to Dr Laigong, the Ministry of Health should provide additional assistance by providing diagnostic equipment, lab support, and social amenities. However, he observes that progress in sensitising medical practitioners is being made. “Right now, the University of Nairobi has a fellowship programme to train paediatricians in paediatric endocrinology,” he explains.
Veronica Mwangi observes that while the government has set up the Intersex Persons Implementation Coordination Committee, no funds have been allocated to the secretariat to support intersex people’s work or programming. As a result, there is a lack of public awareness across the country about who intersex people are and the importance of protecting them. Donor support is also difficult to come by. “Some donors are hesitant to support intersex person programmes on their own,” she adds.
The world is gradually realising that referring to intersex people as hermaphrodites is derogatory. Intersex people’s human rights violations extend beyond barriers to healthcare and employment. Gender-based violence, educational access, and land rights are all issues that must be addressed.
During antenatal care, expectant mothers should be tested for intersex genetic conditions, according to Jedidah. This way, the doctors and parents of an intersex baby can ensure that the necessary treatment and documentation is provided from the start. Moreover, if the gender of the baby is unknown, registration bureaus should add an ‘I’ marker to avoid guessing the sex.
The world is gradually realising that referring to intersex people as hermaphrodites is derogatory.
Karanja is still determined to attend university and pursue a degree in information technology (IT). However, before this can happen, his Kenya National Examinations Council certificate must show the name John Karanja rather than Dorcas Wangui. He recently completed a certificate course in Graphic Design and is looking for work in the field.
Zuri, on the other hand, is still undecided about changing her marker in the future. “It shouldn’t be up to an oppressed group to constantly demonstrate their humanity,” she says. “Regardless of the circumstances, we are all deserving of equal rights under the law.”
This article was produced with support from the Africa Women’s Journalism Project (AWJP) in partnership with Article 19, Meedan and the International Center for Journalists (ICFJ).
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State of Hunger: Unravelling Kenya’s Food Crisis
With 8.9 million Kenyans (17 per cent of the population) living in extreme poverty – below 1.9 USD (Ksh 250) a day –and a hunger level score of 23.5 which is way above the recommended 9 or less, many Kenyans are going hungry because they can’t afford to it.
As of 30th June 670 million people experienced insufficient food consumption globally according to the World Food Programme’s Hunger Map.
Moreover, the findings from the 2023 Global Report on Food Crisis suggest that achieving the goal of ending hunger by 2030 is ever more challenging because the number of people facing high levels of acute food insecurity has increased for the fourth consecutive year. In 2022, nearly 258 million people in 58 countries or territories experienced a food crisis or worse acute food insecurity. Even though there has been an increase in the population analysed, this was the highest on record since the Global Report on Food Crisis (GRFC) began reporting these data in 2017.
This global food crisis is driven by three key factors – conflict, economic shocks and weather extremes – linked to the enduring socioeconomic impacts of Covid-19, the war in Ukraine and repeated droughts.
In Kenya as of 29th June a total population of 14.1 million experienced insufficient food consumption which is a 4.3 million increase from the previous month, according to the Hunger Map.
Although the country produces enough food to feed the population, economic access remains a challenge. Kenya’s rate of self-sufficiency in the production and availability of food is 90.3 per cent against an import dependency of 12.7 per cent, but on the four indicators of the Global Food Security Index in 2022, Kenya scored 41.3 per cent on affordability, the only indicator where the country scored below average.
With 8.9 million Kenyans (17 per cent of the population) living in extreme poverty – below 1.9 USD (Ksh 250) a day –and a hunger level score of 23.5 which is way above the recommended 9 or less, many Kenyans are going hungry because they can’t afford to it.
Frida Mmbone, a casual labourer at a tea farm in Kakamega, said that she earns Ksh250 per day, working six days a week. Her husband is also a tea picker at the same farm, earning a similar wage. Their combined income of Ksh500 can barely meet their needs and those of their four children, given that they spend Ksh425 on food alone. With 85 per cent of their income going to food, they barely have enough to meet other basic expenses like their children’s education, healthcare bills and clothing.
“We have a small piece of land, but it doesn’t produce enough maize to last us till the next harvest, so we have to buy 2kg of maize flour every day. We also buy half a litre of milk, a quarter kilo of sugar, a Ksh20 portion of cooking fat and paraffin worth Ksh30 every day.
“With the constant increase in the prices of basic commodities, we have been forced to do away with some things. Now we only make breakfast during weekends, and luckily three of the children are in high school so they have tea at 10 and lunch in school. My husband and I have tea at work and skip lunch to save on costs,” she said.
The current food crisis is a result of several factors, including drought following a sixth failed rain season. The increasing intensity and shorter cycles between droughts have affected crop yields for five consecutive seasons. Pastoralist communities have also lost substantial numbers of livestock due to malnutrition.
These combined factors have led to the inflation of food prices limiting access and consumption of food staples.
According to the Kenya National Bureau of Statistics (KNBS), maize production in the country declined by 12.8 per cent from 42.1 million bags in 2020 to 36.7 million bags in 2021 and 34.3 million bags in 2022. Similarly, the volume of marketed milk decreased from 801.9 million litres in 2021 to 754.3 million litres in 2022 largely due to drought that resulted in scarcity of fodder for livestock.
As a result of decreased production due to drought, Kenya’s maize imports in the first nine months of 2022 more than doubled to 519,611.30 tonnes (5.7 million 90-kilogramme bags), from 214,100.9 tonnes (2,378,899 90-kilogramme bags) during a similar period in 2021. This is the highest maize import since 2017. The shortage of the staple left 5.1 million people in need of relief food and pushed up retail prices of maize flour.
Similarly, Kenya imported rice worth $275 million, becoming the 32nd largest importer of the cereal in the world, and making it the 12th most imported product in Kenya.
In addition to the effects of drought on food security, the war in Ukraine has disrupted global food markets, leading to higher prices for wheat, maize, and other commodities. Kenya is a major importer of these commodities, so the war has had a significant impact on the country’s food prices.
The war has also contributed to higher costs of production by disrupting the supply chains of fertilisers which resulted in shortages, increasing demand and purchasing costs. In 2020 Russia accounted for 17 per cent of fertiliser exports to Kenya.
Given that food, followed by energy, is one of the key drivers of inflation in Kenya’s consumer price index, these factors have put pressure on food supplies, putting overall inflation at 8 per cent in May, and food inflation at 10.2 per cent, in the same month. Rising prices have reduced the purchasing power of consumers, who now have to spend twice as much as before on most food staples.
Available income to buy basic needs like food is also under pressure from policy adjustments driven by pressure from the International Monetary Fund, which has seen the government increase taxes on everything including cooking gas (with a new VAT of 16 per cent from the previous 8 per cent). These adjustments were passed in the Finance Act 2023, touted to be the way out of the country’s debt crisis and into self-reliance. The law has since been challenged in court and its implementation suspended pending the hearing of the case.
Kenya’s economy is yet to recover from the effects of the Covid-19 pandemic, which affected the tourism sector that contributed up to 10 per cent of GDP before the pandemic. As of 2022, there was a notable increase in tourism revenue by up to 83 per cent but it is yet to reach pre-pandemic levels. The pandemic also created bottlenecks in the supply chain contributing to inflation.
Further, the drastic depreciation of the Kenya shilling against the dollar has made the importation of food and raw materials necessary for food production more expensive. The shilling’s value against the dollar depreciated by an average of 0.6 per cent monthly since March 2020, plunged to an average depreciation of 4 per cent per month in January and February 2023, then 6 per cent in March. The shilling has lost more than 25 per cent of its value against the dollar, exchanging at Sh140 to the dollar, and this has pushed up the prices of imported goods.
In the midst of the crisis Kenyans have nowhere to turn for relief. Among all 113 countries assessed for the Global Food Security Index in 2022, Kenya had an average score of 26.8 on food safety net programmes, which was less than the average of 72.4 for other countries. Moreover, the country scored zero on funding for food safety net programmes, yet it scored 100 on dependency on chronic food aid, against an average of 65.5 for other countries that were assessed.
With 56 per cent of the world’s population living in cities according to the World Bank, a new study reveals how crucial urban farming is to food security, given that the urban population is projected to grow to nearly 70 per cent by 2050. In Africa, the rate of urbanisation is 47 per cent, while in Kenya it increases by 3.7 per cent annually, with the rate of rural depopulation raising concerns about food supply given that there are fewer people living and working in farms.
Dr Antonina Mutoro, Associate Research Scientist at the African Population and Health Research Center, said interventions to address the hunger crisis by promoting urban farming should be sustainable and scalable, rather than temporary. This would mean considering systemic factors and government policies in addition to individual efforts.
“There is only so much we can do because our environment is influenced by what is going on in terms of politics and government policies. I am thinking of people living in informal settlements; they need structures put in place by the government to ensure there is space or innovative methods of producing food in small spaces in urban areas, access to safe water and capacity and knowledge to produce food safely. This will ensure that regardless of whether you have an income or not you have a sustained source of food.
“That being said, there is a limited amount of food one can produce for their own consumption and it also limiting when it comes to growing maize our staple food in those small urban spaces,” she explained.
Given that affordability is a major factor driving hunger in Kenya where there is a high rate of unemployment among the youth, Dr Mutoro said that this should also be addressed to ensure that people can access food sustainably.
“There is need for systems that ensure that people have access to money to buy food through the government creating income-generating activities and promoting farming as a source of livelihood, especially among the younger population by reducing costs of farm inputs and ensuring markets are profitable to farmers rather than causing them losses.
“This can contribute to a consistent food supply and reduce reliance on imports,” she noted.
She added that youth should be supported to adopt farming as a source of livelihood, saying that the average Kenyan farmer is 61 years old and that is likely to have implications on food production in 20 or less years.
Besides promoting food security through food production, innovative solutions are needed to prevent food wastage and ensure that surplus food reaches those in need. For instance, APHRC through its Zero Hunger Initiative champions ensuring that food that is produced is transported from places where it is in excess to areas where it is needed the most. By preventing food wastage, food security can be improved without requiring increased production.
Given that adverse climate conditions, particularly in arid and semi-arid areas contribute to food insecurity through failed rains and drought, long-term planning should consider climate change and invest in innovative irrigation systems and other climate adaptation strategies to maintain sustainable food production despite environmental challenges. Learning from countries like Israel, which effectively produce food in desert conditions, can provide valuable insights.
Subsidies and trade-offs which have been contentious issues, also have the potential to alleviate the crisis while still making farming profitable and ensuring farmers receive fair compensation for their produce. However, the trade-offs and potential impacts on the industry and market dynamics should be carefully considered before implementing such policies. Comprehensive discussions involving all stakeholders are necessary to reach agreements that balance the interests of different parties, and long-term planning should be prioritised over the short-term focus of political agendas.
“It is essential to establish structures and frameworks that transcend individual governments. Long-term planning and consistent implementation of initiatives are crucial for sustainable solutions to address food insecurity in Kenya and other African countries. Shifting agendas with political changes limit the effectiveness and continuity of proposed interventions,” said Dr Mutoro.
The right to adequate food is realised when every man, woman and child, alone or in a community, has physical, social and economic access to adequate food or means for its procurement. It is the state’s obligation to not only respect but protect and facilitate the realisation of this right by ensuring during times of crisis like now there are social safety nets that aim to ensure a minimum amount of food consumption and protect households against shocks to food consumption. These safety nets should be integrated as part of a larger policy of sustainable economic development so they are not viewed as charity but as developmental and as a way of building resilience to shocks.
This articlewas produced as part of the Aftershocks Data Fellowship (22-23)with support from the Africa Women’s Journalism Project (AWJP) in partnership with The ONE Campaign and the International Center for Journalists (ICFJ).
Sex Education: Are We Doing Enough?
Comprehensive Sexual education in Kenya has been a topic of concern in recent years. The question of whether youth in Kenya are equipped with comprehensive sexual education has been raised by many stakeholders in the education sector. Responding to a recent article published by Nation Africa, the United Nations Population Fund (UNFPA) Director Technical Division Julitta Onabanjo said Kenya has withdrawn from the Eastern and Southern Africa (ESA) ministerial commitment to comprehensive sexuality education.
This comes after the Kenya Demographic and Health Survey (KDHS) 2022 revealed in January that almost half of Kenyan adolescents aged 15-17 years do not know how to protect themselves from HIV/AIDS. Moreover, the percentage of girls and young women aged 15–19 years who have ever been pregnant is highest in Samburu (50%), West Pokot (36%), Marsabit (29%), Narok (28%), Meru (24%), Homa Bay (23%), Migori (23%), Kajiado (22%), Siaya (21%), and Baringo (20%), and lowest in Nyeri and Nyandarua (5% each).
Jane* (not her real name) is among the 41.6% of teenage girls aged between 15 -19 years who are sexually active and are not using any contraceptive according to the KDHS 2022. According to KNBS, only 11% of sexually active teenagers in Kenya are using contraceptives to prevent unintended pregnancies.
Jane falls under the other 89% who do not use birth control but are sexually active. These teenagers lack basic information on their sexual and reproductive health. Jane, 17, who requested anonymity to speak freely, told The Elephant that she regrets her first sexual encounter, which happened in the dormitory with a boy in her school. She did it because of peer pressure.
“My friends were talking about it and how good it feels, so I wanted to fit in,” she disclosed.
Jane, however, said that she is not well-informed about safe sex and protecting herself against unintended pregnancy, HIV/AIDS and other sexually transmitted infections.
The little she knows has been gleaned from brief conversations with her mother, Sarah Nekesa, a single mother living in an informal settlement, who has on occasion mentioned that there is a right time to have sex. Jane’s mother has also advised her to use protection if she can’t wait for the “right time.”
Moreover, Jane’s mother has also told her that if she has a boyfriend, they should be tested (for HIV) before engaging in sex. However, her mother discourages her from using contraceptives at her age, which she says is too young. As far as her mother who is staunch Christian is concerned, there is only one way that Jane can protect herself from getting infected or even pregnant—abstain from sex. What she does not know is that, apart from the incident in school, Jane has been engaging in transactional sex for several years. “I started sleeping with men who would give me money to buy pads and other essentials which my mother could not afford to give me,” Jane says.
“I could never talk to my mother about sex. I only did what I saw other friends my age do. After sex, I would take the morning-after pill (P2) to avoid pregnancy. The pills had some side effects. I experienced stomach pain and blood in the urine so I had to stop such activities. I didn’t use any protection, it is a relief I’m in good health,” Jane narrated.
A 2015 study by Guttmacher in three counties, namely Nairobi, Mombasa and Homa Bay found that most students in Forms 2 and 3 (96%) had received some sex education by the time they completed primary school, but the information received at this level is basic and does not include information on safe sex. Messages conveyed are often conservative and focused on abstinence. For instance, six in 10 teachers strongly emphasised that sex is dangerous and immoral and two-thirds strongly emphasised that abortion is immoral. Students said that the lessons focus on reproductive physiology and HIV prevention, and only 2% said they learnt all topics that constitute a comprehensive curriculum (including values and interpersonal skills, gender and sexual and reproductive health rights, contraception and unintended pregnancy).
Many curricula fail to provide adequate information about modern contraception – particularly, but not limited to, emergency contraception and female condoms – or HIV prevention through PrEP and PEP.
The inadequacy of education of children in practical matters of contraception and intercourse is often based on the belief that this information will encourage promiscuity, yet most students (93%) say sex education would be useful or very useful to their personal lives.
Yet abstinence-only programmes are still delivered in many countries despite robust evidence that this approach is ineffective. An increasing number of teen pregnancies in Kenya indicates that abstinence-only programmes are not effective. According to guidelines on sexuality education authored by six UN bodies (UNESCO, UNAIDS, UNFPA, UNICEF, UN Women and WHO), abstinence-only programmes are more likely to contain incomplete or inaccurate information regarding topics such as sexual intercourse, homosexuality, masturbation, abortion, gender roles and expectations, condoms and HIV.
The fact that Jane is sexually active but unaware of safe sex shows the risks that adolescents, especially girls who bear the brunt of teenage pregnancy, HIV infections and sexual and gender-based violence, face in the absence of comprehensive education about healthy sexuality.
A study conducted in Western Kenya in 2018 estimated that among 2.8 million girls aged 15-19 years, 24% (665,000) were sexually active and did not want a child, but were not using a modern contraceptive method. This age group accounted for 86% of all unintended pregnancies in the country.
Some of these girls are survivors of gender-based violence, including child marriage. United Nations Population Fund (UNFPA) estimates that Kenya’s child marriage prevalence rate is 23%. Child marriage is a driver of low education attainment, in turn limiting the employment and life options of girls. On the flip side, low education attainment also drives child marriage, fueling a vicious cycle.
These girls are further exposed to sexually transmitted infections. A study conducted in 2011 in the Rift Valley and Coast regions among HIV-positive adolescents aged 15-19 years found that about half had ever been tested and only a quarter of them knew their HIV status. Moreover, among sexually active HIV-positive adolescents, only a quarter reported using condoms at their first sexual intercourse. The study further found that two-thirds of HIV-positive girls had already begun childbearing or were pregnant, while 27% of boys had impregnated someone. In addition, 75% of pregnancies among HIV-positive girls were reported as unintended.
To equip young people with the information and skills needed for healthy sexuality in adulthood and to protect themselves from the risks that come with a lack of accurate and comprehensive information, UNESCO recommends that information on the cognitive, emotional, physical and social aspects of sexuality be included in the school curriculum. According to UNESCO, comprehensive sexuality education aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: realise their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives.
Further, the Constitution of Kenya guarantees the right to the highest attainable standard of healthcare, including reproductive health, and the Health Act provides for an overarching legal framework for health. The law clearly supports Kenya’s commitments to the regional push for rights-based CSE in 2013, which includes several key goals. The ESA commitment calls for scaling up access to and quality of comprehensive sexuality education, increasing access to youth-friendly sexual and reproductive health services, eliminating all HIV infections, reducing early and unintended pregnancies, and eliminating gender-based violence and child marriage. These commitments are now on hold following Kenya’s withdrawal.
Comprehensive sex education has been opposed by various campaigners, such as the Commission for Education of the Kenya Conference of Catholic Bishops (KCCB) headed by Bishop Paul Njiru Kariuki. One of their campaigns titled Stop CSE said that the curriculum “is one of the greatest assaults on the health and innocence of children.”
The opposition to CSE, however, ignores clear evidence that CSE has a positive impact on sexual and reproductive health, notably contributing to a reduction in sexually transmitted infections, HIV and unintended pregnancy. CSE also improves knowledge and self-esteem, changes attitudes and gender social norms, and builds self-efficacy.
Purity Ngina, the evidence manager at Zizi Afrique Foundation, who recently completed a two-year survey of 17,000 teenagers aged 13-17 years in Kilifi County, said the survey revealed that only 16% have awareness of sexual and reproductive health.
“Many young boys think they can’t interact with girls because it is wrong and they will impregnate them. Lack of guidance and misinformation highly contributes to young people engaging in risky behaviours,” she said, adding that teenagers need to be trained to build decision-making and problem-solving skills, so they can make healthy decisions concerning their sexuality.
Ms Ngina added that the dissonance between what children are taught in church or at home and scientific information only leaves them confused.
“We hope that someone will use the Bible to train them on good morals and how our bodies change, but there is incongruence between science topics and what the adolescents are taught in church or by their parents at home,” she said.
Given the benefits of CSE on sexual and reproductive health, especially in reducing STIs, HIV and unintended pregnancy, it is vital for adolescents to receive proper education during this period of significant growth and development, filled with vulnerabilities. A good education presents a unique opportunity to foster better health outcomes as adolescents’ experiences likely shape their health behaviour throughout their lives. A 2020 study found that CSE programmes are highly effective, cost-effective and may even be cost-saving, especially if they are intra-curricular, nationally rolled out and jointly delivered with youth-friendly services.
This was evident in the results of a pilot study of more than 6,000 students who received sex education. The 2014 study noted a demonstrable increase in HIV knowledge, contraception and condom use among the sexually active, and a reduction in risky sexual behaviour among students. Students who received sex education also reported delayed sexual initiation compared to those who did not.
Evidence of the benefits of CSE is clear, but what will it take for it to work in a country like Kenya?
Ibrahim Okumu, a secondary school teacher says that, for one, the focus should not be on abstinence-only and that education policies that are overreliant on abstinence-only education should be reviewed.
“We are trying to tell our students to abstain but this is becoming more difficult,” he said in a YouTube video on video published by Citizen TV.
According to human rights advocate Wangui Gitahi, Kenya should also renew its official commitment to ESA, and implement its promise to expand comprehensive rights-based sexuality education.
There is also a push for CSE to be a stand-alone subject and not integrated into other subjects as is the case currently. Research from four low and middle-income countries including Kenya, published in PLOS pointed to the drawbacks of an integrated approach. For instance, teachers trained in their primary subject areas are rarely taught how to integrate CSE and might easily skip over topics they consider controversial with the excuse that they do not have adequate knowledge to cover them. Moreover, integration can diminish the importance of CSE in the curriculum as it gets diluted and doesn’t wield the weight of a standalone subject for both teachers and students.
Implementing CSE also requires resources, and the lack of dedicated funding for CSE from governments has posed a challenge. Historically, funding for CSE has been piecemeal, mainly from external sources, and tied to specific projects. Moreover, there is a lack of coordination of the various efforts by central and local government, NGOs and development partners; and inadequate systems for monitoring and evaluating teachers and students on CSE. Curriculum implementation-related challenges included inadequate weight given to CSE when integrated into other subjects, insufficient adaptation of the curriculum to local contexts, and limited stakeholder participation in curriculum development.
Easther Mwema a youth activist from Zimbabew who runs a sexual and reproductive health data collection centre recommends that youth should be included as stakeholders in the discussions on comprehensive sex education.
“Growing up, there were lots of situations that made me feel very unsafe as a female. But I was never asked what I would like to do about them, or what I could do to protect myself. All policies related to sexual education and rights are made by adults. That’s not right. I think youth should be in the room when decisions are being made about their bodies,” she said in an interview with Hivos.
Why CSE works in some countries and not others
As Kenya faces roadblocks in CSE implementation, South Africa’s Department of Basic Education DBE expanded the Comprehensive Sexuality Education curriculum in the Life Orientation subject.
South Africa’s HIV incidence rates are highest among adolescent girls and young women (AGYW), accounting for an estimated 29% of all new infections in 2018. HIV prevalence among girls aged 15–19 years was 5.8%, and 4.7% among boys in 2017. Birth rates have decreased moderately from 78 births per 1000 in 1996 to 65 births per 1000 in 2016 among the 15–19 age group. However, these birth rates remain high with data revealing that the majority of girls who become pregnant while attending school often do not return after childbirth, and in instances where girls do return to school, they face challenges balancing school and childcare.
In response, the SA Department of Basic Education (DBE) developed the HIV, STI, and TB policy, which included the call to educate girls and boys about sexuality and sexual behaviour in an effort to reduce both unintended pregnancy and HIV rates. One of the key interventions pronounced in this policy is the provision of comprehensive sexuality education (CSE). The aim of CSE, as specified by the DBE, is to build and shape learners’ understanding of concepts, content, values, and attitudes around sexuality and sexual behaviour.
Since 2015, the DBE has developed and piloted Scripted Lesson Plans (SLPs) across five provinces (KwaZulu-Natal, Free State, Gauteng, Mpumalanga, and Western Cape) to strengthen the teaching of CSE in schools. These support materials aid educators and improve the effectiveness of CSE lessons. This formed part of the Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) initiative, which aimed to reduce HIV infection among young women. The delivery of CSE using SLPs forms part of the DREAMS package of “layered” evidence-based HIV prevention interventions targeting biological, behavioural, and structural factors to reduce the vulnerability of girls and young women to HIV with the aim of reducing HIV incidence by 40% among adolescent girls and young women over a two-year period (2016–2018).
According to Hivos.org sex education increases the level of sexual responsibility among adolescents, as they gain essential knowledge and skills that will benefit them in adulthood. Currently, because of inadequate sex education, many adolescents and teenagers are uninformed. The myths and misconceptions about sex prevail among them.
In countries like the Netherlands where children learn about relationships from as young as four years old, the results are impeccable. The Netherlands has one of the lowest teenage pregnancies, abortion, and sexually transmitted diseases (STDs) rates in Europe.
A study by the All India Educational and Vocation Guidance Institute found that between 42% to 52% of young students in India feel that they do not have adequate knowledge about sex. In a recent survey conducted by India Today, a leading news magazine, in 11 Indian cities revealed that almost half of all young people interviewed didn’t know enough to protect themselves from HIV/AIDS.
Due to this, it is submitted that India is obliged to provide comprehensive sexuality education in all public and private schools in India and that the denial of such education to children, adolescents and young people generally and the banning of the Adolescence Education Programme (AEP) by state governments specifically is a violation of India’s commitments under international law. Arguments on culture, morality or federalism are invalid in this context. Further, the provision of age-appropriate comprehensive education on sexuality and HIV/AIDS can also have important consequences in dealing with child abuse and in reducing the spread of HIV/AIDS.
In many African countries CSE, gender sensitisation and human rights education are not supported due to lack of political will. The 2003 Maputo Protocol initiated by members of the African Union encourages member states to integrate gender sensitisation and human rights education at all levels of education; it has not been ratified by two-thirds of the African member states. Implementation of CSE is donor-driven with oversight given to both Education and Health Ministries, creating funding and accountability problems.
Without information on sexual and reproductive health and gender equality, young people face a heightened risk of contracting HIV or experiencing unintended pregnancy, which might not only limit their future prospects but also put their lives at risk. Complications during pregnancy and delivery are one of the leading causes of death among adolescents globally. Research has established that CSE can improve sexual and reproductive health knowledge, and be effective in reducing risky sexual behaviour. Studies in sub-Saharan Africa have to an extent affirmed these results, indicating that changes in adolescents' sexual behaviour after exposure to these programmes are modest, but achievable, while positive improvements in adolescents' attitudes and knowledge were consistently produced.
This story has been produced with the support of The Africa Women Journalism Project (AWJP)
Declining Birth Rates No Cause for Alarm
The declining fertility and birth rate could yield a dividend for Kenya, particularly if investments are made in the education and skills of the working-age population.
After decades of efforts to reduce the fertility rate, Kenyan women are having fewer children, from eight children per woman in the 1970s to three in 2022.
According to Yohannes Dibaba Wadoa, a research scientist at APHRC specialised in sexual and reproductive health rights, the decline in fertility and birth rates is driven by socio-economic changes such as changing marriage and family formation patterns, increased use of contraception and access to healthcare, improved child survival, and women’s education and their increased involvement in modern society. Improved income and employment opportunities for both women and men have also led to the desire for fewer children.
“Women’s role has changed. They are perceived as equal to men and engage in productive employment rather than being segregated into childbearing and rearing roles,” said Wadoa, adding that improved healthcare and desire for fewer children lead to increased use of contraceptives. For instance, the percentage of married women who use contraceptives in Kenya increased from 33 per cent in 1993 to 63 per cent in 2022, according to data from the Demographic and Health Surveys.
Financial concerns could also be a factor, going by the concerns raised by respondents to an informal survey by the Africa Women Journalism Project (AWJP) shared on social media platforms. Many of the 39 respondents said they had delayed childbearing or restricted the number of children they had due to financial instability.
One respondent aged between 20 and 24 years said she wanted to have four children in future after working on financial stability to provide a happy life for her children. Yet another (in the 25-29 years age group) said she wanted to have two children and was laying an economic foundation for their future.
“I’m a student. Having a child at this point in my life will make me vulnerable and expose me to financial constraints,” she said, adding that society restricts what she should be doing at a certain age.
One man in his thirties (30-34 years) also cited financial stability, saying that he planned to have four children if his fortunes changed and if he could provide a better future for them; coming from a poor family, he had worked hard in school to break the cycle of poverty, but unemployment stands in the way of creating a better life for himself and subsequently keeps him from starting a family.
“I have been unemployed for 10 years since I graduated, so starting a family is a challenge. I also come from a history of poverty. I worked so hard in school to live a better life, but it’s like I am in a vicious cycle of poverty.”
At 27.357 births per 1000 people, the current birth rate is a 1.2 per cent decline from 2022, a trend that has provoked conversations about what that means for the Kenyan population. Globally, the UNFPA’s State of the World Population Report 2023 revealed widespread “population anxieties” that have governments adopting policies to raise, lower or maintain fertility rates. In countries with lower fertility rates, there have been concerns about the ageing population and the anticipated consequences such as an additional strain on social security services, with fewer workers expected to fund the increasing pension and healthcare needs of a greying population.
He had worked hard in school to break the cycle of poverty, but unemployment stands in the way of creating a better life for himself and subsequently keeps him from starting a family.
Some of these sentiments were expressed by respondents of the AWJP’s informal survey, with 13 per cent of the respondents expressing worry or concern about Kenya’s declining birth rate. However, the majority – Nearly half (49 per cent) of the 39 respondents – expressed positive sentiment towards Kenya’s declining birth rates, while a third (28 per cent) said it doesn’t matter. Most of the respondents (27) were female and 44 per cent were happy with the decline, while 57 per cent of the seven men who responded were content with the declining birth rates.
Most of the respondents who expressed positive sentiment about the declining birth rate were in the 25-29 years age group and had never been married, while those aged 35 years and above expressed concern about the declining birth rate, citing economic concerns, career, breakdown of values and change in priorities.
While most of the respondents did not have children, many of those who did had one or two and a good number said they did not plan to have more.
Since adopting its first family planning policy in 1967, Kenya’s goal has been to increase the use of contraceptives and reduce the fertility rate, which according to the latest National Family Planning Guidelines for Service Providers (6th edition) plays a key role in the achievement of national and international goals such as the Sustainable Development Goals (SDGs). A lower population through women having fewer children is expected to lead to development by reaping from the demographic dividend – having more people of working age to enhance productivity and drive economic growth.
Subsequently, the updated guidelines published in 2019 recommended more investments to accelerate rapid fertility decline. However, the current government reduced the allocation towards procurement of family planning and reproductive health commodities from KSh1.2 billion (2022-2023 financial year) to KSh1 billion for the 2023-2024 financial year, a deficit of 200 million.
Since adopting its first family planning policy in 1967, Kenya’s goal has been to increase the use of contraceptives and reduce the fertility rate.
Even as investments that would lead to a decline in fertility and yield a demographic dividend reduce, the guidelines note that “the demographic dividend is not automatic or guaranteed – it is earned through economic reforms that create jobs, investments in human capital and efficient governance”.
The declining fertility and birth rate could yield a dividend for Kenya, says Wadoa. “Birth rate is one of the key drivers for population growth or decline along with mortality (death) and migration. A falling birth rate brings about a decline in the rate at which the population changes from time to time. In Kenya, the rate of population growth declined from about 3.5 per cent in 1980 to about two per cent in 2020 due to declines in the birth rate. During the same time, the average number of children per woman declined from 7 children to 3.4 children. This has various implications for women, children, families and societies at large,” he says.
For one, fewer and well-spaced pregnancies are beneficial for the health and survival of the mother and the newborn. The converse is true: With too many births, closely spaced births and births at an older age, women may lack the strength and health to withstand the complications of pregnancy.
Secondly, as observed in national policies, a falling fertility rate means a lesser child dependency burden at the household and societal level, which reduces expenses on food, education and health services. Fewer children mean families can spend more on food and invest more in education and health services instead of struggling to meet the needs of many children.
A falling birth rate benefits a country’s development, particularly if investments are made in the education and skills of the working-age population (labour force). This demographic dividend will be larger the faster the birth rate falls.
“For women, a declining birth rate offers them the opportunity to engage in economic and social activities instead of spending their most productive years on childbearing and rearing,” Wadoa said.
A falling birth rate benefits a country’s development, particularly if investments are made in the education and skills of the working-age population.
Wadoa, however, warned of a relentless lowering of the birth rate which he said might create momentum for future population decline. He explained that a low birth rate reduces the population, not at all ages, but among the young, which leads to a smaller workforce and an older population and this has negative implications for economic productivity and per capita income growth.
Falling fertility rates could also lead to population declines in the long term (such as those in European countries), population ageing and a shortage of labour. Nevertheless, countries like Kenya will not experience such demographic challenges in the near future, even though the decline in fertility rates in Africa and in other low- and middle-income countries of the world is the result of years of population policies and programmes that focused on reducing fertility rates.
Kenya, for instance, launched a family planning programme in 1967 to reduce the fertility rate, which stood at eight children per woman in the 1970s. Over the years, the fertility rate has fallen to the current 3.4 in 2022.
For several years, especially before the International Conference on Population and Development (ICPD) that was held in Cairo in 1994, the discussion around population growth centred on the implications of rapid population growth for socio-economic development and environmental sustainability.
It was believed that rapid population growth in Low and Middle-Income Countries (LMICs) contributes to poverty, environmental degradation and conflicts, while the slow population growth in the developed world is leading to a shortage of labour force, population ageing, and social crisis in the long term.
Several Low and Middle-income countries (LMICs) have employed various strategies including educational campaigns, increased availability and affordability of contraceptives, improvements in healthcare infrastructure, and empowering women to make informed decisions about their reproductive health and use modern methods of contraception to bring down fertility rates and reduce population growth.
Policies adopted to manage population growth differ from country to country. For example, while Kenya adopted policies that promoted family planning programmes and created awareness of the various methods available, China adopted a one-child policy in 1979 which restricted couples from having more than one child. This was enforced by a variety of methods, including financial incentives for compliance, promotion of contraceptives, and while not endorsed by the government, compulsory sterilisations and forced abortions were part of the policy.
China’s one-child policy remained in place until January 2016 when it was amended to allow couples to have two children. But even after the policy was amended, couples still hesitate to have a second child for reasons such as concerns about their ability to afford another child, availability of childcare, and worries about how having another child would affect their careers, especially for mothers. Furthermore, decades of messaging and policies devoted to limiting family size to just one child succeeded in ingraining the viewpoint that having one child was preferable.
With the ICPD, the debate shifted from a demographic target (of reducing the fertility rate to 2.6 children per woman by 2030) to ensuring the upholding of people’s reproductive rights. This is the message Wadoa says should take centre stage, and something the UNFPA’s recent report titled Billion Lives, Infinite Possibilities: The Case for Rights and Choices, highlighted, noting that efforts to influence fertility rates can erode women’s rights.
Decades of messaging and policies devoted to limiting family size to just one child succeeded in ingraining the viewpoint that having one child was preferable.
This is often evident in discussions about declining fertility and birth rates, which often incorporate anti-feminist, nationalistic and misogynistic views, with women being viewed as baby-making machines. Their choice on whether to have or when to have children is often criticised as them abandoning the primary role of their existence.
According to Wadoa, the focus of population programmes should be ensuring the reproductive health and the rights of women, girls and men by providing access to sexual and reproductive health information and services. This recognises that people have the right to give birth to the number of children they want, when they want.
Moreover, the ICPD made it clear that women and couples have the fundamental right to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights. Thus, discussion about population growth should consider reproductive rights rather than demographic targets that aim to reduce or increase birth rates.
This article was produced as part of the Aftershocks Data Fellowship (22-23) with support from the Africa Women’s Journalism Project (AWJP) in partnership with The ONE Campaign and the International Center for Journalists (ICFJ).
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