Comprehensive Approach Needed to Improve Young Women’s Well-being

Empowering adolescents to achieve sexual and reproductive health and rights—including preventing unintended pregnancy—is critical to their overall health and well-being. Yet new data from the Guttmacher Institute show that sexual and reproductive health services in Kenya fall short of meeting adolescents’ needs. For example, an estimated 665,000 young women aged 15–19 in Kenya are married or sexually active and want to avoid becoming pregnant in the next two years. More than half of this group—357,000 adolescents—have an unmet need for modern contraception because they either use no contraceptive method or use traditional methods.

Each year, almost two-thirds of the estimated 345,000 pregnancies among adolescent women aged 15–19 in Kenya are unintended. The vast majority (86%) of these unintended pregnancies occur among adolescents who have an unmet need for modern contraception.

“Greater investment is needed to improve young people’s ability to access and use comprehensive sexual and reproductive health care services,” says Taylor Riley, research associate at the Guttmacher Institute and coinvestigator of the new estimates. “Contraceptive counseling and care that enables adolescents to decide whether and when to have children is a critical component of such services.”

The new data also indicate that many of the 217,000 adolescent women who give birth each year in Kenya do not receive the essential components of maternal and newborn health care recommended by the World Health Organization and the Kenyan Ministry of Health. About half of these adolescents have fewer than four antenatal care visits and one-third do not give birth in a health facility.

The authors of this study recommend investments that meet the needs for both modern contraception and maternal and newborn health care because such a joint investment would yield enormous health benefits. They found that full provision of modern contraception combined with adequate care for all pregnant adolescents and their newborns in Kenya would improve young women’s health and well-being by resulting in:

  • 160,000 fewer unintended pregnancies per year (a 73% decline from current levels)
  • 81,000 fewer unplanned births per year (a 73% decline)
  • 57,000 fewer abortions per year (a 73% decline)
  • 340 fewer adolescent maternal deaths per year (a 76% decline)

A joint investment would also cost less than investing in meeting maternal and newborn health care needs alone. In 2018, the annual cost of providing modern contraceptive and maternal and newborn health care services to women aged 15–19 in Kenya was US$24 million. Fully meeting the need solely for maternal and newborn health care among adolescents would require an additional investment of $93 million. By comparison, meeting this need in conjunction with fulfilling the modern contraceptive needs of adolescent women would only require an additional investment of $65 million.

The authors recommend a multifaceted and coordinated approach to fully meet adolescents’ needs and ensure their right to make voluntary and informed choices regarding contraception. To improve young people’s sexual and reproductive health and rights effectively, services must be nondiscriminatory, medically accurate and age-appropriate. Approaches should include improving access to and provision of comprehensive sexuality education and youth-friendly sexual and reproductive health services, in addition to community- and school-based programs that seek to destigmatize adolescent sexual activity and access to reproductive health services.

Adding It Up