In 2017 I was in India for the 11th World Health Congress on Adolescent Health.  I specifically attended this conference because India has the biggest adolescent population globally, hence learning how this magical country engages her adolescents promised to better my own advocacy work in adolescent health.


At the Congress it was clear that most of the world is experiencing a youth bulge (a stage of development in which countries achieve success in reducing infant mortality, but mothers still have a high fertility rate; most common in low-resource settings) and that manner at which the youth bulge was handled would define the failure or success of important development indexes globally.  Unfortunately in my country (Kenya), adolescent reproductive health faces frustrations from influential community stakeholders like religious leaders, policy makers, and even parents rather than governments and decision-makers.  This is, in part, due to retrogressive cultures that censor what adolescents should know about their reproductive health, lack of sufficient information around adolescent reproductive health and incorrect perceptions around comprehensive sexual education making it extremely hard for adolescents and young adults to achieve their highest sexual reproductive health requirements, the basics for achieving good health and wellbeing.

In all policy battles around sexual and reproductive health and rights, the biggest losers are girls and young women between the ages of 10-24 years.  Because they are demographically placed within the highest risk grouping, are the furthest to reach, and the most devastated by negative results of uninformed sexual activities in comparison to their male counterparts.

Last Christmas, while donating foodstuffs to a public hospital, the sight of a teenage girl   lying in one of the beds in the maternity ward caught my attention.  As an advocate for adolescent for adolescent sexual reproductive health. I approached her to talk.  She was very shy and quiet at first (hitherto I was very polite), but I managed to break the ice and she opened up, telling me all about her life.

The 15 year-old girl told me that she only tried sex once and – boom! – She had fallen pregnant.   She hadn’t planned to have a child, but she simply had no other option.  She gave birth to a stillbirth through a Caesarean section, experiencing great physical and psychological suffering.  She explained that sexual activity was common amongst her group of friends, but she had been the unfortunate one to endure that shameful and traumatic experience.  I hadn’t expected our conversation to lead to such confessional sharing, and my heart ached for her.  As sensitively as I could, I gathered the courage to ask her if she knew about contraceptives.  She said she did, but shockingly, still thought that contraceptives were meant exclusively for grown-ups.  Seeing my surprised expression, she added furthermore that she didn’t know where to find such products.

This experience deeply ignited more passion within me to push for comprehensive sexual education and access even further than my usual work did.  I haven’t stopped thinking about that girl since, and even in retelling her story, I have openly wept.  It was unfair enough that her sexual activity had led to an unwanted pregnancy and a stillbirth, but the risk of contracting a sexually-transmitted was additionally high – and regardless of her individual case, the evidence supports this.

In, Africa adolescents and young girls between the ages of 15-24 years contribute to 30% of new sexually transmitted infections.  Teenage pregnancy, in all cases negatively, affects the health and wellbeing of girls and its complications remain the leading cause of death among girls between 15-19 years of age globally.  Furthermore, adolescents and young adults face higher chances of contracting obstetric fistula than older women during the actual child bearing exercise.  Adolescent girls are the most unequally affected groups among the population at-risk banner of adolescents and young adults, which creates an injustice within an injustice.

As the 11th World Health Congress came to an end, I had contributed in drafting the Youth Declaration Policy document that was presented to global health stakeholders.  Breaking gender stereotypes was determined as a prerequisite in order to achieve inclusive sexual reproductive health rights by 2030, as indicated in the Youth Declaration document.  Gender stereotypes that perpetuated stigmatization against girls who seek modern contraceptive services deprive these same girls the power to decide which sexual reproductive health services are the best for them.  This must be stopped in order to achieve good health and wellbeing for all. 


We must think of contraception as a path to true gender equality. 



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