Breaking the Silence: Talking About Sexual and Reproductive Health
The World Health Organization (WHO) defines adolescent sexual and reproductive health (SRH) as encompassing the physical and emotional well-being of adolescents. This includes their ability to avoid unwanted pregnancies, unsafe abortions, sexually transmitted infections (STIs), including HIV/AIDS, and sexual violence. In Laikipia County, as in many regions worldwide, access to SRH services is often limited and stigmatized, making open discussions about these topics vital for individual and community health.
At The Leo Project, we aim to create environments where people can freely discuss their bodies, choices, and futures. This effort is driven by the dedicated health workers at The Caitlin O'Hara Community Health Clinic and the TLP education team who engage with students and young people across Laikipia. This intersection of education and healthcare shapes much of our work at TLP. Yvonne Wachera Mwangi, a dedicated nurse and mentor, is someone who embodies this connection.
Yvonne’s unwavering commitment to fostering environments where adolescents and young adults can engage in open discussions about SRH shines through in her daily work. She facilitates conversations on crucial topics such as contraception, pregnancy, and STIs, witnessing firsthand the transformative impact these discussions have on attitudes and behaviors, ultimately leading to healthier choices. Whether she’s guiding students on menstrual hygiene or leading discussions with young adults about safe sex, Yvonne cultivates spaces that provide young people with the knowledge and confidence they need to make informed decisions about their bodies and futures.
Yvonne at work in the Clinic
Her own life experiences fuel this passion. At 19, Yvonne became a mother and shares that, “Getting pregnant at a young age really made me feel like I need to educate people about family planning,” adding that when she was younger, “Conversations on family planning, conversations on sex, those were conversations that I couldn't have with my parents; conversations I couldn't have with my teachers; couldn't have with anyone. When you talked about such things, they were [seen as] sinful.”
Yvonne’s openness creates an often hard-to-come-by trust with young people. “They want to talk to me because we are peers, they can talk to me freely and I won't judge because I have been there. So I feel like my story usually plays a huge part in making them trust me,” she explains.
These conversations are essential, particularly as 15% of adolescent women age 15-19 have ever been pregnant (2022 KDHS) and data from 2018 showed that 21.5% of young Kenyans report engaging in sexual intercourse before the age of 15 (Langat, E.C., Mohiddin, A., Kidere, F. et al.).
At the Clinic, since September 2023, 117 girls and young women aged 10-24 have sought pregnancy care. Specifically, we have supported 36 adolescent girls aged 15-19; 80 young adults aged 20-24; and, one adolescent girl aged 10-14 through their pregnancies. The Clinic provides free antenatal services throughout their pregnancy as well as free postnatal care and child welfare clinics. They also are assessed for perinatal depression using the Edinburgh Postnatal Depression Scale (EPDS) and have the option of receiving counseling from the Clinic’s mental health department should they choose. In addition to pregnancy-related services, the Clinic offers free family planning methods and counseling to ensure that young men and women can speak with someone like Yvonne who can provide accurate information and answer their questions.
Discussing SRH and family planning can be challenging. Initially, Yvonne faced hurdles in engaging young people who were often shy and hesitant to discuss these critical issues. However, as trust developed, she witnessed a remarkable transformation. Young people in her classes began to approach her with questions about family planning and safe practices, eager to learn.
Yvonne and Alice Muthoga, head nurse at the MCH clinic at TLP, emphasize the importance of discussing family planning not only with adolescents but also with adults. “When I first arrived at TLP, many mothers were unaware of family planning methods, and those who were often felt they couldn’t use them due to cultural beliefs,” Alice explained. To address this, she and the clinic staff are educating women about the benefits of family planning and child spacing.
Yvonne teaching SRH in the classroom
However, many women are hesitant to let their spouses know they are using such methods, prompting the need for efforts to also educate partners about the importance of child spacing. Yvonne recalls an encounter with a Maasai elder who was initially skeptical about family planning. Through conversation, she highlighted the benefits of intentionally spacing childbirth to ensure that families can provide quality education and healthcare for all their children. This elder’s eventual acknowledgment of the value of family planning and his acceptance of its use within his own family demonstrates the profound impact that such conversations can have in shifting perceptions and fostering understanding.
These kinds of conversations are also held in the classroom via TLP’s after-school Life Skills program and in our digital literacy classes. We intentionally bring boys and girls together to discuss SRH topics. As Yvonne states, “Having a conversation with both boys and girls in the same place usually debunks the myths and misconceptions, because boys believe that girls are the only people who should have the family planning.” She has seen how young men become more curious and eager to learn when treated as equals, marking a critical shift in perspective that ultimately creates a more supportive environment for young women.
The Way Forward
Yvonne’s commitment to breaking the silence surrounding sexual and reproductive health is unwavering. She, along with everyone at TLP, envisions a future where conversations about SRH are embraced as essential to the community's well-being. “When I first came [to TLP] and saw that the majority of the staff is young people, I knew that this is an organization that is really focused on the future, because young people are the future of everything,” Yvonne reflected, embodying the hope and belief in our ability to create lasting change that drives us all at TLP.
If you would like to support our sexual and reproductive health work, one way you can do so is by donating.