Gender Based Violence (GBV) and related cases is becoming a serious conversation especially in Nyanza counties. Survivors, mostly minors are facing barriers in accessing critical medical care, that includes post abortion prophylaxis for HIV (PEP).
This has sent reproductive health experts into making a call on urgent reforms in Kenya’s National Reproductive Health Policy 2022-2023, pointing out gaps in current requirements that lead to delays in life threatening interventions.
In reference to Kenya’s current policy, minors require parent or guardian consent to access reproductive health services like PEP and emergency contraception. Children’s officer is entitled to consent incase of a parent’s absence. However, reproductive health experts argue that thus delays in consent exposes the victims to life threatening conditions. They further their arguments that it only gets more worse if the perpetrator is a family member.
“It is the small details that matter in preventing HIV after an assault, like time,who the perpetrator is, and many more. If we are talking of waiting for consent,how is time put into consideration? That is where i find this policy’s rigid consent rules denying these minors timely access to treatment hence exposes them at a further risk,” said Ruth Moraa, a health expert.
Nyanza counties have had the highest numbers of HIV rates, making them brunt of these gaps. According to Kenya Demographic Health Survey (KDHS), Homabay takes the lead on 26% with Siaya, Kisumu and Migori following closely. With studies dictating that over 51% of new infections in these counties are teenage girls and women, fear arises among the experts that the situation is likely to worsen following consent requirements to access PEP.
“I have seen, heard and dealt with cases where violations are done but it comes to light when things get worse, weeks, months or years later. Most of these cases ends us up to the parent covering it up for the perpetrators. These are the cases that put the victim at risk, their health, some end up as victims of (PTSD),” an Assistant chief in Nyamira county who prefers to remain unknown said.
Some parents are also unwilling to consent for their children especially in this tight frame.
“I am a believer, my husband too,we are tied to the church, in our marriage we never use contraceptives, it’s immoral, isn’t it? So now tell me how we should take our children and consent them for the same things we dont use. That’s not going to happen, I would not even dare say something like that to my husband,” said a parent raising four teenagers, three daughters and a son.(She prefers to remain unknown).
There are recommendations by the World Health Organization (WHO) that minors who are victims of GBV should receive immediate care without parents consent. This policy has already been put into place in countries like South Africa and Uganda by creating a child friendly environment followed by an assessment by the healthcare provide on the minors ability to consent. By putting these into place, South Africa, a nation that allows minors starting from 12 years to access PEP, has reported a 30% increase in HIV prevention and 15% drop in teenage pregnancies in just five years. On the other side Rwanda (who have community based GBV response team), have reduced the delays in reporting cases by 60% ensuring timely attention to victims.
Notably, teen pregnancies are on the rise, pressure mounting on the government to align its reproductive health policies with global best practices. It however remains undefined on whether the government will jump into the bandwagon early enough.
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