Over the years, the Ministry of Health in Kenya has made commendable strides in addressing sexual and reproductive health (SRH) issues among adolescents and young people. National guidelines for adolescent youth-friendly services (YFS) have been instrumental in ensuring that young people have access to essential reproductive health services. The ministry’s approach has been informed by both scientific research and the lived experiences of adolescents, a progressive step toward improving youth health outcomes. However, the introduction of the Reproductive Health (RH) Policy 2022-2032 threatens to undo these gains by creating barriers that limit access to SRH services for young people under 18 years.
The Kenyan government has historically demonstrated a strong commitment to ensuring that adolescents have access to healthcare, particularly through the Adolescent Package of Care. This guide provides healthcare professionals with the necessary tools to deliver appropriate and effective healthcare services to young people. Additionally, the National AIDS & STI Control Programme (NASCOP) has played a key role in ensuring that adolescents living with HIV (ALHIV) receive comprehensive care.
One of the most notable aspects of Kenya’s previous adolescent health policies is the recognition that young people face unique challenges when seeking reproductive health services. The Ministry has acknowledged that fear-based narratives suggesting that access to contraception and other SRH services would encourage promiscuity among young people are unfounded. Research has consistently shown that providing young people with the necessary information and services does not increase sexual activity but rather promotes safe and informed choices.
For adolescents living with HIV, access to treatment and counseling is critical. The Adolescent Package of Care sought to address challenges in HIV management, particularly regarding consent. The guidelines made it clear that while parental consent is generally required for minors, exceptions exist for adolescents who are symptomatic, pregnant, married, already parents, or engaging in high-risk behavior. This flexibility was crucial in ensuring that vulnerable youth did not miss out on life-saving healthcare due to bureaucratic restrictions.
Despite these previous gains, the introduction of the RH Policy 2022-2032 signals a worrying shift. The policy takes a more conservative approach, emphasizing parental consent for young people under 18 seeking reproductive health services. This shift places additional barriers in the way of adolescents who may already be in vulnerable situations.
The policy’s approach seems to contradict earlier Ministry guidelines, which recognized the importance of accessible and youth-friendly healthcare services. By prioritizing abstinence and delaying sexual debut until full cognitive maturity (defined at 21 years), the policy ignores the reality that many adolescents are already sexually active and in need of appropriate guidance and healthcare.
One of the most concerning aspects of the policy is its failure to address the complex issue of consent for married adolescents. Statistics cited in the policy indicate an increase in the use of modern contraceptives among married women aged 15-49. However, the policy does not clarify who should provide consent for a 15-year-old who is married. Should it be the parents of the adolescent, or should the spouse be responsible? This ambiguity creates a legal and ethical gray area that could leave young girls without the reproductive healthcare they need.
The restrictive stance taken in the RH Policy 2022-2032 risks reversing the progress that the Ministry of Health has made in adolescent healthcare. The policy undermines previous research-backed guidelines that demonstrated that access to reproductive health services improves the well-being of young people.
A protectionist approach that limits access to SRH services can have severe consequences. For instance, young people who lack access to contraception and proper sexual health education are at higher risk of unintended pregnancies and sexually transmitted infections (STIs), including HIV. Additionally, restrictive policies may discourage adolescents from seeking medical help due to fear of stigma or parental disapproval, further endangering their health.
To ensure that young people continue to receive the healthcare they need, the Ministry of Health must reconsider its approach. Policies should be based on evidence rather than moral panic. The Ministry’s own adolescent-friendly service guidelines have previously stated that providing reproductive health services does not increase sexual activity but rather improves health outcomes. This principle should guide all future policies.
Additionally, policymakers must engage adolescents, healthcare providers, and experts in SRH when formulating policies that affect young people. Input from these groups can ensure that policies are practical, inclusive, and aligned with the realities of adolescent health needs.
The government should also strengthen community education efforts to address misconceptions about adolescent reproductive health services. Parents, religious leaders, and educators should be involved in discussions about the importance of accessible healthcare for young people.
The Ministry of Health has made significant progress in adolescent reproductive health over the years, but the RH Policy 2022-2032 represents a step in the wrong direction. By creating additional barriers to reproductive health services, the policy risks reversing the gains made in ensuring that young people have access to the care they need. The Ministry must retrace its steps and realign its policies with the evidence-based approaches that have previously shaped Kenya’s adolescent health programs. Protecting the health and well-being of young people should remain a priority, and policies should reflect this commitment.
