Testing schoolgirls for pregnancy not likely to cut number of teenage mothers

• Kenyan public health officials are considering a voluntary policy to reduce teen pregnancy by testing schoolgirls at regular intervals. But in a highly charged matter as teen sexuality, how voluntary is ‘voluntary’?

N’gombeni High School principal Cornelius Maganga makes no secret of the fact that teenage mothers are not welcome at his school.

He tells of one student who hid her pregnancy and went home to deliver. “When she came back we told her to look for another place,” he says.

Just an hour’s drive across Kwale District, principal Phyllis Mwachiti has created an atmosphere of respect and belonging at Kichakasimba Secondary School.

“We do not lose girls because we do not chase them away,” she says. “It is always very good if in the school the policy is not sending (pregnant students) home.”

The views of Ms Mwachiti and Mr Maganga, and all those in between, could play out in the private lives of female students if a new health policy aimed at reducing teen pregnancy is put into practice.

The National School Health Policy 2009, under the section on teenage pregnancy, states: “Girls will undergo voluntary medical screening once per term.” But when it comes to teen sexuality in Kenya, how voluntary is “voluntary”?

Social taboos

In a society with strong religious and social taboos against teen sex, where youths lack access to contraception and sex education, leaving interpretation of such a policy up to individual teachers is a potential minefield — giving schools power over a private, moral issue.

“That very easily turns into ‘must’,” says Geoffrey Maganya, a policy developer at Kenyan child’s rights organization, The Cradle. “Schools are places where teachers have absolute power over children.”

The National School Health Policy 2009 is the first of its kind. As such, says Dr Anna Wamai, head of adolescent and child services at the Public Health Ministry, it was designed to take all aspects of children’s and adolescents’ health into consideration.

Research by the Forum for African Women Educationalists (FAWE) suggests that 13,000 Kenyan girls drop out of school due to pregnancy each year. That’s nearly a third of the number of female dropouts. Teenage pregnancy is seen as a major threat to girls’ education, hence the addition of the twice-yearly testing.

“We wanted a comprehensive policy,” Dr Wamai explains. “We are looking at the whole child.”

The policy is still being fine-tuned, she adds, and the ministries still haven’t decided whether parents would be able to opt out of the test on their daughters’ behalf or whether the decision would be entirely up to the student.

The Ministry of Education has always required a pregnancy test for girls as part of the medical exam all students pass before entering Form One.

Parents pay for the exam and present the doctor’s certificate to the school. But with the new school health policy, these tests will be required throughout a student’s academic career.

Signals are conflicting even from the ministries themselves, as to the meaning of the word voluntary.

“Unfortunately, those who will not volunteer are probably those who know they are pregnant,” says Dr Wamai, acknowledging the contradiction with the policy’s wording.

“Because it is a new thing, I think it is good to start with voluntary,” she says, implying that eventually the tests will be mandatory.