Good Sexual and Reproductive Health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.
To maintain one’s Sexual and Reproductive Health, people need access to accurate information and the safe, effective, affordable and acceptable contraception method of their choice. They must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to services that can help them have a safe pregnancy, safe delivery and healthy baby.
Every individual has the right to make their own choices about their Sexual and Reproductive Health. CINCO works toward the goal of universal access to Sexual and Reproductive Health and Rights, including family planning.
- Family planning/contraception reduces the need for abortion, especially unsafe abortion.
- Some family planning methods, such as condoms, help prevent the transmission of HIV and other sexually transmitted infections.
- Family planning reinforces people’s rights to determine the number and spacing of their children.
- An estimated 225 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception.
- By preventing unintended pregnancy, family planning/contraception prevents deaths of mothers and children.
Contraceptive use has increased in many parts of the world, especially in Asia and Latin America, but continues to be low in Sub-Saharan Africa. Globally, the use of modern contraception has risen slightly, from 54% in 1990 to 57.4% in 2015. Regionally, the proportion of women aged 15–49 years reporting use of a modern contraceptive method increased minimally between 2008 and 2015. In Africa it went from 23.6% to 28.5%, in Asia it has increased slightly from 60.9% to 61.8%, and in Latin America and the Caribbean it has remained stable at 66.7%.
Use of contraception by men makes up a relatively small subset of the above prevalence rates. The modern contraceptive methods for men are limited to male condoms and sterilization (vasectomy). In the overall, there is a low uptake of contraceptives in the developing countries. This is further aggravated by the Socio-Cultural beliefs that further make men not to be involved in the family planning. These make women more venerable as it is also the norm that men makes most reproductive health decisions in these countries, Kenya included. There is therefore, need for innovative approaches to ensure men involvement in family planning. CINCO’s approaches in family planning and contraceptive use therefore targets men involvement while expanding access to contraceptives so as to enhance coverage. Our approaches to contraceptive use is rights based thus our endeavor to give information to the youths, men and women of reproductive age to ensure that they make right choices when it comes to reproductive health. As a right we advocate for full enjoyment of the reproductive health by all who are of the reproductive age.
- About 16 million girls aged 15 to 19 and some 1 million girls below 15 years of age give birth every year, most of these are in low and middle income countries.
- Complications during pregnancy and childbirth are the second cause of death for 15-19 year-old girls globally.
- Every year, some 3 million girls aged 15 to 19 undergo unsafe abortions.
- Babies born to adolescent mothers face a substantially higher risk of dying than those born to women aged 20 to 24 years.
For some adolescents, pregnancy and childbirth are planned and wanted, but for many they are not. Adolescent pregnancies are more likely in poor, uneducated and rural communities. In some countries, becoming pregnant outside marriage is very common. By contrast, some girls may face social pressure to marry and, once married, to have children. More than 30% of girls in low and middle-income countries marry before they are 18 years; around 14% before they are 15 years.
Some girls do not know how to avoid getting pregnant: sex education is lacking in many countries. They may feel too inhibited or ashamed to seek contraception services; contraceptives may be too expensive or not widely or legally available. Even when contraceptives are widely available, sexually active adolescent girls are less likely to use them than adults. Girls may be unable to refuse unwanted sex or resist coerced sex, which tends to be unprotected. About 3 million unsafe abortions among girls aged 15 to 19 take place each year, contributing to maternal deaths and to lasting health problems.
CINCO approaches to curb adolescent pregnancies focuses on the following areas
- Reducing marriage before the age of 18
- Creating understanding and support to reduce pregnancy before the age of 20
- Reducing coerced sex among adolescents
- Reducing unsafe abortion among adolescents
- Increasing use of skilled antenatal, childbirth and postnatal care among adolescents
Maternal mortality is higher in women living in rural areas and among poorer communities
- Between 2016 and 2030, as part of the Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births.
- 99% of all maternal deaths occur in developing countries.
- Young adolescents face a higher risk of complications and death as a result of pregnancy than other women.
- Skilled care before, during and after childbirth can save the lives of women and newborn babies.
- Between 1990 and 2015, maternal mortality worldwide dropped by about 44%.
- Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth.
Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. Maternal health and newborn health are closely linked. It is estimated that approximately 2.7 million newborn babies died in 2015, and an additional 2.6 million are stillborn. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby.
Severe bleeding after birth can kill a healthy woman within hours if she is unattended. Injecting Oxytocin immediately after childbirth effectively reduces the risk of bleeding. Infection after childbirth can be eliminated if good hygiene is practiced and if early signs of infection are recognized and treated in a timely manner. Pre-eclampsia should be detected and appropriately managed before the onset of convulsions (Eclampsia) and other life-threatening complications. Administering drugs such as magnesium sulfate for Pre-Eclampsia can lower a woman’s risk of developing eclampsia.
To avoid maternal deaths, all pregnant women need to attend antenatal clinic, deliver under skilled attendant and further attend post-natal clinics. In addition, it is also vital to prevent unwanted and too-early pregnancies. All women, including adolescents, need access to contraception, safe abortion services to the full extent possible, and quality post-abortion care. Poor women in remote areas are the least likely to receive adequate health care. This is especially true for regions with low numbers of skilled health workers, such as Sub-Saharan Africa and South Asia. Globally in 2015, births in the richest 20% of households were more than twice as likely to be attended by skilled health personnel as those in the poorest 20% of households (89% versus 43%). This means that millions of births are not assisted by a midwife, a doctor or a trained nurse especially in the poor settings.
In high-income countries, virtually all women have at least four antenatal care visits, are attended to by a skilled health worker during childbirth and receive Postpartum care. In 2015, only 40% of all pregnant women in low-income countries had the recommended antenatal care visits.
Other factors that prevent women from receiving or seeking care during pregnancy and childbirth include:
- Distance to nearest health care facility
- Lack of information
- Inadequate services
- Retrogressive cultural practices
To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system. It is this reason that CINCO works with the relevant health ministries in Kenya to expand access to maternal care through early identification of pregnant women and referral to the nearest health facilities for Antenatal Care (ANC), skilled delivery and Postnatal care. ANC defaulters are also traced by the Community Health Volunteers (CHVs) and brought back to schedule. We provide evidence based maternal and child health care through routine operational research.
Condom Dispensers Installation - Wichlum, March 2012
A participant demonstrating condom use
Community member filling a dispenser with male condoms
Discordant Couples Training, sharing.
OGAL beach female condom use training
Wichlum beach community mobilizers and educators