Multiple risks faced by adolescent girls in Kenya during COVID-19 pandemic
According to Centers for Disease Control and Prevention (CDC), COVID-19 is a respiratory disease spreading from person to person caused by a novel (new) Corona virus. The noble preventive measures including lock down and Stay-at-home measures to stop the spread of the disease puts vulnerable groups including women, girls and children at more risk. This situation poses a serious public health risk and a major precursor for domestic violence. Stress, the disruption of social and protective networks, loss of income and decreased access to services all can exacerbate the risk of violence for women, girls and children.
With the continued spread of the virus in Kenya, women, girls and children face increased and multiple challenges including physical and psychological violence related to family confinement, isolation and economic vulnerability. The restriction and stay home orders across the globe, including Kenya, do not prescribe measures that should be taken for family set ups with ongoing domestic violence. Kenya Demographic Health Survey 2014 reveals that 32% of girls aged 15-19 years have ever experienced physical violence since age 15 while 32% of young women experience sexual violence before age 18. Kenya Violence Against Children (VAC) survey 2010 estimates that 22% of girls aged 15-19 described their first experience of sexual intercourse as forced. This survey report lists uncles, aunties, fathers, brother and mothers as some of the common perpetrators of violence living in the same household with the victim. Early in March 2020, the Chief Justice of Kenya, Hon. David Maraga indicated an increase in the number of cases reported in court by 35.8%. UNFPA have already predicted a calamitous surge of GBV cases; for every 3 months in lock down, 15 Million cases GBV will be reported while 31 Million persons will experience GBV if the lock down progresses to a further 6 months.
Adolescent girls and young women aged 10-24 years (7.9%) undergo similar vulnerabilities as their female adult counterparts and are exposed to similar susceptible conditions that perpetuate abuse. Adolescents in Kenya face many Sexual Reproductive Health (SRH) challenges including early pregnancy, Sexually Transmitted Infections (STI’s), HIV and related adverse health, social , psychological and economic consequences; this is compounded further by the pressure exerted by the current COVID-19 pandemic on the social systems from household to national levels of government. The “stay-at-home” order for Adolescent Girls and Yong Women (AGYW) will aggravate gender gaps in education and lead to increased risk of sexual exploitation, defilement, early and unintended pregnancy, Child, Early and Forced Marriage (CEFM). Research shows that victims of Gender Based Violence (GBV) are domiciled in more than 60 % of households where domestic violence is perpetrated and are also at risk of suffering significant physical and/or emotional harm. In fact, perpetrators of abuse take advantage of restrictions due to COVID-19 to exercise power and control over the victims by reducing access to services, help and psycho social support from available helpline services.
AGYW are faced with economic and livelihood challenges during lock down period; this exposes them to sexual exploitation from the people that live with them including in the families and the communities they live in. The usual ways of earning living and income generation have been curtailed with opportunities for a sensible livelihood denied.
Approximately 150,000 Adolescent Girls and Young Women (AGYW) benefit from CDC programs DREAMS – (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) and Orphans and Vulnerable Children (OVC) programming. The multisectoral DREAMS core package of interventions for AGYW (15-24 years) goes beyond the health sector to address the structural drivers that directly and indirectly increase girls’ HIV risk, including poverty, gender inequality, sexual violence, and a lack of access to education. Adolescent sexual and reproductive health still remains a major public health issue in sub-Saharan Africa, especially for adolescent girls. This program ensures girls receive interventions that keep them in school and safe spaces that help reduce the vulnerabilities to HIV infection, early pregnancies, sexual exploitation and abuse, early marriage and other related social ills.
The weighty challenges on the health system by the COVID -19 pandemic pulls out health workers from the structural services towards AGYW and have directed their efforts to prevention of COVID-19; while other low cadre providers are faced with the current changing economic realities thus inability to offer their efforts to support safe spaces for the AGYW. It is now challenging to conduct door-to-door visits for support with prevention kits and services and this contributes to possibilities of reduced access to services and therefore increased cases of pregnancy, STIs, HIV and gender violence. During the dusk to dawn curfew, anecdotal reports indicate increased cases of sexual violence amongst this population especially for girls in the informal settlements. Girls report being violated when going to toilets that are often outside their houses during the curfew. Many of these girls do not have access to reporting mechanisms that require them to seek timely response services; noting the presence of perpetrators within the household or their neighbourhoods.
Efforts to sustain safe space interventions must be expanded and continue to function while observing social distancing rules and infection prevention protocols. Community change agents, Community health volunteers, mentors and other actors should continue to conduct regular outreach activities since the girls’ demand for prevention services and information does not cease with the pandemic. These actors must explore innovative and practical ways of how AGYW should report violence including sharing referral details in the event they require access to shelter, security and medico-legal services. The authorities and stakeholders must provide Toll Free hotline numbers for GBV information, response, Psychological First Aid , Tele-counselling and referral services (e.g. 1190, 1195, 116 ) for survivors to raise alarm and seek immediate post violence services. It is therefore incumbent upon the Kenyan health system to ensure that health service providers have adequate access to Personal Protective Equipment (PPE) to further this agenda. These services must be marked as essential services and recognised as so in the Pandemic Response and Management Bill (Senate Bills No. 6 of 2020) owing to the severity of the associated consequences.
While the government of Kenya is committed to ensure availability of SRH services for AGYW and to end violence against women and girls, deliberate measures must be put in place to ensure that economic incentives and social safety nets are gender-sensitive and empower every AGYW during the global pandemic. Conscientious energy must be placed in prioritising AGYW at risk for prevention and protection and therefore strengthen social welfare services, security, shelter and health for timely services. This means that necessary SRH services must remain available and accessible at all times and allow AGYW to access a range of health services including menstrual hygiene products and psycho social support. Also, the teenage mothers need to be recognised as vulnerable population that must benefit from the government cash transfer program. Diminished preventive SRH commodities may lead to catastrophic increase in HIV infections, STI’s and early pregnancies.
By Michael Gaitho- GBV Specialist LVCT Health
 https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-VAW-full-text.pdf COVID-19 and Violence Against Women; What the Health Sector/System can do (2020).
 Campbell A.M., Hicks R., Thompson S., Wiehe S. Characteristics of Intimate Partner Violence incidents and the environments in which they occur: victim reports to responding law enforcement officers.
 Grantees Innovation Challenge (2028); https://www.state.gov/wp-content/uploads/2019/09/PEPFAR2019ARC.pdf Pg. 59