In a shocking turn of events, the heart-wrenching story of Baby Sagini took Kenya by storm, if not the world. The internet was a buzz of the inhumane act of the perpetrators who were close kin to the child survivor of this heinous act of violence. Speculations arose, linking the incident to a cult or ritual within the family. The truth about this we cannot tell. Some believe it was a communal land succession dispute driven by the fact that baby Sagini was seen as a potential inheritor, and the accused saw he was not an entitled inheritance beneficiary; this led to the unimaginable violation. Tragically, such acts of violence against children (VAC) are not isolated but rather a norm within the communities in the hills of Kisii County. Shockingly, these cases of violence against vulnerable children are unreported and undocumented.
The 2019 VAC survey showed the disturbing reality – more than half the children in Kenya have experienced some form of violence. Most survivors do not disclose the violence to anyone nor receive health/social welfare/security/legal/psychosocial support, services, and care.
Violence against children (VAC) transcends borders of nationality, social class, ethnicity, and religion, making it one of the most pervasive and socially tolerated human rights violations. Its impacts are profound and lifelong, affecting the health and well-being of children, families, communities, and nations. According to the Reinforcement Department in Bonchari Sub-County, unreported VAC cases in Kisii County are deeply rooted in Gusii cultural norms and the “kangaroo courts” system—informal setups for conflict resolution. Disturbing statistics illuminate the severity of VAC in the region.
Over the past six months (January 2023 – June 2023), 1,892 children were screened positive for VAC in Kisii County. Shockingly, LVCT Vukisha data set reveals 583 defilement cases in Kisii County in the same period. These reports are assumed to be the tip of the iceberg – many defilement cases are unreported. In April 2023 alone, out of 87 reported cases, only two resulted in convictions, highlighting the challenges in achieving justice and accountability for these heinous crimes. This complex and unresolved puzzle of VAC demands urgent attention and action.
Challenges of Undertaking Violence Against Children
Numerous commendable efforts have been put forth by non-governmental organizations, ministries, and county health departments toward curbing VAC cases in Kisii County. The efforts of the healthcare workers in the link facilities of these communities in ensuring access and the provision of post-GBV service delivery are commendable. Efforts are being made to raise awareness, strengthen preventive measures, and enhance reporting mechanisms. However, this has borne very little fruit. Child survivors of violence do not disclose their ordeals or are silenced and thus suffer in solitude. Reporting mechanisms are not child responsive.
Reports show that accessing justice for child survivors of violence can be futile due to numerous obstacles. The survivors do not report within 72 hours, comprising the collection of medico-legal forensic evidence necessary for court convictions. The prevalence of “kangaroo courts” perpetuates a cycle of impunity, treating these cases as internal family matters rather than criminal offenses. In other instances, the survivor will be married off to the perpetrator in cases of rape and defilement. These cases are often reported when an alternative dispute solution agreement fails, further hindering the pursuit of justice.
The desired outcomes and progress in addressing VAC remain limited, leaving room for reflection and examination. Overcoming these challenges requires dismantling cultural and systemic barriers and strengthening support systems to ensure the child’s best interests are always observed.
This raises the question: What is the missing piece?
Based on our experience in strengthening community health systems to improve health outcomes of vulnerable, marginalized populations, we firmly believe the critical missing piece is utilizing community health structures to prevent and respond to VAC. Optimizing community health strategy and integrating continuous quality improvement models could be an integral part of the broader discourse on enhancing access and provision of quality VAC services.
The role of community health promoters is very clear in the CHP module. However, many governments and organizations remain hesitant about prioritizing and implementing CHPs’ role in addressing VAC. Limited prioritization of the provision of resources and capacity-building opportunities hinders their ability to address VAC. Additionally, sustaining CHPs’ motivation and commitment over time can be challenging, as they often face overwhelming workloads, inadequate recognition, and inadequate incentives, which may affect their engagement and retention in VAC-related initiatives.
Community Health Promoters (CHPs) are often at the frontlines and visit households as they offer essential health services. Through close interactions with community members, CHPs are well-positioned to identify signs of VAC at household and community levels and intervene. They could contribute to prevention efforts by raising awareness on abandoning negative/ harmful social norms change (harsh punishment, early marriages, forced labor, and FGM), conducting community education sessions, supporting survivors, and facilitating access to healthcare and social services. Efforts must be made to reinforce referral mechanisms and policies on community-based responses to child protection. There is value in CHPs being consulted in research and policy decisions, informing better estimates of the levels of VAC (typically underreported) given their proximity to families.
Community Health Promoters with improved capacity on VAC guidelines and response can ignite the demand for prevention, advocacy, stakeholder engagement, and improved knowledge of VAC at the community level, ensuring that services at all levels meet people’s preferences, needs, and expectations that build conviction in health systems. Embedding the uptake of VAC service delivery into community health structures and fully integrating these services into primary care systems will also improve the effectiveness of the prevention and response of VAC in Kisii County. Current and future VAC interventions should recognize the importance of community health strategies for impactful outcomes.
It is time to shift our focus from outrage to action as we strive to address the epidemic of VAC in Kenya. CHPs could be the missing piece in VAC response as they serve as frontline advocates, bridging the gap between communities and formal systems and providing essential support to child survivors.
Acknowledgements: This blog was authored by Mandela Oguche, Program Officer in Community Health at LVCT Health. It was reviewed for accuracy and relevance by Festus Mutua.