ANC Advocates: Helping Teenage Mothers Access Maternal Health Services in Nairobi

One by one they came in, took a seat and waited patiently for their next training session on family planning at the Eastleigh health center. These are a group of young mothers from the Eastleigh region aged 24 and below under the Binti Shujaa program. A program that advocates for teenage mothers to get maternal health services.

Among them is Mercy Ndalu, a 20-year-old mother to a 4-year boy. Mercy became a mother at 16 when she was in form 3.” That’s when my world fell apart. What came to my mind first was for me to secure an abortion”, she tells me. After failing to secure the abortion, Mercy decided to keep the pregnancy. She hid in her house for five months away from other family members and friends. When my mother knew l was pregnant, she was disappointed. She felt l let her down as a single mother, says Mercy. But her worst fear was attending the antenatal clinics (ANC). She tells me she had heard of stories where teenage mothers were mistreated by nurses and she was afraid that she would receive the same treatment.

The first time I went to my first ANC clinic I was 6 months pregnant. After several tests, l was found to have a urinary tract infection (UTI) and l was put under medication. The nurses encouraged me to continue attending clinics for checkups until the baby is born.

In 2020 during the covid 19 pandemic, the government of Kenya and the Ministry of Health introduced strict preventive measures to try to curb the spread of Corona Virus. This included the closing of schools and restricted movements to health facilities. These measures limited the access to sexual and reproductive health and maternal health services. This saw an increase in unplanned pregnancies especially among teenagers.

To ensure teenage mothers like Mercy continued to attend their ANC clinics, Binti Shujaa came up with a way to reach the mothers and their babies. Mary Maina is a mentor at the Binti Shujaa program working with Fahari Jamii and the county government of Nairobi in Eastleigh health center. Binti Shujaa is a program that supports teenage mothers below 24 and their kids 2 years and below. Through this program, they ensure that young mothers attend Antenatal Clinics during and after pregnancy. They make sure the babies get all the vaccines and monitor their development and growth.

We do work with community health service workers where we do door-to-door visits, identify vulnerable young mothers within the community, and enroll them in our program, she narrates. We have 4 Binti Shujaa mentors who work in the whole of Eastleigh, with each having 25 girls in the group. We did some research and determined that young mothers avoid coming to clinics because of the stigma that surrounds teenage pregnancy and rejection from family, and some do not have any idea that they are supposed to attend the ANC clinics because of their young age, explains Mary.

During COVID-19, we saw an increase in teenage pregnancy, but the number of those attending the ANC clinics was low. It was difficult to reach out to young mothers since some of them didn’t have phones. Binti Shujaa, together with the help of community health volunteers, did home visits and gave vaccines and vitamin supplements to some of the girls who had defaulted on coming to clinics. For those who had access to phones, we called to remind them of their clinic dates.

Catherine Mume is another young mother under the Binti Shujaa program. She is now 23, but she had her son when she was only 15 years old. To avoid the wrath of her parents, she ran away from home.” I was afraid that my father would beat me up and jail the father of my baby”, she says. I hid my pregnancy and could only get outside at night. I was afraid of what people would think of me. You know, when you get pregnant at a young age, society considers you a” loose girl”. “She is the girl with no morals, and they will warn their daughters to stay away from you unless they want to get pregnant too,” she tells me. When I went to my first ANC clinic, I was 6 months pregnant. The shock on the nurses’ faces was obvious. Many asked, “How old are you? You are too young to be pregnant. Who got you pregnant? Those kinds of questions always made me avoid going back to hospitals again, she adds.

Mary Maina says they always do follow-ups with the young mothers because if they don’t come to clinics, they risk their lives and that of the unborn baby. And after pregnancy, we have to keep encouraging them to continue their clinics for the baby’s sake. Babies who miss their vaccines and other food supplements risk developing disabilities and contracting diseases such as measles and rubella, leading to death. We have seen cases where we have lost kids to preventable diseases since the mothers did not attend the clinic. “This is why we started this program: to reduce the infant mother mortality rate caused by lack of attendance at ANC”, adds Mary.

In Kenya, the neonatal mortality rate (NMR) is 22 deaths per 1000 live births, with urban areas having a higher rate of 26 per 1000 live births compared to 21 deaths per 1000 live births in rural areas, according to the Kenya Demographic and Health Survey 2014. Neonatal mortality is defined as the death of a newborn within the first 28 days of life. This period is the most vulnerable for the child’s survival.

Mothers who did not attend ANC during pregnancy and those who attended between 1 and 3 ANC visits had higher odds of losing their infants compared to mothers who attended more than 4 ANC visits.

Aside from ensuring that the young mothers and their babies attend all their clinics, the program has training sessions where they educate the mothers on self-care, healthy relationships, family planning, and mental health.

Some young mothers are usually depressed due to postpartum depression and traumatic birth experiences. In this case, we help them get guidance and counseling, and we will walk with them throughout the journey, concludes Mary, the Binti Shujaa mentor.

The program also works with other organizations to provide basic needs such as milk, diapers, soap, and sanitary pads.

This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of Veronica Kaveza and do not necessarily reflect the views of the European Union