 Hello and many thanks for keeping us company. This is Y254. Why in the morning my name is Dereva Hillary and as we had mentioned earlier in this discussion Mandy Held, we are talking about the young voices on future scenarios and contraception. I'm speaking to Andrew Awiti, he is a strategic consultant and from Niigani think tank country but we want to see why did they choose the young people and why is it that they want to see our population is being controlled in regards to what was discussed and one of the implementation outstretched from the ICPD 25 that was held last week. Now Karibusana. Thank you Larry. Now I have seen some of the articles or one of the articles you have done I've seen the report and I have seen some stats in regards to what your findings were in the field and just to bring our viewer into a perspective of these in Kenya 74% of the population is under 35 years of age according to the National Council of Population and Development. Now for this reason the youth bear the biggest brand of the impact from all policy decisions made which are currently occurs for concern based on myriad of development indicators which is high maternal deaths of 6,300 women die annually during pregnancy and childbirth with unplanned pregnancies being a major contributor. Now school droplets from pregnancy reach at 13,000 girls. This is very alarming and youth unemployment is at 80% under 35 years of age those are the youths now all linked to contraception axis and this begs the first question Awiti. Now what do you think Kenyans want for the future or for the future rather? I think what Kenyans want from the future in particular the youth is a chance to control the narrative with regards to where they are heading, how they can get there and how they can contribute towards achieving this future that they want. The bulk of that future basically involves realizing the ambitions they have for their lives and for the children they plan to have. Now there has been a narrative for a longer time that the poor people are the most who do not know how to control the population in terms of bringing up children and we are seeing 80% of young people are unemployed. Would you contribute or would you say this has contributed to the high number now because we stand on 47. I don't know whether it's a good number to speak of or it's not but now we have a big number of young people out here. Do you think other than looking for job and making sure they are busy elsewhere? Well where we are right now is because of a number of decisions we have made in the past basically from the 70s 80s up to now. We have not planned our resources to take care of the population that we have and these kakats across not only unemployment but also healthcare education you have schools that are very crowded and the most visible outcome currently is unemployment because this is what contributes to a number of the ills that we have in the country. When you look at this conversation about the poor people are the ones who are unable to basically dictate the number of children that they have this is largely a systemic issue of unmet needs. You will find that healthcare outcomes currently are largely favorable to those who have the money and this is not a situation where we want to maintain going to the future and the outcomes are very clear. You look at counties like Turkana, West Pokot and Mandera contraception access in those counties is less than 14% and the population that is living below the poverty line in those three counties is over 64%. Compare that to counties like Kini Nyaga and KC for example whose contraception prevalence rate is over 60% less than 34% of their populations live below the poverty line. So that disparity in access contributes quite a bit to how the development in various areas of the country comes about not only in the counties but also the impact of these on women. As you mentioned you have 13,000 girls dropping out of school every year where do these girls go to after they have kids? We don't exactly have a program to bring them back to school after they have kids so they are left to their own devices whereby you find a number of them to pursue other forms of employment but don't really enable them realize their full potential and it goes back to where we started with this conversation. Young Kenyans just want an opportunity to chart the future that they believe is ideal for them as individuals and currently as it stands they tend to fall off the wayside because of a number of things that are beyond their control but are clearly systemic issues that we need to resolve. All right, you just mentioned at Rokana is one of the Aesol Counties the conception of the information. Who do we blame for lack or if any of the information related about contraception and controlling childbirth from those counties fang flang? That's quite complex to approach that because the constitution guarantees access to the best quality healthcare to every Kenyan. The Health Act in 2017 guarantees safe, effective and affordable co-contraception to Kenyans as well. We have envisioned the importance of contraception with regards to achieving our development objectives but what is happening is there is minimal implementation in certain parts of the country. This is largely a systemic issue that stems back from the marginalization that was there before the counties. I would not want to look back at how we got there. We are in a position to change the future. So I would say we must look at how do we change this because as we found out in our report there are four outcomes that the country can take based on how we look at contraception. We can either stagnate or we can be worse off. We have scenarios where the health sector is privately. We'll be speaking about the scenarios but now those areas are part of which we want to have our nation in the vision 2030, the SDGs. How do we include everyone on board and how do we ensure the young people have been incorporated to ensure that we achieve our goal come 2030? We are just 10 years away. Yeah, 10 years away. How do we have everyone on board ensuring that from the population control to how we use our economy to how we develop our nation in line with the big four agenda as we speak? The first thing we need to do is to ensure that there is a clear understanding of the role that contraception plays in development. We need to get the national government to buy in into the idea that a number of the things that you propose will not move if you don't have contraception as a key pillar for development. The same applies for the devolved units. These are the governors and also the individuals. Kindly hold your mic from the middle part. Up, up. Thank you. Also for the individual. Now for a long time contraception has been viewed as one, a women's only issue and two, as a private issue. But then based on our think tanks we go to realize that this is a personal issue with national ramifications. If you look at other so-called personal issues that we have tackled as a country, it places contraception as one of the most important things. Look at how we addressed the AIDS crisis. We realized that it was causing us a lot in healthcare and also the deaths were very high. But yet it is a personal issue. We reworked our systems to adapt to the challenge and there was a decline in new HIV infections and so on. This now needs to be extended to family planning and contraception. The impacts of this are that a number of our girls are not achieving the future they want to achieve. A number of our counties are not developing as fast as others. How do we ensure equitable and sustained development for all Kenyans? We need to tackle this issue of contraception. I have to ask why did you choose to deal with people from the campuses because I have seen you have chosen a number of campuses within Nairobi County. Why did you choose young people from those areas that we have other areas maybe? Is it because they are so proximate or why did you choose them? One of the main reasons why we were... Okay, so our project we were looking at Nairobi and Mngoma. These are two very distinct counties in terms of the demographics. How they are impacted by various decisions from either the national or county levels and also well for the universities. Nairobi has a lion's share of universities so it was kind of a straight forward decision to go with that. Now if you look at other counties in the world the universities play a major role in moving the country forward and this was what Kenya used to be The universities were able to shape the agenda of where the country is going and the universities are some of the most prestigious halls of information in this country. We have not as a country taken advantage of the wealth of knowledge, the wealth of ideas and the power of youth in those institutions and for Fomigani because we are a platform that aims at channeling the voice of the youth towards key issues, most importantly contraception we thought that this was an opportunity to bring back that glory that our universities had and use them to come up with ideas on charting the way forward for our country. Now having dealt with them maybe you could highlight one of the challenges maybe or two and how have you decided to solve the problem? The findings from the report The findings from the report one of the most glaring ones was low male involvement with regards to contraception one of the studies that we incorporated in the report to guide our thinking was one from a Kilifi clinic where of the 20 women who came in for contraception information and methods only two were accompanied by the husbands and still of those 20 ten chose to leave their cards at the clinic because they did want the husbands to know that they are going to seek information on contraception and the others who took their cards went and had them filled at an antenatal clinic to give the impression that I'd gone to check with regards to issues of say a child we are expecting that issue of low male involvement stems from a society that is largely patriarchal I mean if you look at our administrative units the bulk of the governors are men all the presidents you've had are men most high ranking officials are men in this country and the perception we have the framing of the contraception conversation has been that it's a women's issue now we are trying to break those myths and misconceptions by bringing in all youth to have this conversation and one of the ways we are doing that is through the universities that we are engaging in the Fomni Gani idea town currently those intellectual spaces it's very hard to keep the men away and just have a conversation and have a conversation with just women and that involvement of men I guess will go a long way into shaping the narrative on contraception access in Kenya How would you say the reception is in as much as you're trying to engage young men and boys to ensure that the barbaric and the kaiq things of the past kaiq things are not affecting the contraception knowledge or the information with the women they are not now holding back they are included how is the reception so far? the reception so far from the universities has been good I would not like to assume that it's all gravy right now that there are no issues we still have to keep chipping away at the barriers to making this or inclusive conversation and we are trying to get more men involved in this conversation at the policy level at the youth level and also at the administrative level and what are some of the barriers you could point at so far what you have experienced and maybe the way forward some of the few challenges you've gone through from the perspective of youth it has been very minimal but then we also have to be aware that we are in a country with various kakakaitro beliefs which I presume will be a challenge we have Christians, we have Muslims we have traditionalists and there are some elements of conservative thinking that may not be very positive in trying to move this conversation forward the best we can do right now is amplify the voices that are calling for the rights that we have in the constitution to be made now despite the awareness created and the modern methods of contraceptives we still have a number of women who are not into this what's the way forward, what have you planned because they're still holding back what's your plan our plan is to have the youth engage and this what has happened is over the years we have slowly relinquished our role as active and engaged citizens in this country which has allowed us to be subject to myths and misconceptions and misconceptions about various issues I think when starting with the importance of family planning and contraception at the individual level and the impact this has on your family your society, your community once this is clear we expect to see a certain shift in thinking of course this is with various partners in collaboration of course there are individuals who need to understand this issue there are policy makers there are advocacy partners these three format triad that can have this co-conversation and hopefully shape the future now that you're into young people so much but now it's one thing to have the information and it's another thing to utilize that information you're speaking to the young people how about the current generation of our parents who are there are these people becoming ambassadors or you're planning for the generation to come how about these people how are you dealing with them? we are largely planning for the generation that will form the future which is what Formnigani is about our parents we can say that part of the time is gone they have had their kids they have learnt their lessons they have seen that ah I can't afford 5 kids I need to stop but then do young guys have that thinking in mind or is the system enabling them to make those decisions so that is the best place that we can focus on because most of the current statistics that we have uncovered in the report largely affect the 74% of Kenyans under the age of 35 so I would say that would be the biggest place where we concentrate our efforts but then on a later note in the meantime these people do you think they will have done wonders before our generation come because you speak to me I know tomorrow I will need to have this but then there are people who are here currently what are they doing how will we reach out to them so you just repeat that now I'll have the information right now I'll have the information so I'm wary of my tomorrow but then the person who is living today in the meantime by the time I'm coming on board what will they be doing how are you planning to reach them out and ensure they control these are the ones who don't have this information this largely involves a large public awareness campaign I think there are some facts that we are alive to one they are silos that are limiting the collaboration between the public sector the private sector and the community service sector or the advocacy partners they are not collaborating as we would like them to they have the same objectives but they are working in silos and that limits how we manage the information to those who are actually required there needs to be a concerted effort towards achieving this goal that we all agree on and that I guess will go a long way into framing that conversation for those who are not yet sold into the importance of contraception all right now contraception efforts in Kenya are largely donor driven and it has been internationally committed and even nationally but then how do we localize this thing how do we localize and ensure even those people from far they have the information will have the meds they need will have everything to ensure that we have control it is actually quite concerning that we have relegated a very vital aspect of our development to external parties and as we speak right now there have been conversations to lower the funding that is coming from external parties as for bakas 2016 there was a decline of 54% on the amount of funding that is coming in from the donors with regards to family planning now the question how do we make the transition to being self reliant one we must understand contraception from a local context how are Kenyans seeing this issue what are the gaps in understanding that currently exist then the second in which I think is the most important thing where do we want to go as a country we have the big four agenda we have vision 2030 how do we achieve those the answer to that is we need to work with one the resources that we have to take care of the population that we have we want to increase employment through manufacturing do we have the resources to employ the 800,000 Kenyans who are coming every year from universities we want to improve healthcare what do you do about the one in seven deaths every day that result from abortions we spend what 500 500 million shillings every year to repair the damage from unsafe abortions and these are the various local context the various local context and nuances that need to inform how we make that shift from being do do do na funded to being self reliant again the biggest challenge is reframing that narrative to everyone individuals, county governments and national governments not because they don't understand it but because we have allowed ourselves to be reliant externally now county governments and the national governments one they need to be clear on whose role is on whose role is it to bring X, Y and Z at a particular level then they also need to agree on how do we move more funding into this to ensure that it is one sustainable and two accessible to everyone who requires it so those I guess are the two things that we need to do to move from a system where we are largely reliant on donors or speaking of the big four agenda in line with the universal healthcare we have the NHS funding how can we incorporate now the contraception under universal healthcare in light with the NHIF can we have people using their cards to access or to have the services of contraception I think that is a big yes because this is a co-operation I've seen happening a number of times in the past two years NHIF needs to be robust enough to take care of everyone's health needs we need to lower out-of-pocket expenditure one of the key contributors to poor healthcare is the fact that one healthcare is expensive when you have out-of-pocket costs going into healthcare from individuals this basically impacts on the quality of life they say that there is a saying that most Kenyans are a medical emergency away from being poor and that basically reflects on how ineffective our healthcare system has been to meeting some of the needs and contraception is one of the many people will not take up contraception because I have to buy unga I have to buy bread I cannot find that amount of money to take up contraception because there are some immediate needs and we need to move from having our population deciding on which two basic needs to pick over the other and that is where incorporating family planning into the NHIF system comes in as we come to an end but before then I want you to respond in this one thing people have been saying we have been having a conversation so much about women having to be the one to control the population in terms of contraceptives how then apart from using trust for men what else can we have can we have another method other than that because it has been said it has been left for women we start that conversation that's for women how else can men contribute to this one of the biggest ways that men can contribute is accepting that they have a responsibility to this a woman does not get kids on her own there is a man involved which means that it is also your role to be a part of that conversation as men we need to be clear on our plans and also involve the women that we are with I want to buy a piece of land in this number of years I may not be able to buy that piece of land if I have to feed 10 kids that I cannot take care of so it's about having your plans ensuring you are clear on those plans with your partner ensuring that the resources you have are able to take care of this family that you are expecting or currently have that is the first thing and also having those discussions with your wife about which contraceptive method will work for us will work for you we have had conversations about the myths and the misconceptions about family planning this arises from men keeping their distance from women with regards to that conversation for example you will hear something that contraception will make your wife moody contraception will make your wife not able to give birth but it's because we don't know we are not involved in that conversation I would go as far as saying go and visit the gyna or the doctor with your wife learn how these things work learn what is best suited for the kind of family you have and the wife you have in terms of her health and her plans maybe she just wants to have or rather you as a family maybe just need to to space your kids alright in a very few words as you conclude now this is the last thing how can we achieve the first scenario that is wakileshi ukaidi utegemeo and upendeleo ok so ukaidi upendeleo and utegemeo are the more dystopian ones which is where we don't want to go but all the signs are there that we could head into any of those three if we remain adamant about not prioritizing contraception access as a key driver to development in ukaidi we are conservative we ascribe more to the myths and misconceptions of family planning and therefore shan investments in it for utegemeo we are heavily reliant on dodona funding what happens when this dodona funding moves to a more immediate issue what happens to contraception especially at a time when we are heavily reliant on it the ideal one is wakileshi this is where health outcomes are good for every individual whether you're poor, whether you're wealthy whether you're middle class you can afford healthcare and most importantly you have access to contraception information and methods based on of course your needs so it's just not access but it is tied to the specific needs of the individual in this scenario what happens is now Kenyans have the ability to chart their future I want to be a doctor I am a 16-year-old girl I want to be a doctor I will not get pregnant in dopa of school I will be able to continue my studies become a doctor and achieve more and the same can be said about my kids I am a 27-year-old woman I need to space my kids I need to allow for my career growth so those are the kind of outcomes we are looking for as a country with regards to the wakileshi scenario and the end result is that there is equitable and sustainable development across the board many thanks for coming Andrew and Shading Light in regards to this movement that you're having and we wish you all the very best and we are hoping as a nation we will achieve what we intend to have come 2030 as a nation many thanks for coming this has been my guest Andrew which is a strategic consultant and Fominigani think tank contributor we were talking about the young voices on future scenarios and contraception where we want to see young people mostly involved in contraception coming up will be Alex with a man talk we take a very short break my name is Dereva Hillary stay tuned to I-254 any medic and it's totally free and also we have many thanks for coming