Kisii — In a quiet village in Kisii County, southwestern Kenya, 16-year-old Juliet Moraa sits on a wooden plastic stool, cradling her one-month-old baby boy. Her eyes well with tears as she reflects on how a simple visit to a nearby health facility changed the course of her life.
A Form Three student, Moraa says she sought contraceptive services and sexual health information after feeling pressured by her boyfriend and warnings from peers about the risks of early pregnancy. Instead, she says she was turned away.
"You are too young"
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When she walked into the consultation room, Moraa recalls speaking softly as she requested help. The response from the nurse, she says, was dismissive.
"You are too young, come back with your mother," she was told.
Ashamed and afraid of being seen at the clinic, she left and never returned. She feared disclosing her relationship to her mother. Months later, she discovered she was pregnant.
Together with her boyfriend, she says they attempted to seek a backstreet abortion, but the procedure was unsuccessful and left her with complications that nearly cost her life and the pregnancy.
"I didn't know what to do," she says, holding her baby. "I just cried. I felt like my life had ended before it even started."
Today, Moraa is recovering from the experience while relying on her family for support as she hopes to return to school.
Her story reflects a broader crisis affecting thousands of adolescent girls navigating Kenya's sexual and reproductive health system -- one that experts say remains difficult to access despite progressive policy frameworks.
According to the Kenya Demographic and Health Survey (KDHS) 2022, teenage pregnancy has declined to 15%, down from 18% in 2014. However, experts say the numbers remain high, with poverty, lack of information, and social pressure continuing to drive adolescent pregnancies.
The African Population and Health Research Center (APHRC) estimates that nearly 793,000 abortions occurred in Kenya in 2023, with a rate of 57 per 1,000 women of reproductive age. Adolescents aged 15-19 account for a significant share of these cases, estimated at one in four.
At the Kisii Teaching and Referral Hospital, reproductive health specialist Elizabeth Nyabicha warns that teenage pregnancies carry serious health risks due to physical and emotional immaturity.
"These girls are too young and they will experience complications during pregnancy," she says. "They need proper nutrition, and at that stage, it is difficult to share nutrients with the unborn child."
Nyabicha notes that teenage pregnancy remains a persistent public health challenge in Kenya, despite ongoing interventions.
Rights advocates argue that gaps in implementation of sexual and reproductive health policies continue to expose young girls to preventable risks.
Elsie Milimu, a Sexual and Reproductive Health and Rights (SRHR) program officer at the Kenya Legal and Ethical Issues Network on HIV/AIDS (KELIN), calls for reforms to remove legal and structural barriers limiting access to youth-friendly services.
She says the government should address issues such as consent requirements for adolescents, and improve access for persons with disabilities and other vulnerable groups.
Milimu also urges Kenya to strengthen implementation of regional commitments on youth-friendly services and comprehensive sexuality education.
At the Kenya National Commission on Human Rights (KNCHR), Executive Director Dr. Bernard Mogesa stresses the need for public awareness campaigns on reproductive health rights.
He calls for translation of SRHR laws into Kiswahili and local languages, as well as training for legal aid providers to support access to justice.
"No one should be harsh on the side of contraceptives. These girls should be told what contraceptives are," he says. "We should not abbreviate lessons when it comes to SRHR."
A Kisii County Woman Representative echoed similar sentiments, noting that sexual education should not be misinterpreted as encouraging immorality, but as empowering young girls with knowledge about their bodies and health.
According to Advocate Wilkins Ochoki, Kenya's legal framework on abortion remains contradictory.
He notes that while the Constitution guarantees the right to health, including reproductive health, abortion is only permitted when the life or health of the mother is at risk under medical supervision.
However, he says the Penal Code still broadly criminalizes abortion, creating confusion for healthcare workers and patients -- and contributing to unsafe procedures.
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"The state must commit to providing more resources to ensure the right to health is attained," he says.
Despite the challenges, the government says efforts are underway to support teen mothers returning to school.
Basic Education Principal Secretary Julius Bitok reaffirmed the government's commitment to the School Re-Entry Policy, which allows girls who drop out due to pregnancy to resume their education after childbirth.
"Teen mothers should not consider pregnancy as the end of their education," Bitok says. "No girl should be locked out of school because she became a mother."
However, he acknowledges that stigma, poverty, and lack of awareness continue to prevent many young mothers from returning to class.
From denied contraceptive access to unsafe abortions and school dropout risks, experts say Kenya's adolescent reproductive health challenges are not only medical but deeply social and structural.
For girls like Juliet Moraa, the consequences are lifelong -- shaping education, health, and future opportunities in ways that could have been prevented.
