1. 1
www.lvcthealth.org
Access to Emergency Contraception by Adolescents
as a component of
Post Rape Care Services in Kenya
Obbayi, M; Nyaga, L; Digolo, L; Mbugua, C; Otiso,L
6th
International Conference on Peer Education, Sexuality, HIV& AIDS
2014
Dates: 16- 18 June 2014
Nairobi, Kenya

2. We have rebranded. We are now LVCT Health

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About LVCT Health
www.lvcthealth.org
• Formerly known as Liverpool VCT, Care and treatment.
• An indigenous Kenyan non-governmental and non-
profit organization.
• Founded in 1998 and registered in 2001
• LVCT Health envisions healthy societies and uses
research results, capacity improvement and policy
reform action for equitable HIV, SRH services to the
most vulnerable populations.
• LVCT Health reached 1.3M Kenyans with HTC in 2013
with 80% linkage to care, 40,000 in care, 4300 survivors
of sexual violence in 124 MOH facilities and 150,000
youthful callers to one2one hotline.

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Outline
www.lvcthealth.org
 Background
 Access to comprehensive post rape care (PRC)
 Access to Emergency Contraception following
sexual violence
 Challenges
 Lessons Learnt
 Recommendations- Research, Policy, Practice
 Key messages

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LVCT Health
www.lvcthealth.org
 Re- branded
 Indigenous organization
 Vision: Healthy Societies
 Mission: To use research, capacity
improvement and policy reforms action for
equitable HIV, Sexual and Reproductive Health
services to reach the most vulnerable.

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Background
www.lvcthealth.org
• One in five Kenyan women has experienced sexual
violence (KDHS 2008-09); 32% SV incidents occur prior
to Age 18 (Kenya Violence Against Children, VACS,
2010)
• Only 7.9% females age 13-17 report receiving health/
medical services following sexual violence.
• 30% females aged 18 to 24 who experienced sexual
violence before the age of 18 got pregnant as a result.
• Of all rape- related pregnancies, 50% had abortion;

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Background
www.lvcthealth.org
- Comprehensive Post Rape Care (PRC) services that
should be delivered by the health sector include:
- Injury management
- HIV Post Exposure Prophylaxis (HIV PEP)
- Pregnancy prevention
- STI prophylaxis and treatment
- Forensic examination and documentation
- Counselling incl. Trauma, HIV test and PEP adherence
counselling
- Referral to legal, justice and social services.
National guidelines on management of sexual violence in Kenya, 2009

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Comprehensive PRC services accessed
www.lvcthealth.org

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Access to Emergency Contraception
www.lvcthealth.org

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Access to Emergency Contraception
www.lvcthealth.org
• Up to 97% of children age 0-11 are excluded from ECP.
• Possible late presentations.
• Possible non- eligible children.
• Possible general assumption of low or no risk of
pregnancy, even among pre- adolescents.
• Data not able to disaggregate this.
Site 1 Site 2 Site 3 Site 4
No. seen 52 11 40 25
No. given ECP 3 1 0 0
Table showing number of survivors
Age 0-11 receiving ECP over 7 months (N= 128)

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Challenges to access of ECP
www.lvcthealth.org
Health sector/ provider Community/ User
 Lack of clear guidance on
prescription of ECP in pre-
adolescents
 Limited capacity of health
providers to deliver
comprehensive PRC services
 Periodic ECP stock outs
 Lack quality assurance
mechanisms for PRC
services
 PRC/ ECP data collection
tools & reporting systems
 Late presentation of
survivors for care. [100% of
survivors who missed ECP in
Site 2 (March & April 2014)
presented after 120 hours]
 Non- presentation of
survivors. [81% survivors did
not seek services due to socio-
cultural barriers (shame,
ignorance, fear)-Kenya VACS,
2010]

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Lessons Learnt
www.lvcthealth.org
• Rape-related pregnancy occurs with significant
frequency, but is grossly under-reported.
• Proper data collection and reporting systems can
facilitate generation of data for decision making.
• Need for clear guidance on ECP prescription for pre-
adolescents. This should not be left to the discretion of
the provider.
• Community mobilization can be a key strategy for
addressing socio- cultural barriers to service uptake
thereby increasing demand for health services, including
post rape care.

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Recommendations
www.lvcthealth.org

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1. Research
www.lvcthealth.org
Community ECP?
- Pregnancy prevention through community health
resources e.g. Community Health Workers
- Area of global interest
- Need to generate local evidence on feasibility within
local context.

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2. Policy
www.lvcthealth.org
- Develop and disseminate clear policies and guidelines
on ECP prescription to children/ pre- adolescents.
- Resource allocation towards sustained and timely
availability of ECP.
- Establish clear mechanisms for coordination and
supervision of services.
- Establish clear data collection and reporting
frameworks to inform decision making.

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3. Practice/ programming
www.lvcthealth.org
Health Facility:
-Sensitization of providers on pregnancy prevention
-Continuous provider training and mentorship.
-Proper documentation and reporting.
-Best practice sharing forums.
Community Mobilization:
- Engagement of opinion leaders; male engagement
- Social media- Adopt models that have worked e.g.
LVCT Health Online Integrated Digital Platform
- Delivery of GBV/PRC through the Community
Strategy.

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KEY Messages
www.lvcthealth.org
- ECPs prevent chances of pregnancy.
- ECPs may be beneficial up to 120 hours after rape.
Pregnancy can therefore be prevented if you report to
a hospital within 120 hours of rape.
- HIV and STIs can also be prevented if you report to a
hospital within 72 hours of rape.
- It is not your fault that you were raped. Do not feel
guilty. Do not be ashamed. Take action and report to
the nearest hospital immediately!

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Thank You
CONTACT US:
prc@lvcthealth.org
mobbayi@lvcthealth.org
www.lvcthealth.org