Good evening to you and thank you for joining us on Y254 Updates. My name is Patricia Murioki and today we have a very interesting topic or I'd rather say a topic that most people don't like talking about but right here on Y254 we're going to be having the conversation about reproductive health bill and contraceptives which just try to seek really to understand what really does this bill entail. Why is it that many people, many institutions are against this bill and we also try to talk about contraceptives that is accessibility, availability that is do we have the right or reliable information as far as contraceptives when we get to our health facilities and to help us talk about this topic tonight we have two amazing people who I have seen really tackle these topics in different platforms and I would not have thought of any other people to help us discuss this tonight and we have Peter Ngure who is a director part of this policy institute we also have Shalene Mumani who is a co-executive director young women's leadership institute talk to us across our social media platforms that is at Y254 channel you can also reach me at Patricia Murioki. Thank you guys for finding the time to be here and we would like us to tackle the two we had September 26th was the contraceptive day this is something that has been celebrated since 2007 and the theme for this year was sustainable family planning in COVID-19 era and domestic financing and my first question how are we able as a country how are we going to manage to sustain family planning even post COVID-19 Shalene. Thank you so much Patricia. You're welcome. So I think sustaining family planning this is an issue that we've really that has that we've had conversations about for a very long time and note that it has created like COVID-19 has really created new barriers these have been pre-existing barriers you know and it has actually amplified the unmet needs of people in terms of access to family planning and that's why we see now that we're really having these conversations like they are new so for me these have been pre-existing structure like structure barriers that we needed to talk about even before COVID-19. Peter. How do you think that we are able as a country to sustain family planning even now as this year's theme was sustainable family planning in COVID-19 era how we don't put so much pressure in doing it now and then post COVID we find ourselves in situations whereby people can still not assess family planning. Yeah thanks I think we've been learning lessons and COVID is a blessing in this case because it helped us learn new lessons around contraceptives this country has moved from about having 18 percent contraceptive prevalence rate in the 60s to what we are doing now 56 percent and with the hope that by 2022 we can be able to go to 65 percent and by 2030 we could be playing at 75 percent. COVID has brought out new ways of giving contraceptives first. Contraceptives were only available at the facility level yeah and so a lot of women had to go to a healthcare provider for them to get commodities. Right now in COVID times commodities can be gotten by community health workers and brought to the to the citizens so it has changed a bit on that. The other one is that if it spills from government facilities women would only get a refill for a month. With COVID now we can get a refill for three months which means now women don't have to keep coming to the facility all the time for them to come and get commodity so that's another change that has happened. We are now moving to the era of self-care where you can inject yourself with family planning with your contraceptive choice especially those injectables. So that's also another change that has happened now and the conversation is growing and with the the general issue of teenage pregnancy coming up now the conversation has come back to talk can we give our young women commodities because we've been given information and when we know they're sexually active we give them commodities in Yamaji but now the conversation is open how do we give them commodities and even moving the conversation from do we have to always get these commodities contraceptives is not uh it is not medicine you know it's not uh seed you have to get a prescription and all that in fact now it's time we started having the conversation should we have contraceptives in our open shops in our supermarket like we see in the u.s. where all much can go and buy you pills and buy you stuff you don't have to get them from so there's a whole shift and that's what will sustain contraceptive conversation post-covid because now we are able we have seen that it's workable just like we did with M-Pesa we used to do $70,000 now we can do $300,000 now we know I mean COVID has had its good side. Okay, the other thing is when we talk accessibility and availability of information before we even now get to these commodities are the services really available to people do we have the right information when a young lady walks into a health facility or when a young lady is having consultation with a med with a medical personnel and they are looking for options that they want to use whatever methods they that they want to use shallene do you think we have reliable information or data in terms of what we get to offer to people before they make their decision on what method to use as far as family planning is concerned information is very very crucial when it comes to access to contraception because everybody reacts differently every human being reacts differently or every woman reacts differently with the different methods of contraception so for me I think information is very crucial and in our health systems I think this is not really taken seriously because information is never is not given like the right way there's no comprehensive information that is given on different types of methods when a woman or a girl accesses her health facility they do they're not like given that information that they need you know because number one they are faced with discrimination there's discrimination that comes with age discrimination that comes with class there's no confidentiality exactly so so that really affects how even the kind of information that you're given is it really comprehensive is it does it support how how you also need to like what you'd like to hear okay with regard to access to those services you know there's so many myths around contraception you know and that's why information is very important to really demystify that certain methods do not work for people and certain methods work for people and for us moving forward like Peter said that contraception should be available in our supermarkets in our shops you know information is needed you know first I said that we react differently and if a woman or a girl does not know how they react to that kind of method then it will maybe react differently with our body which will not which may may affect her in a bad way you know so then I think it will really be important to even embrace comprehensive sexuality education so that then young people adolescent girls get to learn from an early age on on certain things on body autonomy on how to really embrace themselves and take care of themselves and also access to contraception okay Peter I believe that probably you might have done after this or found yourself in a place where you've assessed information that gets to tell us about accessibility and availability what would you say is the response that probably consumers that is now the women and the young ladies get to give as far as the type of information that they get from facilities yeah a lot of studies have been done on what Charlene mentioned called unmet need for family planning why is it called unmet need it means that a woman really does want to take contraceptives but is unable to get contraceptives so there are many reasons that have been given for unmet need and the first the first reason is information the fact that in our health facilities the health the number of health workers who are given the task to man the maternal neonatal child health unit which is from which has family planning maybe it's one nurse and she's having 20 clients in a day 30 clients that nurse cannot be able to comprehensively give you information so a woman comes and you're given what is available you're not even told there are 10 types of methods this is the kind of method you need then you also go back and decide for yourself which method works for me because as Charlene has rightfully mentioned methods affect women differently there are those methods there are hormonal methods that cannot be given to people with diabetes to people with other kinds of conditions they are non-hormonal that before had some metallic things that couldn't be given to some kind of people there are people who react differently to injectables I mean so information has been the biggest hindrance to realizing contraceptive family planning in Kenya and moving forward I see a lot of and this information should not just be given by healthcare providers in health facilities this information should come to schools this information should come to churches this information should come to open spaces where people now can be able to because human beings access information differently rarely accept adverse on condoms I don't see adverse on any other contraceptives on our TV I've not seen someone say Jadel this is the way to use it or IUD this is the way it's inserted because as you mentioned the myths around contraceptives are so many and if we don't fight myths with the right information then we will always have this guy okay I like it that you've mentioned the myths and conceptions around contraceptives and you've mentioned that the church you should have this information in the church you should have this information at the school but now when we get let us go a little bit to the reproductive health bill that is just a bill I just trying to advocate for some of the things that we're talking about tonight and many people have come out especially if the Kenya bishops have come out and say no we do not advocate for this we have the Kenya the Catholic Church that has for the longest time been against family planning and all these things and we also have individuals in the community who feel this is not the right way so how now are we do we bridge do we build a bridge between making these people understand things are changing probably we can try and adapt to a certain thing without people feeling that we're stepping and forgetting our morals peter it's it's interesting the the people who are fighting the reproductive health have not come out to say specifically this is what I don't like about the bill the bill is very comprehensive the bill actually the first bill came in 2014 yeah and of course the parliament labs in the independent yeah Susan Kihika and has brought a bill that encompasses all the challenges that were in the previous bill the bill says every person has a right to access reproductive health but then this goes down and says if it's around young people then the parent or the guardian consent on the information is required so the thing that the church is fighting that will give 10-year-olds contraceptives it's not true the other thing around it is that it is a lot of people are saying this bill just allows people to hold some legal contraceptives and the bill says if you are accessing family planning the health care provider gives you the advantages and disadvantages of each method and then you choose that's the information that we are looking for on this on this and the bill also has so much more it has about safe motherhood which is a whole chapter it has issues of adolescent sexual reproductive health it has issues on safe motherhood it has issues on a termination of pregnancy depending with and our position gives that right that if the mother the life of the mother is at risk or the child is at risk then our health practitioner can be able to go ahead and make their decision so that bill just brings to life what is in the constitution but a lot of us would want to say take that and say this is abortion or this is giving young people contraceptives all this is oh wow that's a very big statement but i'll cut you short and have us take a very short break here on why 254 but don't go too far away we'll be right back with more give us 10 years on why 254 updates and if you're just joining us tonight we're talking about the reproductive health bill and contraceptives and with me in studio to her to talk about this we have peter guru and we have shellene momani talk to us across our social media platforms that is at why 254 channel you can also reach me at patricia muriochi so during the break we had a very small conversation among the three of us where we got to talk about we feel like women have the bigger burden on carrying so much weight and i've been to do with so so very many things whereas the men are just given like the lighter duties and i want us to talk about male involvement as far as contraceptive is concerned do is it not right that this they probably should also be on family planning and shellene as a woman what is your thought and what is your opinion on that issue i think women have really been burdened by society you know like women have carried like the reproductive role for a very long time and all the blame is always on women anything that happens first women do not have like the right to choose whatever they want to do with their body they can't choose the kind of contraception they want unless the partner is involved and the partner also has to like make the decision at time and is not using it exactly the man has to like most of the time it's the man making decisions on a woman's body for me it is really really problematic and it's so stressful for a woman and it's really time that we have that conversation that men should also i think should also get on gets contraception okay peter you are a man and i'm so glad that you are a man who is advocating for contraceptives because you really get to give us the best advice or rather the best opinion on this what is your thought on male involvement on family planning this is a shared responsibility you know a lot of people refuse to have this honest conversation for you to get pregnant in 28 percent of our setup it's a man and a woman now we have other ways we have surrogacy but normally there's a natural one is it's a man and a woman so anytime when men now start saying why did you get pregnant you ask why are you not the one who is not taking protective measures and sure that i don't get pregnant and it's time with you this responsibility is to both genders yeah men and women at 50 percent where men have color you can use color and all the time i hear men say no i don't like using color you think women like being injected all the time okay that's that's that's the the mentality that we need to put that this is an equal yeah it's supposed to be a shared responsibility and i'm glad i have worked with a few who are doing men's book called male contraceptive now and it is made in women and contraceptives from North Carolina those organizations are MCI is really working hard to ensure that there is a new product and they are doing a lot of research on new pills that men can take or a new purchase that men can also purchase themselves and not be able to provide live spams and the conversation is ongoing but unless men accept to go for trials because every commodity when it's out there yeah coronas vaccine has to go through a trial yeah we need enough men who can go through a trial we have a set to be for men i mean you can cut it and not sigh and that does because the other challenge with men is the fear because we have seen the effect of what some contraceptives have done to women some of the side effects which are natural things that happen men are very much afraid of having side effects by themselves someone thinks if she takes this and she has a headache so men love themselves too much i guess but the thing is we have to have this conversation we have to tell men that these commodities are safe we have to allow them to start taking up and then we need male champions because this conversation we can't just be saying men men men we have to have them in the house say these are the methods even training girls about methods even training other boys about methods and this conversation should also start earlier because by the time i'm 30 that if i then you're coming to tell me now take up this responsibility which you are not used to i mean it takes a lot of time for someone to to get that into them but if you allow people from when they are young to know as a boy as a girl it's equal responsibility both at home both in school to your family yeah dating yeah it's a 50-50 situation let's keep moving this equal conversation from when we are young to the old age and i think that's the only solution we have okay a very tough question it's a yes or no if today a product is brought contraceptive for men would you be open to sit down and talk about with your wife about it and go with that plan oh yes thank you very much so all men should follow yeah because they had no no way to solve that problem they were not ready if they had a method and they had taken appeal or they had taken a part they don't have to run away they don't have to run away so okay so shallene how do we now normalize our communications or conversations around contraceptives in our society how can you normalize that normalizing it means that we all have it is a collective responsibility from religious leaders because we know religion really plays a very big role in modeling how we behave how how like our characteristics in terms of how we think in like just changing the perception okay they should i don't they're really two-sided because religion has really been a great impact a negative impact when it comes to choices in terms of reproductive health okay so then having conversations with stakeholders such as religious leaders political actors young people parents you know parents also have a very have a very tough role to speak to their children but then this role is also left to to mentors and peer counselors and that those children who actually like adolescent girls who don't have mentors and and and peer counselors okay so they lack this kind of information so for me i think we should just we should just engage everyone it is a collective responsibility for everyone to come together to normalize this conversation okay that is seconds peter what are your final thoughts on this topic that we've discussed tonight but time is right for us to to allow to stop hiding behind morals to stop adding ethics or traditions it's time we came out and realized that uh these children who are getting pregnant are our children you need to take care of them even if you're a man remember you will get daughters you will get granddaughters to take care of them don't just it's a women issue it's our issue all of us and to our government continue investing in family planning we have not had a budget lines consequent for family planning which have been done and driven as government we're asking them as national and county government create budget lines for family planning okay thank you very much and i hope people were watching us tonight you've learned something new or rather you have probably added something into the knowledge that you already had we're going to have probably schedule for another interview it's quite a lot that we've not managed to talk about but we'll look for more time to really share the right information with you guys thank you very much my name is patricia muriochi drive yourselves a very good night


The opening words of the Institute of Medicine's report on the potential threat posed by food ads were, marketing works.  But what do you need to know beyond the fact that the industry spends tens of billions of dollars a year on it, right?  It's like when my medical colleagues accept drug launches from pharmaceutical representatives and take a fence that I would suggest it might affect their prescribing practices. I mean, do they really think drug companies are just in the business of giving away free money for nothing, right? They wouldn't do it if it didn't work, right? To give you a sense of marketing's insidious nature, though, let me share an interesting piece of research published in the world's leading scientific journal. In-store music affects product choice. Documented an experiment in which either French accordion or German beer-keller music was played on alternate days in the wine section of a grocery store. On the days the French music was playing in the background, people were three times more likely to buy French wine, and on German music days shoppers were about three times likely more to buy German wine. Despite the dramatic effect, not just a few percent difference, but a complete three-fold reversal when approached afterwards, the vast majority of shoppers denied the music had any influence on their choice. We all like to think we make important life decisions like what to eat consciously and rationally. However, if that were the case, we wouldn't be in the midst of an obesity epidemic, right? Most of our day-to-day behavior does not appear to be dictated by careful, considered deliberations. Rather, we tend to make more automatic impulsive decisions triggered by unconscious cues and habitual patterns, especially when we're tired, stressed, and preoccupied. The unconscious part of our brain is thought to guide human behaviors as much as 95% of the time. This is the arena where marketing manipulations do their dirty work. The part of our brain that governs conscious awareness may only be able to process about 50 bits of information per second, which is roughly equivalent to like a short tweet. Our entire cognitive capacity, on the other hand, is estimated to process in excess of 10 million bits per second. Because we're only able to purposefully process a limited amount of information at a time if we're distracted or otherwise unable to concentrate, our decisions can become even more impulsive. An elegant illustration of this cognitive overload effect was provided from an experiment involving fruit salad and chocolate cake. Before calls could be made at a touch of a button or the sound of your voice, the seven-digit span of phone numbers was based in part on the longest sequence most people can kind of recall on the fly. We only seem to be able to hold about seven chunks of information, plus or minus two, in our immediate short-term memory. Okay, so here's the setup. Randomize people to memorize either a seven-digit number or a two-digit number to be recalled in another room down the hall. On the way, offer them the choice of a fruit salad or a piece of chocolate cake. Memorizing a two-digit number is easy and presumably takes up few cognitive resources. Under the two-digit condition, most chose the fruit salad. Faced with the same decision, most of those trying to keep the seven digits in their heads just went for the cake. This can play out in the real world by potentially the effect of advertising. Have people watch a TV show with commercials for unhealthy snacks and no surprise, they eat more unhealthy snacks compared to those exposed to non-food ads. Or maybe that is a surprise, and we all like to think that we're in control and not so easily manipulatable. The kicker, though, is that we may even be more susceptible the less we pay attention. Randomize people to the same two- or seven-digit memorization task during the show, and the snack attack effect was magnified among those who were more preoccupied. And look, how many of us have the TV on in the background or multitasked during commercial breaks? This research suggests that it may make us even more impressionable to the subversion of our better judgment. There's an irony in all this, right? Calls for restriction on marketing are often resisted by invoking the banner of freedom, right? But what does that even mean in this context, when research shows how easily our free choices can be influenced without our conscious control? A senior policy researcher at the Rand Corporation, even when it's far to suggest that, given the dire health consequences of our unhealthy eating habits, insidious marketing manipulation should be considered in the same light as the invisible carcinogens and toxins in the air and water that can poison us without our awareness.