Nairobi, Kenya – When Ella found out she was pregnant, she was 17, studying at secondary school with a dream of becoming a business owner one day. For as long as she can remember, Ella has wanted to own a beauty shop and earn a good income to support her family.
Ella lives in Nairobi’s Kibera neighbourhood, the largest informal settlement in Africa. In Kibera, life is vibrant, tense and hard. A labyrinth of structures stretch across 2.5 kilometres and is home to over a quarter of a million people. In Kibera, as in many urban informal settlements across sub-Saharan Africa, a lack of access to livelihood opportunities and basic health services puts many communities at risk. For adolescent girls and young women especially, they are left exposed to the triple threat of teen pregnancy, new HIV infections and sexual and gender-based violence. Life expectancy in Kibera is only 30 years old.
After Ella found out she was pregnant, life changed in many ways. Soon to become a single mother, she dropped out of school, fearful of the stigma associated with unwanted pregnancy, and took up menial jobs in order to support her new baby and mother, whom she shared a home with. At first, it was the shock of leaving the lifestyle she loved that had the greatest effect. But then, it was the worry about her health and about possibly falling pregnant once again.
It was at this time that Ella was introduced to Tiko by another girl in her community, who was working as a mobiliser for an organisation called the Awoche Foundation. Initially hesitant, Ella was soon invited to Awoche’s ‘Tiko Club’ where she learned about sexual and reproductive health, and specifically, where Tiko was supporting other girls in her community to access health services.
Tiko’s partnership with the Awoche Foundation is part of a programme of work being implemented under the world’s first Development Impact Bond for adolescent sexual and reproductive health (ASRH). The programme, a collaboration between Tiko, the Joint UN Team comprising the UNFPA, WHO, UNAIDS and SDGPP, Bridges Outcomes Partnership and the Children’s Investment Fund Foundation, aims to reduce new HIV infections, AIDS-related deaths and teenage pregnancies among adolescent girls aged 15-19 in ten high-burden counties in Kenya. The program leverages Tiko to facilitate access to quality and responsive ASRH services, motivating young girls to make and maintain positive health choices.
Wanting to find out her HIV status and avoid another unplanned pregnancy, Ella enrolled onto the Tiko platform with the help of a mobiliser, who used the Tiko app on her phone to create a profile and gave her a physical Tiko card which Ella could use to access free services within her own community. After consulting with a local clinic about the various contraception options available to her, Ella chose to start with a three-month contraceptive injection, and later switched to a five-year implant, a method she had previously known nothing about.
Core to the Tiko platform is enabling choice for young people in where they access health services, whether that be a public or private clinic, or pharmacy. Ella prefers to access services at private facilities in Kibera close to her home, which often have shorter waiting times.
Tiko has been instrumental in influencing Ella’s health choices, and giving her the agency to choose the services she wants, when she wants them. Through ‘Tiko Clubs’, she has learned about changes in her body, relationship management, coping with contraceptive side effects and even self-love and self-care. The platform has also connected her with a network of other girls in Kibera, dealing with the same challenges, and provided her with a safe space to speak openly about her hopes and fears.
While Ella still faces challenges as a single mother in Kibera, today, she’s excited about her future. After rejection from friends, and a dream that seemed to be slipping away, Ella is now more steadfast than ever on becoming a business owner. She plans to take up a course in beauty and hairdressing, and has the support of a new partner and her mother, who has encouraged her each step of the way. If you speak to Ella, she’ll tell you that contraception is a crucial part of the journey to achieving her dream.
This story was written by Tiko, with consent from Ella.
