Painful tradeoffs : intimate-partner violence and sexual and reproductive health rights in Kenya

Intimate-partner violence involves multiple violations of sexual and reproductive rights, with devastating impacts on the health and wellbeing of those affected. This paper is the result of an action-research collaboration between a Kenyan gender-based violence rehabilitation NGO and a research programme. Qualitative and descriptive quantitative analysis of seven years of client records were carried out to investigate women’s experiences of intimate-partner violence and their responses to it. The paper departs from the observation that international human rights, while profoundly conceptually relevant to Kenyan women, are frequently practically irrelevant to their lives. Instead, various and often contradictory forms of rights, or legitimate claims, co-exist and interact in personal beliefs, in social relationships and in national legal and judicial systems. We therefore seek to contextualise rights in the lives of women affected by intimate-partner violence, to understand how they are articulated and constrained in each of these dimensions. We find that physical and sexual abuse within relationships often leads to repeated exposure to sexual and reproductive health risks, and abused women lack knowledge about these impacts, experience feelings of hopelessness about their health, and are unable to access the health services they need. Economic factors lead many women to subordinate their sexual and reproductive rights to their material needs and those of their children. There are limitations to the recognition of rights in both social attitudes and in the national legal framework. Social networks and justice institutions sometimes support individuals in exercising their rights and sometimes obstruct them. Legal reform, and strengthened services and referral systems are needed if the barriers to women’s rights are to be overcome. Measures to facilitate access to sexual and reproductive health services and to address forms of vulnerability in ongoing abusive relationships are needed to help those affected to end the violence and mitigate its impacts. Keywords: intimate-partner violence; sexual and reproductive health; rights; service delivery; Kenya.