Maximización de beneficios a Largo Plazo (LP)

Driven by the religious factor discussed above and cultural interests, politicians and bureaucrats in the case studies were either out-rightly opposed to sensitive SRH issues or uninterested in spearheading reforms on these issues. In the adolescent RH policy process, Moi and Saitoti (president and planning minister, respectively) adopted the position of religious leaders, effectively blocking reforms. In the sexual offences legislative process, male MPs, driven by patriarchal interests, blocked reforms on sexual violence practices that threatened men’s control over women’s sexuality. At the heart of this opposition was an interaction of two factors, namely, politics and personal values (of morality and patriarchy). As discussed in the preceding subsection, most Kenyan politicians believe that for political survival they have to portray a public image that is conservative and supportive of socio- cultural discourses on SRH, particularly sensitive SRH issues. And, at personal level, politicians hold beliefs and values supportive of morality and patriarchy shaped by the socio-cultural context they live in.

Similarly for bureaucrats, their apparent reluctance to lead reforms on contested SRH issues is a product of politics and personal values. Bureaucrats are political appointees and so their career survival in government is dependent on their support for the discourses of the top political leadership. At personal level, they also hold values and beliefs that have been shaped by the obtaining socio-cultural context in Kenya; often these values mediate morality and patriarchy. The interaction of these factors explains why the DRH in the adolescent RH policy process and the AG in the sexual offences legislative process were reluctant to lead reforms on these issues. This finding challenges Grindle and Thomas’s (1991:182) argument that ‘public officials are almost always actively engaged in efforts to influence’ change. Instead, the finding shows that on highly contested issues such as SRH, government officials in Kenya have either shied away from these issues or readily adopted non-supportive narratives promoted by the political establishment. This is the case in several other SSA countries in regard to SRH reforms. In Ghana, for instance, a Minister for Women opposed a proposal to criminalise rape in marriage mainly because the

country’s president was opposed to the proposal (Fallon 2008). In Uganda, the Speaker of Parliament vowed to ensure a bill against gay rights is passed into law by the country’s parliament because that ‘is what Ugandans want’ (BBC News 2012a).

Besides neglecting sensitive SRH issues, bureaucrats also marginalised SRH rights groups in policy networks as seen in the case studies, including the government’s own autonomous

agency for promoting human rights (KNCHR) established in 2003. This strategy of

marginalising actors who focus on contentious SRH issues in policy processes is commonly employed in other developing country contexts. In India, for instance, it was observed that although the government had been more willing to involve civil society in RH-related activities after ICPD, it had remained wary and some bureaucrats openly opposed involving civil society in RH-related policy discussions (Health Watch 1998 in Petchesky 2003:201). However, the situation in India has improved following the implementation of the National Rural Health Missions initiative93, which has increased civil society’s

contribution to policy and legislative reforms (Unnithan and Heitmeyer 2012). In countries where such neglect and marginalisation is still happening such as Kenya, politicians and bureaucrats, most of whom are usually men and/or women supportive of top political leadership’s patriarchal ideals94, have continued to use national policies and laws to control the sexuality and reproduction of adolescents, women, and sexual

minorities. For politicians and bureaucrats, the interplay of political costs with moral and patriarchal values that produces opposition to sensitive SRH issues is further reinforced by the fact that often the restrictive policies they pass do not necessarily affect them at

personal or family level since they or their family members can easily access the opposed SRH services in private health facilities. As Richardson and Birn (2011: 189) have argued regarding abortion restrictions in Latin America:

Those who suffer the most from restrictive laws and policies tend to be the poor, who are not an important lobbying group that politicians are concerned about pleasing. The political and economic elite have other options, such as private clinics offering

clandestine abortions, which diminishes their need to support progressive policy changes… Thus, a “double discourse” persists, whereby official policy is conservative and unquestioned publicly, and privileged individuals, who have choices, can ignore the problems.

However, as noted in Chapter 3 and as evidenced in Chapter 6, there are some politicians and bureaucrats who are supportive of certain sensitive aspects of SRH, but their voices are often drowned in strong opposition from fellow politicians and religious leaders. Prof. Anyang Nyong’o, Minister for Medical Services (until April

93 _{National Rural Health Mission is a 7-year (2005-2012) health programme in India run by the Health} Ministry that aims to improve health care delivery across rural India.

94 _{Since the women are usually government appointees, they are appointed because they share the position of} top political leadership on sensitive SRH issues, and even if they hold opposing views, they are unlikely to contradict top political leadership so as not to jeopardise their careers in government. For instance, in Ghana, a female Minister for Women was strongly opposed to criminalising marital rape, which she termed a ‘Western’ idea that would destroy Ghanaian families (Fallon 2008). Fallon (2008) found that the Minister’s position was in line with that of Ghana’s president at the time. In Kenya, a female head of DRH for several years was noted by a respondent as someone who ‘hated abortion’ [Nairobi, August 8, 2011].

2013) and Dr. Francis Kimani, Director of Medical Services, support the need to legalise abortion in Kenya in order to save the lives of women lost through unsafe abortion practices. Although these two officials hold important positions of power and speak publicly about the need to provide safe abortion care, their arguments remain marginal to the dominant moralised medical narrative within Kenya’s health bureaucracy. Notably, the DRH (responsible for SRH policies) falls under a different ministry, the Ministry of Public Health and Sanitation, whose Minister (Beth Mugo) is strongly opposed to abortion. Similarly, the Catholic President (Mwai Kibaki) is also opposed to abortion. Thus, although not all politicians and bureaucrats in Kenya are opposed to SRH rights, the very few who are supportive of sensitive SRH issues remain powerless in bringing about reforms, given the open opposition by the president, most politicians and bureaucrats, religious leaders, and a large section of the Kenyan public.

7.2.3 Donors and UN agencies: potential drivers of reforms or contextually