Abstract
BackgroundKenya has a high prevalence of adolescent pregnancy and low access to and use of adolescent sexual reproductive health services. Despite the enactment of evidence-based policies to address this problem, adolescents continue to face health problems and barriers to adolescent sexual reproductive health information and services.Main objectiveThis study describes barriers to and facilitators of access to adolescent sexual and reproductive health services in Kisumu and Kakamega counties, Kenya.MethodologyWe used a qualitative design. Through 61 data collection sessions, 113 participants were engaged in key informant interviews, in-depth interviews, and/or focus group discussions. Trained Research Assistants (RAs) engaged adolescents, health care workers, teachers, county leaders, and community representatives. Data were captured using audio recorders and field notes. Socio-demographic data were analyzed for descriptive statistics, while audio recordings were transcribed, translated, and coded. Thematic analysis was done with NVivo.ResultsFindings show that the barriers of access to sexual reproductive health services and information were negative health workers’ attitudes, distance to the health facility, unaffordable cost of services, negative social cultural influences, lack of privacy and confidentiality. Facilitators to adolescent sexual reproductive health services were few and included getting priority for school going adolescents and enabling environment for partnerships on adolescent health issues.ConclusionsAdolescents in Kakamega and Kisumu face a myriad of barriers when seeking sexual reproductive health information and/or health services. We recommend that counties sensitize all stakeholders on adolescent sexual reproductive health problems, and support development of multi-sectoral, sustainable solutions to adolescent health needs.
Highlights
Adolescents comprise 24.5% of Kenya’s 47.6 million total population [1]
Materials and methods Study site and design. This qualitative study was a formative phase of a larger study, whose findings were used as a baseline for an ASRH intervention [15], that was carried out in two wards that were purposively selected: Kobura ward within Nyando sub-county (Kisumu county) and Kholera ward within Matungu sub-county (Kakamega County)
While the World Health Organization (WHO) classifies adolescents as those aged 10– 19-year-old, our study focused on 15–19-year-olds because adolescents aged 10–14 are considered very young and interventions targeting this group were likely to be met with resistance by county governments and stakeholders
Summary
Adolescents comprise 24.5% of Kenya’s 47.6 million total population [1] This segment of the population is at high risk of sexually transmitted infections (STIs), including HIV/AIDS while female adolescents face the additional risk of early pregnancy, unsafe abortion and female genital mutilation [2]. More than half (51%) of all new HIV infections in Kenya in 2015 occurred among adolescents and young people (aged 15–24 years), with young women accounting for 33% of the total number of new infections [5]. Kenya has a high prevalence of adolescent pregnancy and low access to and use of adolescent sexual reproductive health services. This study describes barriers to and facilitators of access to adolescent sexual and reproductive health services in Kisumu and Kakamega counties, Kenya
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