Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

Pamela M Godia,Jan J Hofman,Deborah Quinney,Nynke Van Den Broek,Joyce A Lavussa,Joyce M Olenja

doi:10.1186/1472-6963-13-476

Abstract

BackgroundAddressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya.MethodsQualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach.ResultsThe majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services.ConclusionSupporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice.

Highlights

Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries
There is no single definition of SRH services but within the literature, SRH is described by the amalgamation of “sexual health” and “reproductive health”
Results are presented by the five key thematic areas that emerged: 1) Health Service Providers (HSP) knowledge of policies and guidelines; 2) SRH services young people seek at health facilities; 3) HSPs’ views on SRH service provision; 4) barriers to SRH service provision; and 5) HSP suggestions regarding how SRH services can be improved

Summary

Introduction

Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. During the conference it was recognised that reproductive health needs of young people had largely been ignored by existing health, education and other social programmes. Youth friendly SRH services have been described by WHO (2002) as “services that are accessible, acceptable, equitable and appropriate to meet the SRH needs of young people aged between 10–24 years.”. Such services are provided within an environment that is friendly and welcoming so that young people are able to come back again and refer their friends for the same services [6]. Elements such as adolescent friendly policies, friendly health service providers and support staff, friendly service delivery mechanisms such as convenient opening hours, privacy and comprehensiveness of services have been cited as essential [6,7]

Methods

Results

Discussion

Conclusion