Girls In Kenya Research Articles

Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data

PurposeMany predicted that COVID-19 would have a substantial impact on the sexual and reproductive health (SRH) trajectories of adolescents in sub-Saharan Africa. The lack of longitudinal data with information collected before and into the pandemic has limited investigation into this topic. MethodsWe performed a secondary analysis using nationally representative longitudinal data from Kenya and Burkina Faso, collected at three time points (pre–COVID-19 in late 2019, and during COVID-19 in 2020 and 2021), to determine the extent to which SRH outcomes and behaviors, including pregnancy, contraceptive use, partnership status, and sexual activity, changed during the pandemic among adolescent women. ResultsAmong adolescents aged 15–19 years (Kenya n = 1,893, Burkina Faso n = 1,422), there was a reduction in both partnership and pregnancy in 2021 as compared to pre-COVID 2019. Contraception use significantly increased between 2019 and 2021 in Kenya only (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI] 1.03–1.97). COVID-19–related household income loss was associated with a decline in sexual activity among unmarried Kenyan girls (aOR: 0.47, 95% CI 0.25–0.87) and lower odds of pregnancy in Burkina Faso (aOR: 0.13, 95% CI 0.02–0.91). We did not find a relationship between COVID-19 measures and initiation of partnership or marriage in either setting. DiscussionContrary to expectations, our results suggest that COVID-19 did not have a consistent or sustaining impact on adolescent SRH and behaviors in Burkina Faso and Kenya. Further research is needed to assess the longer-term implications of the pandemic on adolescent social and health outcomes.

Motherhood in Institutions of Higher Learning: The Case of Public Universities in Kenya

In many African societies and in the Old Testament in particular, motherhood is a blessing and a societal educational institution. While Eve is the mother of all the living, Kings shall come from Sarah (Gen. 3:20 & 17:16). By analogy, motherhood in the African traditional society was a sacred faculty of education. Unfortunately, in contemporary African it has become a life altering experience for many young ‘girls’ in institutions of higher learning. Unlike Sarah who gave birth in her old age as in Genesis 17:15-16; many girls in Kenya are giving birth before the age of eighteen. There has been emphasis on supporting ‘girls’ to attain university degrees. However, not much attention has been given to the socio-economic, psychological and gendered stereotypes that young girls go through while trying to balance between the classroom and motherhood in Kenyan Universities. Thus, this paper will use an ethnographic approach through an afro-feminist lens to propose that there is need to 1, have baby care centers in institutions of higher learning, 2 integrate secondary motherhood and parenthood tutorials in educational programs of higher learning, 3, and include financial support for young mothers in university budgets.

The Case for Rights-Based Investments in Adolescent Girls in Kenya: An Economic Modelling Study

The Case for Rights-Based Investments in Adolescent Girls in Kenya: An Economic Modelling Study

Education for Kenyan Girls in the Post Covid-19 ERA: Mitigating Strategies for Future Pandemics

The study examined the effects of school closure during the COVID-19 pandemic on the education of secondary school girls in Moiben Sub-County, Uasin Gishu County, Kenya. It used a mixed-method research design that targeted classroom teachers and Form III and IV students from mixed-day public secondary schools. A sample size representing 251 students was selected, while 66 teachers were purposively selected as respondents for the study. The data for the paper was collected using questionnaires. Data analysis was done using descriptive statistics and presented in tables and figures. The study found that 10 – 14% of students dropped out of school due to the Covid-19 pandemic. Of those who dropped out, the girls accounted for more than 60.0% of the ones who did not resume their education after the opening of schools in January 2021. The study found that teenage pregnancies, child labour, early marriages, and low household income contributed to girls’ not returning back to school. The paper recommends that the government set up appropriate interventions to ensure that future pandemics do not result in the discontinuity of education for students by investing in proper physical and human infrastructure. Other recommendations have been highlighted in the paper

Diverse policy maker perspectives on the mental health of pregnant and parenting adolescent girls in Kenya: Considerations for comprehensive, adolescent-centered policies and programs.

The pregnancy rate in Kenya among adolescent girls is among the highest in the world. Adolescent girls experience increased risk of anxiety and depression during pregnancy and postpartum which can result in poor health outcomes for both mother and baby, and negatively influence their life course. Mental health is often given low priority in health policy planning, particularly in Sub-Saharan Africa (SSA). There is an urgent need to address the treatment gap and provide timely mental health promotion and preventative services, there is a need to focus on the shifting demographic of SSA-the young people. To understand perspectives on policymakers on the mental health prevention and promotion needs of pregnant and parenting adolescent girls, we carried out a series of interviews as part of UNICEF funded helping pregnant and parenting adolescents thrive project in Kenya. We interviewed 13 diverse health and social policy makers in Kenya to understand their perspectives on the mental health experiences of pregnant and parenting adolescent girls and their ideas for optimizing mental health promotion. Six principal themes emerged including the mental health situation for adolescent girls, risk factors for poor mental health and barriers to accessing services for adolescent girls, health seeking behavior effect on maternal and child health outcomes, mental health promotion, protective factors for good mental health, and policy level issues. Examination of existing policies is required to determine how they can fully and effectively be implemented to support the mental health of pregnant and parenting adolescent girls.

Effects of a single cash transfer on school re-enrollment during COVID-19 among vulnerable adolescent girls in Kenya: Randomized controlled trial

COVID-19 related school closures in Kenya were among the longest in Africa, putting older adolescent girls nearing the end of secondary school at risk of permanent dropout. Using a randomized-controlled trial we evaluated a logistically simple cash transfer intervention in urban areas designed to promote their return to school. There were no required conditions for receiving the transfer and the intervention is interpreted as a labeled cash transfer. It had substantial significant effects on re-enrollment of adolescent girls, with greater effectiveness for older girls and even for some not enrolled earlier in the school year. The program effectiveness demonstrates feasibility of the approach and underscores the potential importance of additional resources for schooling during the pandemic, when a large majority of households had suffered income losses.

It's not just about pads! Adolescent reproductive health views in Kenya: A qualitative secondary analysis.

Many adolescents face barriers to accessing reproductive health care even though quality reproductive health care is a fundamental human right. The objective of this study is to understand the requests of quality reproductive health among high school girls in Kenya. We conducted a secondary analysis of qualitative data from a sub-sample of adolescent girls in Kenya who participated in the What Women Want global campaign and analyzed interview data from key informants involved in the survey. We used pre-existing codes and current literature to design the coding framework and thematic analysis to describe emerging themes. Atlas. ti 8 was used to organize and analyze codes. Over 4,500 high school girls, ages 12 and 19 years, were included in the analysis, with 61.6% from all-girls boarding schools and 13.8% from mixed-day schools. Data from nine key informants complemented findings from the survey. Emerging themes included: 1) The need for improved menstrual health and hygiene: Sanitary towels and cleaner toilets; 2) Prevention of adolescent pregnancy: Access to contraception; 3) Respect and dignity: Participants want privacy and confidentiality; and 4) The need to address social determinants of health: Economic stability and a safe physical environment. This study indicated that adolescent high school girls have varied requests for reproductive health care and services. While menstrual health and hygiene are key issues, reproductive needs are beyond just sanitary products. The results suggest a need for targeted reproductive health interventions using a multi-sectoral approach.

Ramifications of Covid-19 pandemic mitigation measures on sexual reproductive health services utilization among women and adolescent girls in Kenya

Background: Women and the adolescents girls in low-middle income countries continue to be the most vulnerable individuals in times of disasters such as the ongoing COVID-19 pandemic with emphasis on their Sexual Reproductive Health (SRH); yet hardly many studies choose to identify gaps that could improve and bring about well-informed interventions during crisis that do not affect other essential services. Hence, this study aimed to identify the effect of the Covid-19 pandemic mitigation measures on access and utilization of sexual reproductive health services and its related SRH outcomes among women and female adolescents in Kenya. Methods: A systematic literature review was performed to collate findings on the given study using 8 databases. Total of 1352 presumably pertinent publication were retrieved of which 20 studies met the study’s inclusion criteria which included studies with quantitative, qualitative and mixed methods study designs in full text and in English without duplicates. Using a data extraction table, thematic analysis was carried out to yield the study findings. Results: Two themes were identified including; service access related outcomes with the sub-themes of maternal health services and HIV/AIDS services and pandemic specific stressors with the sub-themes of Covid-19 mitigation stressors and socio-economic stressors. The findings implied that, women of reproductive age SRH access and utilization was affected by the COVID-19 pandemic’s mitigation responses with adverse SRH adverse health outcomes. Conclusion: In conclusion, the Covid-19 pandemic adversely affected sexual reproductive health services among women and female adolescents in Kenya. The given main findings indicated and recognized the existence of improper set policies and mitigative measures during crisis management, affecting essential services such as SRH.

Access to Oral Fluid-Based Human Immunodeficiency Virus Self-Tests Increases Testing Among Male Partners of Adolescent Girls in Kenya: A Randomized Controlled Trial

PurposeThe risk of human immunodeficiency virus (HIV) among adolescent girls (AGs) may be reduced if they know the HIV status of their male partners. We assessed the ability of AGs in Siaya County, Kenya, to offer HIV self-tests to their partners to promote partner and couples testing. MethodsEligible AGs were 15–19 years old, self-tested HIV-negative, and had a male partner not tested in the past 6 months. Participants were randomly assigned to receive two oral fluid-based self-tests (intervention arm) or a referral coupon for facility-based testing (comparison arm). The intervention included counseling on ways to safely introduce self-tests to partners. Follow-up surveys were conducted within 3 months. ResultsAmong 349 AGs enrolled, median age was 17 years (interquartile range 16–18), 88.3% of primary partners were noncohabiting boyfriends, and 37.5% were unaware if their partner had ever tested. At 3 months, 93.9% of the intervention arm and 73.9% of the comparison arm reported that partner testing occurred. Compared to the comparison arm, partner testing was more likely in the intervention arm (risk ratio = 1.27; 95% confidence interval 1.15–1.40; p < .001). Among participants whose partners got tested, 94.1% and 81.5% in the intervention and comparison arms, respectively, reported that couples testing occurred; couples testing was more likely in the intervention than comparison arm (risk ratio = 1.15; 95% confidence interval 1.15–1.27; p = .003). Five participants reported partner violence, one study-related. DiscussionProvision of multiple self-tests to AGs for the purpose of promoting partner and couples testing should be considered in Kenya and other settings where AGs face a high risk of HIV acquisition.

Improving oral health of adolescent girls in Kenya through education - An observational study.

Dental caries and periodontal diseases are significant health concerns in developing nations. This study assessed the impact of a comprehensive oral health education program on adolescent girls in rural Kenya. Eighty-seven girls aged 13-18 years attending school in rural Nanyuki, Kenya, were enrolled in the study. The comprehensive program included personalized oral hygiene training, education and health advocacy coaching. Dental caries, gingival inflammation and dental plaque biofilm were assessed at baseline, 1- and 2.5-year post-implementation. The intervention was highly effective in arresting pre-existing carious lesions and preventing the formation of new ones in this population. The data revealed that there was a significant remineralization of incipient caries lesion, as shown by decreases in modified ICCMS™ scores from baseline to 1-year post-implementation. From baseline to the 2.5-year post-implementation assessment, only six new carious lesions developed. Dental plaque biofilm was reduced by 83.6%, and gingival inflammation was reduced by 81.6%. A comprehensive oral health program, which included behavioural awareness and educational approaches, resulted in significant positive oral health outcomes in caries, dental plaque biofilm and gingival inflammation.

Sexual and reproductive health service utilization among adolescent girls in Kenya: A cross-sectional analysis.

We examined the association between adolescents' sexual and reproductive health (SRH) service utilization in the past 12 months and structural, health facility, community, interpersonal, and individual level factors in Kenya. This cross-sectional analysis used baseline data collected in Homa Bay and Narok counties as part of the In Their Hands intervention evaluation from September to October 2018. In total, 1840 adolescent girls aged 15 to 19 years were recruited to complete a baseline survey. We used unadjusted and adjusted logistic regression to model factors associated with SRH utilization across the social-ecological framework levels. Overall, 36% of participants reported visiting a health facility for SRH services in the past 12 months. At the structural level being out-of-school (AOR: 2.12 95% CI: 1.60-2.82) and not needing to get permission to go (AOR: 1.37 95%CI: 1.04-1.82) were associated with SRH service utilization. At the interpersonal level, participants who reported being able to ask adults for help when they needed it were more likely to report using SRH services in the past 12 months (AOR: 1.98, 95% CI: 1.09-3.78). At the individual level, having knowledge about where to obtain family planning (AOR = 2.48 95% CI: 1.74-3.57) and receiving information on SRH services in the past year (AOR: 1.44 95% CI:1.15-1.80) were associated with SRH service utilization. Our findings demonstrate the need for interventions, policies, and practices to be implemented across structural, health facility, community, interpersonal, and individual levels to comprehensively support adolescent girls to access and use SRH services.

An exploratory investigation into the factors related to EdTech use among Kenyan girls

AbstractThis paper contributes to the scarce literature on factors affecting EdTech use in households. These factors were considered through exploratory mixed‐methods analyses of cross‐sectional data on Kenyan girls and caregivers, captured during the COVID‐19 pandemic. Quantitative analysis of the child dataset (n = 544) suggested the importance of both structural factors—such as technology hardware availability—and non‐structural factors—including caregiver permission. Findings were supported by a thematic analysis of interview data from girls' caregivers (n = 58), which emphasised the role they play in girls' use of EdTech. Interviews also highlighted numerous caregiver concerns with EdTech, related to the relevance and rigour of educational content, the possibility of children accessing age‐inappropriate material and child health (especially eyesight). Policy makers could alleviate these concerns by providing guidance on EdTech use and clearly signalling their approval of verified initiatives. Practitioner notesWhat is already known about this topic EdTech can benefit girls' education, yet there are various barriers to it being used. Existing research shows clearly that EdTech use can be impeded by structural factors (eg, hardware ownership). However, we find insufficient empirical evidence on the role of non‐structural or behavioural factors. What this paper adds This paper addresses this gap, using a mixed‐methods approach to explore the influence of 33 different measures (including non‐structural factors) that could affect the number of hours girls spend using EdTech at home. Findings from a quantitative sample of girls (n = 544) and a qualitative sample of girls' caregivers (n = 58) highlighted the importance of non‐structural factors, especially caregiver permission. The variable most strongly associated with girls' EdTech usage in our selected quantitative model concerned whether this was sanctioned by their caregivers. Our qualitative data suggested why caregiver permission to use EdTech might be withheld: caregivers emphasised perceived concerns about the risks and rigour of EdTech. Implications for practice and/or policy Our findings suggest the viability of policy interventions that provide EdTech guidance to caregivers. Caregivers uncertain about EdTech could be reassured of the appropriateness of verified initiatives, while those already convinced might be aided in their attempts to support EdTech learning. Such guidance could provide a low‐cost means of further exploiting the benefits that household EdTech learning can provide.

Robust Designs for Prospective Randomized Trials Surveying Sensitive Topics.

We consider the problem of designing a prospective randomized trial in which the outcome data will be self-reported and will involve sensitive topics. Our interest is in how a researcher can adequately power her study when some respondents misreport the binary outcome of interest. To correct the power calculations, we first obtain expressions for the bias and variance induced by misreporting. We model the problem by assuming each individual in our study is a member of one "reporting class": a true-reporter, false-reporter, never-reporter, or always-reporter. We show that the joint distribution of reporting classes and "response classes" (characterizing individuals' response to the treatment) will exactly define the error terms for our causal estimate. We propose a novel procedure for determining adequate sample sizes under the worst-case power corresponding to a given level of misreporting. Our problem is motivated by prior experience implementing a randomized controlled trial of a sexual-violence prevention program among adolescent girls in Kenya.

School attendance and sexual and reproductive health outcomes among adolescent girls in Kenya: a cross-sectional analysis

BackgroundGiven the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties.MethodsThis study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15–19 years participated in the baseline survey, of which 1810 were included in the present analysis. Multivariable logistic regression models were used to assess the association between school attendance (in- versus out-of-school) and ever having sex, condom use during last sex, and ever pregnant, controlling for age, orphan status, income generation, religion, county, relationship status, and correct SRH knowledge.ResultsAcross the 1810 participants included in our study, 61.3% were in-school and 38.7% were out-of-school. Compared to adolescent girls who were in-school, those out-of-school were more likely (AOR 5.74 95% CI 3.94, 8.46) to report ever having sex, less likely (AOR: 0.21, 95% CI 0.16, 0.31) to have used a condom during their last sexual intercourse, and more likely (AOR: 6.98, 95% CI 5.04, 9.74) to have ever been pregnant.ConclusionsSchool attendance plays an integral role in adolescent girls’ SRH outcomes, and it is imperative that policy actors coordinate with the government and community to develop and implement initiatives that support adolescent girls’ school attendance and education.

Girls in Kenya's Juvenile Detention System: Recommendations for Abolition and Reform

Girls in Kenya's Juvenile Detention System: Recommendations for Abolition and Reform

How the Global Violence Against Children and Youth Surveys Help Improve Pediatric Global Health.

How the Global Violence Against Children and Youth Surveys Help Improve Pediatric Global Health.

Rafiki

Rafiki

Failing the rights: sexual vulnerability, access to services and barriers to contraceptives among adolescents in Narok County, Kenya

Purpose Around one in five girls in Kenya, aged 15 to 19 years old are either pregnant or have given birth. Of 47 counties, adolescent pregnancy is highest in Narok, where about 40% of girls aged 15 to 19 years old have begun childbearing. This study aims to explore drivers to sexual activity, access to sexual and reproductive health (SRH) services and barriers to contraceptive use among adolescents in Narok County, Kenya to inform the design of SRH interventions and safeguard young people’s rights to sexual health. Design/methodology/approach A cross-sectional mixed methods study was conducted in December 2019. Quantitative data were collected through structured questionnaires among girls aged 15 to 19 years old who were either pregnant or had given birth and those who had not and boys aged 15 to 19 years old. Qualitative data were collected through focus group discussions with adolescent girls and boys and through structured key informant interviews with parents, community leaders and health workers. Findings The mean age at first sexual intercourse for both genders was 15 years. While the majority of girls and boys knew where to access SRH services, few used contraception during their last sexual activity. There was no significant difference in the condom or other contraceptive methods use between girls who had begun child bearing and those who had not (p = 0.549 and p = 0.563, respectively). Key drivers for sexual activity among young people were poverty and peer pressure. Cultural practices such as female genital mutilation and early marriage contributed to early sex. Community attitudes toward contraception discouraged young people from taking up contraceptives. Originality/value This mixed methods study explores the drivers of adolescent pregnancy in Narok, Kenya, the county with the highest rates of adolescent pregnancy; twice the national pregnancy rates. Understanding the drivers of pregnancy and the underlying human rights violations will help policymakers and health leaders to design interventions which will improve outcomes.

The impact of Menstrual Hygiene Management and gender on psychosocial outcomes for adolescent girls in Kenya

ABSTRACT This research measures the psychosocial impact of a Menstrual Hygiene Management (MHM) program in Kenya by assessing change in self-efficacy, authenticity, and hope in adolescent girls. Trained researchers administered baseline and end-line assessments, 16 weeks apart, to 311 participants in the Always Keeping Girls in School Program. The schools were assigned to one of three program versions: only period products, only menstrual health education, or both menstrual health education and period products; in all-girls or coed classes. When girls received MHM education and pads in coed classes, there was no change in their self-efficacy or hope scores, but in all-girls classes, self-efficacy and hope scores significantly increased. Authenticity in girls decreased in coed classes unless period products were distributed, and then girl’s authenticity scores increased. The role of gender in assessing change in self-efficacy, authenticity and hope has provided a useful frame for evaluating MHM programming.

Pre-pandemic Influences on Kenyan Girls’ Transitions to Adulthood during COVID-19

COVID-19 containment measures have left adolescent girls in Nairobi, Kenya vulnerable to negative educational, economic, and secondary health outcomes that threaten their safe transitions into adulthood. In June 2020, the Population Council conducted phone-based surveys with 856 girls aged between 10 and 19 in 5 informal settlements who had been surveyed prior to COVID-19 as part of five longitudinal studies. We performed bivariate and multivariable logistic regression analyses to assess the relationship between COVID-19 outcomes and potential protective or risk factors. We found that younger girls are experiencing high levels of food insecurity and difficulty learning from home during school closures, while many older girls face the immediate risk of dropping out of school permanently and have been forgoing needed health services.