Young People In Kenya Research Articles

Development of a Child-Informed Measure of Subjective Well-Being for Research on Residential Care Institutions and Their Alternatives in Low- and Middle-Income Countries

Abstract10% of children worldwide live in households without a biological parent, and 5.4 million children live in residential care institutions. This study describes a participatory, child-informed process of developing a multidimensional measure of child subjective well-being tailored towards the priorities of children who have lived in residential care. Eight focus groups were held with n = 49 adolescents reunified with family after living in residential care in Kenya and Guatemala and six focus groups were held with n = 29 young adults who had lived in residential care during childhood. After analysis of the focus groups, and using the Orphans and Vulnerable Children Wellbeing Tool as a foundation, the resulting tool contained 43 survey questions. Member checking, translation, and cognitive interviewing were conducted. The survey was administered to N = 180 young people in Kenya and Guatemala who were reunified with family after living in residential care or at risk of entering residential care. Exploratory factor analysis indicated that the measure had three salient factors with good convergent validity and internal consistency: care and safety (12 items), basic needs (13 items), and leisure and freedom (7 items). This study contributes a new, psychometrically validated survey measure that can be used to assess the well-being of children connected to residential care, as well as a replicable model for creating contextualized quantitative measures via child participation that can inform policymaking on children’s care in low- and middle-income countries.

Voices from the Youth in Kenya Addressing Mental Health Gaps and Recommendations.

Studies including adolescents and young people (AYP) enhance the relevance of research results, benefit stakeholders, and inform future research. There exists a mental health gap in services for AYP living in low and middle-income countries. This study aims to identify mental health challenges faced by adolescents and young people in Kenya, develop practical recommendations to mitigate these issues, and reduce the mental health burden among this population. We convened an AYP-led meeting that involved 41 participants. The meeting objectives were to (1) identify efforts to support existing national and regional strategic priorities and review goals for addressing mental health needs among AYPs, (2) develop immediate action plans for strengthened mental health services, (3) review and strengthen country-level coordination mechanisms, and (4) identify how participating county experiences can inform mental health services in Kenya. Ministry of Health (MoH) officials from national and county levels, academic experts, and implementing partner agencies involved in mental health services participated in the meeting. The team, including AYP representatives, identified various mental health challenges among the AYA and recommended interventions aimed towards improving their mental health situation in the country. The challenges were clustered into three themes and comprehensively reviewed to establish the precipitating factors to mental health outcomes among AYPs in Kenya and provide recommendations. The themes included (1) legislative, (2) service provider/Ministry of Health, and (3) adolescent/individual-level factors. To bridge the mental health gap in the country and scale up mental health outcomes, the stakeholders recommended interventions within the context of the three clusters. The key suggestions included an increase in insurance financing, acceleration of community health interventions, the establishment of adolescent-friendly spaces, the training of adolescent youth champions, interactive service provision models, implementation of the existing mental health policies and structures, the development of comprehensive assessment tools, well equipped mental health departments in health facilities, the enhancement of telehealth services and digital villages, the mobilization of a functional mental health response team, and the development of a mental health database.

Facilitating Uptake of Post-abortion Contraception for Young People in Kenya.

Globally, maternal mortality is unacceptably high, and unsafe abortion is the most easily preventable cause of maternal death. Post-abortion contraception, recognized as a High Impact Practice in Family Planning, can reduce rates of unintended pregnancies and unsafe abortion and ultimately save lives. Implementation of this, however, is limited, especially for young people. This case study documents strategies, results, and lessons learned from Planned Parenthood Global's project in South West Kenya, which improved access to and provision of comprehensive abortion care, including safe abortion, post-abortion care and post-abortion contraception, at 80 public and private health facilities. By prioritizing training and mentorship of mid-level providers on both medical and surgical abortion care, post-abortion contraception and youth friendly services, in addition to community engagement and referrals, this intervention removes common barriers to care for women and young people. Eighty-five percent of abortion care clients served by the project accepted same-day contraception, with the vast majority—including 90% of clients aged 24 and under—choosing long-acting reversible contraception. The Closing the Gap project was funded by an anonymous donor.

Changes in prevalence of violence and risk factors for violence and HIV among children and young people in Kenya: a comparison of the 2010 and 2019 Kenya Violence Against Children and Youth Surveys

Previous research has shown a high prevalence of violence among young people in Kenya. Violence is a known risk factor for HIV acquisition and these two public health issues could be viewed as a syndemic. In 2010, Kenya became the third country to implement the Violence Against Children and Youth Survey (VACS). The study found a high prevalence of violence in the country. Led by the Government of Kenya, stakeholders implemented several prevention and response strategies to reduce violence. In 2019, Kenya implemented a second VACS. This study examines the changes in violence and risk factors for violence and HIV between 2010 and 2019. The 2010 and 2019 VACS used a similar sampling approach and measures. Both VACS were cross-sectional national household surveys of young people aged 13-24 years, designed to produce national estimates of physical, sexual, and emotional violence. Prevalence and changes in lifetime experiences of violence and risk factors for violence and HIV were estimated. The VACS uses a three-stage cluster sampling approach with random selection of enumeration areas as the first stage, households as the second stage, and an eligible participant from the selected household as the third stage. The VACS questionnaire contains sections on demographics, risk and protective factors, violence victimisation, violence perpetration, sexual behaviour, HIV testing and services, violence service knowledge and uptake, and health outcomes. For this study, the main outcome variables were violence victimisation, context of violence, and risk factors for violence. All analyses were done with the entire sample of 13-24-year-olds stratified by sex and survey year. The prevalence of lifetime sexual, physical, and emotional violence significantly declined in 2019 compared with 2010, including unwanted sexual touching, for both females and males. Experience of pressured and forced sex among females also decreased between the surveys. Additionally, significantly more females sought and received services for sexual violence and significantly more males knew of a place to seek help in 2019 than in 2010. The prevalence of several risk factors for violence and HIV also declined, including infrequent condom use, endorsement of inequitable gender norms, endorsement of norms justifying wife beating, and never testing for HIV. Kenya observed significant declines in the prevalence of lifetime violence and some risk factors for violence and HIV, and improvements in some service seeking indicators between 2010 and 2019. Continued prioritisation of preventing and responding to violence in Kenya could contribute to further reductions in violence and its negative outcomes. Other countries in the region that have made substantial investments and implemented similar violence prevention programmes could use repeat VACS data to monitor violence and related outcomes over time. None.

What is News? A Young Peoples’ Perspective in Kenya

ABSTRACT This study investigates emerging news consumption patterns among a contingent of young people drawn from two public universities in Kenya. Guided by the relatively new concept of scalable sociality and emerging third wave of non-normative audience studies in sub-Saharan Africa, this study maps emerging news exposure avenues among young people in Kenya. Through a mixed approach, it specifically explores how young people access and consume news through internet-enabled mobile devices. It also probes how young people define news and draws a nexus between the rise of news technologies, particularly mobile phones and the shifting definition(s) of news. Findings support the conclusion that internet-enabled mobile devices continue to cause unprecedented disruption in Kenya. This has profoundly altered the understanding of news. News was mainly understood as a node that connects young people to themselves and to the social world. However, the ambivalence evident in young people’s conceptualization of news is reflective of the dynamic society within which the internet and mobile devices are critical catalysts in accessing and consuming news. News consumption thus becomes a complex, multilayered process enmeshed in a web of technical and social networks online and offline.

‘Respect’ and ‘justice’ for whom? Culturally irresponsive ethical practices with refugee communities

This article explores how two common social work ethical principles, respect for persons and justice, are understood by refugee young people aged 18–30 years old in Kenya. Through 31 semi-structured, in-depth interviews with refugee young people who had previously participated in academic and/or organization-based qualitative research, this article explores how this group conceptualizes research ethics. The analysis suggests that refugee young people in Kenya did not necessarily feel that researchers were respectful. As such, the article claims that researchers must reconsider how Eurocentric social work and research ethics codes are understood globally.

High Acceptance and Completion of HIV Self-testing Among Diverse Populations of Young People in Kenya Using a Community-Based Distribution Strategy.

Oral HIV self-testing (HIVST) may expand access to testing among hard-to-reach reach adolescents and young adults (AYA). We evaluated community-based HIVST services for AYA in an urban settlement in Kenya. Peer-mobilizers recruited AYA ages 15–24 through homes, bars/clubs, and pharmacies. Participants were offered oral HIVST, optional assistance and post-test counseling. Outcomes were HIVST acceptance and completion (self-report and returned kits). Surveys were given at enrollment, post-testing, and 4 months. Log-binomial regression evaluated HIVST preferences by venue. Among 315 reached, 87% enrolled. HIVST acceptance was higher in bars/clubs (94%) than homes (86%) or pharmacies (75%). HIVST completion was 97%, with one confirmed positive result. Participants wanted future HIVST at multiple locations, include PrEP, and cost ≤ $5USD. Participants from bars/clubs and pharmacies were more likely to prefer unassisted testing and peer-distributers compared to participants from homes. This differentiated community-based HIVST strategy could facilitate engagement in HIV testing and prevention among AYA.

Positive and Healthy Living Program Manual Development for Young People Living With HIV at the Comprehensive Care Center at the Kenyatta National Hospital: An Open Pilot Implementation Trial.

Background: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a great challenge among young people in Kenya. Young people living with HIV are faced with a lot of challenges that are often overlooked and may have an impact on their treatment adherence and overall well-being. This calls for interventions that are age-appropriate and which tap into the psychosocial problems they experience. This is a protocol of a proposed study aimed at developing a facilitator-led peer support manual called the “Positive and Healthy Living Program” that will be the basis for running support groups with young people at the Comprehensive Care Center (CCC) at the Kenyatta National Hospital (KNH).Methods: We will carry out our study in two phases. The first phase will focus on the development of the manual and training of peer-facilitators. The second phase will make use of a pilot trial research design using both qualitative and quantitative approaches. It will be carried out among 10–24 year-olds attending CCC at KNH, and will consist of three groups: Tumaini Group (10–14 years), Amani Group (15–19 years), and Hodari Group (20–24 years). The groups will participate in an eight-session support group, whose activities will focus on four domains: social-recreation, psychotherapy, peer-modeling, and psychoeducation. Quantitative data will be collected using laboratory measures of Viral Load and CD4 as well as socio-psychological assessment tools. Qualitative data will be collected through interviews with the young people and peer facilitators. We will conduct a descriptive analysis which will describe the key features of the dataset and bivariate analyses will examine the association between variables. The change will be measured at baseline and post-treatment. The interviews will be coded into themes and we will generate experiential categories from the data around the effectiveness of the program, the peer facilitators' experience of providing support, how the young people respond to the program, and its influence on their overall well-being.Discussion: We expect that the peer facilitators will find this manualized treatment acceptable and the eight-sessions group intervention will be feasible for the three age groups. We hypothesize that there will be improvements detected with regards to reported adherence and viral load, self-esteem, depression, and psychological functioning.

Bleeding Bodies, Untrustworthy Bodies: A Social Constructionist Approach to Health and Wellbeing of Young People in Kenya.

The Sustainable Development Goals provide a global development agenda that is meant to be inclusive of all people. However, the development needs for vulnerable populations such as youth are not reflected within the policy agenda of some developing countries. One of the reasons for this is that research that explores health and wellbeing concerns for young people are sparse in the region and where they exist, the focus has been on marginalized subgroups. To address this gap, this cross-sectional study explored the health and wellbeing of youth in Kenya. We conducted 10 focus group discussions and 14 in-depth interviews with youth ages 15 to 24 years. A thematic analysis of the data revealed that structural factors are important influencers of youth perceptions and their social constructions of health and wellbeing. Kenyan youth are concerned about the health status and healthcare services in their communities, as well as issues of community trust of youths and perceived risks of political misuse and emotional suffering. Our findings suggest that youth transitioning into adulthood in resource-constrained areas experience feelings of powerlessness and inability to take charge over their own life. This impacts how they perceive and socially construct health and wellbeing.

"What is the best method of family planning for me?": a text mining analysis of messages between users and agents of a digital health service in Kenya

Background: Text message-based interventions have been shown to have consistently positive effects on health improvement and behavior change. Some studies suggest that personalization, tailoring, and interactivity can increase efficacy. With the rise in artificial intelligence and its incorporation into interventions, there is an opportunity to rethink how these characteristics are designed for greater effect. A key step in this process is to better understand how users engage with interventions. In this paper, we apply a text mining approach to characterize the ways that Kenyan men and women communicated with the first iterations of askNivi, a free sexual and reproductive health information service. Methods: We tokenized and processed more than 179,000 anonymized messages that users exchanged with live agents, enabling us to count word frequency overall, by sex, and by age/sex cohorts. We also conducted two manual coding exercises: (1) We manually classified the intent of 3,834 user messages in a training dataset; and (2) We manually coded all conversations between a random subset of 100 users who engaged in extended chats. Results: Between September 2017 and January 2019, 28,021 users (mean age 22.5 years, 63% female) sent 87,180 messages to askNivi, and 18 agents sent 92,429 replies. Users wrote most often about family planning methods, contraception, side effects, pregnancy, menstruation, and sex, but we observed different patterns by sex and age. User intents largely reflected the marketing focus on reproductive health, but other topics emerged. Most users sought factual information, but requests for advice and symptom reports were common. Conclusions: Young people in Kenya have a great desire for accurate and reliable information on health and wellbeing, which is easy to access and trustworthy. Text mining is one way to better understand how users engage with interventions like askNivi and maximize what artificial intelligence has to offer.

"What is the best method of family planning for me?": a text mining analysis of messages between users and agents of a digital health service in Kenya.

Background: Text message-based interventions have been shown to have consistently positive effects on health improvement and behavior change. Some studies suggest that personalization, tailoring, and interactivity can increase efficacy. With the rise in artificial intelligence and its incorporation into interventions, there is an opportunity to rethink how these characteristics are designed for greater effect. A key step in this process is to better understand how users engage with interventions. In this paper, we apply a text mining approach to characterize the ways that Kenyan men and women communicated with the first iterations of askNivi, a free sexual and reproductive health information service. Methods: We tokenized and processed more than 179,000 anonymized messages that users exchanged with live agents, enabling us to count word frequency overall, by sex, and by age/sex cohorts. We also conducted two manual coding exercises: (1) We manually classified the intent of 3,834 user messages in a training dataset; and (2) We manually coded all conversations between a random subset of 100 users who engaged in extended chats. Results: Between September 2017 and January 2019, 28,021 users (mean age 22.5 years, 63% female) sent 87,180 messages to askNivi, and 18 agents sent 92,429 replies. Users wrote most often about family planning methods, contraception, side effects, pregnancy, menstruation, and sex, but we observed different patterns by sex and age. User intents largely reflected the marketing focus on reproductive health, but other topics emerged. Most users sought factual information, but requests for advice and symptom reports were common. Conclusions: Young people in Kenya have a great desire for accurate and reliable information on health and wellbeing, which is easy to access and trustworthy. Text mining is one way to better understand how users engage with interventions like askNivi and maximize what artificial intelligence has to offer.

Attributions and private theories of mental illness among young adults seeking psychiatric treatment in Nairobi: an interpretive phenomenological analysis

BackgroundMental illness affects every segment of population including young adults. The beliefs held by young patients regarding the causes of mental illness impact their treatment-seeking behaviour. It is pertinent to know the commonly held attributions around mental illness so as to effectively provide psychological care, especially in a resource constrained context such as Kenya. This helps in targeting services around issues such as stigma and extending youth-friendly services.MethodsGuided by the private theories interview (PTI-P) and attributional framework, individual semi-structured interviews were carried out with ten young adults of ages 18–25 years about their mental health condition for which they were undergoing treatment. Each interview took 30–45 min. We mapped four attributions (locus of control, stability, controllability and stigma) on PTI-P questions. Data was transcribed verbatim to produce transcripts coded using interpretive phenomenological analysis. These codes were then broken down into categories that could be used to understand various attributions.ResultsWe found PTI-P to be a useful tool and it elicited three key themes: (a) psychosocial triggers of distress (with themes of negative thoughts, emotions around mental health stigma and negative childhood experiences, parents’ separation or divorce, death of a loved one etc.), (b) biological conditions and psychopathologies limiting intervention, and (c) preferences and views on treatment. Mapping these themes on our attributional framework, PTI-P themes presented as causal attributions explaining stigma, locus of control dimensions and stability. External factors were mainly ascribed to be the cause of unstable and uncontrollable attributions including persistent negative emotions and thoughts further exacerbating psychological distress. Nine out of the ten participants expressed the need for more intense and supportive therapy.ConclusionOur study has provided some experiential evidence in understanding how stigma, internal vs external locus of control, stability vs instability attributions play a role in shaping attitudes young people have towards their mental health. Our study points to psychosocial challenges such as stigma, poverty and lack of social support that continue to undermine mental well-being of Kenyan youth. These factors need to be considered when addressing mental health needs of young people in Kenya.

Social media, youth and everyday life in Kenya

Abstract With an increasing accessibility of smartphones and mobile Internet, social media are becoming an integral part of everyday life for young people in Kenya. The use of new social media tools like Facebook, Twitter and WhatsApp is quickly changing in the country. Previous research on new media, however, indicates socio-demographic differences in the access, appropriation and use of new technologies. This article aims at advancing our understanding of how young people in developing countries are appropriating and using new social media platforms. It examines the multiple ways in which young people in Kenya use social media platforms and how they use these new spaces to connect, interact, communicate and engage on different issues. The article argues that the new social media configurations are invariably making possible access to alternative spaces, relatively ‘free’ from mainstream communication platforms. These changes have implications on different aspects of social change processes such as sociocultural and socio-economic changes in the Kenya.

The Sheng Identity, Cultural Background and Their Influence on Communication in Academic Endevours: The Case of Machakos University College

Young people in Kenya want to be identified with Sheng and some, in addition, want to be identified with their cultures. Sheng is a slang language originating in Nairobi, Kenya, spoken by the youth all over the country. It is a mixture of several languages, mainly English, Kiswahili and Kenyan languages. It is coined in the eastern part of the city. Youths from other parts of the country also come up with their own vocabulary which may be at variance with this Sheng. At Machakos University College there are various types of Sheng used which become a hindrance in the communication process between the students themselves and in academic discourse.Cultural background, which is manifested in incorrect pronunciations, coupled with dissimilar interpretations of the varieties of sheng also affects communication in academic discourse.The objectives of this study are designed to answer the question of whether the use of Sheng and the cultural background of the students have an impact on communication between the lecturer and the students and among students themselves.Purposive sampling will be used to get the respondents. Qualitative methods will be used to analyze the data.The findings of the study will be used to come up with a way of mitigating so as to improve communication in academic discourse.In conclusion, this study purposes to establish the fact that it’s not just Sheng but the various types of Sheng used and that each individual wants to identify with their type, so these types can affect communication in academic discourse. The potential impact of conducting this research is to improve communication in academic discourse.

Effects of a Large-Scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya

Effects of a Large-Scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya

Effects of a Large-Scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya

PurposeThis study investigates the causal effect of Kenya's unconditional cash transfer program on mental health outcomes of young people. MethodsSelected locations in Kenya were randomly assigned to receive unconditional cash transfers in the first phase of Kenya's Cash Transfer Program for orphans and Vulnerable Children. In intervention locations, low-income households and those with orphans and vulnerable childrens began receiving monthly cash transfers of $20 in 2007. In 2011, 4 years after program onset, data were collected on the psychosocial status for youth aged 15–24 years from households in intervention and control locations (N = 1960). The primary outcome variable was an indicator of depressive symptoms using the 10-question Center for Epidemiologic Studies Depression Scale. Secondary outcomes include an indicator for hopefulness and physical health measures. Logistic regression models that adjusted for individual and household characteristics were used to determine the effect of the cash transfer program. ResultsThe cash transfer reduced the odds of depressive symptoms by 24 percent among young persons living in households that received cash transfers. Further analysis by gender and age revealed that the effects were only significant for young men and were larger among men aged 20–24 years and orphans. ConclusionsThis study provides evidence that poverty-targeted unconditional cash transfer programs, can improve the mental health of young people in low-income countries.

Music listening in families and peer groups: benefits for young people's social cohesion and emotional well-being across four cultures.

Families are central to the social and emotional development of youth, and most families engage in musical activities together, such as listening to music or talking about their favorite songs. However, empirical evidence of the positive effects of musical family rituals on social cohesion and emotional well-being is scarce. Furthermore, the role of culture in the shaping of musical family rituals and their psychological benefits has been neglected entirely. This paper investigates musical rituals in families and in peer groups (as an important secondary socialization context) in two traditional/collectivistic and two secular/individualistic cultures, and across two developmental stages (adolescence vs. young adulthood). Based on cross-sectional data from 760 young people in Kenya, the Philippines, New Zealand, and Germany, our study revealed that across cultures music listening in families and in peer groups contributes to family and peer cohesion, respectively. Furthermore, the direct contribution of music in peer groups on well-being appears across cultural contexts, whereas musical family rituals affect emotional well-being in more traditional/collectivistic contexts. Developmental analyses show that musical family rituals are consistently and strongly related to family cohesion across developmental stages, whereas musical rituals in peer groups appear more dependent on the developmental stage (in interaction with culture). Contributing to developmental as well as cross-cultural psychology, this research elucidated musical rituals and their positive effects on the emotional and social development of young people across cultures. The implications for future research and family interventions are discussed.

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

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.

There are some questions you may not ask in a clinic: Providing contraception information to young people in Kenya using SMS

ObjectiveTo evaluate the acceptability, information access, and potential behavioral impact of providing contraception information via text message on mobile phones to young people in Kenya. MethodsThree methods of data collection were implemented during the 17-month pilot period for the Mobile for Reproductive Health (m4RH) program in Kenya: automatic logging of all queries to the m4RH system; demographic and behavior change questions sent via short message service protocol (SMS) to everyone who used m4RH during the pilot period; and telephone interviews with a subset of m4RH users. ResultsDuring the pilot period, 4817 unique users accessed m4RH in Kenya. Of these, 82% were 29years of age and younger, and 36% were male. Condom and natural family-planning information was accessed most frequently, although users queried all methods. One in 5 used the m4RH system to locate nearby clinics. Respondents liked the simple language and confidentiality of receiving health information via mobile phone, and reported increased contraceptive knowledge and use after using m4RH. ConclusionProviding contraception information via mobile phone is an effective strategy for reaching young people. More research is needed to learn how to link young people to youth-friendly services effectively.

Policy scripts and students' realities regarding sexuality education in secondary schools in Kenya

This paper explores the sexual and reproductive health (SRH) policy context and the realities facing in-school young people in Kenya. It is based on a review of the health and education sector policy documents as well as data from self-administered questionnaires with 3624 male and female students from eight secondary schools in Nairobi. Findings show that although the policies emphasise the right to access accurate SRH information, there are restrictions on the content of messages that can be provided to in-school young people. At the same time, students continue to be exposed to the risks of undesired SRH outcomes and quest for comprehensive SRH information. The findings suggest that as policy-makers, parents, teachers, civil and faith-based organisations debate about the value and content of sexuality education in schools, it is important to consider the views and experiences of students who are the intended beneficiaries of such education.