Adolescent Reproductive Health: 2005 -2008
An outcome assessment of an ABC-based HIV peer education
intervention among Kenyan university students.
Author:
Miller AN; Mutungi M; Facchini E; Barasa B; Ondieki W
Source:
Journal of Health Communication. 2008 Jun;13(4):345-356.
Abstract:
This study reports an outcome assessment on an HIV peer education
intervention at the main campus of Kenyatta University in Nairobi,
Kenya. A quasi-experimental separate sample pretest-posttest design was
used. Campus-wide baseline and end line surveys were conducted with
632 and 746 students, respectively, soliciting information on HIV-related
knowledge, attitudes, and behavior. After 2 years of on-campus
intervention, no changes in behavior were evident with respect to either
abstinence or number of sexual partners. Small but statistically significant
changes were found in condom attitudes and behavior, and a large
increase in HIV testing was evident. It is recommended that future
research more specifically compare abstinence versus multiple option
peer education programs, giving special attention to the role of peer
educators as models. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | PRE-POST TESTS | STUDENTS |
HIV PREVENTION | PEER EDUCATORS | INTERVENTIONS |
PROGRAM EVALUATION | PROGRAM EFFECTIVENESS | HIV
TESTING | CONDOM USE | BEHAVIOR CHANGE | ABSTINENCE
| MULTIPLE PARTNERS | DEVELOPING COUNTRIES | AFRICA,
EASTERN | AFRICA, SUB SAHARAN | AFRICA | PROGRAMS |
ORGANIZATION AND ADMINISTRATION | EDUCATION | HIV
INFECTIONS | VIRAL DISEASES | DISEASES | LABORATORY
EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND
DIAGNOSES | MEDICAL PROCEDURES | MEDICINE | HEALTH
SERVICES | DELIVERY OF HEALTH CARE | HEALTH | RISK
REDUCTION BEHAVIOR | BEHAVIOR | FAMILY PLANNING,
BEHAVIORAL METHODS | FAMILY PLANNING | SEXUAL
PARTNERS | SEX BEHAVIOR
Document Number: 327076
1
Adolescent Reproductive Health: 2005 -2008
Effectiveness of web-based education on Kenyan and Brazilian
adolescents’ knowledge about HIV/AIDS, abortion law, and
emergency contraception: Findings from Teen Web.
Author:
Halpern CT; Mitchell EM; Farhat T; Bardsley P
Source:
Social Science and Medicine. 2008 Aug;67(4):628-637.
Abstract:
Little evidence is available about the utility of web-based health
education for students in low resource settings. This paper reports results
from an evaluation of the Teen Web project, a multi-year, web-based
health education intervention implemented in two urban settings:
Nairobi, Kenya (N = 1178 school students) and Rio de Janeiro, Brazil (N=
714 school students). A quasi-experimental, school-based pre-test/posttest design was implemented at each study site to determine if easy access
to web-based reproductive health information, combined with
intellectual "priming" about reproductive health topics, would result in
improved knowledge and attitudes about topics such as condom use,
access to HIV testing, emergency contraception and abortion laws.
Students in web-access schools completed one web-based module
approximately every 6-8 weeks, and in return, had access to the Internet
for at least 30 min after completing each module. Although students were
encouraged to access project-supplied web-based health information,
freedom of web navigation was an incentive, so they could choose to
access other Internet content instead. Most measures showed statistically
significant differences between students in "web" and "comparison"
conditions at post-test, but only about half of the differences were in the
hypothesized direction. Results of an embedded experiment employing
more directed feedback tripled the likelihood of correctly reporting the
duration of emergency contraception effectiveness. Review of URL logs
suggests that the modest results were due to inadequate exposure to
educational materials. Future intervention should focus on teen's
purposeful searching for health information when they are in personal
circumstances of unmet health needs. (author's)
Language:
English
Keywords:
KENYA | BRAZIL | RESEARCH REPORT | PROGRAM
EVALUATION | PRE-POST TESTS | ADOLESCENTS | STUDENTS
| INTERVENTIONS | SCHOOL-BASED SERVICES | HEALTH
EDUCATION | SEX EDUCATION | REPRODUCTIVE HEALTH |
CONDOM USE | EMERGENCY CONTRACEPTION | COMPUTERS
| TECHNOLOGY | INTERNET | PROGRAM EFFECTIVENESS |
DEVELOPING COUNTRIES | AFRICA, EASTERN | AFRICA, SUB
SAHARAN | AFRICA | SOUTH AMERICA, EASTERN | SOUTH
AMERICA | LATIN AMERICA | AMERICAS | PROGRAMS |
2
Adolescent Reproductive Health: 2005 -2008
ORGANIZATION AND ADMINISTRATION | YOUTH | AGE
FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC
FACTORS | POPULATION | EDUCATION | HEALTH | RISK
REDUCTION BEHAVIOR | BEHAVIOR | CONTRACEPTION |
FAMILY PLANNING | INFORMATION PROCESSING |
INFORMATION | ECONOMIC FACTORS | INFORMATION
NETWORKS | COMMUNICATION
Document Number: 327535
Factors associated with risky sexual behaviour among out-of-school
youth in Kenya.
Author:
Khasakhala AA; Mturi AJ
Source:
Journal of Biosocial Science. 2008 Sep;50(5):641-653.
Abstract:
This paper examines factors that may predispose unmarried and
unemployed out-of-school youth to risky sexual behaviour. Data for
analysis were derived from the Behaviour Surveillance Survey carried out
in Kenya in late 2002. A total of 6129 male and female unmarried and
unemployed out-of-school youth in the age range 15-24 years were
successfully interviewed. However, for this paper only a sample of 3961
comprising sexually experienced youth in the 12 months preceding the
survey was used. Methods of analysis included descriptive statistics and
multinomial logistic regression. Results for males indicate that factors
associated with low and high risk were whether they had fathered a
child, district of residence and frequency of alcohol use, while current age
and age at first sexual debut stood out for those with low risk alone. For
females the district of residence and age of partner at sexual debut were
the factors that predisposed them to low-risk sexual behaviour, while for
high risk the district of residence, current age and ever being pregnant
were significant. The results indicate that for these youth, contextual and
probably social factors appear to be the main determinants of risky sexual
behaviour for both males and females. The findings also support those of
other studies that link risky sexual behaviour among youth, especially
males, to alcohol consumption. Programmes for intervention therefore
need to focus on these aspects. There is also a need for studies that can
look at district-specific factors for more focused interventions. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | DATA ANALYSIS | OUT-OFSCHOOL YOUTHS | UNMARRIED | SEX BEHAVIOR | ALCOHOL
USE AND ABUSE | INTERVENTIONS | AGE FACTORS |
3
Adolescent Reproductive Health: 2005 -2008
SOCIOECONOMIC FACTORS | DEVELOPING COUNTRIES |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
RESEARCH METHODOLOGY | EDUCATIONAL STATUS |
SOCIOECONOMIC STATUS | ECONOMIC FACTORS | MARITAL
STATUS | NUPTIALITY | DEMOGRAPHIC FACTORS |
POPULATION | BEHAVIOR | PROGRAMS | ORGANIZATION
AND ADMINISTRATION | POPULATION CHARACTERISTICS
Document Number: 324183
Youth in Kenya: health and HIV. 2003 Kenya Demographic and
Health Survey (2003 KDHS).
Author:
Kenya. Central Bureau of Statistics; Kenya. Ministry of Health; Kenya
Medical Research Institute; ORC Macro. MEASURE DHS
Source:
[Nairobi], Kenya, Central Bureau of Statistics, [2005]. 16 p.
Abstract:
Young people today face many health-related challenges. This report is
designed to help program managers, parents, church groups and other
people and organizations working with youth to understand some of
these challenges. Drawing from the most recent Kenya Demographic and
Health Survey, this report outlines the latest information about Kenya's
young people, age 15 to 24. The Demographic and Health Survey
collected data from more than 11,500 women and men nationwide
including more than 4,000 young women and men age 15-24. (excerpt)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH
SURVEYS | YOUTH | PERSONS LIVING WITH HIV/AIDS |
ADOLESCENT HEALTH | EDUCATION | EMPLOYMENT |
REPRODUCTIVE BEHAVIOR | DOMESTIC VIOLENCE | RISK
BEHAVIOR | CONTRACEPTIVE USAGE | AFRICA, EASTERN |
AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING
COUNTRIES | DEMOGRAPHIC SURVEYS | POPULATION
DYNAMICS | DEMOGRAPHIC FACTORS | POPULATION | AGE
FACTORS | POPULATION CHARACTERISTICS | HIV
INFECTIONS | VIRAL DISEASES | DISEASES | HEALTH |
MACROECONOMIC FACTORS | ECONOMIC FACTORS |
FERTILITY | CRIME | SOCIAL PROBLEMS | SOCIOCULTURAL
FACTORS | BEHAVIOR | CONTRACEPTION | FAMILY
PLANNING
4
Adolescent Reproductive Health: 2005 -2008
Document Number: 308353
Evaluating the Kenya Girl Guides Association's HIV / AIDS peer
education program for younger youth: baseline results.
Author:
Juma M; Mwaniki M; Muturi C
Source:
Nairobi, Kenya, Population Council, Horizons, 2005 Nov. [10] p.
(Horizons Research Update USAID Cooperative Agreement No. HRN-A00-97-00012-00)
Abstract:
In Kenya, like in many other African countries, it is estimated that half of
all new HIV infections occur among youth between the ages of 15 and 24
(CBS, MOH, and ORC Macro 2004; NASCOP 2003). However, many of
these individuals are much younger when they initiate sexual activity.
Survey data show that 13 percent of girls and 31 percent of boys have had
sex by age 15 (CBS, MOH, and ORC Macro 2004). Unfortunately, few
prevention programs exist to help younger youth, specifically those
between the ages of 10 and 14 years, to delay their sexual debut and
develop communication and relationship skills that will keep them
uninfected. In response to this need, the Kenya Girl Guide Association
(KGGA) and Family Health International (FHI)/Impact began a program,
which was developed by PATH, in 1999 to train young Girl Guides as
HIV peer educators in their schools. The project aims to improve
knowledge and skills related to HIV prevention and care among Girl
Guides and their peers. In collaboration with KGGA and FHI/Impact, the
Horizons Program is currently conducting a study to evaluate the
effectiveness of this intervention model in achieving the objectives of the
peer education program. This research update presents baseline findings
from the intervention study. (excerpt)
Language:
English
Keywords:
KENYA | EVALUATION REPORT | YOUTH | PEER EDUCATORS |
PERSONS LIVING WITH HIV/AIDS | ORGANIZATIONS | HIV
PREVENTION | HEALTH EDUCATION | SEXUALLY
TRANSMITTED DISEASE PREVENTION | BELIEFS |
KNOWLEDGE | SEX BEHAVIOR | AFRICA, EASTERN | AFRICA
SOUTH OF THE SAHARA | AFRICA | DEVELOPING COUNTRIES
| EVALUATION | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| EDUCATION | HIV INFECTIONS | VIRAL DISEASES |
DISEASES | POLITICAL FACTORS | SOCIOCULTURAL FACTORS
| SEXUALLY TRANSMITTED DISEASES | REPRODUCTIVE TRACT
INFECTIONS | INFECTIONS | CULTURE | BEHAVIOR
5
Adolescent Reproductive Health: 2005 -2008
Document Number: 307107
Fact sheet: Sobering facts on alcohol and teen pregnancy.
Author:
National Campaign to Prevent Teen Pregnancy
Source:
Washington, D.C., National Campaign to Prevent Teen Pregnancy, 2005
Oct. [1] p.
Abstract:
Teen sex combined with drug and/or alcohol use is increasing. Fully onequarter of sexually experienced high school aged teens say they used
alcohol and/or drugs the last time they had sex. The proportion of high
school aged teens who used drugs and/or alcohol the last time they had
sex has increased 18 percent----from 22% in 1991 to 25% in 2003. Lots of
teens drink. Many start drinking in junior high and get drunk often. More
than half of 8th graders and eight out of ten 12th graders have tried
alcohol. Nearly 1/3 of all high school seniors say that most or all of their
friends get drunk at least once a week. (excerpt)
Language:
English
Keywords:
UNITED STATES | PROGRESS REPORT | EPIDEMIOLOGIC
METHODS | ADOLESCENTS, FEMALE | ADOLESCENT
PREGNANCY | PREVENTION AND CONTROL | SEX BEHAVIOR |
RISK BEHAVIOR | CAMPAIGNS | ALCOHOL USE AND ABUSE |
DRUG USE AND ABUSE | NORTH AMERICA | AMERICAS |
DEVELOPED COUNTRIES | RESEARCH METHODOLOGY |
ADOLESCENTS | YOUTH | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| REPRODUCTIVE BEHAVIOR | FERTILITY | POPULATION
DYNAMICS | DISEASES | BEHAVIOR | COMMUNICATION
PROGRAMS | COMMUNICATION
Document Number: 306838
6
Adolescent Reproductive Health: 2005 -2008
Models of Care Project. Linking HIV/AIDS treatment, care and
support in sexual and reproductive health care settings: examples
in action.
Author:
International Planned Parenthood Federation [IPPF]; Deutsche
Gesellschaft fur Technische Zusammenarbeit [GTZ]
Source:
London, England, IPPF, 2005 Dec. 29 p.
Abstract:
IPPF wishes to showcase different models using a variety of entry points
to bring SRH closer to HIV/AIDS. The three types of examples in action
covered in this booklet use these entry points: Better linking of prevention
and care through providing ARVs and opportunistic infection (OI)
services (our case studies on the Dominican Republic, Kenya and
Rwanda); Working with and developing programmes to reach specific
populations (our case study on Colombia); Strengthening programming
to address HIV/AIDS vulnerability and young people (our youth course).
(excerpt)
Language:
English
Keywords:
DOMINICAN REPUBLIC | KENYA | RWANDA | COLOMBIA |
PROGRESS REPORT | PILOT PROJECTS | HIV PREVENTION |
AIDS PREVENTION | TREATMENT | CARE AND SUPPORT |
INTEGRATED PROGRAMS | REPRODUCTIVE HEALTH |
PROGRAM DEVELOPMENT | CARIBBEAN | AMERICAS |
DEVELOPING COUNTRIES | AFRICA, EASTERN | AFRICA
SOUTH OF THE SAHARA | AFRICA | AFRICA, CENTRAL |
SOUTH AMERICA, NORTHERN | SOUTH AMERICA | LATIN
AMERICA | STUDIES | RESEARCH METHODOLOGY | HIV
INFECTIONS | VIRAL DISEASES | DISEASES | AIDS | MEDICAL
PROCEDURES | MEDICINE | HEALTH SERVICES | DELIVERY OF
HEALTH CARE | HEALTH | PROGRAMS | ORGANIZATION AND
ADMINISTRATION
Document Number: 315097
Social scripts and stark realities: Kenyan adolescents' abortion
discourse.
Author:
Mitchell EM; Halpern CT; Kamathi EM; Owino S
Source:
Culture, Health and Sexuality. 2006 Nov-Dec;8(6):515-528.
7
Adolescent Reproductive Health: 2005 -2008
Abstract:
This study explores students' narratives and discourses about adolescent
pregnancy and abortion elicited via internet-based open-ended questions
posed in response to a cartoon vignette. We report on content analysis of
recommendations and strategies for how to manage the unplanned
pregnancy of a fictional young couple and in their own personal lives.
The responses of 614 young people were analysed. Strategies vary
widely. They include giving birth, adoption, running away, abortion,
denial, and postponement until discovery. Young people were also
queried about unplanned pregnancy resolution among their peers.
Discourse analysis reveals competing social scripts on abortion. Florid
condemnation of abortion acts in the hypothetical cases contrasts with
more frank and sober description of peers' real life abortion behaviour.
Students' language is compared with that found in official curricula. The
rhetorical devices, moralizing social scripts and dubious health claims
about abortion in students' online narratives mirror the tenor and content
of their academic curricula as well as Kenyan media presentation of the
issue. The need for factual information, dispassionate dialogue and
improved contraceptive access is considerable. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS
| STUDENTS | PEER GROUPS | ABORTION | INTERNET |
AUDIOVISUAL AIDS | PREGNANCY, UNPLANNED |
PERCEPTION | ATTITUDE | PEER PRESSURE | LANGUAGE |
MASS MEDIA | AFRICA, EASTERN | AFRICA, SUB SAHARAN |
AFRICA | DEVELOPING COUNTRIES | SURVEYS | SAMPLING
STUDIES | STUDIES | RESEARCH METHODOLOGY | YOUTH |
AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | EDUCATION |
KNOWLEDGE SOURCES | COMMUNICATION | FERTILITY
CONTROL, POSTCONCEPTION | FAMILY PLANNING |
INFORMATION NETWORKS | EDUCATIONAL TECHNICS |
EDUCATIONAL ACTIVITIES | REPRODUCTIVE BEHAVIOR |
FERTILITY | POPULATION DYNAMICS | PSYCHOLOGICAL
FACTORS | BEHAVIOR | PSYCHOSOCIAL FACTORS
Document Number: 310602
Condom use among sexually active Kenyan female adolescents at
risk for HIV-1 infection.
Author:
Cherutich P; Brentlinger P; Nduati R; Kiarie JN; Farquhar C
Source:
AIDS and Behavior. 2008
8
Adolescent Reproductive Health: 2005 -2008
Abstract:
High rates of unintended pregnancy and HIV infection occur in subSaharan Africa yet few Kenyan studies have defined correlates of condom
use in sexually active female adolescents. Female adolescents receiving
reproductive health care and aged 15-19 were interviewed. The
prevalence of ever-use of condom was 21.4% and 52 (7.3%) subjects were
infected with HIV-1. Older age, higher levels of education, ever-use of
hormonal contraceptives and higher numbers of sexual partners, nonconsensual sex and exchange of sex for favours, were independent
correlates of condom use. Condom use should be promoted in this
population. Further exploration is needed on the developmental and
contextual factors predisposing female adolescents to increased risk of
HIV.
Language:
English
Keywords:
KENYA | RESEARCH REPORT | SURVEYS | CROSS SECTIONAL
ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION |
SEX BEHAVIOR | CONDOM USE | PREVALENCE |
CORRELATION OF DATA | HIV INFECTIONS | RISK FACTORS |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
DEVELOPING COUNTRIES | SAMPLING STUDIES | STUDIES |
RESEARCH METHODOLOGY | ADOLESCENTS | YOUTH | AGE
FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC
FACTORS | POPULATION | BEHAVIOR | RISK REDUCTION
BEHAVIOR | MEASUREMENT | CORRELATION STUDIES |
STATISTICAL STUDIES | VIRAL DISEASES | DISEASES |
BIOLOGY
Document Number: 328121
Personal involvement of young people in HIV prevention
campaign messages: the role of message format, culture, and
gender.
Author:
Geary CW; Burke HM; Johnson L; Liku J; Castelnau L
Source:
Health Education and Behavior. 2008 April
Abstract:
To examine young people's reactions to and understanding of HIV
prevention messages developed for MTV's global HIV prevention
campaign Staying Alive, videotaped campaign materials were shown to
focus group discussion (FGD) participants living in urban areas of Brazil,
Kenya, Nepal, and Senegal. Responses related to "personal involvement"
with the message were identified in the data from these FGDs and were
9
Adolescent Reproductive Health: 2005 -2008
examined in relationship to the emerging message themes, the message
format (public service announcements [PSAs] vs. documentary), cultural
context (site), and participant gender. Across groups, greater personal
involvement (measured by personal connections, emotional reactions,
and lessons learned) was found in responses about the documentary
format compared to the PSA format. Exceptions were found for specific
PSAs that were considered more relevant within specific gender or
cultural contexts. Implications of findings for global campaigns were
considered.
Language:
English
Keywords:
BRAZIL | KENYA | NEPAL | SENEGAL | RESEARCH REPORT |
FOCUS GROUPS | PROGRAM EVALUATION | YOUTH | HIV
PREVENTION | AIDS | CONDOM USE | STIGMA | CAMPAIGNS
| TELEVISION SPOT | FILM AND VIDEO | ATTITUDE |
BEHAVIOR CHANGE COMMUNICATION | SOUTH AMERICA,
EASTERN | SOUTH AMERICA | LATIN AMERICA | AMERICAS |
DEVELOPING COUNTRIES | AFRICA, EASTERN | AFRICA, SUB
SAHARAN | AFRICA | ASIA, SOUTHERN | ASIA | AFRICA,
WESTERN | DATA COLLECTION | RESEARCH METHODOLOGY |
PROGRAMS | ORGANIZATION AND ADMINISTRATION | AGE
FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC
FACTORS | POPULATION | HIV INFECTIONS | VIRAL DISEASES
| DISEASES | RISK REDUCTION BEHAVIOR | BEHAVIOR |
SOCIAL PROBLEMS | SOCIO-CULTURAL FACTORS |
COMMUNICATION PROGRAMS | COMMUNICATION |
TELEVISION | BROADCAST MEDIA | MASS MEDIA |
PSYCHOLOGICAL FACTORS | BEHAVIOR CHANGE
Document Number: 325779
Multisectoral engagement increases support for youth RH.
Source:
Population Council. Frontiers in Reproductive Health
Washington, D.C., Population Council, Frontiers in Reproductive Health,
2007 May.
Abstract:
Collaboration among three key government ministries, communities, and
local institutions helped to mainstream adolescent reproductive health
activities in Kenya. Procedures and tools from the pilot project have been
expanded throughout the pilot province, into two further provinces, and
plans are in place to expand to an additional two provinces.
Language:
English
10
Adolescent Reproductive Health: 2005 -2008
Keywords:
KENYA | SUMMARY REPORT | PILOT PROJECTS |
ADOLESCENTS | STUDENTS | SECONDARY SCHOOLS |
SCHOOL-BASED SERVICES | AIDS PREVENTION |
REPRODUCTIVE HEALTH | SOCIAL MOBILIZATION | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
DEVELOPING COUNTRIES | STUDIES | RESEARCH
METHODOLOGY | YOUTH | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| EDUCATION | SCHOOLS | PROGRAMS | ORGANIZATION
AND ADMINISTRATION | AIDS | HIV INFECTIONS | VIRAL
DISEASES | DISEASES | HEALTH | SOCIAL CHANGE | SOCIOCULTURAL FACTORS
Document Number: 327076
Regarding "male and female circumcision associated with
prevalent HIV infection in virgins and adolescents in Kenya,
Lesotho, and Tanzania" [letter]
Author:
Adams J; Trinitapoli J; Poulin M
Source:
Annals of Epidemiology 2007 Nov
Abstract:
Brewer, Potterat, Roberts, and Brody (BPRB) provide the latest in a series
of papers encouraging researchers to explore nonsexual routes of human
immunodeficiency virus (HIV) transmission in sub-Saharan Africa (SSA).
Whereas recent findings demonstrate that circumcision provides a
substantial protective effect against contracting HIV, BPRB suggest
tempering the enthusiasm for any interventions based on these findings
until hygienic means to obtaining circumcisions can be guaranteed. They
highlight levels of HIV prevalence among self-reported virgins in several
SSA countries and assess variation in these countries in light of male and
female circumcision practices - which they suggest add to the mounting
evidence supporting iatrogenic transmission routes. We agree that
medical practitioners should take care in implementing any new
strategies (i.e., hygienic circumcision should be the goal, not just
circumcision). Furthermore, we recognize that identifying routes of HIV
transmission in SSA is an empiric question demanding rigorous
exploration - that transmission routes should not be a foregone
conclusion. But in light of our experience collecting data in this context
and assessing data quality, we contend that the evidence in BPRB calls for
an alternate interpretation. (excerpt)
Language:
English
11
Adolescent Reproductive Health: 2005 -2008
Keywords:
KENYA | LESOTHO | TANZANIA | RESEARCH REPORT |
CRITIQUE | METHODOLOGICAL STUDIES | DATA ANALYSIS |
ADOLESCENTS | HIV TRANSMISSION | HIV PREVENTION |
MALE CIRCUMCISION | FEMALE GENITAL CUTTING | HYGIENE
| VIRGINITY | DATA QUALITY | SEX BEHAVIOR | DEVELOPING
COUNTRIES | AFRICA, EASTERN | AFRICA, SUB SAHARAN |
AFRICA | AFRICA, SOUTHERN | RESEARCH METHODOLOGY |
YOUTH | AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | HIV INFECTIONS |
VIRAL DISEASES | DISEASES | MEDICAL PROCEDURES |
MEDICINE | HEALTH SERVICES | DELIVERY OF HEALTH CARE |
HEALTH | HARMFUL TRADITIONAL PRACTICES |
TRADITIONAL HEALTH PRACTICES | CULTURE | SOCIOCULTURAL FACTORS | PUBLIC HEALTH | BEHAVIOR
Document Number: 322604
Mainstreaming and scaling up the Kenya Adolescent Reproductive
Health Project.
Author:
Askew I; Evelia H
Source:
[Washington, D.C.], Population Council, Frontiers in Reproductive
Health, 2007 March.
Abstract:
From 1999-2003, FRONTIERS implemented a Global Agenda program of
operations research (OR) projects to address the reproductive health (RH)
needs of adolescents in four countries - Bangladesh, Kenya, Mexico, and
Senegal. The project was implemented in two districts of Western
Province in Kenya, and was known as the Kenya Adolescent
Reproductive Health Project (KARHP). The project supported a public
sector, multisectoral intervention to enhance young people's knowledge
and behaviour regarding reproductive health and HIV prevention, and
systematically tested its feasibility, acceptability, effectiveness and cost.
This OR project, implemented jointly with PATH, demonstrated that such
a multisectoral intervention could be implemented by the public sector,
was acceptable to communities, its effect in influencing reproductive
health and HIV/AIDS knowledge, attitudes and behaviour was
understood, and the type and amount of financial and other resources
needed to implement each of the component activities was calculated.
The pilot project showed that it was possible to reach 50% of the adult
population (over 7,200) and over two-thirds of all 10-19 year olds, in and
out of school (over 30,000) living in the project area, through supporting
three Government of Kenya ministries: Ministry of Education, Science
12
Adolescent Reproductive Health: 2005 -2008
and Technology (MOEST); Ministry of Gender, Sports, Culture and Social
Services (MGSCSS); and Ministry of Health (MOH). FRONTIERS and
PATH subsequently undertook a broad and systematic dissemination of
the findings and their programmatic, financial and policy implications.
Dissemination included the communities where the study was
implemented, district level ministry staff, and national-level stakeholders
in the three ministries and other interested organizations. These activities
were completed by April 2003. (excerpt)
Language:
English
Keywords:
KENYA | BANGLADESH | MEXICO | SENEGAL | SUMMARY
REPORT | OPERATIONS RESEARCH | YOUTH | REPRODUCTIVE
HEALTH | KNOWLEDGE | SEX BEHAVIOR | ATTITUDE | HIV
PREVENTION | INTERVENTIONS | AFRICA, EASTERN | AFRICA,
SUB SAHARAN | AFRICA | DEVELOPING COUNTRIES | ASIA,
SOUTHERN | ASIA | NORTH AMERICA | AMERICAS | AFRICA,
WESTERN | RESEARCH METHODOLOGY | PROGRAM
EVALUATION | PROGRAMS | ORGANIZATION AND
ADMINISTRATION | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| HEALTH | SOCIOCULTURAL FACTORS | BEHAVIOR |
PSYCHOLOGICAL FACTORS | HIV INFECTIONS | VIRAL
DISEASES | DISEASES
Document Number: 315805
Expanding safe spaces and developing skills for adolescent girls.
Author:
Austrian K
Source:
New York, New York, Population Council, 2007 Oct.
Promoting Healthy, Safe, and Productive Transitions to Adulthood Br
No. 29
Abstract:
Almost 1 billion people around the globe live in urban informal
settlements, or "slums," and the number of such residents is increasing. In
Kenya, 60 percent of Nairobi's nearly 3 million inhabitants live in slum
areas characterized by high levels of poverty and HIV. Kibera, the largest
of these slums, is about 2.5 square kilometers and home to almost 800,000
people, commonly migrants from rural areas. The term "informal
settlements" underscores their non-permanence and implicitly justifies
the lack of infrastructure and services provided by the government,
including water, electricity, health services, sanitation, and public schools.
Most residents rely on an informal system of services provided by NGOs,
13
Adolescent Reproductive Health: 2005 -2008
faith-based groups, and local entrepreneurs, and live in one-room houses
made of semi-permanent materials such as mud, wooden planks, or metal
sheets. The majority of slum residents live in extreme poverty, with
residents sustaining themselves in whatever manner they can, often
through informal-sector activities such as petty trade or casual labor.
(excerpt)
Language:
English
Keywords:
KENYA | PROGRESS REPORT | BASELINE SURVEYS |
ADOLESCENTS, FEMALE | SLUMS | ETHNIC GROUPS |
MICROECONOMIC FACTORS | HUMAN GEOGRAPHY |
CURRICULUM | LEADERSHIP | PROGRAM EVALUATION |
DEVELOPING COUNTRIES | AFRICA, EASTERN | AFRICA, SUB
SAHARAN | AFRICA | SURVEYS | SAMPLING STUDIES |
STUDIES | RESEARCH METHODOLOGY | ADOLESCENTS |
YOUTH | AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | URBANIZATION |
URBAN POPULATION DISTRIBUTION | POPULATION
DISTRIBUTION | GEOGRAPHIC FACTORS | CULTURAL
BACKGROUND | ECONOMIC FACTORS | GEOGRAPHY |
SOCIAL SCIENCES | SCIENCE | SOCIOCULTURAL FACTORS |
EDUCATION | ORGANIZATION AND ADMINISTRATION |
PROGRAMS
Document Number: 326786
Adolescent Reproductive Health and Development Policy plan of
action, 2005—2015.
Author:
Kenya. Ministry of Planning and National Development. National
Coordinating Agency for Population and Development; Kenya. Ministry
of Health. Division of Reproductive Health
Source:
Nairobi, Kenya, Ministry of Planning and National Development,
National Coordinating Agency for Population and Development, 2005
Aug.
Abstract:
Estimates indicate that more than half the world's population is below the
age of 25 -- the largest youth generation in history -- and nearly one-third
is between the ages of 10 and 24. Their numbers are still growing,
particularly in sub-Saharan Africa. About 83 per cent of all adolescents
currently live in developing countries with Africa holding the largest
proportion. In Kenya specifically, the high fertility and declining
mortality that are typical of the region have yielded a youthful
14
Adolescent Reproductive Health: 2005 -2008
population. Over 40 per cent of Kenyans are younger than 15 years and
only about 4 per cent are aged 65 years and above according to the 1999
census data. This means that over half of Kenya's population of about 31
million is aged below 24 years, with the larger proportion being
adolescents. Indeed, more than one-quarter of the country's population
consists of young people aged 10 to 24 years. Unfortunately, pervasive
social, economic and health problems mean that circumstances for
Africa's and Kenya's adolescents are often especially difficult even though
these young people comprise form a formidable force that can no longer
be ignored. Thus, Africa -- Kenya included -- must rise to the massive
challenge of providing its adolescents with opportunities for a safe,
healthy and economically productive future. (excerpt)
Language:
English
Keywords:
KENYA | SUMMARY REPORT | PLANNING | GOALS |
ADOLESCENTS | REPRODUCTIVE HEALTH | POLICY |
BEHAVIOR CHANGE COMMUNICATION | IMPLEMENTATION |
MONITORING | PROGRAM DEVELOPMENT | AFRICA, EASTERN
| AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING
COUNTRIES | ORGANIZATION AND ADMINISTRATION |
YOUTH | AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | HEALTH |
POLITICAL FACTORS | SOCIOCULTURAL FACTORS |
COMMUNICATION PROGRAMS | COMMUNICATION |
BEHAVIOR CHANGE | BEHAVIOR | PROGRAMS | EVALUATION
Document Number: 304869
Research on Adolescent health in Kenya and Uganda.
Author:
Winkler J; Wood S
Source:
Nairobi, Kenya, Program for Appropriate Technology in Health [PATH],
Scouting for Solutions, 2006 Oct.
USAID Cooperative Agreement No. GPO-A-00-05-00009-00
Abstract:
Scouting for Solutions is a five-year project that aims to prevent the
spread of HIV and AIDS by promoting health sexual behavior amongst
Scouts in Kenya and Uganda, including the promotion of abstinence until
marriage, fidelity in marriage, and monogamous relationships. The
project, funded by the US Agency for International Development, is being
implemented by the US-based nongovernmental organization PATH, in
conjunction with national Scouts associations in Kenya and Uganda. By
2009, the project will reach an estimated 325,000 girls and boys aged 12-15
15
Adolescent Reproductive Health: 2005 -2008
years with intensive and repeated HIV prevention strategies and health
promotion activities. (excerpt)
Language:
English
Keywords:
KENYA | UGANDA | SUMMARY REPORT | LITERATURE REVIEW
|ADOLESCENTS, FEMALE | SEX EDUCATION | ABSTINENCE |
FIDELITY | PROMOTION | HIV PREVENTION | KNOWLEDGE |
PUBLIC OPINION | AFRICA, EASTERN | AFRICA SOUTH OF THE
SAHARA | AFRICA | DEVELOPING COUNTRIES |
ADOLESCENTS | YOUTH | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| EDUCATION | FAMILY PLANNING, BEHAVIORAL METHODS |
FAMILY PLANNING | SEX BEHAVIOR | BEHAVIOR |
MARKETING | ECONOMIC FACTORS | HIV INFECTIONS |
VIRAL DISEASES | DISEASES | SOCIOCULTURAL FACTORS |
ATTITUDE | PSYCHOLOGICAL FACTORS
Document Number: 317992
Nurse-Midwives' attitudes towards adolescent sexual and
reproductive health needs in Kenya and Zambia.
Author:
Warenius LU; Faxelid EA; Chishimba PN; Musandu JO; Ong'any AA
Source:
Reproductive Health Matters. 2006 May
Abstract:
Adolescent sexuality is a highly charged moral issue in Kenya and
Zambia. Nurse-midwives are the core health care providers of adolescent
sexual and reproductive health services but public health facilities are
under-utilized by adolescents. The aim of this study was to investigate
attitudes among Kenyan and Zambian nurse-midwives (n = 820) toward
adolescent sexual and reproductive health problems, in order to improve
services for adolescents. Data were collected through a questionnaire.
Findings revealed that nurse-midwives disapproved of adolescent sexual
activity, including masturbation, contraceptive use and abortion, but also
had a pragmatic attitude to handling these issues. Those with more
education and those who had received continuing education on
adolescent sexuality and reproduction showed a tendency towards more
youth-friendly attitudes. We suggest that critical thinking around the
cultural and moral dimensions of adolescent sexuality should be
emphasized in undergraduate training and continuing education, to help
nurse-midwives to deal more empathetically with the reality of
adolescent sexuality. Those in nursing and other leadership positions
could also play an important role in encouraging wider social discussion
16
Adolescent Reproductive Health: 2005 -2008
of these matters. This would create an environment that is more tolerant
of adolescent sexuality and that recognizes the beneficial public health
effect for adolescents of greater access to youth-friendly sexual and
reproductive health services. (author's)
Language:
English
Keywords:
KENYA | ZAMBIA | RESEARCH REPORT | KAP SURVEYS | ,
FEMALE | NURSE-MIDWIVES | WOMEN IN DEVELOPMENT |
ATTITUDE | ADOLESCENT HEALTH SERVICES | SEXUALLY
TRANSMITTED DISEASE PREVENTION | REPRODUCTIVE
HEALTH | SEX BEHAVIOR | ABORTION | SCHOOLS, NURSING |
PSYCHOSOCIAL FACTORS | AFRICA, EASTERN | AFRICA, SUB
SAHARAN | AFRICA | DEVELOPING COUNTRIES | AFRICA,
SOUTHERN | SURVEYS | SAMPLING STUDIES | STUDIES |
RESEARCH METHODOLOGY | ADOLESCENTS | YOUTH | AGE
FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC
FACTORS | POPULATION | HEALTH PERSONNEL | DELIVERY
OF HEALTH CARE | HEALTH | ECONOMIC DEVELOPMENT |
ECONOMIC FACTORS | PSYCHOLOGICAL FACTORS |
BEHAVIOR | HEALTH SERVICES | SEXUALLY TRANSMITTED
DISEASES | REPRODUCTIVE TRACT INFECTIONS | INFECTIONS
| DISEASES | FERTILITY CONTROL, POSTCONCEPTION |
FAMILY PLANNING | SCHOOLS | EDUCATION
Document Number: 304722
Services for prevention of mother-to-child transmission (PMTCT).
Integrating Contraceptive information into PMTCT services is
challenging, particularly for youth.
Author:
Reynolds HW; Kimani J Arlington, Virginia, Family Health International
[FHI], YouthNet, 2006 May.
Source:
YouthNet Briefs on Reproductive Health and HIV / AIDS No. 12.
Research Results;USAID Development Experience Clearinghouse DocID
/ Order No.
Abstract:
Programs designed to prevent mother-to-child transmission (PMTCT) of
HIV are usually part of antenatal care programs. These services typically
include HIV counseling and testing for pregnant women and, if they test
HIV-positive, provision of antiretroviral drugs to prevent transmission of
HIV to the baby (called vertical transmission). Another critically
important service that could be offered through PMTCT activities -- but
rarely is -- is the provision of contraceptive information and methods.
17
Adolescent Reproductive Health: 2005 -2008
Contraception could help prevent future unintended births to HIVinfected women. Services for the prevention of mother-to-child
transmission are relatively new additions to antenatal programs, and
little information exists about young women's access to, and use of, these
services. Moreover, because adolescents and young women are early in
their reproductive years, they are likely to want children in the future.
How family planning services and messages are integrated into PMTCT
services for these younger women requires particular attention. To better
understand these issues, Family Health International/YouthNet
conducted a study at four diverse antenatal care clinics with PMTCT
programs in several regions of Kenya. Antenatal programs are relatively
widespread in Kenya, and PMTCT services are growing rapidly in the
country. (excerpt)
Language:
English
Keywords:
KENYA | SUMMARY REPORT | YOUTH | PREVENTION OF
MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION |
COMMUNICATION STRATEGY | ADOLESCENT PREGNANCY |
CONTRACEPTIVE METHODS | KNOWLEDGE | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
DEVELOPING COUNTRIES | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| DISEASE TRANSMISSION CONTROL | PREVENTION AND
CONTROL | DISEASES | HIV INFECTIONS | VIRAL DISEASES |
COMMUNICATION | REPRODUCTIVE BEHAVIOR | FERTILITY |
POPULATION DYNAMICS | CONTRACEPTION | FAMILY
PLANNING | SOCIOCULTURAL FACTORS
Document Number: 303800
Sexual behavior and STI / HIV status among adolescents in rural
Malawi: an evaluation of the effect of interview mode on reporting.
Author:
Mensch BS; Hewett PC
Source:
[Unpublished] 2006. Presented at the 2006 Annual Meeting of the
Population Association of America, Los Angeles, California, March 30 April 1, 2006.
Abstract:
Our understanding of the dynamics of HIV transmission in developing
countries is seriously compromised by unreliable data on sexual
behavior. Epidemiological studies in Africa have observed little
association between self-reported risky sexual behavior and HIV status. A
large multi-site study of factors determining HIV prevalence in four
18
Adolescent Reproductive Health: 2005 -2008
African cities revealed considerable numbers of women who were HIV
positive yet reported themselves to be virgins or reported having only
one sexual partner and few episodes of sexual intercourse. The
inconsistency between reported sexual behavior and HIV incidence has
prompted some epidemiologists to question the conventional explanation
for the African AIDS epidemic. Arguing that pre-conceived notions of
African sexuality have unduly influenced researchers, several
epidemiologists suggest that it is not risky sexual behavior but rather
parenteral transmission resulting from medical injections with
contaminated needles that has played a substantial role in the spread of
HIV. While these scientists have closely examined the data on
heterosexual transmission, they are less thorough in their assessment of
survey data on sexual behavior data. Gisselquist and Potterat assert:
"[The care with which these [surveys] ... have been performed, the
familiarity of investigators with local conditions, their experience in the
conduct of such studies, and the consistency of response makes summary
dismissal of such results untenable." The willingness of these and other
researchers to accept survey data of questionable validity has serious
implications for interpretations of the etiology of HIV transmission.
(excerpt)
Language:
English
Keywords:
MALAWI | KENYA | RESEARCH PROPOSAL |
METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS |
INTERVIEWS | SURVEY METHODOLOGY | HIV TRANSMISSION
| PREVALENCE | SEX BEHAVIOR | RISK BEHAVIOR | DATA
QUALITY | DATA REPORTING | COMPUTER PROGRAMS AND
PROGRAMMING | EVALUATION | DEVELOPING COUNTRIES |
AFRICA, SOUTHERN | AFRICA, SUB SAHARAN | AFRICA |
AFRICA, EASTERN | RESEARCH METHODOLOGY | DATA
COLLECTION | SURVEYS | SAMPLING STUDIES | STUDIES |
HIV INFECTIONS | VIRAL DISEASES | DISEASES |
MEASUREMENT | BEHAVIOR | DATA ANALYSIS |
INFORMATION PROCESSING | INFORMATION
Document Number: 318890
Tuko Pamoja: adolescent reproductive health and life skills
curriculum.
Author:
Behague S; Christenson K; Martin S; Wysong M; Kibusu K
Source:
Nairobi, Kenya, Program for Appropriate Technology in Health [PATH],
2006 Mar.
19
Adolescent Reproductive Health: 2005 -2008
Abstract:
Adolescence is a time of dynamic change, filled with new feelings,
physical and emotional changes, excitement, questions, and difficult
decisions. During this time, young people need information about their
own sexuality and skills to help them plan for a happy future. As they
move through adolescence, young people begin to have different kinds of
relationships with their peers, family members, and adults; good
communication and other relationship skills can help ensure that these
relationships are satisfying and mutually respectful. Young people need
to learn how to manage new feelings about sexuality in order to make
responsible decisions about their health, reproduction, and parenthood.
This curriculum, entitled Tuko Pamoja (We Are Together), can help
facilitate dialogue between adults and young people on issues related to
adolescent reproductive health. It’s for teachers; community, religious,
and youth group leaders; health care professionals; and anyone working
with young people. The curriculum is designed to delay sexual debut and
promote sexual and reproductive health by addressing gender,
reproductive health, preventive behaviours, sexually transmitted
infections, HIV and AIDS, abstinence, gender violence, and decisionmaking, communication, and other important life skills. (excerpt)
Language:
English
Keywords:
KENYA | MANUAL | CHILD | YOUTH | ADOLESCENTS |
CURRICULUM | ABSTINENCE | DRUG USE AND ABUSE |
ABORTION | SAFETY | GENDER ISSUES | SEX BEHAVIOR | RISK
BEHAVIOR | PUBERTY | INTERPERSONAL RELATIONS | SELF
ESTEEM | DECISION MAKING | SEXUAL EXPLOITATION |
VOLUNTARY COUNSELING AND TESTING | SEXUALLY
TRANSMITTED DISEASE PREVENTION | HIV PREVENTION |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
DEVELOPING COUNTRIES | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| EDUCATION | FAMILY PLANNING, BEHAVIORAL METHODS |
FAMILY PLANNING | BEHAVIOR | FERTILITY CONTROL,
POSTCONCEPTION | PUBLIC HEALTH | HEALTH |
SOCIOCULTURAL FACTORS | REPRODUCTION |
PSYCHOLOGICAL FACTORS | HIV TESTING | LABORATORY
EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND
DIAGNOSES | MEDICAL PROCEDURES | MEDICINE | HEALTH
SERVICES | DELIVERY OF HEALTH CARE | SEXUALLY
TRANSMITTED DISEASES | REPRODUCTIVE TRACT
INFECTIONS | INFECTIONS | DISEASES | HIV INFECTIONS |
VIRAL DISEASES
Document Number: 315809
20
Adolescent Reproductive Health: 2005 -2008
RxGen pharmacy project: reaching youth through pharmacies.
PATH develops a model for increasing youth's access to
reproductive health services.
Source:
Program for Appropriate Technology in Health [PATH]
[Seattle, Washington], PATH, 2006.
Abstract:
During adolescence, people are more likely to take risks and less capable
of predicting and dealing with the consequences than at any other time of
life. Reproductive health is especially threatened; rates of sexually
transmitted infections (STIs) are highest among young people aged 15 to
24 years. For young women, in particular, adolescence is a time of
vulnerability--a time when their ability to negotiate safe sexual
interactions is often slight. Complications from pregnancy, childbirth,
and unsafe abortions have become the major causes of death for girls
aged 15 to 19. PATH is working to reduce adolescents' risk of unintended
pregnancy and sexually transmitted infections by making it easier for
them to get the health information and products they need. Our point of
contact is the pharmacy, an anonymous setting that is less threatening
and more accessible than a health care clinic. (excerpt)
Language:
English
Keywords:
CAMBODIA | KENYA | NICARAGUA | VIETNAM | PROGRESS
REPORT | PHARMACISTS | REPRODUCTIVE HEALTH |
PHARMACIES | YOUTH PROGRAMS | PROGRAM
ACCESSIBILITY | TRAINING ACTIVITIES | CURRICULUM |
REFERRAL AND CONSULTATION | CONTRACEPTION | LOGOS
| DEVELOPING COUNTRIES | ASIA, SOUTHEASTERN | ASIA |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
CENTRAL AMERICA | LATIN AMERICA | AMERICAS | HEALTH
PERSONNEL | DELIVERY OF HEALTH CARE | HEALTH |
HEALTH FACILITIES | PROGRAMS | ORGANIZATION AND
ADMINISTRATION | PROGRAM EVALUATION | TRAINING
PROGRAMS | EDUCATION | PROGRAM ACTIVITIES | FAMILY
PLANNING | MARKETING | ECONOMIC FACTORS
Document Number: 308256
Choosing life in a world with HIV/AIDS.
Source:
Ray of Hope: A Newsletter of the Hope for African Children Initiative
2006 Mar.
21
Adolescent Reproductive Health: 2005 -2008
Abstract:
"The impact of HIV/AIDS is so big that communities can no longer cope.
Children are being orphaned at an alarming rate and poverty fuelled by
the epidemic is quickly engulfing our communities,'' says Osunga Kuyoh,
the Coordinator of Sirembe Child Development Program, a communitybased organization assisting children and families impacted by
HIV/AIDS in North West Gem Location of Siaya District in western
Kenya. Recent statistics from Sirembe Mobile VCT, supported by Centres
for Disease Control (CDC), indicated the HIV prevalence rate in North
West Gem was 23%, compared to the national rate of 6.7%. "This figure is
pretty high and signals worse things to come. It means many more
children are on their way to orphan-hood as infected adults die from the
disease,'' he says. But beyond the grim statistics is a resolute community
initiative towards off the negative impact of the disease. Through the
Sirembe Child Development Program, residents of North West Gem have
come together to support children made vulnerable by the disease and
carry out HIV prevention campaigns. The organization, supported by
HACI through Save the Children Canada, has also set up HIV/AIDS
clubs in 12 schools. "School children provide a window of opportunity in
the war against HIV/AIDS because if they are educated about the
epidemic at an early age, they will grow up armed with all the
information required to prevent it and will be able to make the right
choices,'' says Osunga. (excerpt)
Language:
English
Keywords:
KENYA | CRITIQUE | PERSONS LIVING WITH HIV/AIDS |
ORPHANS AND VULNERABLE CHILDREN | CHILDREN |
ADOLESCENTS | NONGOVERNMENTAL ORGANIZATIONS |
CARE AND SUPPORT | HIV PREVENTION | CAMPAIGNS |
SCHOOL-BASED SERVICES | STIGMA | AFRICA, EASTERN |
AFRICA SOUTH OF THE SAHARA | AFRICA | DEVELOPING
COUNTRIES | HIV INFECTIONS | VIRAL DISEASES | DISEASES |
YOUTH | AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | ORGANIZATIONS |
POLITICAL FACTORS | SOCIOCULTURAL FACTORS | HEALTH
SERVICES | DELIVERY OF HEALTH CARE | HEALTH |
COMMUNICATION PROGRAMS | COMMUNICATION |
PROGRAMS | ORGANIZATION AND ADMINISTRATION |
SOCIAL PROBLEMS | FAMILY AND HOUSEHOLD
Document Number: 303639
22
Adolescent Reproductive Health: 2005 -2008
Baseline survey results for the "Young Men as Equal Partners"
Project. 10-24 year-olds from Nyando, Bondo and Homa Bay
districts in Nyanza Province, Kenya.
Author:
Thomsen S; Katz K; Janowitz B
Source:
[Nairobi], Kenya, Family Health International [FHI], 2007 Feb.
Abstract:
Two cross-sectional, population-based household surveys among young
men in the targeted districts were designed to conduct this evaluation.
The baseline survey was planned to take place prior to the
implementation of the YMEP program and a follow-up survey would be
conducted one year after program implementation. From January to
February 2006, FHI, in conjunction with Impact Research and
Development Organization (IRDO), carried out the baseline survey in
Nyando, Homa Bay and Bondo districts in Nyanza. A total of 1,058 boys
and young men between the ages of 10 and 24 were interviewed. All
survey participants were asked about their knowledge of HIV/AIDS and
sources of reproductive health information, including exposure to sex
education in schools and peer education. Questions about knowledge of
reproductive health, family planning and STIs were asked only to 13-24
year olds. Only 15-24 year olds were asked about their sexual behaviours
and experiences, HIV risk perceptions and attitudes toward gender
equity. (excerpt
Language:
English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS,
MALE | YOUTH | PERSONS LIVING WITH HIV/AIDS | MEN'S
INVOLVEMENT | SEX BEHAVIOR | GENDER ISSUES |
INEQUALITIES | CONDOM USE | UTILIZATION OF HEALTH
CARE | DEVELOPING COUNTRIES | AFRICA, EASTERN |
AFRICA, SUB SAHARAN | AFRICA | SURVEYS | SAMPLING
STUDIES | STUDIES | RESEARCH METHODOLOGY |
ADOLESCENTS | AGE FACTORS | POPULATION
CHARACTERISTICS | DEMOGRAPHIC FACTORS | POPULATION
| HIV INFECTIONS | VIRAL DISEASES | DISEASES | PROGRAMS
| ORGANIZATION AND ADMINISTRATION | BEHAVIOR |
SOCIOCULTURAL FACTORS | SOCIOECONOMIC FACTORS |
ECONOMIC FACTORS | RISK REDUCTION BEHAVIOR | HEALTH
SERVICES | DELIVERY OF HEALTH CARE | HEALTH
Document Number: 323689
23
Adolescent Reproductive Health: 2005 -2008
Vulnerability to HIV infection among Luo female adolescent
orphans in western Kenya.
Author:
Nyambedha EO
Source:
African Journal of AIDS Research. 2007 Nov
Abstract:
Large-scale surveys have reported that about 55% of orphans worldwide
are adolescents. In Kenya, the majority of HIV-infected adolescents are
females. The current study used the anthropological methods of in-depth
case studies to analyse how migratory life situations of individual female
adolescent orphans in the Luo community of Western Kenya may
increase their exposure to HIV. The study shows that the ability of the
female adolescent orphans to adopt risk-preventive behaviour in relation
to HIV is determined by a range of factors beyond their control of
individual sexual behaviour. Although analysis of a single case study
limits generalization of the findings, the results provide insights into the
reason for sex differentials in HIV infection rates among adolescents as
reported in some large-scale surveys. The paper recommends that HIV
prevention strategies for adolescents should examine the specific life
situations of female orphans by focusing on the impacts of HIV and AIDS
and poverty on the protective role of the family. It also recommends that
keeping female adolescent orphans in school or in vocational training can
be an effective HIV prevention strategy for them. (author's
Language:
English
Keywords:
KENYA | RESEARCH REPORT | QUALITATIVE RESEARCH |
ORPHANS AND VULNERABLE CHILDREN | ADOLESCENTS |
HIV PREVENTION | FOSTERING | SEX BEHAVIOR | SEX
FACTORS | MIGRATION | DEVELOPING COUNTRIES | AFRICA,
EASTERN | AFRICA, SUB SAHARAN | AFRICA | RESEARCH
METHODOLOGY | FAMILY AND HOUSEHOLD |
SOCIOCULTURAL FACTORS | YOUTH | AGE FACTORS |
POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS |
POPULATION | HIV INFECTIONS | VIRAL DISEASES | DISEASES
| CHILD REARING | BEHAVIOR | POPULATION DYNAMICS
Document Number: 314047
24
Adolescent Reproductive Health: 2005 -2008
Sexual initiation and contraceptive use among female adolescents
in Kenya.
Author:
Ikamari LD; Towett R
Source:
African Journal of Health Sciences. 2007
Abstract:
This paper examines the timing of sexual initiation and contraceptive use
among female adolescents in Kenya. Data are drawn from the 2003 Kenya
Demographic and Health Survey. The main analytical tools are regression
models. A Cox regression model is used to consider the probability of a
young woman having first sex during adolescence and linear regression
model to quantify the effects of a set of factors on female adolescent's age
at first sexual debut. Finally, logistic regression model is used to model
the probability of a sexually experienced adolescent woman using a
contraceptive method. The results obtained indicate the onset of sexual
activity is early and contraceptive use is fairly low and both the timing of
first sex and contraceptive use are affected by a variety of factors. Despite
engaging in unsafe sex practices, the majority of the adolescents do not
view themselves as being at the risk of contracting HIV/AIDS. A number
of recommendations are proposed. (author's)
Language:
English
Keywords:
KENYA | RESEARCH REPORT | RECOMMENDATIONS |
DEMOGRAPHIC AND HEALTH SURVEYS | STATISTICAL
REGRESSION | KAP SURVEYS | ADOLESCENTS, FEMALE |
WOMEN IN DEVELOPMENT | FIRST INTERCOURSE |
CONTRACEPTIVE USAGE | PROBABILITY | AGE FACTORS |
RISK BEHAVIOR | PERCEPTION | DEVELOPING COUNTRIES |
AFRICA, EASTERN | AFRICA, SUB SAHARAN | AFRICA |
DEMOGRAPHIC SURVEYS | POPULATION DYNAMICS |
DEMOGRAPHIC FACTORS | POPULATION | DATA ANALYSIS |
RESEARCH METHODOLOGY | SURVEYS | SAMPLING STUDIES |
STUDIES | ADOLESCENTS | YOUTH | POPULATION
CHARACTERISTICS | ECONOMIC DEVELOPMENT | ECONOMIC
FACTORS | SEX BEHAVIOR | BEHAVIOR | CONTRACEPTION |
FAMILY PLANNING | STATISTICAL STUDIES |
PSYCHOLOGICAL FACTORS
Document Number: 324425
25
Adolescent Reproductive Health: 2005 -2008
Addressing early marriage in areas of high HIV prevalence: a
program to delay marriage and support married girls in rural
Nyanza, Kenya.
Author:
Erulkar A; Ayuka F
Source:
New York, New York, Population Council, Frontiers in Reproductive
Health, 2007 Mar. Promoting Healthy, Safe, and Productive Transitions to
Adulthood Brief No. 19
Abstract:
Married adolescent girls form a large segment of Kenyan youth, yet they
are largely overlooked by researchers and programmers concerned with
the lives of adolescents. As evidence demonstrates, this neglected
population of married girls is likely to be vulnerable and in need of
support. HIV infection is much higher among adolescent girls in subSaharan Africa than among boys. In settings such as Nyanza Province,
Kenya, rates of HIV infection are extremely high, and evidence is
increasing in some settings that girls who are married are much more
likely to be infected with HIV, compared with their unmarried
counterparts who are sexually active. This brief describes a program
addressing the problem of early marriage, the reproductive risks
associated with early marriage, and the risk of HIV infection transmission
within marriage. The program was based on the Population Council's
analysis of the 2003 Kenya Demographic and Health Survey (KDHS) as
well as on formative research within the rural Nyanza community.
(excerpt)
Language:
English
Keywords:
KENYA | SUMMARY REPORT | PREVALENCE | RURAL AREAS |
CHILD MARRIAGE | ADOLESCENTS, FEMALE | PREVENTION
AND CONTROL | HIV PREVENTION | MARRIAGE
POSTPONEMENT | AFRICA, EASTERN | AFRICA, SUB SAHARAN
| AFRICA | DEVELOPING COUNTRIES | MEASUREMENT |
RESEARCH METHODOLOGY | GEOGRAPHIC FACTORS |
POPULATION | MARRIAGE PATTERNS | MARRIAGE |
NUPTIALITY | DEMOGRAPHIC FACTORS | ADOLESCENTS |
YOUTH | AGE FACTORS | POPULATION CHARACTERISTICS |
DISEASES | HIV INFECTIONS | VIRAL DISEASES
Document Number: 315800
26
Adolescent Reproductive Health: 2005 -2008
Trends in primary and secondary abstinence among Kenyan youth.
Author:
Chiao C; Mishra V
Source:
Calverton, Maryland, Macro International, Demographic and Health
Research Division, MEASURE DHS, 2007 Nov. DHS Working Papers No.
36;USAID Contract No. GPO-C-00-03-00002-00
Abstract:
Promoting sexual abstinence among never-married youth is an important
component of HIV/AIDS prevention campaigns for youth in countries
with generalized epidemics. The objective was to examine trends in
primary and secondary abstinence among never-married youth age 15-24
in Kenya over a ten-year period and to explore the role of HIV prevention
knowledge, schooling, and contextual factors in affecting abstinence
behavior. Data were from Kenya Demographic and Health Surveys
conducted in 1993, 1998, and 2003. Primary abstinence was defined as
never-married youth who never had sex. Secondary abstinence was
defined as never-married youth who ever had sex but not in the past
year. Logistic regression models were used to estimate the effects of
prevention knowledge, schooling, and contextual factors in affecting
abstinence behavior, after accounting for sampling weights and clustering
in the survey design. Both primary and secondary abstinence levels have
risen in the past 10 years in Kenya. The abstinence levels were higher
among female youth than among male youth. Multivariate analyses show
that knowledge that abstinence can prevent HIV infection was positively
associated with the likelihood of practicing abstinence (both primary and
secondary). However, knowledge that condom use can prevent HIV
infection was associated with lower abstinence practice. In-school youth
were 4-5 times more likely to abstain from sex than those working
(aOR=4.12; p=0.000 for female youth and aOR=4.83; p=0.000 for male
youth). Not-in-school female youth were about as likely to abstain as
working female youth, but not-in-school male youth were about 2 times
more likely to abstain than working male youth. Muslim youth were
much more likely to abstain than other youth. Female youth with weekly
exposure to television and those with a secondary or higher education
were significantly more likely to have abstained, whereas male youth
were significantly less likely. Effects of these factors on secondary
abstinence practice were generally weaker, but sexually experienced inschool male youth were significantly more likely to have abstained in th
Effects of the contextual variables on the likelihood of abstinence were
generally small and insignificant, except for primary abstinence among
female youth. Increasing knowledge that abstinence can prevent HIV
infection and keeping youth in schools can help promote abstinence
behavior. Abstinence programs need to be gender sensitive and culturally
appropriate. (author's)
Language:
English
27
Adolescent Reproductive Health: 2005 -2008
Keywords:
KENYA | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH
SURVEYS | DATA ANALYSIS | YOUTH | ADOLESCENTS |
STUDENTS | PRIMARY SCHOOLS | SECONDARY SCHOOLS |
ABSTINENCE | HIV INFECTIONS | TRANSMISSION | HIV
PREVENTION | KNOWLEDGE | CONDOM USE | BEHAVIOR |
SEX EDUCATION | PROGRAM EFFECTIVENESS | DEVELOPING
COUNTRIES | AFRICA, EASTERN | AFRICA, SUB SAHARAN |
AFRICA | DEMOGRAPHIC SURVEYS | POPULATION DYNAMICS
| DEMOGRAPHIC FACTORS | POPULATION | RESEARCH
METHODOLOGY | AGE FACTORS | POPULATION
CHARACTERISTICS | EDUCATION | SCHOOLS | FAMILY
PLANNING, BEHAVIORAL METHODS | FAMILY PLANNING |
VIRAL DISEASES | DISEASES | INFECTIONS | SOCIOCULTURAL
FACTORS | RISK REDUCTION BEHAVIOR | PROGRAM
EVALUATION | PROGRAMS | ORGANIZATION AND
ADMINISTRATION
Document Number: 322987
Converging evidence suggests nonsexual HIV transmission among
adolescents in sub-Saharan Africa [letter]
Author:
Brewer DD; Potterat JJ; Muth SQ; Brody S
Source:
Journal of Adolescent Health. 2007
Abstract:
In their article on human immunodeficiency virus (HIV) infection in
Zimbabwean adolescents, Gavin and colleagues do not specifically
consider blood exposures to explain HIV infection in virgins. They
recruited a nationally representative sample of girls aged 15-19 years;
90% agreed to be tested. Strikingly, 41% of 192 HIV-positive girls
reported no sexual exposure. The authors suspect the infected virgins
lied. This suspicion is not based on empiric evidence such as physical or
laboratory examination, nor psychometric measures of response validity.
We are not aware of evidence that underreporting of sexual experience in
Africa is positively related to HIV infection, and false positive tests likely
predominated in previous studies comparing self-reports and markers of
sexually transmitted disease and pregnancy in African youth. The
authors venture that HIV might have been vertically transmitted, though
they undermine their speculation, observing that "it is unlikely that many
perinatally infected infants in Zimbabwe would survive for 15-19 years".
(excerpt
Language:
English
28
Adolescent Reproductive Health: 2005 -2008
Keywords:
AFRICA, SUB SAHARAN | ZIMBABWE | KENYA | LESOTHO |
TANZANIA | CRITIQUE | ADOLESCENTS, FEMALE | PERSONS
LIVING WITH HIV/AIDS | HIV TRANSMISSION | VIRGINITY |
NEEDLE PIERCING | FEMALE GENITAL CUTTING |
DEVELOPING COUNTRIES | AFRICA | AFRICA, SOUTHERN |
AFRICA, EASTERN | ADOLESCENTS | YOUTH | AGE FACTORS |
POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS |
POPULATION | HIV INFECTIONS | VIRAL DISEASES | DISEASES
| SEX BEHAVIOR | BEHAVIOR | RISK BEHAVIOR | HARMFUL
TRADITIONAL PRACTICES | TRADITIONAL HEALTH
PRACTICES | CULTURE | SOCIOCULTURAL FACTORS
Document Number: 312685
Male and female circumcision associated with prevalent HIV
infection virgins and adolescents in Kenya, Lesotho, and Tanzania.
Author:
Brewer DD; Potterat JJ; Roberts JM Jr; Brody S
Source:
Annals of Epidemiology 2007 Mar
Abstract:
Remarkable proportions of self-reported virgins and adolescents in
eastern and southern Africa are infected with HIV, yet non-sexual routes
of transmission have not been systematically investigated in such
persons. Many observers in this region have recognized the potential for
HIV transmission through unhygienic circumcision procedures. We
assessed the relation between male and female circumcision (genital
cutting) and prevalent HIV infection in Kenyan, Lesothoan, and
Tanzanian virgins and adolescents. We analyzed data from recent crosssectional national probability sample surveys of adolescents and adults in
households, focusing on populations in which circumcision was common
and usually occurred in puberty or later. Circumcised male and female
virgins were substantially more likely to be HIV infected than
uncircumcised virgins (Kenyan females: 3.2% vs. 1.4%, odds ratio [OR] =
2.38; Kenyan males: 1.8% vs. 0%, OR undefined; Lesothoan males: 6.1%
vs. 1.9%, OR 3.36; Tanzanian males: 2.9% vs. 1.0%,OR 2.99; weighted
mean phi correlation = 0.07, 95% confidence interval, 0.03 to 0.11). Among
adolescents, regardless of sexual experience, circumcision was just as
strongly associated with prevalent HIV infection. However,
uncircumcised adults were more likely to be HIV positive than
circumcised adults. Self-reported sexual experience was independently
related to HIV infection in adolescent Kenyan females, but was unrelated
to HIV infection in adolescent Kenyan, Lesothoan, and Tanzanian males.
HIV transmission may occur through circumcision
29
Adolescent Reproductive Health: 2005 -2008
Language:
English
Keywords:
KENYA | LESOTHO | TANZANIA | RESEARCH REPORT |
DEMOGRAPHIC AND HEALTH SURVEYS | DATA ANALYSIS |
MALE CIRCUMCISION | FEMALE GENITAL CUTTING | HIV
INFECTIONS | PREVALENCE | VIRGINITY | HYGIENE |
HEPATITIS | AFRICA, EASTERN | AFRICA SOUTH OF THE
SAHARA | AFRICA | DEVELOPING COUNTRIES | AFRICA,
SOUTHERN | DEMOGRAPHIC SURVEYS | POPULATION
DYNAMICS | DEMOGRAPHIC FACTORS | POPULATION |
RESEARCH METHODOLOGY | MEDICAL PROCEDURES |
MEDICINE | HEALTH SERVICES | DELIVERY OF HEALTH CARE |
HEALTH | HARMFUL TRADITIONAL PRACTICES |
TRADITIONAL HEALTH PRACTICES | CULTURE |
SOCIOCULTURAL FACTORS | VIRAL DISEASES | DISEASES |
MEASUREMENT | SEX BEHAVIOR | BEHAVIOR | PUBLIC
HEALTH
Acknowledging young people's sexuality and rights.
Author:
Reinders J; Darwisyah W; Okwaput A; Wongwareethip; Obbuyi A
Source:
Exchange on HIV / AIDS, Sexuality and Gender. 2007 Winter
Abstract:
Today, over 50% of young people worldwide are sexually active by the
time they are Liberal attitudes of a new global youth culture, combined
with not acknowledging young people's sexuality and rights and not
providing them with information, lead to unprepared experimenting
with sexuality. Young people in many countries are therefore
increasingly affected with sexual health problems. Examples of these are
teenage pregnancy, early motherhood, unsafe abortions, STIs including
HIV, sexual harassment and abuse. In addition, young people's lower
sexual health status is fuelled by gender inequality, exclusion for being
HIV positive and discrimination based on sexual orientation. Sexuality
education is needed to prevent these problems, but also to guide young
people in a healthy sexual development and should therefore start at an
early age, at least before the age of 15. To be effective, a comprehensive
and rights-based approach supports young people best in making their
own decisions about their sexual life, whenever this will start. (excerpt)
Language:
English
Keywords:
UGANDA | KENYA | INDONESIA | THAILAND | SUMMARY
REPORT | TEACHERS | YOUTH PROGRAMS | SEXUALITY |
HUMAN RIGHTS | SEX EDUCATION | CURRICULUM |
30
Adolescent Reproductive Health: 2005 -2008
COMPUTERS | TRAINING PROGRAMS | DEVELOPING
COUNTRIES | AFRICA, EASTERN | AFRICA, SUB SAHARAN |
AFRICA | ASIA, SOUTHEASTERN | ASIA | EDUCATION |
PROGRAMS | ORGANIZATION AND ADMINISTRATION |
PERSONALITY | PSYCHOLOGICAL FACTORS | BEHAVIOR |
POLITICAL FACTORS | SOCIOCULTURAL FACTORS |
INFORMATION PROCESSING | INFORMATION
Document Number: 314267
Integrating reproductive health and HIV services for youth.
Author:
Scholl E; Finger W
Source:
YouthLens on Reproductive Health and HIV / AIDS No. 21
YR: 2007 Research Triangle Park, North Carolina, Family Health
International [FHI], Interagency Youth Working Group, 2007 Mar.
Abstract:
Young people, especially those who are sexually active, need access to a
variety of reproductive health (RH) and HIV services, including
contraception, HIV counseling and testing, testing and treatment for
other sexually transmitted infections (STIs), pre- and postnatal care, and
postabortion care. Frequently youth seek services only when there is an
acute illness or problem - such as a symptomatic STI or pregnancy - and
do not typically seek preventive services, such as contraception to avoid
pregnancy. Also, health facilities serving youth sometimes offer one
primary service or have separate units providing different types of
services. In either situation, to provide comprehensive care, a provider
may need to refer clients between contraceptive and HIV/STI services. As
a result, although many young people are at risk of both pregnancy and
HIV/STIs, they may receive only one service while related sexual health
needs are not addressed. An integrated approach can make a variety of
services available during the same hours, at the same facility, or from the
same provider. While such integration seems appealing, more analysis
was needed to address whether this was feasible, what needs were
unmet, and what kinds of models might work best. (excerpt)
Language:
English
Keywords:
TANZANIA | HAITI | KENYA | SUMMARY REPORT | YOUTH |
CONTRACEPTION | ADOLESCENT HEALTH SERVICES | UNFPA
| MOTHER-TO-CHILD TRANSMISSION | TREATMENT |
DEVELOPING COUNTRIES | AFRICA, EASTERN | AFRICA, SUB
SAHARAN | AFRICA | CARIBBEAN | AMERICAS | AGE
FACTORS | POPULATION CHARACTERISTICS | DEMOGRAPHIC
31
Adolescent Reproductive Health: 2005 -2008
FACTORS | POPULATION | FAMILY PLANNING | HEALTH
SERVICES | DELIVERY OF HEALTH CARE | HEALTH | UN |
INTERNATIONAL AGENCIES | ORGANIZATIONS | POLITICAL
FACTORS | SOCIOCULTURAL FACTORS | TRANSMISSION |
INFECTIONS | DISEASES | MEDICAL PROCEDURES | MEDICINE
| SCHOOLS | EDUCATION
Document Number: 315529
National Youth Shadow Report: Progress Made on the UNGASS
Declaration of Commitment on HIV / AIDS. Kenya.
Author:
Omondi RO; Arege DM; Ndegwa JN
Source:
New York, New York, Global Youth Action Network, Global Youth
Coalition on HIV / AIDS, [2006].
Abstract:
Over half of all new infections worldwide each year are among young
people between the ages of 15 and 24. Every day, more than 6,000 young
people become infected with HIV - almost five every minute. Yet the
needs of the world's over one billion young people are often ignored
when strategies on HIV/AIDS are drafted, policies developed, and
budgets allocated. This is especially tragic as young people are more
likely than adults to adopt and maintain safe behaviors. Young people are
vulnerable to HIV infection because they lack the crucial information,
education, and services to protect themselves. The 2001 United Nations
General Assembly Special Session on HIV/AIDS noted, "Poverty, underdevelopment and illiteracy are among the principal contributing factors
to the spread of HIV/AIDS". These factors are particularly poignant for
young people who are so often voiceless and powerless in society. Young
people are in a transitional phase between childhood and adulthood, and
are rarely taken into account in official statistics, policies, and programs.
This year, 2006, marks five years since the DOC was put into effect. The
author and 60 young leaders in HIV/AIDS will participate in the Five
Year AIDS 2006 Review at the United Nations Secretariat to advocate to
decision-makers to scale-up comprehensive, evidence-based
interventions on HIV/AIDS for and with young people. (excerpt)
Language:
English
Keywords:
KENYA | SUMMARY REPORT | RESEARCH METHODOLOGY |
PREVALENCE | YOUTH | HIV INFECTIONS | AIDS | SEX
EDUCATION | CONDOM USE | COMMUNITY PARTICIPATION |
INFORMATION SOURCES | RECOMMENDATIONS | AFRICA,
EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA |
32
Adolescent Reproductive Health: 2005 -2008
DEVELOPING COUNTRIES | MEASUREMENT | AGE FACTORS |
POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS |
POPULATION | VIRAL DISEASES | DISEASES | EDUCATION |
RISK REDUCTION BEHAVIOR | BEHAVIOR | ORGANIZATION
AND ADMINISTRATION | INFORMATION
HIV counseling and testing for youth: a manual for providers.
Author:
Fischer S; Reynolds H; Yacobson I; Barnett B; Schueller J
Source:
Arlington, Virginia, Family Health International [FHI], YouthNet
Program, 2005.
Abstract:
At 1.7 billion strong, today’s generation of youth is the largest in history.
Among the many challenges young people face is the risk of HIV/AIDS.
Youth account for an estimated half of the five million new HIV
infections each year — approximately 6,000 young people become
infected every day. Although these statistics are sobering, with early
detection of HIV through counseling and testing, more people can receive
care and support and adopt healthy behaviors to improve their quality of
life and avoid infecting others. In addition, HIV counseling and testing
offers youth who test negative with an opportunity to change behaviors
that may put them at risk of infection in the future. HIV counseling and
testing provides an important opportunity for young people to think
about issues related to sexual behaviors, including the prevention of other
sexually transmitted infections (STIs) and unintended pregnancy. The
counseling and testing process can be a powerful tool for helping young
people deal with peer pressure and begin to adopt and sustain healthy
behaviors that will benefit them the rest of their lives. (excerpt)
Language:
English
Keywords:
KENYA | MANUAL | EVALUATION | YOUTH | COUNSELORS |
COUNSELING | HIV TESTING | CONTRACEPTIVE METHODS |
REFERRAL AND CONSULTATION | DEVELOPING COUNTRIES |
AFRICA, EASTERN | AFRICA SOUTH OF THE SAHARA | AFRICA
| AGE FACTORS | POPULATION CHARACTERISTICS |
DEMOGRAPHIC FACTORS | POPULATION | CLINIC ACTIVITIES
| PROGRAM ACTIVITIES | PROGRAMS | ORGANIZATION AND
ADMINISTRATION | LABORATORY EXAMINATIONS AND
DIAGNOSES | EXAMINATIONS AND DIAGNOSES |
CONTRACEPTION | FAMILY PLANNING
Document Number: 291242
33
Adolescent Reproductive Health: 2005 -2008
Tuko Pamoja. A guide for talking with young people about their
reproductive health.
Author:
Martin S; Madiang’ O; Muthuuri E; Trangsrud R; Kaplan J
Source:
Nairobi, Kenya, Program for Appropriate Technology in Health [PATH],
2005 Nov.
Abstract:
Adolescence is the time of transition between childhood and adulthood.
During this time, young people experience many physical, emotional and
social changes. Physical changes, such as menstruation in girls or
development of facial hair in boys, can be confusing and worrisome for
adolescent. During adolescence, young people develop new interests and
attempt to establish their independence from adults. Peer pressure
increases and can become particularly difficult for young people to resist.
Providing young people with support by talking with and listening to
them as well as ensuring they have access to accurate information can
help them understand the wide range of changes they are experiencing,
and make this transition period easier. Unfortunately, many adolescents
do not have access to the reproductive health information they need to
make informed choices about their health and their futures. They may be
embarrassed asking parents or other adults questions about sexual and
reproductive health. Although parents, teachers, religious and
community leaders, and health care providers are expected to educate
adolescents about personal and physical development, relationships and
their roles in society, it may be difficult for them to do so in a comfortable
and unbiased way. For this reason, it is important to meet adolescents’
needs for information and services. This ca help them resist peer
pressure to become sexually active and protect themselves against
unintended pregnancies and sexually transmitted infections, including
HIV, if they decide to have sex. Young people have both the need and
the right to access this type of information and services. Adolescent
reproductive health education provides adolescents with information
about reproductive physiology and puberty; protective behavior,
including abstinence and contraceptives; and the responsibilities and
consequences that come with sexual activity. (escerpt)
Language:
English
Keywords:
KENYA|MANUAL|YOUTH
|ADOLESCENTS|CURRICULUM|GROUP
PROCESSES|ABSTINENCE|DRUG USE AND
ABUSE|ABORTION|SAFETY|GENDER ISSUES|SEX
BEHAVIOR|RISK BEHAVIOR|PUBERTY|INTERPERSONAL
RELATIONS|SELF ESTEEM|DECISION MAKING|SEXUAL
EXPLOITATION\VOLUNTARY COUNSELING AND
34
Adolescent Reproductive Health: 2005 -2008
TESTING|SEXUALLY TRANSMITTED DISEASE
PREVENTION|HIVE PREVENTION |AFRICA, EASTERN | AFRICA,
SUB SAHARAN |AFRICA |DEVELOPING COUNTRIES |AGE
FACTORS| POPULATION | EDUCATION | SOCIAL BEHAVIOR|
BEHAVIOR| FAMILY PLANNING, BEHAVIORAL METHODS|
FAMILY PLANNING| FERTILITY CONTROL, POST CONCEPTION|
PUBLIC HEALTH | HEALTH | SOCIAL CULTURAL FACTORS|
REPRODUCTION| PSYCHOLOGICAL FACTORS| HIV TESTING|
LABORATORY EXAMINATIONS AND DIAGNOSES|
EXAMINATIONS AND DIAGNOSES| MEDICAL PROCEDURES|
MEDICINE |HEALTH SERVICES| DELIVERY INFECTIONS|
DISEASES| HIV INFECTIONS| VIRAL DISEASES
Document Number: 315810
Reaching Kenyan youth with HIV messages in school.
Author:
Taravella S
Source:
Arlington, Virginia, Family Health International [FHI], Institute for HIV /
AIDS, 2005.
Abstract:
Nuru is an upbeat 17-year-old Kenyan who is well-liked and has many
friends. The daughter of a trucker, she lives in a boarding-school, where
she has come to know other young people from different parts of the
country, different classes and different tribes. Known for her good
judgment, Nuru has abstained from sexual activity and is something of a
role model for her younger friend, Janet. But Nuru's boyfriend Leon, a
soccer player at the school, recently left Nuru for the more free spirited
Angel. Angel, who once had sex with a teacher to improve her grades, is
kept by a sugar-daddy--who happens to be Janet's father. In a recent sixmonth period, Leon had sex with six different people and has since
become HIV positive. In the teenagers' skittish community, this prompted
some to question aloud whether Leon should continue playing team
sports or whether another player could even safely wear Leon's jersey.
Meanwhile, Nuru's friend Oscar is facing his own HIV dilemma as he
adjusts to living with his HIV-positive uncle. In many ways, Nuru and
her circle of friends define the challenges of adolescence for young
Kenyans. The challenges are very real, but Nuru and her friends are not:
Nuru (meaning light in Swahili), Janet, Leon, Oscar and Angel are all
characters in a popular comic book series. The Nuru comic books have
proven remarkably effective at reaching young people with health
messages they may not hear in other ways. (excerpt)
Language:
English
35
Adolescent Reproductive Health: 2005 -2008
Keywords:
KENYA | PROGRESS REPORT | EVALUATION | PERSONS
LIVING WITH HIV/AIDS | SCHOOL AGE POPULATION | HIV
INFECTIONS | SCHOOL-BASED SERVICES | HIV PREVENTION |
NEWSPAPERS | SEX FACTORS | UNICEF | DEVELOPING
COUNTRIES | AFRICA, EASTERN | AFRICA SOUTH OF THE
SAHARA | AFRICA | VIRAL DISEASES | DISEASES |
POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS |
POPULATION | PROGRAMS | ORGANIZATION AND
ADMINISTRATION | PRINTED MEDIA | MASS MEDIA |
COMMUNICATION | UN | INTERNATIONAL AGENCIES |
ORGANIZATIONS
Document Number: 295757
The sexual scripts of Kenyan young people and HIV prevention.
Author:
Maticka-Tyndale E; Gallant M; Brouillard-Coyle C; Holland D; Metcalfe K
Source:
Culture, Health and Sexuality. 2005 Jan
Abstract:
The scripting of sexual encounters among young people in Kenyan is
described using results of 28 focus group discussions conducted with
young people attending primary school standard 7, from four different
ethnic groups and living in 22 different communities. Sexual encounters
were described as both mundane and inevitable and followed a
predetermined scripted sequence of events and interactions in which girls
and boys played complementary roles. These scripts were set within
discourses of force and the exchange of gifts for sex. The gendered nature
of the script and its social and cultural foundations are discussed.
Potential strategies for developing HIV prevention programming are
discussed from the perspective of existing sexual scripts. (author's
Language:
English
Keywords:
KENYA | RESEARCH REPORT | FOCUS GROUPS | YOUTH |
PERSONS LIVING WITH HIV/AIDS | HIV PREVENTION | SEX
BEHAVIOR | FEMALE ROLE | MALE ROLE | GENDER ISSUES |
CULTURE | AFRICA, EASTERN | AFRICA SOUTH OF THE
SAHARA | AFRICA | DEVELOPING COUNTRIES | DATA
COLLECTION | RESEARCH METHODOLOGY | AGE FACTORS |
POPULATION CHARACTERISTICS | DEMOGRAPHIC FACTORS |
POPULATION | HIV INFECTIONS | VIRAL DISEASES | DISEASES
| BEHAVIOR | SOCIAL BEHAVIOR | SOCIOCULTURAL FACTORS
36
Adolescent Reproductive Health: 2005 -2008
Document Number: 303930
Factors associated with sexual activity among high-school students
in Nairobi Kenya.
Author:
Kabiru CW, Oripnas P
Source:
Department of Health Promotion and Behavior, College of Public Health,
308 Ramsey Center, University of Georgia, Athens, GA 30602-6522, USA.
Abstract:
The high level of HIV infection in sub-Saharan Africa has led to an
increased interest in understanding the determinants of sexual activity
among young people, who are at high risk of sexually transmitted
infections. The present study examined socio-demographic, behavioral,
and psychosocial factors associated with heterosexual activity among a
sample of 3556 male and female high-school students in Nairobi, Kenya.
Approximately 50% of the males and 11% of females reported having had
sexual intercourse at least once in their lifetime with a significant
proportion reporting multiple sexual partnerships. Sexual activity was
associated with various factors including religiosity, perceived parental
attitudes towards sex, living arrangements, and school characteristics.
However, the pattern of association differed for males and females.
Results suggest that adolescents may benefit from sex education
programs addressing multiple factors that may predispose adolescents to
sexual activity, and that take into account gender differences.
Language:
English
Document Number: 20081007
Condom use among sexually active Kenyan female adolescents at
risk for HIV-1 infection.
Author:
Cherutich P, Brentlinger P, Nduati R, Kiare JN, Farquhar C
Source:
National AIDS/STD Control Programme, Ministry of Health-Kenya, P.O.
Box 19361-00202, Nairobi, Kenya. pcheru@aidskenya.org
Abstract:
High rates of unintended pregnancy and HIV infection occur in subSaharan Africa yet few Kenyan studies have defined correlates of
condom use in sexually active female adolescents. Female adolescents
receiving reproductive health care and aged 15-19 were interviewed. The
prevalence of ever-use of condom was 21.4% and 52 (7.3%) subjects were
infected with HIV-1. Older age, higher levels of education, ever-use of
37
Adolescent Reproductive Health: 2005 -2008
hormonal contraceptives and higher numbers of sexual partners, nonconsensual sex and exchange of sex for favours, were independent
correlates of condom use. Condom use should be promoted in this
population. Further exploration is needed on the developmental and
contextual factors predisposing female adolescents to increased risk of
HIV.
Language:
English
Quasi-experimental evaluation of a national primary school HIV
intervention in Kenya.
Author:
Maticka-Tyndale E, Wildish J, Gichuru M
Source:
Department of Sociology and Anthropology, University of Windsor, 401
Sunset Avenue, Windsor, Ont., Canada N9B 3P4. maticka@uwindsor.ca
Abstract:
This study examined the impact of a primary-school HIV education
initiative on the knowledge, self-efficacy and sexual and condom use
activities of upper primary-school pupils in Kenya. A quasi-experimental
mixed qualitative-quantitative pre- and 18-month post-design using 40
intervention and 40 matched control schools demonstrated significant
program impact on targeted objectives of (1) adequate program delivery
and, for standard 6 and 7 pupils (ages 11-16 years), (2) increased HIVrelated knowledge; (3) increased communication with parents and
teachers about HIV and sexuality; (4) increased assistance to fellow pupils
to avoid sexual activity; (5) increased self-efficacy related to abstinence
and condom use; (6) decreased exposure to HIV through delayed first
intercourse, decreased sexual activity and increased condom. Results
support the conclusions that the existing infrastructure is adequate for
national roll-out of the program; that the program has its most beneficial
effect on sexually inexperienced youth and should therefore be
implemented with the youngest age groups possible; and that gains are
gender specific, with boys reporting increased condom use while girls
are more likely to decrease or delay sexual activity. Based on these
results, the program began national roll-out to all primary schools in
2005. By June 2006, the program was operating in 11,000 of the country's
nearly 19,000 schools. Avenue, Windsor, Ont., Canada N9B 3P4.
maticka@uwindsor.ca
Language:
English
Keywords:
ADOLESCENT| AGE FACTORS |CHILD| COMMUNICATION
|CONDOMS/UTILIZATION |FEMALE |FOCUS GROUPS |HIV
INFECTIONS/EPIDEMIOLOGY/PREVENTION & CONTROL
|HEALTH KNOWLEDGE, ATTITUDES, PRACTICE |HUMANS
38
Adolescent Reproductive Health: 2005 -2008
|KENYA/EPIDEMIOLOGY |MALE |MODELS, EDUCATIONAL
|PROGRAM EVALUATION/METHODS |QUESTIONNAIRES
SCHOOL HEALTH SERVICES/ORGANIZATION &
ADMINISTRATION |SELF EFFICACY
SEX EDUCATION/METHODS |SEX FACTORS |SEXUAL
BEHAVIOR/PSYCHOLOGY
Identification of novel risks for non-ulcerative sexually transmitted
infections among young men in Kisumu, Kenya.
Author:
Mehta SD, Moses S, Ndinya-Achola JO, Agot K, Maclean I, - Bailey RC
Source:
Department of Epidemiology and Biostatistics, University of Illinois,
Chicago School of Public Health, IL 60622, USA. supriyad@uic.edu. 2007
Oct
Abstract:
Objectives:
STI prevention interventions often aim to reduce HIV
incidence. Understanding STI risks may lead to more effective HIV
prevention.
Goal:
To identify STI risks among men aged 18-24 in Kisumu, Kenya.
Study design:
We analyzed baseline data from a randomized trial of male circumcision.
Participants were interviewed for sociodemographic and behavioral risks.
Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were
diagnosed by polymerase chain reaction assay and Trichomonas vaginalis
(TV) by culture. The outcome for logistic regression analysis was infection
with NG, CT, or TV.
Results:
Among 2743 men, 214 (7.8%; 95% CI: 6.8%-8.8%) were infected with any
STI. In multivariable analysis, statistically significant risks for infection
were: living one's whole life in Kisumu (OR = 1.50; 95% CI: 1.12-2.01),
preferring "dry" sex (OR = 1.47; 95% CI: 1.05-2.07), HSV-2 seropositivity
(OR = 1.37; 95% CI: 1.01-1.86), and inability to ejaculate during sex (OR =
2.04; 95% CI: 1.15-3.62). Risk decreased with increasing age and
education, and cleaning one's penis less than 1 hour after sex (OR = 0.51;
95% CI: 0.33-0.80).
Conclusion:
Understanding how postcoital cleaning, "dry" sex, and sexual dysfunction
relate to STI acquisition may improve STI and HIV prevention.
39
Adolescent Reproductive Health: 2005 -2008
Language:
English
Keywords:
ADOLESCENT |ADULT |COHORT STUDIES |CROSS-SECTIONAL
STUDIES |HUMANS |KENYA/EPIDEMIOLOGY |MALE |MALE
UROGENITAL |DISEASES |EPIDEMIOLOGY |ETIOLOGY
|PREVENTION & CONTROL |URINE |RANDOMIZED
CONTROLLED TRIALS AS TOPIC |RISK FACTORS |SEXUAL
BEHAVIOR |SEXUALLY TRANSMITTED DISEASES|
EPIDEMIOLOGY |ETIOLOGY |PREVENTION & CONTROL/URINE
Document Number: 20080117
Determinants of teenage pregnancies: the case of Busia District in
Kenya.
Author:
Were M,
Source:
Kenya Institute for Public Policy Research and Analysis, P.O. Box 56445,
00200 Nairobi, Kenya. mwere@kippra.or.ke 2007 May
Abstract:
Sub-Saharan Africa has one of the highest levels of teenage pregnancies in
the world. In spite of that, there is paucity of empirical research on causes
of teenage pregnancies in African countries. This paper investigates the
determinants of teenage pregnancies based on a case study of Busia
District in Kenya. The data are from a household survey conducted in
1998/1999. Empirical results indicate that girls' education level has
significant influence on the probability of teenage birth, with nonschooling adolescents and those with primary school level education
being more vulnerable. Among the variables used as proxies for access to
sex education, availability of church forums that educate adolescents
about sex and family life issues reduce probability of teenage pregnancy.
Age is positively related to teenage pregnancies, with older adolescents
being more predisposed to pregnancies. Though use of contraceptives is
found to have a positive effect, only a small proportion of adolescents
were using modern contraceptives and, supply side factors such as
quality and availability were not accounted for. Other key factors as
outlined by the adolescents themselves include peer pressure and social
environment-related factors like inappropriate forms of recreation, which
act as rendezvous for pre-marital sex, as well as lack of parental guidance
and counselling. Overall, lack of access to education opportunities, sex
education and information regarding contraceptives, as well the
widespread poverty predispose girls to teenage pregnancies. The
problem of teenage pregnancies should be viewed within the broader
socio-economic and socio-cultural environment in which the adolescents
operate. For instance, lack of parental guidance on issues of sexuality and
40
Adolescent Reproductive Health: 2005 -2008
sex education was reinforced by cultural taboos that inhibit such
discussions. Adolescents should be equipped with the relevant
knowledge to enable them make informed choices regarding sexual
relationships. This should be complemented with broader programmes
aimed at promoting girl education and poverty alleviation.
Language:
English
Keywords:
ADOLESCENT|ADOLESCENT BEHAVIOR|
PSYCHOLOGY|ADOLESCENT DEVELOPMENT/PHYSIOLOGY|
ADULT| AGE FACTORS| CONTRACEPTION
BEHAVIOR/*STATISTICS & NUMERICAL DATA |EDUCATIONAL
STATUS |FEMALE |HEALTH KNOWLEDGE, ATTITUDES,
PRACTICE |HUMANS |INTERVIEWS AS TOPIC |KENYA
|MARITAL STATUS/STATISTICS & NUMERICAL DATA |PEER
GROUP |PREGNANCY |PREGNANCY IN
ADOLESCENCE/PSYCHOLOGY/*STATISTICS & NUMERICAL
DATA |PROBABILITY |QUESTIONNAIRES |RISK FACTORS |SEX
EDUCATION |SEXUAL BEHAVIOR/PSYCHOLOGY/STATISTICS &
NUMERICAL DATA |SOCIAL ENVIRONMENT
|SOCIOECONOMIC FACTORS
Document Number: 20070604
Adult male circumcision outcomes: experience in a developing
country setting.
Author:
Krieger JN, Bailey RC, - Opeya JC, Ayieko BO, Opiyo FA, Opiyo FA, Agot
K, Parker C, Ndinya-Achola JO, Moses S
Source:
Department of Urology, University of Washington, Seattle, WA 98195,
USA. jkrieger@u.washington.edu 2007 Aug
Abstract:
Introduction:
We examined male circumcision outcomes among young adults in and
African setting.
Materials and methods:
Participants were healthy, sexually active, uncircumcised, HIVseronegative males aged 18-24 years. The main outcomes measured
included complications, healing, satisfaction and resumption of
activities.
Results:
41
Adolescent Reproductive Health: 2005 -2008
Of 1,475 procedures, 26 (1.8%) were associated with 27 adverse events,
most commonly wound disruption/delayed healing (0.6%), wound
infection (0.4%), and bleeding (0.3%). Adverse events per clinician
averaged 3.8 and 2.1% for procedures 1-100 and 101-200, respectively,
and <1% for procedures 201-300, 301-400 and >400, respectively (p <
0.001). Participants resumed normal general activities after a median of 1
postoperative day and 93% with regular employment resumed working
within 1 week. After 30 days, 99% of participants reported being very
satisfied. After 90 days, 65% reported having had sex, 45% reported that
their partners had expressed an opinion, 92% of whom were very
satisfied with the outcome.
Conclusions: Safe and acceptable adult male circumcision services can be
delivered in developing country settings.
Language:
English
Keywords:
ADOLESCENT| ADULT |AGE FACTORS | CIRCUMCISION,
MALE|ADVERSE EFFECTS| DEVELOPING COUNTRIES |HIV
INFECTIONS|PREVENTION & CONTROL |HUMANS |KENYA
|MALE
Document Number: 20071004
Reaching youth through franchise clinics: assessment of Kenyan
private sector involvement in youth services.
Author:
Decker M, Montagu D,
Source:
Harder & Company Community Research, San Francisco, California,
USA. 2007 Feb 24
Abstract:
This paper evaluates the ability of social franchise programs, which use
private providers to offer reproductive health services, to provide
services to youth in western Kenya. Although franchise clinics have
rarely targeted youth, they appear to offer a viable alternative for
providing reproductive health services to this age group.
Language:
English
Keywords:
ADOLESCENT |ADOLESCENT BEHAVIOR |ADOLESCENT
HEALTH SERVICES |ORGANIZATION & ADMINISTRATION
|UTILIZATION |ADULT |CONTRACEPTION
BEHAVIOR/STATISTICS & NUMERICAL DATA |FEMALE
|HEALTH KNOWLEDGE, ATTITUDES, PRACTICE| HUMANS|
42
Adolescent Reproductive Health: 2005 -2008
KENYA |NEEDS ASSESSMENT |PRIVATE SECTOR |PROGRAM
EVALUATION |REPRODUCTIVE HEALTH SERVICES
|ORGANIZATION & ADMINISTRATION |UTILIZATION
Document Number: 20070301
Poor pregnancy outcomes among adolescents in South Nyanza
region of Kenya.
Author:
Magadi M
Source:
Centre for Research in Social Policy, Department of Social Sciences,
Loughborough University, Leicestershire, UK. m.a.magadi@lboro.ac.uk
2007 July
Abstract:
In this paper, we examine factors associated with poor pregnancy
outcomes among teenagers in South Nyanza region of Kenya. The
analysis is based on a recent WHO funded study on Adolescent safe
motherhood in the region, which involved a survey of 1247 adolescents
aged 12-19 and in-depth interviews with 39 of the adolescents who had
experienced very early pregnancies or a pregnancy wastage. The
indicators of poor pregnancy outcomes analysed include pregnancy
wastage and pre-term delivery. A striking finding is the unusually high
rate of pre-term deliveries, especially in cases of unintended pregnancies.
Analysis of the qualitative data based on in-depth interviews sheds
some light on possible explanations for the poor pregnancy outcomes
observed among these adolescents. In particular, unsafe abortion
attempts and poor maternal health-care emerge as important issues of
concern.
Language:
English
Keywords:
|ABORTION, INDUCED |ABORTION,
SPONTANEOUS/EPIDEMIOLOGY |ADOLESCENT |ADULT |AGE
FACTORS |CHILD |FEMALE |HUMANS
|KENYA/EPIDEMIOLOGY |PREGNANCY|PREGNANCY
OUTCOME |EPIDEMIOLOGY |PREGNANCY IN ADOLESCENCE
|STATISTICS & NUMERICAL DATA |PREGNANCY, UNPLANNED
|PREMATURE BIRTH/EPIDEMIOLOGY/ETIOLOGY |PRENATAL
CARE/UTILIZATION |SOCIOECONOMIC FACTORS
Document Number: 20071012
43
Adolescent Reproductive Health: 2005 -2008
What is youth-friendly? Adolescents' preferences for reproductive
health services in Kenya and Zimbabwe.
Author:
Erulkar AS, Onoka CJ, Phiri A
Source:
African Journal of Reproductive Health. 2005 Dec
Abstract:
While there has been increased attention to youth-friendly reproductive
health services, little research has been conducted among adolescents in
developing countries to assess what characteristics of reproductive health
services are most important to them. Large scale population-based
surveys were carried out among youth in Kenya and Zimbabwe. A list of
characteristics that programmers often think of as youth-friendly was
read to respondents, after which they were asked to assess the
importance of those characteristics in choosing their reproductive health
services. Adolescents rated confidentiality, short waiting time, low cost
and friendly staff as the most important characteristics. The least
important characteristics included youth-only service, youth involvement
and young staff, suggesting that adolescents do not prioritize stand-alone
youth services such as youth centres, or necessarily need arrangements
particular to youth such as youth involvement. The findings imply that
most existing clinical services, even in the most resource-poor settings,
are in a position to improve their level of youth friendliness.
Language:
English
Keywords:
ADOLESCENT| ADOLESCENT BEHAVIOR| ADULT| CHILD|
FEMALE KENYA| MALE| REPRODUCTIVE HEALTH SERVICES
|ORGANIZATION & ADMINISTRATION| ZIMBABWE
Document Number: 20060522
Adult Male Circumcision: Effects on Sexual Function and Sexual
Satisfaction in Kisumu, Kenya.
Author:
Krieger, J. N.; Mehta, S. D.; Bailey, R. C.; Agot, K.; Ndinya-Achola, J. O.;
Parker, C., and Moses
Source:
J Sex Med. 2008 Aug 28
Abstract:
Introduction:
Male circumcision is being promoted for HIV prevention in high-risk
heterosexual populations. However, there is a concern that circumcision
may impair sexual function.
44
Adolescent Reproductive Health: 2005 -2008
Aim:
To assess adult male circumcision's effect on men's sexual function and
pleasure.
Methods:
Participants in a controlled trial of circumcision to reduce HIV incidence
in Kisumu, Kenya were uncircumcised, HIV negative, sexually active
men, aged 18-24 years, with a hemoglobin >/=9.0 mmol/L. Exclusion
criteria included foreskin covering less than half the glans, a condition
that might unduly increase surgical risks, or a medical indication for
circumcision. Participants were randomized 1:1 to either immediate
circumcision or delayed circumcision after 2 years (control group).
Detailed evaluations occurred at 1, 3, 6, 12, 18, and 24 months. Main
Outcome Measures. (i) Sexual function between circumcised and
uncircumcised men; and (ii) sexual satisfaction and pleasure over time
following circumcision.
Results:
Between February 2002 and September 2005, 2,784 participants were
randomized; including the 100 excluded from this analysis because they
crossed over, were not circumcised within 30 days of randomization, did
not complete baseline interviews, or were outside the age range. For the
circumcision and control groups, respectively, rates of any reported
sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2%
and 5.8% at month 24. Changes over time were not associated with
circumcision status. Compared to before they were circumcised, 64.0% of
circumcised men reported their penis was "much more sensitive," and
54.5% rated their ease of reaching orgasm as "much more" at month 24.
Conclusions:
Adult male circumcision was not associated with sexual dysfunction.
Circumcised men reported increased penile sensitivity and enhanced ease
of reaching orgasm. These data indicate that integration of male
circumcision into programs to reduce HIV risk is unlikely to adversely
effect male sexual function.
The effect of weekly iron and vitamin A supplementation on
hemoglobin levels and iron status in adolescent schoolgirls in
western Kenya
Author:
Leenstra, T.; Kariuki, S. K.; Kurtis, J. D.; Oloo, A. J.; Kager, P. A., and Ter
Kuile, F. O.
Source:
Eur J Clin Nutr. 2007 Oct 10.
45
Adolescent Reproductive Health: 2005 -2008
Abstract:
Background/Objectives:
Iron deficiency anemia is a major public health problem in developing
countries and may affect school performance and physical work capacity
in nonpregnant adolescents, and may increase the risk of anemia during
subsequent teenage pregnancies. We assessed the effect of weekly iron
(120 mg elemental iron) and vitamin A (25 000 IU) supplementation on
hemoglobin, iron status and malaria and nonmalaria morbidity in
adolescent schoolgirls.
Subjects/Methods:
A total of 279 schoolgirls aged 12-18 years from public primary schools in
Kisumu, western Kenya. Double-blind randomized placebo-controlled
trial using a factorial design.
Results:
Five months of iron supplementation was associated with a 0.52 g dl(-1)
(0.21, 0.82) greater increase in hemoglobin relative to iron placebo. The
effect was only observed in girls with iron deficiency on enrollment (1.34
g dl(-1) (0.79, 1.88)), but not in iron-replete girls (-0.20 g dl(-1) (-0.59,
0.18)). Similar differences in treatment effect were seen between
menstruating and non-menstruating girls. The effect of iron was
independent of vitamin A. The baseline prevalence of vitamin A
deficiency was low (6.7%) and no sustained increase in hemoglobin was
seen with weekly vitamin A (-0.07 g dl(-1) (-0.38, 0.25)). Incidence of
malaria parasitemia was higher in the iron than iron-placebo groups
(Rate ratio 1.33 (0.94, 1.88)).
Conclusions:
Weekly iron supplementation results in substantial increases in
hemoglobin concentration in adolescent schoolgirls in western Kenya,
which may outweigh possible risks caused by malaria, but only in irondeficient or menstruating girls and not in iron-replete and nonmenstruating girls.
The sexual scripts of Kenyan young people and HIV prevention.
Author:
Source:
Abstract:
Maticka-Tyndale, E.; Gallant, M.; Brouillard-Coyle, C.; Holland, D.;
Metcalfe, K.; Wildish, J., and Gichuru, M
Cult Health Sex. 2005 Jan; 7(1):27-41.
The scripting of sexual encounters among young people in Kenyan is
described using results of 28 focus group discussions conducted with
young people attending primary school standard 7, from four different
ethnic groups and living in 22 different communities. Sexual encounters
were described as both mundane and inevitable and followed a
46
Adolescent Reproductive Health: 2005 -2008
predetermined scripted sequence of events and interactions in which girls
and boys played complementary roles. These scripts were set within
discourses of force and the exchange of gifts for sex. The gendered nature
of the script and its social and cultural foundations are discussed.
Potential strategies for developing HIV prevention programming are
discussed from the perspective of existing sexual scripts.
A nested case-control study of sexual practices and risk factors for
prevalent HIV-1 infection among young men in Kisumu, Kenya.
Author:
Mattson, C. L.; Bailey, R. C.; Agot, K.; Ndinya-Achola, J. O., and Moses
Source:
Sex Transm Dis. 2007 Oct; 34(10):731-6.
Abstract:
Objectives:
To investigate sexual practices and risk factors for prevalent HIV
infection among young men in Kisumu, Kenya.
Goal:
The goal of this study was to identify behaviors associated with HIV in
Kisumu to maximize the effectiveness of future prevention programs.
Study design:
Lifetime sexual histories were collected from a nested sample of 1337
uncircof male circumcision to reduce HIV incidence.
Results:
Sixty-five mumcised participants within the context of a randomized
controlled trial en (5%) tested positive for HIV. Multiple logistic
regression revealed the following independent predictors of HIV: older
age, less education, being married, being Catholic, >4 lifetime sex
partners, prior treatment for an STI, sex during partner's menstruation,
ever practicing bloodletting, and receipt of a medical injection in the last 6
months. Prior HIV testing and postcoital cleansing were protective.
Conclusions:
This analysis confirms the importance of established risk factors for HIV
and identifies practices that warrant further investigation.
47
Adolescent Reproductive Health: 2005 -2008
Exploring sexuality: a journey towards embracing sexual rights.
Source:
Center for Rights Education and Awareness (CREAW) and the School of
Law, University of Nairobi
Abstract:
This study was carried out between March and May 2006 as a joint
project of the Center for Rights Education and Awareness (CREAW) and
the School of Law, University of Nairobi and sought to address the
following questions: What are the levels and sources of awareness on
sexuality and sexuality-related rights among students at the School of
Law in particular and the University of Nairobi in general? What is the
nature and extent of sexuality-related rights' violations among students
and staff at the School of Law? To what extent do both the law curricula
and the university's administrative policies and practices address
sexuality issues and sexuality-related rights? What are the prevailing
perceptions, attitudes and practices among both students and staff at the
School of Law in regard to sexuality and sexuality-related rights? What
ought to be done to empower students at the School of Law in particular
and University of Nairobi in general, to claim and protect their sexualityrelated rights? (excerpt)
HIV / AIDS TRaC study evaluating abstinence among urban youth
(10-14 years). Second round.
Source:
Kenya (2005)
Abstract:
Nimechill (meaning "I have chilled" or "I am abstaining") is an abstinence
promotion mass media campaign. This study identifies perceptions that
influence abstinence in urban 10-14 year olds, evaluates Nimechill's
effectiveness in changing those perceptions and abstinence levels over a
seven month period (September 2004 to April 2005), and provides
guidance for future abstinence promotion campaigns. Nimechill's aim
was to change three perceptions correlated with abstinence: social norms,
self-efficacy and behavioral intentions to remain abstinent. Nimechill's
persuasion strategy was based on positive affect (messages were
optimistic and encouraging, rather than risk based) and positive deviance
(messages featured older youth, aged 14-16, defying early teenage sex
norms). The USD $550,000 campaign (Kshs 41.5 million) was delivered
through television, radio, print, billboards, poster, T-shirts, and event
sponsorships. (excerpt)
48
Adolescent Reproductive Health: 2005 -2008
Youth in Kenya: health and HIV.
Source:
2003 Kenya Demographic and Health Survey (2003 KDHS).
Abstract:
Young people today face many health-related challenges. This report is
designed to help program managers, parents, church groups and other
people and organizations working with youth to understand some of
these challenges. Drawing from the most recent Kenya Demographic and
Health Survey, this report outlines the latest information about Kenya's
young people, age 15 to 24. The Demographic and Health Survey
collected data from more than 11,500 women and men nationwide
including more than 4,000 young women and men age 15-24. (excerpt)
Expanding safe spaces and developing skills for adolescent girls.
Author:
Austrian, K.
Abstract:
Almost 1 billion people around the globe live in urban informal
settlements, or "slums," and the number of such residents is increasing. In
Kenya, 60 percent of Nairobi's nearly 3 million inhabitants live in slum
areas characterized by high levels of poverty and HIV. Kibera, the largest
of these slums, is about 2.5 square kilometers and home to almost 800,000
people, commonly migrants from rural areas. The term "informal
settlements" underscores their non-permanence and implicitly justifies
the lack of infrastructure and services provided by the government,
including water, electricity, health services, sanitation, and public schools.
Most residents rely on an informal system of services provided by NGOs,
faith-based groups, and local entrepreneurs, and live in one-room houses
made of semi-permanent materials such as mud, wooden planks, or metal
sheets. The majority of slum residents live in extreme poverty, with
residents sustaining themselves in whatever manner they can, often
through informal-sector activities such as petty trade or casual labor.
(excerpt)
Dialogue between adults and young people on issues related to
adolescent reproductive health. It for teachers; community, religious, and
youth group leaders; health care professionals; and anyone working with
young people. The curriculum is designed to delay sexual debut and
promote sexual and reproductive health by addressing gender,
reproductive health, preventive behaviours, sexually transmitted
infections, HIV and AIDS, abstinence, gender violence, and decisionmaking, communication, and other important life skills. (excerpt)
49
Adolescent Reproductive Health: 2005 -2008
Trends in primary and secondary abstinence among Kenyan youth.
Author:
Chiao C and Mishra, V.
Abstract:
Promoting sexual abstinence among never-married youth is an important
component of HIV/AIDS prevention campaigns for youth in countries
with generalized epidemics. The objective was to examine trends in
primary and secondary abstinence among never-married youth age 15-24
in Kenya over a ten-year period and to explore the role of HIV prevention
knowledge, schooling, and contextual factors in affecting abstinence
behavior. Data were from Kenya Demographic and Health Surveys
conducted in 1993, 1998, and 2003. Primary abstinence was defined as
never-married youth who never had sex. Secondary abstinence was
defined as never-married youth who ever had sex but not in the past
year. Logistic regression models were used to estimate the effects of
prevention knowledge, schooling, and contextual factors in affecting
abstinence behavior, after accounting for sampling weights and clustering
in the survey design. Both primary and secondary abstinence levels have
risen in the past 10 years in Kenya. The abstinence levels were higher
among female youth than among male youth. Multivariate analyses show
that knowledge that abstinence can prevent HIV infection was positively
associated with the likelihood of practicing abstinence (both primary and
secondary). However, knowledge that condom use can prevent HIV
infection was associated with lower abstinence practice. In-school youth
were 4-5 times more likely to abstain from sex than those working
(aOR=4.12; p=0.000 for female youth and aOR=4.83; p=0.000 for male
youth). Not-in-school female youth were about as likely to abstain as
working female youth, but not-in-school male youth were about 2 times
more likely to abstain than working male youth. Muslim youth were
much more likely to abstain than other youth. Female youth with weekly
exposure to television and those with a secondary or higher education
were significantly more likely to have abstained, whereas male youth
were significantly less likely. Effects of these factors on secondary
abstinence practice were generally weaker, but sexually experienced inschool male youth were significantly more likely to have abstained in the
past year than sexually experienced working male youth. Effects of the
contextual variables on the likelihood of abstinence were generally small
and insignificant, except for primary abstinence among female youth.
Increasing knowledge that abstinence can prevent HIV infection and
keeping youth in schools can help promote abstinence behavior.
Abstinence programs need to be gender sensitive and culturally
appropriate. (author's)
50
Adolescent Reproductive Health: 2005 -2008
Relative risks and the market for sex: teenagers, sugar daddies and
HIV in Kenya.
Author:
Dupas, P.
Abstract:
An information campaign that provided Kenyan teenagers in randomly
selected schools with the information that HIV prevalence was much
higher among adult men and their partners than among teenage boys led
to a 65% decrease in the incidence of pregnancies by adult partners
among teenage girls in the treatment group relative to the comparison.
This suggests a large reduction in the incidence of unprotected crossgenerational sex. The information campaign did not increase pregnancies
among teenage couples. These results suggest that the behavioral choices
of teenagers are responsive to information on the relative risks of
different varieties of a risky activity. Policies that focus only on the
elimination of a risky activity and do not address risk reduction strategies
may be ignoring a margin on which they can have substantial impact.
(author's)
Football teams offer competition and education on HIV / AIDS.
Struggling youth find new beginning.
Author:
Finger, W..
Abstract:
Neema Sanga, 19, grabs her baby, a two-month old boy named Rahel, as
her football teammates from the Upendo Vocational Educational School
take a break at halftime. Neema holds the little boy as she discusses her
transformation, a result of joining the football team. (Some countries refer
to football as "soccer.") "Before joining the team, I was having lots of
sexual partners and spent my time having sex and using bhangi
(marijuana)," she says. "Now, I like playing football more than my
previous life." Across town, two primary school boys' teams are also
playing a game. At their halftime, a 15-year-old named Tony echoes the
story of Neema. "I am trying to separate myself from the bad groups,
where I was using a lot of bhangi and alcohol," he says. "The training
with the team is helping a lot, as well as the gathering with the other
boys, which gives me support. It is helping me free myself from the bad
guys." (excerpt)
51
Adolescent Reproductive Health: 2005 -2008
Sexual initiation and contraceptive use among female adolescents
in Kenya.
Author:
Ikamari, L. D. and . Towett R
Source:
African Journal of Health Sciences. 2007; 14(1-2):1-13.
Abstract:
This paper examines the timing of sexual initiation and contraceptive use
among female adolescents in Kenya. Data are drawn from the 2003 Kenya
Demographic and Health Survey. The main analytical tools are regression
models. A Cox regression model is used to consider the probability of a
young woman having first sex during adolescence and linear regression
model to quantify the effects of a set of factors on female adolescent's age
at first sexual debut. Finally, logistic regression model is used to model
the probability of a sexually experienced adolescent woman using a
contraceptive method. The results obtained indicate the onset of sexual
activity is early and contraceptive use is fairly low and both the timing of
first sex and contraceptive use are affected by a variety of factors. Despite
engaging in unsafe sex practices, the majority of the adolescents do not
view themselves as being at the risk of contracting HIV/AIDS. A number
of recommendations are proposed. (author's)
Factors inhibiting educated mothers in Kenya from giving
meaningful sex-education to their daughters.
Author:
Mbugua, N.
Source:
Soc Sci Med. 2007 Mar; 64(5):1079-89.
Abstract:
Public health studies advocate the education of women, especially
mothers, stating that educated mothers are highly likely to pass on their
education to their children, as well as enforce in their homes healthy
practices thereby protecting entire families from disease. Whereas this is
usually true in regard to most infectious diseases such as influenza, it is
not usually the case when it comes to sexually transmitted infections
(STIs) such as HIV/AIDS. The research is based on a survey focus group
discussion with high-school students (aged 17-19) and interviews with 10
high-school teachers in 1996. In 2003, data were collected from a focus
group with fourth-form students and interviews with 4 teachers and 15
mothers whose daughters were in high school. The findings indicate that
most educated mothers in urban Kenya experience socio-cultural and
religious inhibitions which hinder them from providing meaningful sexeducation to their pre-adolescent and adolescent daughters. This paper
discusses these inhibitions and the steps educated mothers take to ensure
that their daughters receive some form of sex-education.
52
Adolescent Reproductive Health: 2005 -2008
Gender-role Attitudes and Reproductive health communication
among female Adolescents in South Nyanza, Kenya.
Author:
Obare F; Agwanda A, and Magadi, M.
Source:
African Population Studies/Etude De La Population Africaine. 2006;
21(1):37-54.
In this paper, we use data from three districts of Nyanza Province in
Kenya to examine gender-role attitudes and reproductive health
communication among adolescent females aged 12-19 years. We test for
differences in gender-role attitudes between younger (12-15) and older
(16-19) adolescents. We explore the possible association between
educational attainment and gender-role attitudes by estimating a
random-effects model. We also examine the association between genderrole attitudes and reproductive health communication via an unordered
multinomial logit model. The results show that adolescent females in this
setting hold conservative views on decision making within the home and
at the same time portray less conservative views concerning marriage and
reproductive behaviour. We also find some differences by age regarding
gender-role attitudes and reproductive health communication. Our
findings further indicate that educational attainment is significantly
associated with gender-role attitudes, which in turn are significantly
associated with reproductive health communication. (author's)
Abstract:
Reaching Kenyan youth with HIV messages in school.
Abstract:
Nuru is an upbeat 17-year-old Kenyan who is well-liked and has many
friends. The daughter of a trucker, she lives in a boarding-school, where
she has come to know other young people from different parts of the
country, different classes and different tribes. Known for her good
judgment, Nuru has abstained from sexual activity and is something of a
role model for her younger friend, Janet. But Nuru's boyfriend Leon, a
soccer player at the school, recently left Nuru for the more free spirited
Angel. Angel, who once had sex with a teacher to improve her grades, is
kept by a sugar-daddy--who happens to be Janet's father. In a recent sixmonth period, Leon had sex with six different people and has since
become HIV positive. In the teenagers' skittish community, this prompted
some to question aloud whether Leon should continue playing team
sports or whether another player could even safely wear Leon's jersey.
Meanwhile, Nuru's friend Oscar is facing his own HIV dilemma as he
adjusts to living with his HIV-positive uncle. In many ways, Nuru and
her circle of friends define the challenges of adolescence for young
Kenyans. The challenges are very real, but Nuru and her friends are not:
Nuru (meaning light in Swahili), Janet, Leon, Oscar and Angel are all
characters in a popular comic book series. The Nuru comic books have
53
Adolescent Reproductive Health: 2005 -2008
proven remarkably effective at reaching young people with health
messages they may not hear in other ways. (excerpt)
Determinants of Consistent Condom Use Vary by Partner Type
among Young Men in Kisumu, Kenya:
Author:
Westercamp, N.; Mattson, C. L.; Madonia, M.; Moses, S.; Agot, K.;
Ndinya-Achola, J. O.; Otieno, E.; Ouma, N., and Bailey, R. C.
Source:
A Multi-level Data Analysis. AIDS Behav. 2008 Sep 13.
Abstract:
To evaluate whether determinants of consistent condom use vary by
partner type among young sexually active Kenyan men, we conducted a
cross-sectional assessment of lifetime sexual histories from a sub-sample
of men enrolled in a clinical trial of male circumcision. 7913 partnerships
of 1370 men were analyzed. 262 men (19%) reported never, 1018 (74%)
sometimes and 92 (7%) always using a condom with their partners.
Condoms were always used in 2672 (34%) of the total relationships-212
(70%) of the relationships with sex workers, 1643 (40%) of the casual and
817 (23%) of the regular/marital relationships. Factors influencing
condom use varied significantly by partner type, suggesting that HIV
prevention messages promoting condom use with higher-risk partners
have achieved a moderate level of acceptance. However, in populations
of young, single men in generalized epidemic settings, interventions
should promote consistent condom use in all sexual encounters,
independently of partner type and characteristics.
Youth, Church and Sexuality in Kenya.
Author:
Kangara L.,
Source:
Egerton University Kenya & Institute of Tropical Medicine and Infectious
Diseases, Jomo Kenyatta University of Science and Technology, Kenya
Abstract:
The church holds an important place in the socioeconomic and political
life of Kenya. Out of a total population of 30 million, over 50% are
Christians and despite the social changes that have occurred in the lives
of Kenyans, religious institutions continue to celebrate an era of chastity
and sexual conservatism. In an era of sexual freedom, religious
institutions still hamper dispensation of sex education that can guide and
assist its members towards surviving in the global sex culture. In a world
that is characterized by technological advanced and increased
connectivity, people are confronted with sexuality issues on a daily basis through television, radio, music, newspapers, magazines, adverts,
dressing, etc, making it impossible to escape the invasion. Without
54
Adolescent Reproductive Health: 2005 -2008
adequate information about sex, people face a risk of being swallowed up
by a culture that does not rhyme with the doctrine they receive in
religious institutions. While churches need to preserve the sanctity of
marriage (as seen in their discouragement of condoms and insistence of
abstinence), such an objective can only be attained if people possess
adequate knowledge of their sexuality and how to express it in a
changing society. Hence the purpose of this study was to examine what
Christian churches are doing to create a conducive environment for
young people to discuss sexuality issues openly without fear or guilt.
Kenya is a country where 80 percent of the population is Christian and
sexuality issues have not been given spaces for discussion within
churches on "moral" ground. Religious leaders have a role to play in
addressing social and development issues within communities. All over
Africa churches through their church leaders have the capacity to
influence a community's response on various issues
This study aims to qualitatively seek young Christian's views and how
their different churches are dealing with sexuality issues. The Method
used was in-depth literature review on various Kenyan newspapers on
sections that have reported on issues of sexuality, then focus group
discussion that involved young people, church leaders/ elders. The
discussion was recorded and thereafter transcribed and analyzed. The
Findings indicated that the churches have made progress on certain areas
especially in urban areas but a lot still needs to be done in rural areas.
Churches in rural areas still do not openly discuss or debate sexuality
issues.
Partnering with Religious Leaders to Advance ASRH1 Rights:
Lessons Learnt from the Network of Adolescents and Youth of
Africa.
Author:
Ravon L.,
Source:
PPFA-International, Africa Regional Office, Kenya
Abstract:
Background and objectives:
The Network of Adolescents and Youth of Africa (NAY A) was launched
in 2002 to contribute towards the creation of an enabling policy
environment that fosters ASRH and rights in selected African countries.
The network has chapters in Benin, Cameroon, Kenya, Nigeria, Sudan and
Uganda, and is composed of approximately 100 member organizations.
One of the key strategies of the program has been to enlist the support of
religious leaders in advocating for the enactment and implementation of
national policies to improve ASRH rights.
55
Adolescent Reproductive Health: 2005 -2008
A study of the NAYA program was carried out in 2005 to evaluate the
initial program design and to determine whether partnerships with
religious leaders had proven to be a strategic means of advocating fm
ASRH rights. The purpose of this presentation is to highlight both the pros
and cons of working with religious leaders as a means of improving
ASRH rights.
Findings and lessons learnt:
With regard to the program's work with religious leaders, the study found
that NAYA chapters generally focused on a very limited scope of ASRH
topics, shied away from controversial issues relating to youth sexuality,
and failed to clearly convey NAYA's commitment to the sexual rights of
youth and adolescents. It has been a challenge for NAYA members to be
assertive about their commitment to ASRH rights when working with
religious leaders. As a result, many of the religious leaders that have
partnered with NAYA appear to be unaware of the program's key vision
and mission, and few share its commitment to advancing ASRH rights.
Although NAYA has partnered with close to 150 religious leaders, very
few have actively participated in advocacy activities aimed at advancing
ASRH rights. This is due to the failure of NAYA chapters to clearly
articulate the type of support they require from religious leaders, and
because the program's work with religious leaders has been insufficiently
geared towards well-defined ASRH advocacy objectives.
Conclusions and recommendations:
In order for partnerships with religious leaders to be an effective ASRH
advocacy strategy:
 ASRH advocates must be assertive about their commitment to
ASRH rights, and must clearly spell out their ASRH policy
objectives to the religious leaders with whom they partner.
 ASRH advocacy program must clearly articulate the type of
support they are requesting of religious leaders.
 Program activities with religious leaders should be geared towards
very tangible ASRH advocacy outputs, not merely awarenessraising.
 Programs should encourage religious leaders to advocate for
ASRH and rights in a wide range of social and political forums,
rather than merely encourage them to discuss ASRH topics during
their weekly sermons.
 Programs should make a concerted effort to work with religious
leaders that represent all the major religious denominations in the
regions in which these programs are implemented.
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Adolescent Reproductive Health: 2005 -2008
Male Circumcision Adds No Value to One's Life, Just Scars.
Author:
University Students Speak
Source :
Moi University, Eldoret, Kenya
Abstract:
Background and Objective:
Human beings socialize the young in various ways. Every preceding
generation sets the values for the incoming group. Every stage of life
marks a socialization process with different dimensions. In African
communities, initiation into adulthood rites defines a community's
understanding of sexuality (Khamasi et al, 2005). Male circumcision is a
rite that certain communities enact to symbolize transition from
childhood to adulthood. It is also a socialization process into cultural
practices, norms, and values that make one community distinct from their
neighbors. For males it reflects what constitutes ones masculinity.
This paper is a product of a research survey that was designed to
investigate the value of male circumcision as perceived by students in a
public university campus in Kenya. A sample of 65 males from selected
ethnic groups that practice male circumcision as a rite of passage and of
65 females was selected (n= 130). Questionnaires were used to generate
data from both groups whereas face to-face interviews were used to
solicit information from 25 females. The 25 females were known to the
second "Author as sexually active and therefore their knowledge and
experience with circumcised and uncircumcised men was important.
Findings and lessons learnt:
The findings show that male circumcision is perceived to be valuable to
the respondent's lives for both social and medical reasons. Among the
reasons given as to how the rite adds value are: hygiene (45%); cultural
and religious beliefs (29%); enhances pleasure during intercourse (10%)
and builds one's self esteem (16%). The decision to be circumcised
depended on the parents who are largely informed by their own cultural
and/or religious beliefs. Though majority of the male respondents were
circumcised between age 10 and 15, none was consulted for consent
before surgery was performed. However, majority of the respondents
expressed that "male circumcision adds value to one's life and not just
scars".
Conclusions and Recommendations
This paper analyses the respondent's perceptions, ways in which the
perceptions admiration and sometimes abuse. The paper calls the readers
to investigate ways in which rites of passage as socialization processes
could be used to educate the youth to understand human sexuality from
a holistic perspective and promote safe sex and therefore move towards
57
Adolescent Reproductive Health: 2005 -2008
reducing risky behaviors that contribute to unplanned pregnancies, STls
including HIV and AIDS and unsafe abortions.
Keywords:
Sexuality| male circumcision| safe sex| sexuality| socialization
The Youth for Youth (Y 4Y) program in Western Kenya: Improving
rural youths' knowledge, skills and access to reproductive health
services.
Author:
Albert Obbuyi
Source:
Youth for Youth, Bungoma, Ministry of Education, Kenya
Abstract:
Background objectives:
Many youths in Kenya are at risk of HIV/STls and unwanted pregnancies
due to limited access to information, low self-efficacy and unwelcoming
health facilities. The Youth for Youth (Y4Y) program was designed to
improve rural youth's reproductive health knowledge and life skills, to
increase access to services, and to reduce risky sexual behaviours. It was
launched in September 2003 in Bungoma district, Kenya, and is a joint
effort of two local NGOs, an American university, and two government
ministries
Y 4Y has three main components: (1) Extra-curricular sexuality education
and skills-building using peer educators in secondary schools and
mentors in primary schools; (2) Peer service delivery where teen peer
providers in participating health clinics provide information and
condoms directly to youths; and (3) Quality monitoring through regular
school meetings and youth satisfaction exit cards at health facilities.
To assess impact, the program used anonymous self administered
student questionnaires, pre- and post intervention, in both the
intervention area (Webuye division) and a comparison area (Kimilili
division). A 35-minute video was made in August 2004 for replication
purposes.
Main findings:
 Y4Y has reached over 4000 youths in two years.
 Y 4 Y seems to have significantly-raised AIDS knowledge and
condom self-efficacy.
 Y4Y seems to have decreased forced sex among boys and girls in
primary schools and among girls in secondary schools.
 Y4Y seems to have increased condom use in primary schools for both
boys and girls, and for girls in secondary schools.
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Adolescent Reproductive Health: 2005 -2008

In both comparison and intervention areas, a marked increase in
sexual activity and pregnancies' occurred, possibly due to cultural
encouragement of sexual activity -during the male circumcision
period of July-August 2004.
Conclusions:
 Y4Y was successful in raising knowledge and self efficacy, as well as
reducing some risky behaviours. However, its impact on secondary
school boys' behaviour was marginal.
 Y4Y faced numerous challenges mostly due to limited time available
at schools, opposition of some teachers and church leaders, and lack
of cooperation of some providers.
 Male circumcision ceremonies seem to contradict efforts in reducing
unprotected sex. Linking Y4Y to
 male circumcision ceremonies could increase the programs efficacy
 It is difficult youth access to clinical services, partly because clinics are
closed during times most convenient to youths(evenings and
weekends).Training youths as peer providers is valuable, but
mobilization of youths to use the services and overcoming provider
antagonism are ongoing challenges.
Rights-Based Youth VCT services: What Works.
Author:
Omondi E,
Source:
Family Health Options Kenya
Abstract:
Background:
Twenty Friends of the Youth (FOYs) and 40 Peer Youth Educators (PYEs)
were trained in right-based approach and life planning skills. Their role is
to refer youth for VCT services, conduct youth friendly days and parent
youth discussion forums and to provide youth with IEC materials at
youth friendly corners. The project's HIV prevention initiatives put most
vulnerable youth at the centre of its outreach activities especially young
girls in low income areas
Eight VCT Counsellors were recruited and trained to provide youth
friendly VCT services. They also conduct VCT outreach activities
targeting the underserved youth in the slums. Monitoring and
supervision is carried out by three Project Coordinators. Three Project
Advisory Committees were formed to guide the implementation process.
A baseline survey provided the benchmark data. All trainings and
recruitment considered gender balance.
59
Adolescent Reproductive Health: 2005 -2008
Findings/lessons learned:
"There is nothing for the youth without the youth." Active involvement of
the youth in interventions that concern them enhance their ownership.
More female youth tested HIV positive than their male counterparts.
Strengthening referral networks with other partners providing ARVs
helped in assisting young people testing HIV positive to access treatment
and care. Availability of ART therefore compliments VCT services.
Functional Post Test Clubs cushion the anxiety that comes with the
knowledge of being HIV positive among the youth. Participation, rights
and gender were the driving force behind services and information
provision.
Conclusion and recommendations:
Addressing the fears and the needs of young people in a non-judgmental
and non-moralizing manner when they go for VCT, not only makes them
open up, but also enables them to confidently provide possible solutions
when they test HIV positive. The youth need strong partnership with
adults not tokenism and each young person especially the girl child, has
specific concerns and needs that VCT Counsellors need to address. An
integrated VCT model that addresses the sexual needs of HIV positive
youth, their rights and welfare, gender disparity, lack of participation and
inability to uphold the rights of young people is the best way forward for
the future. A healthy youth is a healthy future able to conquer social
economic challenges.
Non-consensual Sexual Experiences of Young People in Kenya:
Boys as Perpetrators and Victims.
Author:
Carolyne Njue-Ngari,
Source:
Consultant, formerly Population Council
Abstract:
Several studies have shown that non-consensual sex among young people
in Kenya is relatively common, especially for girls but also for boys. In
particular, first sexual experience is likely to be non-consensual, and so
may influence the person's future perceptions of appropriate sexual
behavior and expression of their sexuality. This paper draws on data
collected during a baseline survey for an adolescent reproductive health
intervention in Western Province of Kenya; over 3,500 adolescents aged
10 - 19 years were individually interviewed, including 951 boys and 2,571
girls, drawn randomly from all households with adolescents in this age
range. The objectives of the study were to determine the type of sexual
activities experienced the nature and consensuality of first and
subsequent intercourse, experiences with forced sex, and the correlates of
perpetrating or suffering non-consensual sex among boys.
60
Adolescent Reproductive Health: 2005 -2008
The study confirmed that for sexually experienced girls, almost 40% were
coerced at first intercourse, including those in romantic relationships, and
that 10% of boys reported being coerced; 45% of girls reported ever
experiencing non-consensual sex. The study highlights the role played by
'sweet talking' and persuasion through gifts or money, and explores the
often ambiguous way in which these approaches to initiating romantic
relationships and/or sexual experiences play out in this social context.
Forced first time sex was reported by 16°/" of girl's and 4% of boys, and
the implications of these findings are explored with reference to
qualitative data collected simultaneously. The sexual experiences of boys
were examined in more detail - 21% reported ever having persuaded or
forced a girl to have sex and I 7% reported ever having themselves been
persuaded or forced, with 1 0% reporting both experiences. Multiple
logistic regression was used to identify the correlates of boys reporting
perpetrating or suffering coerced sex. Boys who witnessed violence and
discord among parents, who held traditional gender role attitudes and
who were out of school were significantly more likely to coerce a girl to
engage in sex than were other boys; moreover, those whose initiation was
early and unwanted, or occurred with someone other than a girlfriend
appeared to be significantly more likely to have ever persuaded or forced
a girl to have sex than others. A significant finding was the link between
the experience of coerced first sex and subsequent perpetration of forced
sex.
The paper will also discuss a number of methodological problems with
undertaking research into adolescent sexual behavior, in particular the
importance of the use of nuanced language when asking questions about
sexual behaviors, understanding the role of gift giving and receiving in
the context of initiating relationships, both consensual and nonconsensual, and the difficulties in detecting and describing same-sex
sexual experiences and in determining whether this was coerced or
voluntary.
Adolescent Sexual and Reproductive Health and Rights: Mysteries
of Menstruation For School Going Girls.
Author:
Mercy Musomi M,
Source:
Girl Child Network, Nairobi, Kenya
Abstract:
Objectives
 Understanding menstruation as a reproductive health Right
 Demystification of menstruation among adolescent girls
Background:
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Adolescent Reproductive Health: 2005 -2008
Menstruation, the monthly shedding of the uterine lining, is a normal,
natural process that occurs in all healthy adult women who have not
reached menopause. Girls can begin to menstruate at any time between
eight and eighteen years. To deal with the management of the flow,
women over the ages have used unhygienic materials like grass, sponges,
cotton pads, mattresses, tissue paper and other absorbents to control the
blood. In addition, over decades, women have been taught that having
periods is shameful. The embarrassment surrounding menstruation is a
somewhat universal phenomenon, found in most cultures of the world
and with many associated code words, euphemisms and phrases used as
linguistic substitutes: examples of reference made to menstrual flow curse, womanly chromosomes, monsoon winds, red devil etc. Women
and girls have indirectly, if not directly, absorbed the message that
menstrual blood is dirty, smelly, unhygienic and unclean. With all these
negative messages it is natural for women to want to hide their
menstruation. But menstruation is a natural physical process - a harmless
by-product of a biological event.
Findings:
In the year 2004 Girl Child Network conducted a research on. Gender
Equity and Equality in primary Education. The researchers used
sampling methods among them materials facts sheet, interview guides,
questionnaire, and focus group discussions. One of the many factors that
hinder girls from attending schools through out the years was outlined as
lack of sanitary towels. The study targeted boys and girls, teachers, school
managers, school committees and Ministry of Education officials. During
the dissemination, the Ministry of Education officials singled out lack of
sanitary towels as one of the factors that leads to increase of drop out of
girls from school while "still in school". This is because on average a girl
will lose 3-5 days from school in a month hence missing approximately 1
0-15 days in a 3 month term!
After the Launch of Sanitary Towel Campaign by Girl Child Network
girls have been able to speak out openly on menstruation which has been
seen as a taboo in some communities. Girls have been using socks, leaves,
rags which they wash after use to reuse it again and other unhygienic
materials.
Lessons learnt:
 Lack of Sanitary towels has left many girls out of the school system as
they are passive rather than active participants in the education
system.
 Menstruation issues have been seen as a taboo in many communities.
 After sensitization people are ready to talk about Sanitary towels and
other reproductive health issues which seemed to be very sensitive.
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Adolescent Reproductive Health: 2005 -2008
Conclusion:
Menstruation being sexual reproductive health issue which sta/1s at
adolescent is surrounded by so many myths that women have been
forced to keep it a secret leading to a lot of, suffering, especially for the
young adolescent girls that are confused with their body changes. It's
upon the responsibility of development workers in collaboration with the
government to break the silence and speak out about menstruation and
its management. It's through this that our girls can enjoy the free primary
education as we achieve the Millennium Development goal on education.
Addressing Adolescent Sexual and Reproductive Health (ASRH)
through a multi-sectoral public program.
Author:
Evelia H.,
Source:
Population Council, Nairobi, Kenya
Abstract:
Background:
This paper outlines a public sector program highlighting the unique
experiences and opportunities of a multi sectoral approach in fostering
ASRH and rights. It draws on the experience of the Kenya Adolescent
Reproductive Health and HIV/AIDS prevention Project (KARHP)
implemented in Vihiga and Busia districts of Western Province since
1999. Funded by USAID, the pilot project was implemented by
Population Council and Program for Appropriate Technology in Health
(PATH) in collaboration with three government Ministries of Education,
Ministry of Health, and the Ministry of Gender, Sports, Culture and
Social Services. The project developed and pilot tested innovative
approaches for public sector authorities to work with adolescents, their
parents, teachers and community leaders and health workers in
providing sexual and reproductive health information and skills. It
sought to establish the viability and effectiveness the approaches to
increase ASRH knowledge, rights, and health service uptake among in
and out of school adolescents aged 10-19 years. The successful
implementation of the pilot project generated interest among partners
and the beneficiaries leading to its expansion in the two original districts
in 2003 and eventually it's scaling up into eight districts of Western
Province in 2005.
Findings:
The pilot project showed that multi-sectoral approaches are feasible and
effective in achieving positive sexual and reproductive health (SRH)
behavior change among adolescents. SRH education provided through a
life skill manual increased knowledge, consciousness, and
communication of adolescent sexual and reproductive health rights. Endline survey findings showed increased levels of delayed onset of sexual
63
Adolescent Reproductive Health: 2005 -2008
activity, reduced number of sexual partners, reduced .incidences of
sexual violence, reduced levels of unplanned pregnancies especially
among in-school youth and the related drop out rates due to pregnancy,
and reduced STI infection rates and safer sexual practices. Parent to-child
discussion on SRH improved and communities became very receptive to
information and dialogue about ASRH creating a large constituency for
the program.
Conclusion:
Multi sectoral programs playa crucial role in providing appropriate SRH
information and services for the majority of adolescents. They provide
feasible opportunities for promoting sexual and reproductive health
rights among the young people while creating a wider supportive
environment. They also provide the best avenues for reaching the vast
majority of young people with ASRH information and services for
shaping positive sexual and reproductive health behavioral attributes.
Providing leadership through partnerships encourages ownership and
increases effective utilization of experiences and sustainability of ASRH
and HIV/AIDS programs through the public sector.
Keywords:
ADOLESCENTS| SEXUAL AND REPRODUCTIVE HEALTH AND
RIGHTS| MULTI SECTORAL AND PUBLIC SECTOR
APPROACHES| HIV|AIDS| POSITIVE BEHAVIOR CHANGES
Sexual activities and implications for the reproductive health of adolescent
street girls in Nairobi.
Author:
Njiru R.,
Source:
University of Nairobi
Abstract:
Background and Objectives:
In the last few years, there has been a continued increase in the number of
street children in most urban areas in Kenya. This has occurred despite
government, civil society and religious organizations' efforts to
rehabilitate them. Several studies have been carried out on the street
children mainly focusing on reasons for leaving home or rehabilitation
centre’s to live in the streets. The few health related studies have focused
on general health problems for both girls and boys together which
presupposes that they face similar problems. There has been no specific
study targeting street girls and more so their reproductive health. This
study, therefore, examined the sexual behaviour or activities of adolescent
street girls in Nairobi and how this behaviour impacts on their
reproductive health. Specifically, the study sought to find out the age at
which the girls start experiencing sex, reasons behind their sexual
64
Adolescent Reproductive Health: 2005 -2008
behaviour, sexual harassment or assault in the streets, whether or not they
practice safe sex, and how these sexual activities impact on their
reproductive health.
Method:
Qualitative data was collected through in depth interviews with a
purposively selected sample of fifty adolescent street girls. Supplementary
data included four FGDs, twelve key informant interviews, and
observations. Data was analyzed qualitative Findings: Findings show that
sexual debut for street girls begins as early as four years old. Reasons for
in/voluntarily having sex include; money and gifts, protection, comfort.
Initiation, punishment or fear of assault. There is very limit&4contraceptive use linked to lack of power to negotiate for safe sex and
unaffordability of contraception. This has serious reproductive health
consequences such as STls and HIV/AIDS; unplanned pregnancies, earlyage delivery; abortions and post-abortion complications.
Conclusion/recommendations:
In light of the findings of the study, the overall solution to the street
children problem is socio-economic empowerment and strengthening
family relationships. However, while girls are still on the streets, there is
need for sexual and reproductive health education, life skills and
empowerment of street girls to negotiate for safe sex. Family planning and
counselling services should be made affordable, accessible and friendly to
street girls. In addition, further research on street girls and reproductive
health of boys would help shape reproductive health programmes for all
street children.
Keywords:
ADOLESCENT STREET GIRLS| SEXUAL ACTIVITIES|
BEHAVIOUR| REPRODUCTIVE HEALTH STIS AND HIV/ AIDS|
UNPLANNED PREGNANCY| ABORTION.
Factors associated with risky sexual behaviour among the out of school
youth in Kenya.
Author:
Khasakhala A.,
Source:
Population Studies and Research Institute, University of Nairobi, Kenya
Abstract:
This paper examines factors that may predispose out of school youth to
risky sexual behaviour. The data is from the Behaviour surveillance
Survey carried out in Kenya in late 2002. The survey interviewed
unmarried out of school youth aged 15-24 in eight districts representing
the eight provinces of Kenya. The focus is on those who had sex in the last
12 months of the survey. The factors that are examined in the paper are
65
Adolescent Reproductive Health: 2005 -2008
age at first sexual debut, use of condom at first sexual debut, median age
at first sexual intercourse, number of sexual partners, sex with commercial
sex workers without condom, frequency of condom use with non and
commercial partners, level of education, district of residence, religion of
respondent, current age (As at time of survey) among others.
Methods of analysis include descriptive statistics and multivariate analysis
in order to determine which variables if any are predictors of risky sexual
behaviour. An index of risky sexual behaviour consisting of such variables
as sex in past twelve months, sex with commercial sex partners without
condom, number of commercial an~ non commercial sex partners,
frequency of alcohol use, frequency of condom use with commercial and
non commercial partners (all these relate to last twelve months).
Preliminary analysis of data indicate that out of a sample of 6129 out of
school youth, who were successfully interviewed, 64.6 percent reported
ever having sex, only 13.8 percent used condom at first sexual debut.
Median age at first sexual debut was 16 years for both males and females.
52.5 percent of males had their first sexual debut between ages 15 and 17
while 51.6 percent of the females had their first sexual debut between ages
18 and above. More females reported having ever attended school than
males (51.6 percent and 48.4 percent respectively). 50 percent of the
respondents were Christians (protestant). 57.1 of males reported having
had sex within 12 months of the survey as compared with 42.9 percent of
the females. Whereas 8.1 % of the males reported having had sex with
more than one commercial sexual partner, 43.5% reported that they had
sex with more than one non-commercial partners (12 months prior to
survey). The preliminary multivariate results for males indicate that age at
sexual debut and circumcision status are high predictors of risky sexual.
behaviour for males. The paper will offer some explanations for such
findings once detailed analysis has been completed and policy
implications thereof. Results for females are yet to be included.
Community Perceptions of Young Girls' Sexual Behavior and Health
Implications in Nairobi's Informal Settlements.
Author:
Elizabeth Kimani,
Source:
African Population and Health Research Center (APHRC), Nairobi, Kenya
Abstract:
Background and Objectives:
The objective of this paper is to explore community perceptions of young girls'
sexual behavior and the implications of such behavior on their health in two slum
settings in Nairobi. Although much is known about the sexual behavior of young
people in the context of urban poverty, far less attention has been given to the
intricate, less obvious factors that shape such behavior. Results from other
66
Adolescent Reproductive Health: 2005 -2008
studies indicate early sexual debuts for female slum-dwellers in Nairobi. Money
transfers for sex as a means of sheer survival in the slums are also welldocumented. This paper however, goes beyond a mere description of sexual
behavior to center on the highly nuanced drivers behind girls' sexual behavior in
informal settlements and the health implications of the same.
Data and methods:
Data used are derived from a study carried out in 2004 by the African Population
and Health Research Center which sought to clarify the linkages between food
security, child health, and schooling. A total of thirty-two focus group
discussions and sixty in-depth interviews were conducted with parents,
community leaders, teachers, and young boys and girls. It was in the course of
this study that issues to do with sexuality emerged as also being important among
slum residents. The data was analyzed using the qualitative computer software
QSR NUDIST.
Results:
Several factors shape girls' sexual behavior in informal settlements, including
living arrangements and the construction of gender roles. These factors leave
girls at seemingly greater risk for HIV transmission and unwanted pregnancies.
Furthermore, vulnerability to HIV/AIDS in urban poor settings has greatly
informed young girls' perceptions of sex and relationships with the opposite sex.
For example, feelings of fear and negativity towards sex were expressed in many
focus group discussions with girls. However, this perceived danger does not
seem to playa part in influencing young girls' sexual behavior.
Conclusions and recommendations:
Finding ways to present healthy relationships (whether sexual or not) among
young boys and girls in the slum areas as an option and a positive phenomenon is
of critical necessity. In the fight against HIV and AIDS, the importance of
information on risk and gender vulnerability for instance in developing contextspecific interventions cannot be over-emphasized.
Like Chocolate: Adolescent Emergency Contraception use in
Nairobi.
Author:
Jill Keesbury.,
Source:
Population Council, Nairobi
Abstract:
Background and Objectives:
In 2004, the Kenyan media featured a set of reports alleging that an
epidemic of emergency contraception (EC) abuse had emerged among
adolescents in Nairobi. Fueling an already heated debate on reproductive
rights in Kenya, both a newspaper article and a television news story
suggested that easy access to EC encouraged risky sexual behaviors
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Adolescent Reproductive Health: 2005 -2008
among adolescents. The features implied that although educated youth
have adequate knowledge of the modes of HIV transmission, access to EC
has encouraged frequent and risky sexual encounters. According to the
newspaper, young women in Nairobi were so regularly and repeatedly
engaging in such risky behavior that they were "using (EC pills) like
chocolate."
Despite the compelling nature of these reports, little empirical evidence
exists--either in Kenya or abroad-linking EC access and risky sexual
behaviors among adolescents. To test popular assumptions, while at
the same time contributing to a growing understanding of adolescent
sexuality, the Population Council undertook a rapid diagnostic
assessment of EC use among adolescents in Nairobi.
Methodology:
This rapid assessment was conducted over a two-month period in 2005
using a quantitative survey instrument administered to 300 participants.
To ensure that findings are directly relevant to the current public debate
on EC, efforts were made to collect information from the same type of
respondents cited in the media reports: namely young women in Nairobi
between the ages of 14 and 25. The survey measured prior contraceptive
knowledge, use, and participation in risky sexual behaviors, such as
having sex for money and having sex without a condom. Repeat use of
EC was also assessed, and participants were asked to rank their own
susceptibility to both pregnancy and sexually transmitted infections,
including HIV.
Expected Findings and Conclusions:
Data analysis, currently underway, focuses on understanding the
characteristics of three types of adolescents: those who have knowledge
of EC, but have not used it; those who have used it once; and those who
have used it more than once. Within each of these categories, the
relationships between contraceptive knowledge of all types, knowledge
and access to EC, risk perception and risky behaviors are being explored.
Key findings on the sexual behaviors and prevalence of EC use in all
three populations will be presented.
This information will help assess the validity of media claims regarding
an epidemic of EC abuse in Nairobi and consequent risky sexual
behaviors. It will contribute to the emerging literature on the
relationships between easy access to EC, adolescent sexuality, and HIV
transmission. It is also intended to serve as formative research for a future
qualitative study that further investigates the linkages between access to
EC and risk perception.
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Adolescent Reproductive Health: 2005 -2008
The situation of SRHR in Kenyan secondary schools-the SBB
experience-Focus on Machakos District.
Author:
Gathumbi N.,
Source:
Sisters Beyond, Kenya
Abstract:
Background and objectives:
Sisters Beyond Boundaries (SBB) is an organization of women whose
mission is to build capacities of women and the youth to promote and
protect Sexual reproductive Health and Rights. They do this through
providing education, information on SRHR, networking, and advocacy
for policies that are responsive
to the SRHR needs of the target group.
SBB has been implementing a program on Sexual and Reproductive
Health in selected schools in Machakos district of Eastern province,
Kenya since 2003. The objectives of the program are:
 To engage the students on SRHR issues in a bid to establish their
needs and come up with ways of addressing those needs
 To transform the education system trough policy advocacy from its
current status to one that is responsive to the SRHR needs of the
youth
This program has revealed a big gap that exists within our education
system. It lacks adequate education on SRHR, correct/factual information
and services required by the youth when they are in school. There is
currently no clear policy on SRHR education in Kenyan schools. The only
SRHR available is what is taught in Biology classes, which both the youth
and the teachers admit is not adequate to appropriately empower them in
matters relating to sexuality and reproductive health.
Recommendations:
 Organizations working in the area of sexuality education should seek
to come up with a curriculum that systematically tackles identified
issues and needs in appropriate depth and share it out to enhance the
efforts being made to address the issues.
 There is need to involve teachers so that they can inform the process
of addressing the issues that they think are not being addressed
within the education system with regard to SRH.
 Counseling services should be intensified to ensure that
individualized cases that may not be handled in the open forums are
attended.
 There's also need to assess and enhance the skills of SRHR education
facilitators to ensure they meet the needs expressed by the youth
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Adolescent Reproductive Health: 2005 -2008
Conclusion:
The schools outreach program is one of the efforts being made to
transform an education system that has been blind to the SRHR needs of
the youth. The reception it has been accorded in all the schools visited is
quite telling-that there is lot of work to be one if the youth and women in
Kenya are to enjoy their SRHR fully. It is therefore important not to loose
the goodwill that the teachers and the youth have shown and utilize the
provided space to improve the SRHR situation in our schools.
Determining Knowledge and Attitudes of Peer Youth Educators
(PYEs) On Sexuality Education in Kenya (February 2006).
Author:
Koronya C.,
Source:
Planned Parenthood Federation of America - International, Africa
Regional Office
Abstract:
Using primary and secondary data, this study sought to determine the
knowledge and attitudes of Peer Youth Educators (PYEs) on sexuality
education in Kenya. Further, it explored the nature of sexuality education
provided by the PYEs to other youth and the challenges PYEs face in the
course of providing sexuality education to other young people. Purposive
sampling was used to select the respondents. Respondents were selected
based on their availability, willingness to participate in the study, and on
the number of years they have been involved in sexuality education. Only
those PYEs with a minimum of two years experience in Peer Education
participated in the study. The sample size was 131 respondents (n= 131).
Data collected was both quantitative and qualitative. FGD guide and self
administered questionnaire were developed, pre-tested and used in data
collection. A structured self administered questionnaire was filled by 100
PYEs while 4 FGDs were conducted .A literature review of relevant
materials from the Internet, training manuals and curricula, books,
journals, research reports and program reports was conducted. A total of
131 young people from nongovernmental and community based
organizations most of whom have been trained in peer education
participated in this study conducted in Nairobi-Kenya.
The study found that PYEs from different organizations were trained
using different training curricula and that PYEs knowledge on sexuality
education vary from one organization to another on certain areas
depending on the emphasis of specific areas in the different curricula or
their exclusion all together. Further, topics that are overlooked by the
PYEs while disseminating sexuality information were either not covered
or not well understood during the PYEs training. The PYEs attitudes
towards sexuality education were positive as majority of the respondents
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Adolescent Reproductive Health: 2005 -2008
considered all sexuality topics important for informing the young people.
The greatest challenge facing PYEs in communicating sexuality
information emanates from the fact that sexuality issues remain taboo
and many religious groups consider sexuality information inappropriate
for young people.
In conclusion, sexuality education remains beyond reach of many young
people and even PYEs shy off from discussing some of the vital topics on
sexuality with their peers mostly because they feel incompetent to discuss
them. Based on the findings, the study recommends the standardization
of training curricula and manual to come up with a comprehensive
sexuality education manual that will provide the much-needed relevant
and accurate sexuality information to the young people. Further, there is
need to step-up advocacy efforts for introduction of comprehensive
school-based sexuality education that is appropriate to students' age,
development level and cultural background and to clear these
misconceptions within the communities on sexuality education.
Designing a Secondary School HIV Prevention Program: Kenya
Author:
Gichuru M.,
Source:
Cenlre for British Teacehrs, Kenya
Abstract:
Background:
With a primary school HIV education programme being rolled- out
across Kenya, attention is now turning to developing a program for
secondary schools. This presentation reports results of formative research
and how it was used to inform the content and design of a school-based
HIV prevention programme for secondary school youth.
Method:
In September 2005, 21 focus groups were held with students from schools
in 12 regions of Kenya. Interviews were held with 2 teachers in each
participating school.
Results:
Youth had high levels of knowledge about HIV transmission and
prevention and knew how to use and where to get condoms. They
identified themselves as high risk for HIV because of their sexual activity
and were concerned about their risk, but not enough to change behaviours.
They claimed abstinence was what they should be doing, but they could
not or did not want to abstain. Boys described this as a time when they
should 'freely experiment' with many partners. Girls were split between
those who shared this view and those who promoted abstinence to
marriage. Enjoyment and need were the dominant reasons for sex with
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Adolescent Reproductive Health: 2005 -2008
material gain also present for girls. With the exception of Muslim youth,
boys claimed 5+ sexual partners and girls 2-3 in the past year. Muslim
youth maintained that they were not sexually active. Youth were
ambivalent about condom use. Youth and teachers alike identified local
conditions and situations and school policies and procedures and that
contributed to youth sexual activity.
Conclusions:
An HIV prevention program for secondary schools using a peer-leader
model to capitalize on local age mate identification and role modeling was
designed to address the situations, conditions, and personal experiences of
secondary school youth. The program uses local narratives and interactive
learning to shift norms and teach skills related to number of partners and
condom use. Schools are being challenged to change policies and
procedures to reduce their collusion in providing situations conducive to
risky sexual practices.
Meeting the needs of youth with HIV prevention: Designing and
delivering school-based programmes to reach large populations.
Author:
Maticka-Tyndale E.,
Source:
Canada Research Chair in Social Justice & Sexual Helalh, Department of
Sociology & Anthropology, University of Wine/sol; Canada
Abstract:
Background:
If HIV is to be slowed in its progress, it is important to reach as many
youth as possible with prevention programming before they become
infected. Primary schools are one setting that has the capacity to reach
large numbers of youth. Primary School Action for Better Health
(PSABH) was designed to use the existing educational infrastructures to
deliver an on-going HIV intervention in upper primary school grades
across Kenya~ The intervention has demonstrated success in 6 different
regions of Kenya and is currently being phased into all primary schools in
the country using Ministry of Education infrastructure with support from
OBT, the original implementing NGO.
Method:
This presentation uses results from a review of HIV prevention
programmes delivered in diverse countries in sub Saharan Africa together
with results from monitoriug the roll-out of PSABH to identify lessons
that inform the development and delivery of large-scale school-based HIV
prevention programming to reach youth in sub Saharan Africa.
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Adolescent Reproductive Health: 2005 -2008
Results:
Key characteristics of school-based prevention programmes that are
sustainable, can be implemented on a large-scale and have a positive
impact on the vulnerability of youth to HIV infection include designing
programmes: with particular attention to sustainability and scale; that
work within and build the capacity of the existing educational
infrastructure; that address local situations and acknowledge and respect
local concerns; that are responsive to the needs of teachers; that have a
built-in monitoring and evaluation that feeds information back to schools
on challenges, progress and emerging issues; that work within the
capacities and limitations of local schools. Success also requires: local
acknowledgement that HIV is a problem for youth and a desire to address
the problem; national leadership supportive of HIV prevention
programming in schools; schools that are functioning at least at a basic
level.
Conclusions:
Most HIV prevention programmes are designed for testing on a small
scale. These rarely go beyond delivery in a small number of schools leaving the vast majority of youth without needed programming. It is
possible, and preferable, to design programmes to scale, i.e. so that they
can be delivered over wide geographical regions. It will take such widescale programmes to meet the HIV prevention needs of youth in sub
Saharan Africa
Married adolescents and HIV in Nyanza.
Author:
Ayuka F.,
Source:
Population Council, Nairobi, Kenya
Abstract:
Background and objectives:
Hitherto, most research on adolescents had focused on their reproductive
health problems and HIV infection rates, which has been high amongst
this group and has continued to grow. Currently, there has been a shift in
focus to married adolescents because of emerging evidence that HIV
infection rates may be higher in this group than in the unmarried
adolescent. Married adolescents may also be more vulnerable because of
the assumption that once married they enter the social category of adults.
They are presumed to carry the same status and rights like any other
married adult and have same service needs.
The presentation will draw on formative research carried out by the
Population Council in Rachuonyo district, Nyanza province to understand
the process of marriage, perception of risk of HIV within and outside
marriage, pre-marital and marital VCT among other issues. Eight Married
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Adolescent Reproductive Health: 2005 -2008
adolescent girls were interviewed over three consecutive visits carried out
over three successive days. Other respondents were, eight husbands of
adolescents (not matched to interviewed adolescents so as to promote
candid discussion of sensitive issues), four mothers, four fathers, four
mothers-in laws and four fathers in-law, were interviewed once.
Findings:
While discussing the process of marriage, it was evident that the
adolescents had known their spouses for a short time or not at all
(marriage was arranged) the adolescents were getting married early
because of death of their parents, most likely due to AIDS. The problems
occasioned by such deaths, notably poverty, left the young girls with no
alternative but to get married to any suitor, irrespective of time known or
status. When asked about whether they ever declined sex from their
husbands, most replied that it was up to the husband to decide whether or
not to have sex. Declining sex from husband was met with violence and
sometime forced sex, yet at times the reason for refusal was because the
husband had brought another woman to the house and they were scared of
being infected. The only place they could go without permission was the
church. Any other place including the hospital was at the pleasure of the
husband thus denying the girls access to reproductive health services.
Distance and fear were reported as the biggest barriers to access VCT
services. VCT being a recent phenomenon is located in established sites or
clinics, which were considered too far by the respondents. For those who
have not tested, the fear of receiving a positive result was expressed, while
those who have tested voluntarily feared disclosing to their partners.
Conclusions and recommendations:
More research needs to be done to understand the relationship between
HIV/ AIDS and adolescent marriage and ecological factors that encourage
adolescent marriage. Programs need to explore the barriers to VCT, more
specifically disclosure, distance and fear.
Expanding and integrating the Deaf HIV/ AI DS/STI Programme
towards efficiency.
Author:
Henderson K.,
Source:
Liverpool VCT & Care (LVCT) Kenya
Abstract:
Background:
The Deaf community numbers approximately 650,000 out of about
32,000,000 people in Kenya. It is most concentrated in the urbane regions
and also spread out in the rural areas in lesser but significant numbers. In
the Deaf community, access to education and services is more limited and
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Adolescent Reproductive Health: 2005 -2008
employment either is lower or reaps less per capita income than the rest of
the population. With its own linguistic culture based in Kenyan Sign
Language, this community faces stigma and poverty at a more alarming
level than general.
As the mission of LVCT Kenya is to reduce the rate of HIV transmission
in Kenya, the organization aims to:
 Implement high quality voluntary counseling and testing (VCT) and
care services throughout Kenya
 Provide technical assistance and support to GoK and partners
 Develop research- and evidence-based practice to inform policy
Since October 2003, LVCT has trained 12 Deaf counselours and
mobilizers and established three Deaf VCT stand-alone sites in Kisumu,
Mombasa, and Nairobi, reinforced by monthly mobile VCT clinics in
surrounding regions. After counlseling and testing, Deaf clients who test
positive for HIV are referred to local clinics that provide care and ART
therapy.
The objectives of the programme are two-fold:
 To increase provision and quality of VCT and care services for Deaf
clientele
 To increase provision and quality of VCT services for the adjacent
hearing population
In 2005, a coordinator position held by a Deaf professional was also
established to run the programme.
Findings/Lessons Learnt:
 Maintaining anonymity and confidentiality in Deaf community
 Mobilization of rural Deaf communities requires
 more support, consistency, time, and creativity
 Data on Deaf clientele is lacking
 Limited Deaf involvement in professional development
 Quality of care of Deaf PLWHA decreases after VCT service
Conclusions and Recommendations:
 Data collection of Deaf and physically challenged clientele needs to be
incorporated in national data system
 VCT & Care scale-up then must begin to reflect above data e.g. access
ramps & lifts, sign language fluency and sensitivity training among
care providers
 Increase provision of Deaf counsellors at rural standalone sites near
sizable Deaf communities and trim down over-reliance on costly
mobile VCT activities
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Adolescent Reproductive Health: 2005 -2008
Keywords:
DEAF| CULTURE| BARRIERS TO ACCESS| HIV/AIDS| SEXUAL
HEALTH
Left behind: Where are the youth living with disabilities in the war
against HIV/ AIDS?
Author:
Fredrick Ouko,
Source:
International Disabled Youth Initiative. (IDYl), Nairobi Kenya
Abstract:
Background and Objectives:
Whereas youth account for the largest percentage of the world's
population, less attention is being given towards addressing the myriad
problems experienced by the world's vast majority.
The situation is even more worse when a segment of this population are
disabled youth, who have been excluded from the mainstream socioeconomic and political life; forcing them into the dark alleys of the society
resulting in object poverty and deprivation of their human rights.
Every effort meant to fight the HIV/AIDS scourge is minus the focus on
youth living with disabilities, yet they make the largest percentage of
persons with disabilities and have varied needs that require specific
attention. This abstract is therefore meant to bring to the fore:



The magnitude of the problem.
Why youth living with disabilities continue to remain the silent
statistics on HIV/AIDS.
What needs to be done and how.
Findings:
While there is no focus being accorded to disabled youth in terms of
reducing the spread of HIV/ AIDS, the number of disabled youth being
infected with the disease is on increase without any check. We know they
are the poorest of the poor, yet the gnawing truth is that; HIV/AIDS is
taking toll on them as it knows no disability.
An attempt to create awareness on the disease amongst the youth has 'not
made effort to target disabled youth specifically, yet they have differing
needs. They continue to be left behind.
Conclusion and Recommendation:
It is high time sexuality issues among youth living with disability receive
equal attention and efforts towards the fight against HIV/AIDS inculcate
their active participation.
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Adolescent Reproductive Health: 2005 -2008
Disabled youth are at the verge of extinction if urgent measures are not
made to educate them on HIV/AIDS prevention. Young disabled women
continue to be the most vulnerable due to their physical disability and lack
of bargaining power; never than before, efforts to fight HIV/AIDS must
reflect the diversity within the society for them to be successful in the end.
HIV/AIDS knows no disability; we cannot win the fight against it without
them.
There is need for government intervention to augment the efforts that have
been initiated by NGO's, CBOs, etc and use of more formalized victim
empowerment programs should be designed for the disabled persons.
Teaching Human Sexuality to Freshers: An Educator's Reflection
on Students' Journals.
Author:
Khamasi W.,
Source:
Africa Population and Health Research Centre, Nairobi Kenya
Abstract:
Background Information and Objectives:
After teaching family life education for almost 10 years and engaging in
the study of sexuality (see Khamasi, 2002; Wambua & Khamasi, 2003;
Khamasi & Maina-Chinkuyu, 2005) it became apparent that there was
need to teach human sexuality as a course and not as a topic to university
students. My department restructured the curricula and developed a
course on human sexuality which is taught to first years (freshers) in the
first semester. This was an intervention strategy to assist students
understand their sexuality in a social environment where sexual activities
are the norm. First year female students report to college and find senior
male students waiting to grab the chance to befriend them for sex, a
phenomena otherwise referred to as 'the gold rush'. Rush by senior male
students for female freshers, 'the gold'.
In teaching the course, various instructional skills were used. As a class
we agreed to break the silence on issues of sexuality and call a 'spade a
spade' in all discussions. There was no taboo word. Students were
required to keep a journal and reflect on the topics discussed in class and
with peers under whichever circumstances. The aim of offering the
course is to promote sexual health through responsible, respective,
pleasurable and safe sex or voluntary abstinence. This paper is our
reflection on the students' reflections in their journals the first author.
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Adolescent Reproductive Health: 2005 -2008
Findings and lessons learnt:
Revelations through the journals point to the gains experienced in the
process of learning about ones sexuality and how socialization processes
inform/deform our understanding of our sexual bodies, sexual issues,
peers in relation to sexuality and what we perceive the teaching of
sexuality should entail. We agreed there was no taboo word in that class.
The students therefore developed a non-judgmental attitude that
accommodated each other's views.
Conclusions and Recommendations:
Offering the course in the first year first semester allowed freshers to
understand human sexuality in a context that comprised of the newly
found freedom on campus and the instantly acquired marketability as the
'gold'/female fresher. This was in relation to one's body which on arrival
on campus transforms to an object of desire by several senior male
students, especially in the first two months of the semester. Most issues
discussed in class were observable since they were enacted by majority of
students when out of class and therefore relevant to the students' daily
lives.
Keywords:
SEXUALITY| SEXUAL HEALTH| SAFE SEX| PLEASURABLE SEX
Translating Policies into Action for Improved Adolescent Health:
Advocacy for Policy Implementation.
Author:
Mutunga A.,
Source:
Family Care International, New York
Abstract:
Background:
HIV/AIDS has reached epidemic proportions among young people in subSaharan Africa, with nearly 10 million currently infected. In response to
this situation, Family Care International launched an l8-month regional
advocacy project on HIV/AIDS aimed at strengthening the capacity of
local organizations in Kenya, Mali, Niger, and Tanzania to advocate
effectively for the implementation of existing policies aimed at reducing
young people's risks for HIV/AIDS. Each country had a policy framework
in place that addressed adolescent sexual and reproductive health (ASRH)
and/or HIV/AIDS prevention. While the policies were generally
supportive of young people's needs for sexual and reproductive health
information and services, implementation of these government directives
was lagging, particularly at the district level where responsibility for
policy implementation is increasingly concentrated.
In selected districts, FCI identified a range of local youth groups and
community-based partners, trained them in advocacy strategies, and
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Adolescent Reproductive Health: 2005 -2008
updated them on current ASRH and HIV/AIDS policies. Sub-grants and
technical assistance were provided to enable local partners to launch a
range of grassroots advocacy activities targeting district and local
decision-makers. Activities included radio call-in programs; sports events;
participatory community drama; music and dance performances; and
information leaflets for religious leaders, teachers, parents, and health care
providers.
Objectives:
Session participants will be able to:
Results:
Results of the initiative included successful grass roots advocacy
campaigns, as well as the development of new networks of advocates and
stronger youth organizations capable of advocating in support of HIV
prevention and ASRH efforts.
Conclusions and Recommendations:
District-level officials often know little about the content of policies
related to ASRH and have little guidance on their mandate for
implementing these policies in their respective spheres. Grassroots Level
activists, including youth advocates can play an important role in creating
broad-based support or efforts to improve adolescent health and wellbeing, and encouraging key decision-makers at the district level to take
action to implement policy directives.
Youth-Friendly services in an HIV/AIDS Comprehensive Care
Centre in Nairobi, Kenya: Preliminary results of Needs
Assessment.
Author:
Dr. Gathari Ndirangu
Source:
P.O. Box 17 KNH, Nairobi 00202, ggndirangu22@yahoo.com
Abstract:
Summary:
Worldwide, 5 young people under the age of 24 are infected with HIV
every minute, 7000 every day. In Kenya, like in many other countries in
sub-Saharan Africa, half of all new HIV infections occur among
adolescents and young adults aged 15-24 years. Girls are 2-3 times as
likely to be infected as boys the same age.
Despite this high rate of infection, many HIV positive youth have been
observed not enter into HIV/AIDS care. Additionally, few of those who
access care remain in it. In some parts of the country 9% of persons aged
13-21 have tested HIV positive but the majority are not enrolled in care.
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Adolescent Reproductive Health: 2005 -2008
In one region (Nyanza), only 5% of persons enrolled in HIV/AIDS care
are youth.
One of the major reasons for this low participation by young people
living with HIV/AIDS (YPLWHA) is lack of youth friendly services
(YFS). In Kenya, services at ARV clinics have not been youth friendly. A
survey in 2004 demonstrated that only 12% of health facilities were able
to provide YFS.
YFS should be accessible, acceptable, appropriate (in the right place at the
right time) and affordable. They should have convenient opening and
closing hours. Privacy and confidentiality should be guaranteed and
autonomy promoted. They should ensure short waiting times and
consultation with or without an appointment. It should be equitable,
inclusive, non-discriminatory and reach the vulnerable. Staff should be
competent and motivated, with ability to communicate in a nonjudgmental and considerate manner that also sets the right climate.
Since YPLWHA represent a very significant proportion of people living
with HIV/AIDS, every effort must be made to encourage them access and
remain in HIV/AIDS care and treatment.
Objectives:
To determine whether or not young people living with HIV/AIDS
consider it necessary to have a day and time set aside for them to attend
clinic at an HIV/AIDS comprehensive care centre (CCC) in a public
tertiary referral hospital in Nairobi, Kenya
Methods:
The study was carried out during school vacation in the month of August
2007. Consecutive HIV-positive adolescents and young adults attending
the CCC at Kenyatta National Hospital were interviewed by use of a
standard pre-designed questionnaire that was administered by clinicians
and counselors at the end of each consultation.
The month of August was chosen because it coincides with school
vacation when many school-going young people living with HIV/AIDS
attend the clinic.
Results:
A total of 27 consenting adolescents and young adults living with
HIV/AIDS were interviewed. The youngest was aged 14 and the oldest
26.
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Adolescent Reproductive Health: 2005 -2008
Age
<14
15-19
20-25
>25
Frequency
1
14
11
1
Percent
3.7
51.9
40.7
3.7
Gender
Female
Male
Not Known
Frequency
17
6
4
Percent
63.0
22.2
14.8
Of the females, the mean age was 19.6 years while that of males was 16.8
years
The majority (25/27, 92.6%) felt there was need to have a clinic day
dedicated to the youth, while 2 (7.4%) felt there was no such need.
The most frequent expectation of a youth-friendly service was faster
service with a shorter waiting time, followed by health
education/counseling and recreation/socializing with peers.
Suggestions on improvement of care at the CCC, included change of
attitude by healthcare workers, and shorter waiting time. Other
expectations included, provision of free services, increase in supply of
drugs to last for a longer period to reduce on the number of days missed
from school, counseling by older PLWHA, and facilitation of income
generating activities.
Most (93%) were willing to participate in a youth support club. Males
were more likely to be willing to offer peer counseling than females,
83.3% and 64.7%, respectively
Conclusions:
Even though the number of YPLWHA interviewed was too small to make
any concrete conclusions, the findings indicate that the sex distribution of
YPLWHA in this group is consistent with the national HIV prevalence
rates where for every infected young man, 3 young women are infected.
As care for PLWA becomes more available in Kenya and possibly
elsewhere in low resource countries, there is need to reach a larger
proportion of adolescents and young adults. There is an overwhelming
expression by YPLWHA to obtain care in a friendlier atmosphere that
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Adolescent Reproductive Health: 2005 -2008
addresses their needs that may not be possible in a general HIV/AIDS
treatment and care setting.
Recommendations:
Just like other adolescents and young adults, YPLWHA require youthfriendly services and institutions should respond to meet that need.
Sexuality, HIV Risk and Potential acceptability of involving
Adolescent girls in Microbicide Research in Kisumu, Kenya.
Author:
Michele Montandon, Nuriye Nalan Sahin-Hodoglugil, Elizabeth Bukusi,
Kawango Agot, Brigid Boland , Craig R Cohen
Source:
Center for Microbiology Research, KEMRI, Box 19464, Post Code 00202,
Nairobi Honorary Lecturer, Department of Obstetrics and Gynecology,
University of Nairobi, email: ebukusi@csrtkenya.org
Abstract:
Background:
Microbicide clinical trials infrequently involve female participants under
18, a population at high risk of HIV acquisition should you mention why
this is so? Why it is difficult to involve those under the age of 18 despite
the risks they face? . We sought to understand the individual, family and
community-level factors that may influence the acceptability of
microbicide research involving adolescent girls.
Methods:
We conducted 30 interviews with adolescent girls aged 14-17 and nine
focus group discussions with adolescent girls, parents and community
leaders in Kisumu, Kenya. Participants discussed adolescent sexuality,
HIV prevention methods, perceptions about microbicide use and views
about microbicide research involving adolescent girls.
Results:
Adolescent sexual activity is stigmatized yet acknowledged to be a
natural part of the “adolescent stage.” Desperation to stop the spread of
HIV among youth and support for female-initiated HIV prevention
methods led to enthusiasm about microbicides and future microbicide
research. Yet concerns about microbicides were numerous and included:
difficulty using it in a timely manner due to the rushed, unplanned
nature of adolescent sex; a fear of trying experimental products and
concerns about microbicide efficacy; and parental worry that supporting
microbicide use in youth would defy societal pressures that denounce
adolescent sexual activity.
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Conclusions and Recommendations:
Microbicide acceptability for youth in sub-Saharan Africa may be
bolstered by desperation for new methods to stop the spread of HIV, yet
hindered by misgivings about experimental HIV prevention methods for
youth. Understanding and addressing the microbicide’s perceived
benefits and shortcomings, as well as the broader context of adolescent
sexuality and HIV prevention, may facilitate future research and
promotion of microbicides in this high-risk group.
Risk-Reducing Behaviors towards HIV infection among sexually
active female adolescents.
Author:
Professor Koigi Kamau, Dr. Ruth Jahonga, Dr. James Kiarie
Abstract:
Background:
Sexually active adolescents constitute an HIV infection pandemic
reservoir. Children continually replenish this reservoir as they evolve
through adolescence to become adults. Knowledge on HIV transmission,
level of risk perception for HIV infection and risk-reducing practices are
prerequisites to the depletion of this HIV infection reservoir.
Objective:
To determine risk-reducing behaviors for HIV infection among sexually
active adolescents
Design:
Cross-sectional descriptive study
Setting:
Maternity and emergency gynecological wards of Kenyatta National
Hospital
Subjects:
Post abortion and postpartum single adolescents
Results:
Adolescents who knew of existence of HIV infection were 89.0%, but only
63% knew of sexual route of transmission and 36.2% knew about mother
to child transmission. On preventive behavior, use of condoms was the
most commonly known (52.7%) while voluntary counseling and testing
and antiretroviral treatment for PMTCT as HIV prevention strategies
were known by 19.5% and 4.1% respectively. Ever use of condoms was
37.0%. Only 57.5% perceived themselves as at risk of HIV infection and
only 52.1% perceived their sex partners as being at risk of HIV infection.
Age was not an important determinant of adoption of risk-reducing
behavior. However, education at the level of high school and above was
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Adolescent Reproductive Health: 2005 -2008
associated with higher frequency of knowledge of HIV status of partner
(p<0.05), use of condoms (p<0.01), use of condoms at coitarche (p<0.05).
Whereas perception of no risk for HIV infection was significantly
associated with greater frequency of knowledge of self and sex partner’s
HIV satus (<0.05 p<0.005 respectively), perception of being at risk of HIV
infection was associated with significantly higher frequency of use of
condoms at coitarche (58.4%, p<0.001) and ever rejection of coitus unless
the partner’s HIV status is known(83.9%, p<0.001).
Conclusion:
Knowledge on transmission and on risk-reducing behavior is low, and so
is the level of practice of risk-reducing behaviors and risk-perception for
HIV infection. However, education and self-risk perception for HIV
infection are associated with increased practice of risk-reducing behavior.
It is therefore recommended that programs should be designed to
address this need for pre-adolescence and adolescence active provision of
factual information that would lead to enhanced knowledge, self-riks
perception for HIV infection and risk-reducing practices for HIV infection
Youth Reproductive Health and HIV/AIDS Programs in Kenya.
Author:
Jennifer Liku1, Jane Schueller2, Garrett Hubbard2, John McWilliam1
Source:
Family Health International (FHI), Nairobi, Kenya; 2YouthNet, ARL
Family Health International, P.O. Box 38835- 00623, Nairobi, Kenya
E-mail: jliku@fhi.or.ke
Abstract:
Background:
Young people in Kenya today face severe threats to their health and wellbeing. They also have an uphill struggle to stay in school, postpone
marriage and childbearing, find gainful employment, and remain free of
sexually transmitted infections (STIs), including HIV and other social
vices such as substance abuse. Although most young people have heard
about HIV/AIDS, many still do not know how to prevent it and do not
believe they could be at risk. Those who possess information about
reproductive health (RH) and HIV/AIDS often do not protect themselves,
because they lack adequate decision-making skills, social support, or the
ability to adopt safer sexual behaviors.
In August/September 2005, FHI conducted an assessment of Youth
Reproductive Health and HIV/AIDS Programs in Kenya in order to
provide USAID/Kenya, the Government of Kenya, other stakeholders in
Kenya, with a comprehensive list of Youth Serving Organizations (YSOs),
identify youth reproductive health needs and gaps in programming, and
make recommendations on what actions could be taken.
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Adolescent Reproductive Health: 2005 -2008
Objectives:
1) Determine how youth RH and HIV/AIDS programs address the needs
of youth at different life stages and in varying settings; 2) Examine the
social and cultural contexts in which youth programming takes place;
and 3) Identify technical and program gaps and challenges.
Methods:
Background information on the youth program in Kenya was collected
and a desk review conducted during the first phase. In phase two, key
informant interviews (with youth, parents, government representatives
and other stakeholders) and site visits were carried out to obtain more
program-oriented information.
Results:
There is a wide range of youth serving organizations that offer both
diverse and complementary services to young people. Disparities in
geographic coverage, duplication of efforts and inadequate sharing of
best practices were also noted. In addition, a number of needs/gaps were
documented including limited adult-youth partnerships, inadequate
awareness of relevant policies, and lack of social support systems for HIV
positive youth among others.
Conclusion:
There is need for comprehensive youth programming in Kenya in order
to respond to their RH and HIV/AIDS needs and address the gaps
identified.
KAP among Nakuru Municipality Primary School pupils on
HIV/AIDS.
Author:
Dr. D.K Ngotho, Senior Lecturer,
Source:
Faculty of Health Sciences Egerton University, P.O Box, 536. Njoro.
Abstract:
Background:
Despite the establishment of VCT centers for HIV/AIDS, the adolescents
are a potentially risky group that is not catered for yet sexual practices are
known to be even among those under the age of 15years.
Objective:
To determine knowledge, attitude and practice (KAP) among Nakuru
Municipality Primary School pupils on HIV/AIDS.
Design:
Cross sectional study.
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Adolescent Reproductive Health: 2005 -2008
Methodology:
A structured and pre-tested questionnaire was administered to a sample
of 1008 standard seven and eight children out of a population of 1982
standard seven and eight children within the Nakuru Municipality on
23rd September 2005.
This comprised 547 boys and 461 girls.
Results:
The majority 892, (88.5%) felt youth should have no sex before marriage.
Only 140 (13.9%) of the pupils were above the age of 14 years. Of all the
girls 148, (32.1%) had not had menarche. Only 29 (2.9%) of the pupils had
not heard of HIV/AIDS. The majority 884(87.7%) had seen people with
AIDS and the majority of these people were known to them. The pupils
empathized with them. No pupil had been tested for HIV/AIDS but
majority 875, (86.8%) said they would disclose their HIV status and
mainly to their family. About 19% (188 pupils) had had sex. Five girls had
become pregnant. Of those who had had sex, about 60% had had the sex
debut below the age of 15 years.
The majority of the sexual partners were neighbours and the majority had
had multiple sexual partners. Currently only about 53% had one partner.
Despite this only 21 (11.2%) pupils were using condoms and irregularly
at best.
Recommendation/Conclusion:
Sexual activity starts very early and the danger of HIV/AIDS among
these children is real. It is evident that much more needs to be done than
just passing on knowledge on sexuality in schools. There is an urgent
need for establishing youth- friendly VCT clinics alongside the already
existing clinics that are more or less adult oriented.
Determinants of Fertility among Adolescents and Youth 15-24 years
in Kenya.
Author:
Joyce W. Kinaro MA,
Source:
Population Studies (UoN), MPH (Boston, USA) Senior Program Officer,
Planned Parenthood Federation of America International/Africa Region
Office
Abstract:
Background:
Teenage pregnancies are a major problem not only in Kenya but also in
the whole world. Teenage pregnancies have demographic and health
implications. Using data of 3506 of adolescents and youth 15-24 years
from Kenya Demographic and Health Survey of 1998, this study explores
factors that influence children ever born among this age group.
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Adolescent Reproductive Health: 2005 -2008
Methodology:
The study used cross tabulation and ordinary multiple regression
analysis. The results from analysis suggest that the most significant
influence of fertility among adolescents and youth is age at first birth and
age itself. Religiosity is not a factor that influences children ever born
among adolescents and youth 15-24 years.
Result:
The analysis among ethnic group indicated that Luo, Luhya and Kalenjin
have the highest number of adolescents with 2 children and more.
Education was found to be associated with children ever born. The study
indicates that among women sampled in Kenya demographic and Health
Survey of 1998, 52 % of children were born before their mothers were 25
years. Mean age at first sex is found to be15.87, median at 16.00, mode at
15 while minimum age at first sex is 8 years.
Conclusion/Recommendation:
Results of this study suggest that it is important to commence family life
education before 8 years and intensify it before 15 years when majority of
adolescents seem highly sexually active. Further studies are
recommended to determine most appropriate messages and programs to
sustain virginity.
Young Schooling Adolescents’ attitudes and Behavior towards
PLHA and Orphans.
Author:
Milka Juma, Margaret Mwaniki, Jane Mbugua, Charity Muturi
Source:
Horizons Program/Population Council, 2Kenya Girl Guides Association
of Kenya, Family Health International
Abstract:
Background:
In communities affected by HIV/AIDS young adolescents are
increasingly providing care to as well as interacting with PLHA and
orphans. However, little IS known about young adolescents’ attitudes
and experiences with PLHA and orphans. Such knowledge would help
programs to design interventions to enhance positive altitudes among
young adolescents and motivate them to care and support PLHA and
orphans in their communities.
Methods:
Data was collected from 1,348 Girl Guides and 1,384 male and female
peers at 57 Primary, schools in Rift Valley and Coast provinces of Kenya,
The survey was conducted using an interviewer assisted self
administered questionnaire, This analysis focuses on 2148 young
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Adolescent Reproductive Health: 2005 -2008
adolescents aged 10 -14 years, comprised of 1148 Girl Guides and 1040
peers (548 boys and 492 peers) from 57 primary schools in Rift Valley and
Coast provinces of Kenya.
Results:
No differences were observed by gender of between Girl Guides and their
peers, Less than half the young adolescents are willing to buy food from a
person with HIV or AIDS with 44% in Rift valley and 26% in Coast.
Nearly half (46%) are afraid of people with AIDS with 22% feeling people
with AIDS should be separated from others. Young people however had
positive attitudes towards family members and children orphaned by
AIDS, Eighty-eight percent and 75% are willing to care for a family
member with AIDS and a child orphaned by AIDS respectively. Thirtyeight percent and 36% percent of respondents have played with or helped
such a child respectively,
Conclusions:
Negative perceptions, fear and stigmatizing attitudes towards PLHA are
prevalent among young people indicating that programs for young
adolescents should include stigma reduction activities. On the positive
side, the vast majority are willing to assist a child orphaned by AIDS, and
many have already done so, Therefore, this type of assistance could easily
be built into HIV/AIDS programs, for younger youth.
An Evaluation of an alternative Community Based Health
Programme for young people.
Author:
Annabel S. Erulkar, The Population Council Linus Ettyang, Family
Planning Association of Kenya Charles Onoka, Family Planning
Association of Kenya Alex Muyonga, Family Planning Association of
Kenya Fredrick Nyagah, Family Planning Association of Kenya
Source:
The Population Council
Abstract:
Recently, there have been increasing investments in reproductive health
(RH) programmes for young people in sub-Saharan Africa. Popular
approaches in adolescent programming have included peer education
programmes, youth centers, and youth-friendly health services. At the
same time, there is little systematic evidence of the effectiveness of such
programmes on young people, including impacts on their RH
knowledge, sexual behaviour, and health seeking behaviour.
In 1994, Family Planning Association of Kenya (FP AK) and Population
Council (PC) initiated an innovative programme of research and
intervention for young people in Kenya. Based on formative research
conducted in Kenya, an intervention was designed to improve young
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Adolescent Reproductive Health: 2005 -2008
people's access to both RH information and services. In the "Nyeri Youth
Health Project", respected and well-known parents in the community are
trained on adolescent reproductive health issues and advocacy. These
parent motivators, referred to as "Friends of Youth" (FOYs), work in their
own communities to educate both adolescents and other parents on
reproductive health, and to encourage dialogue between them. In
addition to the FOYs, FPAK trained a network of local doctors and
medical officers from the private sector who provide youth-friendly
reproductive health services to young people. Youth are referred to these
providers by FOY s with a coupon, which entitles them to service at
subsidized cost. This intervention was designed after an initial period of
formative, qualitative research among adolescents and parents in Nyeri,
and is consistent with Kikuyu traditions where parents assigned young
parents - mutiri and atiri - to give guidance on sexually related issues.
A quasi-experimental design was used to evaluate the impact of the
three-year intervention. Baseline and end line surveys were conducted in
both experimental and control sites. At end line, additional questions
were added to measure exposure to the program. This paper describes
experiences in implementing the "Nyeri Youth Health Project," and
highlights the extent and nature of impact
The correlation between parents' and their adolescents' attitudes
toward the role of men and women in the society: The Case of
Central Kenya.
Author:
Linus Ettyang, Charles Onoka, Alex Muyonga, Fredrick Nyagah,
Annabel S. Erulkar, (All of FPAK)
Source:
The Population Council
Abstract:
If parent's attitudes are predictors of adolescents attitudes towards the
role of men and women in the society, what other factors helps to
understand adolescents' attitudes toward the role of men and women in
the society?
This paper seeks to establish whether or not there is relationship between
parents' and their adolescents' views on the gender roles in the society.
The paper will explores other factors including adolescents' age, level of
education, whether or not adolescents have had romantic relationships
with persons of the opposite sex as well as living arrangements.
The data used in the analysis is on 601 parents/guardians of l, 865
adolescents interviewed in both Nyeri and Nyuhururu Municipalities.
The sub-sample includes only those parents/guardians whose
adolescents were between 10 and 14 years. Deliberate attempts were
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Adolescent Reproductive Health: 2005 -2008
made to ask the parents/guardians similar questions as the adolescents in
order to facilitate comparison.
Expanding Livelihood options among Adolescents through
Integrated Savings, Credit and Credit Programs: The experience of
K-REP Development Agency.
Authors:
Arimand Banu Khan, Annabel S. Erulkar, Ann Gathuku,
Source:
Population Council, K-Rep Development Agency
Abstract:
Currently, most interventions targeting adolescents in Kenya are limited
to either the education or health sectors. Yet, unemployment and lack of
livelihood opportunities and skills are often chief concerns among young
people and their parents. To date, few programs exist that explore the
expansion of young people’s livelihood options as a means to both
alleviate poverty and as strategy to promote a healthy and safe transition
to adulthood.
In an effort to bridge this gap, in 1998, the Population Council, and K-Rep
Development Agency (KDA), a micro-finance research and development
organization in Kenya established a two-year pilot project entitled "Tap
and Reposition Youth (TRY) Savings and Credit Scheme for Adolescent
Girls". The objective was to improve the understanding of savings and
credit programs in expanding livelihood opportunities for adolescent
girls. TRY targeted out of ¬school adolescent girls and young women
aged between 16-22, who were not employed in the formal sector, and
who were residing in low income and slum areas of Nairobi. The project
provided participants with access to credit, savings services and training
in basic business and life skills including reproductive health. Over 200
girls and young women participated in the project and received training,
credit and savings services.
In November 2000, Population Council conducted an endline survey
among participants as well as dropouts from the program. In addition,
qualitative data was collected through focus groups and longitudinal
studies of a few selected participants. Findings revealed a significant
demand for credit and savings among adolescents and that the group
based lending methodology (with a few modifications) is, appropriate for
bringing adolescent girls together and delivering credit and savings
services. The experience of the pilot project demonstrated that such
initiatives, if carefully designed and implemented, could be successful.
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Adolescent Reproductive Health: 2005 -2008
Building on lessons from phase one, Population Council and KDA have
entered into a second phase. This phase will scale up the intervention
among adolescent girls in Nairobi, and pilot test savings and micro-credit
schemes among boys in Nairobi as well as young people living in rural
areas. The project also seeks to measure the impact of the project on
adolescents' livelihoods, household and individual economics, sexual and
reproductive health behavior, and social interactions and mobility. This
paper will outline experiences and lessons learned in pilot testing a
livelihoods initiative for adolescents in Kenya as well as describe some of
the findings from qualitative studies associated with the project.
How Marriage changes Girls’ lives: Married Adolescents in Kenya.
Author:
Annabel S. Erulkar, Linus Ettyang, Charles Onoka, Alex Muyonga,
Fredrick Nyagah,
Source:
The Population Council, Family Planning Association of Kenya
Abstract:
While there has been increased research and programmatic attention to
adolescents, the attention has been focused largely on the unmarried,
with little or no attention paid to young people who are married during
their adolescent years. The lack of attention has resulted, in part, because
once young people are married, they enter the social category of adult, no
matter what their age. In marriage, they are presumed to carry the same
status and rights as adults, an assumption that may be false. Girls in subSaharan Africa are most likely to marry at an early age, with median age
at first marriage being 19 or below in 13 of 16 sub-Saharan African
countries reviewed in a recent survey (Singh and Samara, 1996). Marriage
has been described to have a significant impact on the quality of a girl's
life, yet little research has focused on the way that early marriage changes
young peoples' lives (Mensch, et aI, 1998).
This paper draws on a representative, population-based study of over
3000 adolescents in Central Province, Kenya. The paper describes the
experience of marriage during adolescence for young women in Kenya
and compares married girls in the sample with unmarried. First,
descriptive analysis is presented on the nature and experience of
adolescent marriages. Then, comparative analysis will explore differences
between girls who have been married during their adolescent years before age twenty - and girls who finished their adolescence without
being married. Girls are compared on several levels, including
educational attainment and reasons for leaving school, work and
livelihoods, time use, mobility within the community, as well as sexual
behaviour and family planning use. Finally, girls' own perceptions of the
marriage experience will be examined. The findings have powerful
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Adolescent Reproductive Health: 2005 -2008
programmatic and policy implications for this largely neglected group of
young people.
Condoms: Attitudes, Use and Distribution among young people in
Western Kenya.
Author:
Maureen Kuyoh, Paul Feldblum, Julius Munyao, Michael Welsh, Lorie
Broomhall
Source:
Family Health International. Nairobi, Kenya and North Carolina, USA
Abstract:
Introduction:
Prior to implementing a controlled trial comparing different means of
condom promotion, we conducted formative research among adolescents
and young adults in western Kenya. We aimed to identify key
determinants of and obstacles to condom use; uncover attitudes and
beliefs that must be addressed in our intervention trial; gain an enhanced
understanding of the operation of the Ministry of Health/German
Technical Cooperation Reproductive Health community-based youth
program; and Inform the development of a youth counselor training
program, and o1her Information, education and communication
materials.
Methods:
We used multiple data collection methods In 6 locations of Bondo,
Kakamega and Vihiga districts; participant observations of the structure
of the youth program, key informant and in-depth interviews with youth
service providers and their clients; rapid street survey among, young
people; focus group discussions (FGDs) with youth counselors and their
clients; and direct observations of youth counselors during outreach
activities. For this presentation, we focus on results from the rapid survey
data (N=180), the FGDs (15 with youth counselors and 24 with clients),
and in-depth interviews (34 with key informants and 36 with clients).
Results:
In the rapid survey, we enrolled young men and women age 15-24 years
old. Educational level of the respondents W8r& equally divided between
primary and secondary education; 23% were still in school. 82% were
never married, and 81% were sexually experienced. FGDs with youth
counselors and their clients revealed that poverty was a major
contributing factor in early sexual debut and continued sexual activity
especially among gifts. Knowledge of condom was high but use uneven,
46% had ever used male condoms (more males than females) and ~"
reported current condom use. We found that the GTZ youth counselor
program is generally well received by the communities and the
counselors achieve 8 certain prestige with their role. One third of
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Adolescent Reproductive Health: 2005 -2008
respondents had received services from a youth counselor, mostly
HIVJS11 counseling and information, and one in six sought STI services
in the past year. YCS distribute large numbers of condoms, but myths
about and negative perceptions of condoms persist, as does shame about
STls and reluctance to seek treatment.
Conclusions:
The youth counselor program is a reliable and credible source of
condoms and information on reproductive health for young people in
parts of westem Kenya. The program Is viewed positively by most
interviewees, and is being expanded into new districts. 'There are barriers
to condom use related to rumors, myths1md the spontaneous nature of
sex among young people.
Scaling up an Adolescent Reproductive Health and HIV Prevention
Project in Kenya.
Author:
Nzoya Munguti, Ian Askew, Rick Homan. Caroline Njue1, Eva Muthuri
Source:
FRONTIERS Population Council, Nairobi, Kenya, Family Health
International, North Carolina, USA, Program for Appropriate Technology
in Health (PATH), Nairobi Kenya
Abstract:
Introduction:
The Kenya Adolescent Reproductive Health Program (ARHP) is based on
a pilot project that was implemented between 1999 and 2003 by the
FRONTIERS Program in collaboration with the Ministries of Education,
Science and Technology (MOEST); Health (MOH) and; Gender, Sports,
Culture and Social Services (MGSCSSS). The goal of the project was to
address the concerns of the youth by making existing services more
accessible and by providing young people with reproductive health
information and skills. Following the successful implementation of the
project, a cost analysis was conducted to estimate the additional financial
resources required by the Ministries to expand the initiative from current
levels of coverage. This presentation focuses on the costing elements and
the additional resources required and challenges faced when taking the
initiative to scale.
Methods:
Information on resource use was gathered from the two pilot districts of
Western Kenya covering a period of 8 months. The assessment of costs
was conducted from the perspective of the MOEST and MGSCSSS. Only
direct costs such as materials/supplies, transport, accommodation and
allowances were considered, Costs were assessed for expanding the
package within the pilot districts and moving to new districts previously
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Adolescent Reproductive Health: 2005 -2008
not covered. Annual costs were allocated per school and per location to
inform the budget process within the target Ministries.
Result:
To introduce the initiative in districts previously not covered would
require the MOEST to increase it's per school recurrent budget allocation
(non-wage) by about 6% during the first year of expansion while the
MGSCSSS would require to increase its budgetary allocations per location
by about 569% (six times). However, to expand the initiative to cover
more schools and locations within the pilot sites would exert less
pressure on the Ministries budgets representing an increment of 2.4% and
286% in per school and per location allocations during the first year of
expansion. Efforts to rearrange the, existing resources to meet this
requirement are constrained by a number of factors that include limited
resources and weak linkage between planning and budgetary process.
The latter limits the ability of districts to plan and execute new activities
not covered in the budgets, a process which requires months of intense
lobbying to meet budget timelines.
Conclusions:
The project has demonstrated that even when an initiative is financially
affordable the process of re-organizing existing resources to meet this
additional requirement is constrained; by. Poor linkage between the
planning and budget process at both national and local
levels, This could be improved by giving districts mandate to develop
action plans and budgets that are flexible to accommodate emerging local
needs.
Coercive First Sex among Adolescent Females in Sub-Saharan
Africa: Prevalence and Context.
Author:
Johannes John-Langba,
Source:
African Population and Health Research Center, Kenya
Abstract:
Background and Objectives:
Sexual coercion that includes sexual intercourse has increasingly been
drawing the attention of reproductive health researchers due to its
connection to demographic and health outcomes of interest including
STls and unintended pregnancy. Using a unique set of data collected in
20032004 in Burkina Faso, Ghana, Malawi, and Uganda with young
people, we comparatively examine:
Coercive sex experiences
The circumstances under which coercive sexual experiences take place;
and


94
Adolescent Reproductive Health: 2005 -2008

Social vulnerability to unwanted sexual intercourse.
Methodology:
Fifty-five FGDs; over 100 in-depth interviews and a nationallyrepresentative household survey with approximately 5,000 respondents
in each country on sexual and reproductive health were conducted with
male and female adolescents.
Findings:
The most prevalent forms of coercion enunciated by the female
respondents in all four countries were force, pressure from money or
gifts, passive acceptance, being talked into having sex/pressure, and
deception. While alcohol and drugs were named in the FGDs as ways that
males coerce females into sex, this was not reported in the IDls.
Data from the surveys show that among 12-19 year old females, the
percent who said they were "not willing at all" to have sexual intercourse
at sexual debut was15 percent in Burkina Faso, 24 percent in Uganda, 30
percent in Ghana and 38 percent in Malawi. Surprisingly, age difference
with the partner did not seem to be correlated with the probability of
experiencing an unwanted sexual debut. Logistic regression was used to
estimate the odds for being "not willing at all" at sexual debut among
female adolescents aged 12-19 years in the four countries. Different
patterns regarding when sex was unwilling emerged across the study
sites with the most robust finding being that all females were significantly
more likely to be coerced when their first sex partner was a casual
acquaintance than when the partner was a boyfriend or husband.
Conclusion:
Sexual coercion is one of the many forms of violence against young
people in number of African societies and reflects underlying structural
factors that contribute to the oppression and exploitation of women in the
region. By using a mixed methods approach, this study advances our
understanding of the context of sexual coercion at sexual debut among
young people in the countries where the study took place. Nonconsensual sex needs to be put on the sexual and reproductive health and
rights agenda as part of the process of protecting the next generation.
95