U.S. Agency for International Development Kenya and East Africa, Nairobi, Kenya.
Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
PLoS One. 2020 Nov 12;15(11):e0241985. doi: 10.1371/journal.pone.0241985. eCollection 2020.
Kenya has a high prevalence of adolescent pregnancy and low access to and use of adolescent sexual reproductive health services. Despite the enactment of evidence-based policies to address this problem, adolescents continue to face health problems and barriers to adolescent sexual reproductive health information and services.
This study describes barriers to and facilitators of access to adolescent sexual and reproductive health services in Kisumu and Kakamega counties, Kenya.
We used a qualitative design. Through 61 data collection sessions, 113 participants were engaged in key informant interviews, in-depth interviews, and/or focus group discussions. Trained Research Assistants (RAs) engaged adolescents, health care workers, teachers, county leaders, and community representatives. Data were captured using audio recorders and field notes. Socio-demographic data were analyzed for descriptive statistics, while audio recordings were transcribed, translated, and coded. Thematic analysis was done with NVivo.
Findings show that the barriers of access to sexual reproductive health services and information were negative health workers' attitudes, distance to the health facility, unaffordable cost of services, negative social cultural influences, lack of privacy and confidentiality. Facilitators to adolescent sexual reproductive health services were few and included getting priority for school going adolescents and enabling environment for partnerships on adolescent health issues.
Adolescents in Kakamega and Kisumu face a myriad of barriers when seeking sexual reproductive health information and/or health services. We recommend that counties sensitize all stakeholders on adolescent sexual reproductive health problems, and support development of multi-sectoral, sustainable solutions to adolescent health needs.
肯尼亚青少年怀孕率较高，获得和使用青少年性生殖健康服务的机会有限。尽管制定了以证据为基础的政策来解决这一问题，但青少年仍面临健康问题和获取性生殖健康信息和服务的障碍。
本研究描述了肯尼亚基苏木县和卡卡梅加县获得青少年性生殖健康服务的障碍和促进因素。
我们采用定性设计。通过 61 次数据收集会议，有 113 名参与者参与了关键人物访谈、深入访谈和/或焦点小组讨论。经过培训的研究助理（RAs）与青少年、卫生保健工作者、教师、县领导和社区代表进行了接触。使用录音机和现场记录来收集数据。对社会人口统计数据进行了描述性统计分析，同时对音频记录进行了转录、翻译和编码。使用 NVivo 进行了主题分析。
研究结果表明，获得性生殖健康服务和信息的障碍包括卫生工作者的负面态度、医疗设施的距离、服务费用的不可承受性、负面的社会文化影响、缺乏隐私和保密性。促进青少年性生殖健康服务的因素很少，包括为在校青少年提供优先服务，以及为青少年健康问题建立伙伴关系的有利环境。
基苏木县和卡卡梅加县的青少年在寻求性生殖健康信息和/或健康服务时面临着诸多障碍。我们建议各县提高所有利益攸关方对青少年性生殖健康问题的认识，并支持制定多部门、可持续的解决方案，以满足青少年的健康需求。
