Center of Excellence in Women and Child Health, Aga Khan University, East Africa, Kenya.
Pwani University, Kilifi, Kenya.
BMC Public Health. 2024 Feb 15;24(1):484. doi: 10.1186/s12889-024-17999-9.
BACKGROUND: Globally, adolescents and youth experience high unmet need for sexual and reproductive health (SRH) information and services. In Kenya, evidence shows that more than half of teenage pregnancies are unintended and that half of all new HIV infections occur in people ages 15-24-year-olds, with the majority of those being female. The coastal counties in Kenya record a relatively high adolescent pregnancy rate and higher rates of unmet need for contraception for all women of reproductive age compared to the national average. This study focused on gaining a deeper understanding of the existing challenges to and opportunities for accessing SRH information and services among adolescents and youth (AY) at the Kenyan coast. METHODS: Using qualitative methods, this study conducted thirty-six focus group discussions with adolescents, youth, and community health volunteers across all the six coastal counties in Kenya. The sample included adolescents aged 10-14 years in school (male and female), adolescents aged 15-19 years not in education (male and female), youths aged 20-24 years (mix of both male and female), and community health volunteers who were conveniently sampled. Thematic analysis was used to examine the data and report the study results. RESULTS: The barriers to accessing AYSRH identified in the study are individual factors (feelings of shame, lack of information, and fear of being judged) parental factors, healthcare worker and health institution factors, teacher/educators factors, and broader contextual factors such as culture, religion, poverty, and illiteracy. Factors that facilitate access to AYSRH information and services included, supportive parenting and culture, AYSRH sessions in schools, peer support, supportive health institutions, gender inclusivity, and digital technology. CONCLUSIONS: AYSRH information and services at the Kenyan coast is strongly influenced by a range of individual, social, cultural, and economic factors. Improving access to AYSHR necessitates meaningful AY engagement, provision of youth-friendly services, use of digital technology as alternative pathways for sharing SRH information, strengthening parent-AY relationships, embracing peer-to-peer support, and the adoption of gender-inclusive approaches in AYSRH programming.
背景:全球范围内,青少年和青年对性与生殖健康(SRH)信息和服务的需求未得到满足的比例很高。在肯尼亚,有证据表明,超过一半的少女怀孕是意外怀孕,而且所有新感染艾滋病毒的人中,有一半发生在 15-24 岁的人群中,其中大多数是女性。肯尼亚沿海各县的青少年怀孕率相对较高,与全国平均水平相比,所有育龄妇女对避孕的需求未得到满足的比例也更高。本研究专注于深入了解肯尼亚沿海地区青少年和青年获取性与生殖健康信息和服务所面临的挑战和机遇。
方法:本研究采用定性方法,在肯尼亚六个沿海县的所有地区,对青少年、青年和社区卫生志愿者进行了 36 次焦点小组讨论。样本包括在校的 10-14 岁青少年(男、女)、不在校的 15-19 岁青少年(男、女)、20-24 岁青年(男女混合)和随机抽样的社区卫生志愿者。使用主题分析来检查数据并报告研究结果。
结果:研究中确定的获取青少年性与生殖健康的障碍包括个人因素(感到羞耻、缺乏信息和害怕被评判)、父母因素、医疗保健工作者和医疗机构因素、教师/教育者因素以及更广泛的文化、宗教、贫困和文盲等背景因素。促进获取青少年性与生殖健康信息和服务的因素包括支持性的父母和文化、学校中的青少年性与生殖健康课程、同伴支持、支持性的医疗机构、性别包容性以及数字技术。
结论:肯尼亚沿海地区的青少年性与生殖健康信息和服务受到一系列个人、社会、文化和经济因素的强烈影响。要改善青少年性与生殖健康的获取,就需要让青少年有意义地参与,提供适合青年的服务,利用数字技术作为分享性与生殖健康信息的替代途径,加强父母与青少年的关系,接受同伴支持,并在青少年性与生殖健康规划中采取性别包容性方法。
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