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肯尼亚青少年的气候变化、资源不安全状况与性健康和生殖健康:一项多方法定性调查

Climate change, resource insecurities and sexual and reproductive health among young adolescents in Kenya: a multi-method qualitative inquiry.

作者信息

Logie Carmen H, Hasham Aryssa, Kagunda Julia, Evelia Humphres, Gachoki Clara, Omondi Beldine, Wanjiru Mercy, Gittings Lesley, Van Borek Sarah, Newman Peter A, Fuller-Thomson Esme, Taing Lina, Sternthal Isabel, Weiser Sheri, Hogg Robert, Turan Janet

机构信息

Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada

United Nations University Institute for Water Environment and Health, Richmond Hill, Ontario, Canada.

出版信息

BMJ Glob Health. 2025 May 5;10(5):e016637. doi: 10.1136/bmjgh-2024-016637.

Abstract

INTRODUCTION

Growing evidence supports linkages between climate change and extreme weather events (EWEs) and sexual and reproductive health (SRH) among adults. Yet knowledge gaps persist regarding climate-related experiences and pathways to SRH among young adolescents (YA). We conducted a multi-method qualitative study to explore climate change-related factors and linkages with SRH among YA aged 10-14 years in Kenya.

METHODS

This six-site study was conducted in Nairobi's urban slum Mathare; Naivasha's flower farming community; Kisumu's fishing community; Isiolo's nomadic and pastoralist community; Kilifi's coastal smallholder farms and Kalobeyei refugee settlement. Methods involved: n=12 elder focus groups, n=60 YA walk-along interviews (WAIs) and n=12 2-day YA participatory mapping workshops (PMWs). We conducted codebook thematic analysis informed by the resource insecurity framework.

RESULTS

Participants (n=297) included: elders (n=119; mean age: 60.6 years, SD: 7.9; men: 48.7%, women: 51.3%), YA WAI participants (n=60; mean age: 13.4, SD: 1.5; boys: 51.4%, girls: 48.6%) and YA PMW participants (n=118; mean age: 12.1, SD: 1.3; boys: 50.8%, girls: 49.2%). Narratives identified climate-related changes and EWEs increased existing resource insecurities that, in turn, were linked directly and indirectly with SRH vulnerabilities. Food and water insecurity contributed to YA missing school, sexual violence, transactional sex and exploitative relationships. Sanitation insecurity produced challenges regarding menstrual hygiene, sexual violence risks and transactional sex. Transactional sex and exploitative relationships were linked with unplanned pregnancy and sexually transmitted infection risks. Gender inequities increased girls' risks for violence and sexual exploitation, whereas boys were more prone to running away.

CONCLUSION

We found that climate change exacerbated resource insecurities that may drive SRH outcomes among YA in Kenya. We developed a conceptual model to illustrate these pathways linking climate change, EWEs, resource insecurities and SRH. Climate-informed interventions should consider these pathways within larger social environmental contexts to advance young adolescent SRH in Kenya.

摘要

引言

越来越多的证据支持气候变化与极端天气事件(EWE)以及成年人的性与生殖健康(SRH)之间存在联系。然而,关于青少年(YA)与气候相关的经历以及通往性与生殖健康的途径,仍然存在知识空白。我们开展了一项多方法定性研究,以探索肯尼亚10至14岁青少年中与气候变化相关的因素以及与性与生殖健康的联系。

方法

这项在六个地点开展的研究在内罗毕的城市贫民窟马萨雷、奈瓦沙的花卉种植社区、基苏木的渔业社区、伊索洛的游牧和牧民社区、基利菲的沿海小农户农场以及卡洛贝耶伊难民定居点进行。方法包括:12个老年人焦点小组、60次青少年随行访谈(WAI)以及12次为期两天的青少年参与式绘图工作坊(PMW)。我们在资源不安全框架的指导下进行了编码本主题分析。

结果

参与者(n = 297)包括:老年人(n = 119;平均年龄:60.6岁,标准差:7.9;男性:48.7%,女性:51.3%)、青少年随行访谈参与者(n = 60;平均年龄:13.4岁,标准差:1.5;男孩:51.4%,女孩:48.6%)以及青少年参与式绘图工作坊参与者(n = 118;平均年龄:12.1岁,标准差:1.3;男孩:50.8%,女孩:49.2%)。叙述表明,与气候相关的变化和极端天气事件加剧了现有的资源不安全状况,而这又直接或间接地与性与生殖健康的脆弱性相关联。粮食和水不安全导致青少年缺课、遭受性暴力、进行交易性性行为以及陷入剥削关系。卫生设施不安全在月经卫生、性暴力风险和交易性性行为方面带来了挑战。交易性性行为和剥削关系与意外怀孕和性传播感染风险相关。性别不平等增加了女孩遭受暴力和性剥削的风险,而男孩更容易离家出走。

结论

我们发现气候变化加剧了资源不安全状况,这可能推动肯尼亚青少年的性与生殖健康结果。我们开发了一个概念模型来说明这些将气候变化、极端天气事件、资源不安全和性与生殖健康联系起来的途径。考虑到气候因素的干预措施应在更大的社会环境背景下考虑这些途径,以促进肯尼亚青少年的性与生殖健康。

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