Adolescents face several problems as they move into adulthood, mainly because of social/cultural taboos that restrict open discussion between children and parents, which leads to inadequate knowledge about sexual and reproductive health. Many adolescents also suffer from depression, anxiety, eating disorders, conduct disorder, mood fluctuations, and dizziness.
This project aims to improve adolescent health through awareness generation and enhancing access to quality SRH services. The project will strengthen the inter-linkages between the local actors, school teachers, and parents thereby improving the present and future health aspects of adolescents in the area.
Project Background
Psychological, physical and emotional changes associated with adolescence period are often accompanied with stress and confusion. While coping with the changes that occur physically and emotionally, adolescents frequently isolate themselves and face problems in adjusting with parents, teachers and social norms.
Adolescents face several problems as they move into adulthood mainly because of social/cultural taboos that restrict open discussion between children and parents, which leads to inadequate knowledge about sexual and reproductive health. Many adolescents also suffer from depression, anxiety, eating disorders, conduct disorder, mood fluctuations and dizziness.
As this period is the transition from childhood to adulthood, it is necessary that adequate counselling sessions and health services are provided to adolescents, so that they grow into responsible and healthy adults. It is therefore essential to develop programs that enhance awareness of adolescents and also provides proper services for Contraception, HIV testing, prevention of Sexually Transmitted Diseases and AIDS etc.
Studies conducted by international agencies across the world, reveal that educative programs related to Sexual and Reproductive Health (SRH) are very effective in improving the overall health of youth. To assure that adolescents develop the right attitude it is essential that they are nurtured in an environment where they learn not only about their health but also about human rights and life skills. Research provides evidence that effective SRH programs help in:
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- Enhancing accurate knowledge thereby reducing misinformation
- Strengthening positive attitude
- Improving academic performance
- Increasing interaction and communication with parents
- Improving perception about peer pressure and social norms
- Improving the overall health of adolescents
Society would face severe consequences on the social, economical and cultural front, in the absence of provisions for the health and educational needs of the youth. A countries prosperity and progress primarily depends on the wellbeing of youth, and therefore it is essential to invest in providing adequate education and health services to them.
Need of Sexual and Reproductive Health (SRH) in Kenya
According to the census of 2009, Kenya has a rapidly growing population with an annual growth rate of 3% per annum. The census also indicates that 63% of the population is below 25 years of age which means that Kenya, has a Pyramid shaped population structure. Both the rapid population growth and the large proportion of young people, requires immediate attention to the growing demand of health, education and employment.
Research studies reveal that youth in Kenya, does not get adequate information and access to services related to SRH issues. Due to inaccessibility of services and lack of awareness, youth in Kenya face numerous social, economic and health problems. Kenya National Bureau of Statistics (2009), and the National Population Census (2009), suggest that in the absence of adequate opportunity to acquire life skills, young people often get involved in risky behaviours such as substance abuse, school dropout, crime, social unrest, unemployment, unintended pregnancy and life threatening sexually transmitted diseases and infections.
The current situation in Kenya requires enhancing accessibility of SRH services to young people. Even though there are government led interventions for improving the SRH services, there is an urgent need to strengthen and catalyse these initiatives.
Project Location
Kwale District is one of the seven districts in Coast Province, and has an area of 8,322 km2 of which 62km2 are under water. The district is divided into 5 divisions namely; Kinango, Kubo, Matuga, Msamweni and Samburu. Matuga and Msamweni divisions occupy the Coastal plains and foot plateau.
The district currently faces severe problems associated with HIV and reproductive problems. The census reveals that around 50-60% beds in the hospital beds in the district are occupied by AIDS patients. The cultural beliefs and poverty in the community are some of the major reason for the rise in HIV and other STD cases. The district has 3 hospitals, 5 health centres, 37 dispensaries (GOK), and 3 private dispensaries, but despite these health services, the accessibility of health services is very low.
Major health issues in the area are as follows:
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- Increased cases of STI/HIV/AIDS infection
- Slow behavioural change
- Inadequate care and support for the infected and affected people
- High prices of ARV (Anti Retro Vital Drugs)
- Inaccessibility of SRH services
- Ignorant youth about SRH issues
Project Objectives
Through the proposed project, we will provide a platform to facilitate SRH services amongst the vulnerable adolescents of Kwale district. The project aims to improve adolescent health of 500 adolescents through awareness generation and enhancing accessibility to quality SRH services.
Objective 1. To create awareness among 500 adolescents aged 12 to 19 years and their parents on aspects of reproductive and sexual health.
Objective 2. To mobilise and enhance knowledge of adolescent girls and boys SRH issues, through the formation of youth groups and establishment of a youth friendly club.
Objective 3. To build capacities of teachers and parents as counsellors to facilitate better communication with children related to adolescent health.
Project Implementation Strategy
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- Baseline generation: Data on current level of sexual and reproductive health will be collected in the Kwale District. Data will be collected through a set of PRA tools viz. Interview, Structured Interview, Focus Group Discussions, Questionnaire survey etc. Through the surveys and the FGDs we will gather both quantitative and qualitative data on adolescent health. This will help in finding out the extent to which the community is aware about the current government schemes and also the willingness of the people to contribute in the project. Some of the indicators that will be used to identify adolescent health issues will be:
- Total number of adolescents in the area
- Education level of the children
- School dropout rate
- Government run health care facilities
- Health facilities in the area
- Sexual activity amongst adolescents
- Birth rates among young women, both unmarried and married
- STD rates among youth
- HIV and AIDS cases among those 15 to 19 and 20 to 30 years old
- Use of contraception
- Average age at marriage
- Infant morbidity and mortality rates of children by age of mother
- Rates of alcohol and/or drug use connected with sexual activity among youth
- Incidence of sexual abuse and violence
- Prevalence of prostitution among youth
- Percentage of youth enrolled in primary and secondary schools and universities.
- Baseline generation: Data on current level of sexual and reproductive health will be collected in the Kwale District. Data will be collected through a set of PRA tools viz. Interview, Structured Interview, Focus Group Discussions, Questionnaire survey etc. Through the surveys and the FGDs we will gather both quantitative and qualitative data on adolescent health. This will help in finding out the extent to which the community is aware about the current government schemes and also the willingness of the people to contribute in the project. Some of the indicators that will be used to identify adolescent health issues will be:
This data will be analysed using statistical techniques so as to provide the project staff with adequate information on the needs of the people. The combined information will help the project team in designing the future course of action, the ICT material and training material for future purpose.
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- Development of ICT material and toolkits: Comprehensive SRH material will be developed in form of training toolkits, leaflets, audio-video material and comic books. The training material will be used for distribution in schools and amongst parents. Culture plays a very essential role in shaping the way people perceive about sexual education and therefore the educative material will be developed considering the culture and local traditions. This way local support can be gathered to disseminate and adopt relevant SRH practices. Another important aspect of effective SRH material is its integration with life skills and other social issues, so as to groom the adolescents for a successful future. The World Health Organisation has also recommended the SRH education should be provided within the context of school programs and activities that promote health. The material will be made in vernacular language which is easy to understand so as to engage the local populace.
- Awareness Generation: A mass awareness drive will be carried out in the villages to sensitise the youth. The ICT material will be distributed in the villages. Also street plays focussing on HIV/AIDS, Early marriage and pregnancy, STDs, sexual abuse etc will be organised. Some myths and stories about adolescents will also be shared and discussed with the people. Comic books will also be distributed amongst school children, so as to engage them in the program. The comic book will have short stories on various aspects of SRH and life skills, which would enhance the children’s awareness level on SRH issues.
- Mobilising youth through formation of youth groups: Separate groups of adolescent girls and boys will be formed in the identified villages to discuss with them the SRH issues in detail. Also within each group, two sub groups will be formed one comprising of children of the age 12-15 years and the other comprising of children of the age 16-19 years; this will help in discussing issues which are more important for each group. Weekly meetings will be organised in the villages and discussions will be carried on the following aspects:
- HIV and AIDs
- Gender Empowerment
- Health and Nourishment
- Sanitation and Hygiene
- Human Rights
- STDs
- Physical and Emotional changes
- Peer Pressure
- Contraception
- Sexual health
- Menstruation and hygiene
Along with the discussions on SRH issues, the project team will also provide special lectures on life skills and gender equality principles.
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- Establishment of Youth Club: A youth club will be established in a location that is midway to the identified villages. This club will not only work as centre where adolescents can avail health services but will also work as a centre to enhance life skills of the youth. The centre will have youth friendly environment, which would facilitate healthy discussions between the youth and they can clear their doubts. The youth club will have a library, a gym and a play area. The main purpose of this club will be to initiate a healthy dialogue between the adolescents that visit it. Unlike a regular health clinic, young people can come and visit the club without any hesitation. A doctor will be available to discuss all health issues and also necessary medication, sanitary napkins, condoms etc. will be provided.
- Capacity building of schools and parents: A very essential component of the project is the engagement of schools in advocating the project. Our project team will meet with the school administration so as to discuss our project in detail. The ICT material will be shared with them and we will carry a session on SRH in the schools. Also we will seek teachers support to work as counsellors and communicate with children about the problems they face. Some teachers will also be trained to conduct SRH sessions in the school on a timely manner. The training sessions will be carried out by Health experts and our project team through distribution of training tool kits.
Parents play a very important role in the upbringing of children, we will conduct a parents awareness session in the villages. This will help in engaging the parents in a healthy discussion and letting them know about ways to counsel the children. The orientation will help in improving healthy communication between adolescents and their parents.
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- Engaging local actors and integrating with Government efforts: Government is already investing in health facilities and promoting SRH services for youth through primary health clinics. To ensure better accessibility of the services being offered by these health centred we will integrate our project activities in the centres as well.
Project Output
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- Baseline report on sexual and reproductive health compiled for Kwale District
- 500 adolescents made aware about SRH issues through awareness sessions
- Adolescents mobilised into youth groups
- 1 youth club established for the all round development of the youth
- 10 Schools and parents engaged in promoting SRH issues in the area.
- ICT material developed for distribution during awareness sessions.
- Integration of project activities with primary health clinic to facilitate quality health services.
Project Sustainability
The project will strengthen the inter-linkages between the local actors, school teachers and parents thereby improving the present and future health aspects of adolescents in the area.
The toolkits and awareness generation material will help in making the community more aware about the importance of SRH issues, these people will then act as the driving force to carry forward to the masses and the peers. As the entire process has been made participatory the skills and knowledge gained by the present group of people, will be transferable and also replicable.
The involvement of local agencies and primary health workers will also ensure improvement and access to the government initiatives in this direction, as these agencies are permanent, they will help in sustaining the project activities beyond the project duration.
