Policy and practices shaping the delivery of health services to pregnant adolescents in informal urban settlements in Kenya

Bibliographic Data

ID15127199
AuthorsLinet Okoth (0009-0001-4272-4635, LVCT Health , Nairobi, Kenya, corresponding author), Rosie Steege (0000-0003-2120-649X, Liverpool School of Tropical Medicine), Anne S Wangui Ngunjiri (0000-0001-6893-9047, LVCT Health), Anne Ngunjiri (LVCT Health , Nairobi, Kenya), Sally Theobald (0000-0002-9053-211X, Liverpool School of Tropical Medicine), Lilian Otiso (0000-0003-0164-154X, LVCT Health , Nairobi, Kenya)
Year2023
Volume38
IssueSupplement_2
Pagesii25-ii35
Publication date2023-11-16
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czad070
PMID37995266
OpenAlexW4388929685
LanguageEN
Citations received2
References cited31

In Kenya, the pregnancy rate of 15% among adolescents aged 15–19 years is alarmingly high. Adolescent girls living in informal urban settlements are exposed to rapid socio-economic transitions and multiple intersecting health risks and may be particularly disadvantaged in accessing sexual reproductive health services. Understanding vulnerabilities and service-seeking behaviours from different perspectives is important in order to support the development and implementation of progressive policies and services that meet adolescents’ unique needs within urban informal settlements. This study explored policy makers, community health service providers’ and community members’ perceptions of access to, and delivery of, sexual reproductive health services for pregnant adolescents in one informal urban settlement in Nairobi. We employed qualitative methods with respondents throughout the health system, purposively sampled by gender and diversity of roles. We conducted focus group discussions with community members (n = 2 female-only; n = 2 male-only), key informant interviews with policy makers (n = 8), traditional birth attendants (n = 12), community health volunteers (CHVs) (n = 11), a nutritionist (n = 1), social workers (n = 2) and clinical officers (n = 2). We analysed the data using thematic analysis. Government policies and strategies on sexual and reproductive health for adolescents exist in Kenya and there are examples of innovative and inclusive practice within facilities. Key factors that support the provision of services to pregnant adolescents include devolved governance, and effective collaboration and partnerships, including with CHVs. However, inadequate financing and medical supplies, human resource shortages and stigmatizing attitudes from health providers and communities, mean that pregnant adolescents from informal urban settlements often miss out on critical services. The provision of quality, youth-friendly reproductive health services for this group requires policies and practice that seek to achieve reproductive justice through centring the needs and realities of pregnant adolescents, acknowledging the complex and intersecting social inequities they face

Business · Community health · Economic growth · Environmental health · Focus group · Government (linguistics) · Health facility · Health services · Population · Public health · Qualitative research · Reproductive health · Service (business) · Service delivery framework · Service provider · Socioeconomics · Sociology · Thematic analysis · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · Medicine · Nursing · Poverty, Education, and Child Welfare