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Failing the rights: sexual vulnerability, access to services and barriers to contraceptives among adolescents in Narok County, Kenya

Griffins Manguro (International Centre for Reproductive Health Kenya, Mombasa, Kenya and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium)
Jefferson Mwaisaka (School of Public Health, University of Ghana, Accra, Ghana)
Dan Okoro (Unfpa Kenya, Nairobi, Kenya)
Kigen Korir (Unfpa Kenya, Nairobi, Kenya)
Patricia Owira (International Centre for Reproductive Health Kenya, Mombasa, Kenya and School of Public Health, London School of Hygiene and Tropical Medicine, London, UK)
Gerald Githinji (International Centre for Reproductive Health Kenya, Mombasa, Kenya)
Ademola Olajide (Unfpa Kenya, Nairobi, Kenya)
Marleen Temmerman (Chair of the Centre of Excellence in Women and Child Health at Aga Khan University, Nairobi, Kenya and a Professor at Ghent University, Ghent, Belgium)

International Journal of Human Rights in Healthcare

ISSN: 2056-4902

Article publication date: 23 August 2021

Issue publication date: 25 October 2021

89

Abstract

Purpose

Around one in five girls in Kenya, aged 15 to 19 years old are either pregnant or have given birth. Of 47 counties, adolescent pregnancy is highest in Narok, where about 40% of girls aged 15 to 19 years old have begun childbearing. This study aims to explore drivers to sexual activity, access to sexual and reproductive health (SRH) services and barriers to contraceptive use among adolescents in Narok County, Kenya to inform the design of SRH interventions and safeguard young people’s rights to sexual health.

Design/methodology/approach

A cross-sectional mixed methods study was conducted in December 2019. Quantitative data were collected through structured questionnaires among girls aged 15 to 19 years old who were either pregnant or had given birth and those who had not and boys aged 15 to 19 years old. Qualitative data were collected through focus group discussions with adolescent girls and boys and through structured key informant interviews with parents, community leaders and health workers.

Findings

The mean age at first sexual intercourse for both genders was 15 years. While the majority of girls and boys knew where to access SRH services, few used contraception during their last sexual activity. There was no significant difference in the condom or other contraceptive methods use between girls who had begun child bearing and those who had not (p = 0.549 and p = 0.563, respectively). Key drivers for sexual activity among young people were poverty and peer pressure. Cultural practices such as female genital mutilation and early marriage contributed to early sex. Community attitudes toward contraception discouraged young people from taking up contraceptives.

Originality/value

This mixed methods study explores the drivers of adolescent pregnancy in Narok, Kenya, the county with the highest rates of adolescent pregnancy; twice the national pregnancy rates. Understanding the drivers of pregnancy and the underlying human rights violations will help policymakers and health leaders to design interventions which will improve outcomes.

Keywords

Acknowledgements

The authors would like to thank the Narok County Department of Health for granting us access and permission to conduct the study. We also want to thank the UNFPA Kenya office for funding the research. Our gratitude also goes to all health facilities and school-in-charge personnel who allowed the research team to conduct the study on their property. Last but not least, we would like to express our heartfelt gratitude to everyone who contributed to the qualitative and quantitative data for this study.

Citation

Manguro, G., Mwaisaka, J., Okoro, D., Korir, K., Owira, P., Githinji, G., Olajide, A. and Temmerman, M. (2021), "Failing the rights: sexual vulnerability, access to services and barriers to contraceptives among adolescents in Narok County, Kenya", International Journal of Human Rights in Healthcare, Vol. 14 No. 4, pp. 374-386. https://doi.org/10.1108/IJHRH-11-2020-0099

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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