Health and sexuality among out of school adolescents in an urban slum in Nairobi, Kenya

Abstract

In the last decade, the reproductive health and sexuality of adolescents has received increasing recognition world-wide. Several factors have accounted for these new trend. more than half of the population in developing countries, constituting 85% of the worlds young people is under the age of 25 years. Hence, the demographic prospects of the future, with its consequences, will depend on the reproductive, sexual behaviour and health of these adolescents. The emerging epidemic of the hazards of unprotected premarital and teenage sexual relations, especially pregnancy complications, induced abortions, sexually transmitted diseases, including HIV/AIDs among today's adolescents put a greater burden on public health both in the short and long-term. The high population rate of Kenya (3. ']010 p.a.) is significantly contributed to by the adolescents who have a very high Age-specific fertility rate (ASFR). In Kenya, adolescents constitute about 25% of the total population and it is the fastest growing segment of the population'. Previous Surveys show that teenage sexual activity is increasing in many countries, and that in some, adolescents are starting sexual activity earlier and having more partners and more casual relationships. This was a cross-sectional survey conducted on out of school adolescent health and sexuality in Kibera slum in the division of the Nairobi city, with the aim of investigating: the common health problems and sexual behaviour; opinion on abortions; contraceptive knowledge, attitudes and use; and knowledge on STDs HIV/ in adolescents out of school. The study population comprised offemale and male adolescents aged between 14 and 20 years who were not attending school. Both structured interviews and Focus group discussions (FGDs) were used to collect data A total of 397 adolescents were interviewed and nine Focus group discussions were carried out. In most cases results obtained from the FGDs were similar to those of the structured interviews. the study found tJmta large proportion of the adolescents (81%) had indulged in sex) the mean age at first coitus being 14 years. Majority of the respondents also knew of a method of modern contraception and current use of a method was found to be high (43.6%). The main sourcefor contraceptives was mass media followed by peers) although they preferred their parentsto be their main source of information on Reproductive Health and Sexuality. The studyconcluded that majority of the adolescents are sexually active and that the prevalence of unprotected sex in out of school adolescents is high) leading to the high prevalence of STDs. The study also implied that there are some activities in the study area which have lead to the high knowledge on modem contraceptive and Sexually Transmitted Diseases.There was also good knowledge on the transmission ofHIV/AIDs. Adolescents alsofeltthatparents could be of great help to them on matters related to sexuality. Thestudy underscores the need to strengthen and sustain whatever activities that are responsiblefor the high level of contraceptive knowledge and prevalence, Activities that willenhance and develop the parents participation and peers in Family Health Education also need to be developed. Programmes addressing the needs of adolescents need to be strengthened.Accessibility to family planning services, and counseling on family planning labortionsfor the youth need. to be provided. These services should be youth friendly.