Multisectoral and Inclusive Strategies for Improving Pregnant Adolescents' and Teenage Mothers' Access and Utilisation of Sexual and Reproductive Health Services in Kenya

Abstract

Background: Adolescent girls between 15 and 19 years of age make up just over one-fifth of the women of Kenya, and they account for 14% of all births. This study explored barriers to access and utilization of sexual and reproductive health services (SRH) for pregnant adolescents and teenage mothers in Kakamega County (Kenya).

Methods: The qualitative study included a desk review, interviews and focus group discussions and a validation workshop with the engaged stakeholders to produce a framework for action.

Results: The main barriers emerged in the following domains: acceptability (stigma and socio-cultural influences, negative healthcare workers attitude, lack of privacy and confidentiality), accessibility (distance to the health facility, costs for transport and drugs, opening times), availability (lack of staff, drugs and equipment, low coverage of SRH services specific for adolescents), contact/use (lack of information about SRH services offered), effectiveness (poor collaboration between all the relevant sectors and stakeholders, lack of adequate financing, no inclusion of adolescent perspectives in the policy-making process, lack of reliable data). Moreover, COVID-19 starkly impacted access and utilization of the services.

Conclusion: A pathway to impact framework was coproduced building on the findings of the research to guide decision-makers in Kakamega and Kenya to improve access and utilization of SRH services for adolescents and especially pregnant girls and teenage mothers. Crucially, a multisector and multistakeholder approach including adolescent voices, could support the effectiveness of SRH services for adolescent girls.

Figure 1.

The Five Dimensions of the Tanahashi Framework

Figure 2.

Pathways to Impact Framework