Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

Abstract

BackgroundAddressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya.MethodsQualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach.ResultsThe majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services.ConclusionSupporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice.

Sexually Transmitted Infection Services for Adolescents and Youth in Low- and Middle-Income Countries: Perceived and Experienced Barriers to Accessing Care

“…Among the accessibility barriers most frequently mentioned were those related to cost of services[19–21, 27–30, 32], hours services were offered[19, 21, 29, 31, 33], and waiting times to receive services[21, 29, 31, 32]. The locations of services, or issues related to transportation, were also sometimes mentioned.…”

“…Many providers felt that they needed more training in working with youth and sometimes felt that those being trained were not necessarily those most in need of it [22, 30, 32, 33]. Some providers saw barriers in national health policies and guidelines.…”

“…Some providers saw barriers in national health policies and guidelines. Other providers reported limited knowledge of national health policies and guidelines for providing SRH services to youth [28, 32]. Discussions about policy frequently focused on ‘youth rights’ with respect to SRH services and revealed a mixed level of acknowledgement that youth had a right to services or to confidentiality [28, 30, 32].…”

“…Health services providers frequently mentioned that attributes such as age and sex [22, 28, 30–33], as well as provider behavior toward youth, could be impediments to youth seeking SRH care. Some providers acknowledged that youth needed to feel welcomed to come back for services [30–32]. While this was recognized by some providers, others (and even some of the same providers themselves) also acknowledged that they judged or lectured youth when they came in for STI/SRH care [22, 30, 32].…”

“…Some providers acknowledged that youth needed to feel welcomed to come back for services [30–32]. While this was recognized by some providers, others (and even some of the same providers themselves) also acknowledged that they judged or lectured youth when they came in for STI/SRH care [22, 30, 32].

“Because if you are a young boy or young girl and you go there asking for family planning or condoms and the nurse might say “you are a young girl or young boy so you don’t need to use that.

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