Innovations to Address Reproductive Health for Youth and Adolescents

There are 9.2 million adolescents and young people aged 15 – 24 years in Kenya. This is close to 20% of Kenya’s total population. This is a Key demography whose health status directly affects the socioeconomic status of the country. Even though we would want this age group to contribute positively in the development of the country, they are instead held back due to poor reproductive health status. Sexual debut is early in teenage life, unprotected sexual activity continues as they transition to adulthood. Their rate of contraceptive use is low translating to high unmet need for contraceptives. PS Kenya has identified this as one of the priority target audience in dire need of specifically tailor made interventions which address their unique needs. This is because addressing their Sexual Reproductive Health (SRH) needs now would significantly improve the current national SRH indicators and guarantee a healthy future generation.

What the youth know on reproductive health does not always directly translate to appropriate behavior! For example, TRaC 2016 showed us that 77% of young women intend to use contraceptives however their actual contraceptive use is still low. Despite several interventions targeting the youth they are still struggling with SRH problems.

To address this gap in 2016, PS Kenya sought to use different approaches to meet the needs of adolescents and youth of Kenya.

1. Understanding their World, developing interventions together with the youth and co- creation.
2. Youth friendly service provision through the Tunza Social franchise.

Understanding their world and developing interventions with the youth.

In 2016, PS Kenya used Target Audience (TA) immersions to understand the Youth of Kenya. We felt this was significant and instead of using the same interventions as previously used, we first needed to holistically understand the audience, gather insights and develop themes which would help us in designing the interventions. The approach believed that since the youth are the ones facing these problems every day then they are the ones who hold the key to their answer. The process started with explorative research which explored the lifestyle and needs which are synonymous with the youth. The themes generated from the explorative research were then used to provide communication ideas. At this stage the youth were involved in coming up with the communication messages and the channels which would speak to them. From this approach, youth co-created messages were developed and packaged for roll out. By using this approach, we gathered very exciting insights and in 2017 we are committed to explore this further and be the leaders in providing the opportunity where the youth design interventions for themselves. Going forward through 2017, we intend to combine the immersions and co-creation approach with Human Centered Design (HCD).

Youth friendly service provision through the Tunza Social franchise.

In 2016, PS Kenya used the Tunza Social Franchise Network to provide SRH services to adolescents and young people. We believe that to meet the contraceptive needs for adolescents and young people, health services must be offered in an environment where the adolescents and young people feel free to access them without been judged or condemned by the health facility and the entire society. To achieve this, our model for youth friendly services is through integration of youth service provision with the other services in the facility. To make sure that the service providers are equipped with skills and have the right attitude to field and deliver this model, PS Kenya trained and certified a total of 22 franchise providers. The main objective of the training was to address provider attitude and beliefs in providing youths with SRH services. The approach of the training was through Value Clarification and Attitude Transformation (VCAT). This approach seeks to address the provider attitude and beliefs in serving the young especially with contraceptives. It ensures that the providers have the right attitude, are not judgmental and provide a conducive environment for young people to access services.

In 2016, we saw the numbers of adolescent girls and young women accessing contraceptive services in Tunza clinics increase. A total 0f 59,781 FP methods were issued to adolescent girls and young women. This accounted to 27% of all FP methods served through the Tunza franchise. Over 3,800 IUCDs and over 11,200 implants were served to this demography. Comparing these numbers the proportion of young women opting for long acting methods were higher compared with the older generation. Although the increase in total numbers could not be directly attributed to the YFS training since a smaller proportion of providers were trained, there were higher numbers of youths served in the facilities which were trained. With this recognition, PS Kenya plans to train more franchise providers on provision of youth friendly services in 2017.