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Using indigenous systems and the community to improve reproductive health in Kenya

Page history last edited by Rosemary 12 years, 8 months ago

Using indigenous systems and the community to improve reproductive health in Kenya

Rather than importing models from elsewhere, the Family Planning Association of Kenya turned to local cultural traditions and worked with existing youth groups and service providers to develop a project that provided young people with reproductive health information and services at a time when such programs were controversial and difficult to carry out. The project showed that indigenous systems and existing community structures can be used and adapted to improve youth reproductive health status in sub-Saharan Africa.

In Kikuyu tradition, youth became adults through an initiation process during which they were advised by atiri, or respected adult counsellors, chosen by their parents. In the Nyeri Youth Health Project, these 25 counsellors (18 women and seven men known as Friends of Youth) were well-known and respected young parents nominated by young people and parents. Over a three-year period, they worked in their own communities to educate adolescents and parents on reproductive health, encourage dialogue between youth and adults, and provide referrals for services.

The adult counselors used a life skills curriculum entitled "Life Planning Skills for Adolescents in Kenya" that includes sessions on community, family and individual values, adolescent development, sexuality, gender roles, relationships, pregnancy, STIs, HIV/AIDS, harmful traditional practices, substance abuse, planning for the future, children's rights and advocacy.

After a month's training, each counsellor was assigned to a specific geographical area that included about 300 youth. They went door to door in their area to introduce themselves and the project before they started work. Counsellors used existing structures such as schools, church youth groups, youth clubs and sports clubs to work with youth. Only if young people did not belong to such groups did counselors form their own groups or seek out young people individually.

Counselors conducted a range of activities including group discussions, role playing, drama and lectures. They tailored the curriculum to age, preferences and needs - for example, spending more time on values and puberty with younger teens, more time on STIs and HIV/AIDS with older youth. Counselors typically met with groups weekly for 4-8 weeks, in 90-120 minute sessions. The counselors also worked with adults on community approaches to youth issues, and coached teachers to improve their communication with young people.

As research showed that young people tend to visit private service providers for sensitive reproductive health problems, the association trained a network of local doctors, clinical officers, chemists and laboratory personnel—mostly from the private sector—to provide youth-friendly services. Counselors referred youth to service providers and gave them a coupon entitling them to subsidized services. Young people paid the equivalent of US $0.50-1.50 for services; the association and collaborating service providers covered the rest. Evaluation showed that the project had a significant positive effect on youth and community behaviour.

Summarized from Erulkar AS et al., Behavior change evaluation of a culturally consistent reproductive health program for young Kenyans, International Family Planning Perspectives, 2004, 30(2):58–­67. Http://www.guttmacher.org. Used with permission.


UPDATE: The Family Planning Association of Kenya has been renamed Family Health Options Kenya (FHOK). Its Adolescent/Youth programme area, begun in 1977 as a Family Life Education (FLE) project aimed at young people in schools which later expanded to serve out of school youth and provide services through model youth centres, aims to empower youth to make informed choices in terms of sexual and reproductive health. The program operates in five youth centres located in Nairobi, Mombasa, Nakuru, Eldoret and Kisumu towns which are run by young people who are trained Peer Youth Educators (PYEs).

Family Health Options Kenya (FHOK), P.O. Box 30581 00100, Nairobi, Kenya. Email.


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