How Community Attitudes Shape Adolescent Reproductive Health in Rural Kenya

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Principal Investigator: Paula Tavrow

In sub-Saharan Africa, young unmarried people have the right to comprehensive reproductive health information and services. However, they may be unable to exercise these rights. This presentation will provide results from studies I conducted in rural Western Kenya to elucidate the impact of community attitudes on youths’ access to services. After introducing a comprehensive after-school activity called Youth for Youth in Bungoma District, Western Province, Kenyan colleagues and I conducted 31 focus group discussions with community members, both students and adults. Our main findings were that despite AIDS educational campaigns and high HIV prevalence, about half of community members opposed youths’ access to condoms, and 1 in 7 would punish youths found with condoms. Furthermore, girls were likely to be blamed if they were coerced into sex. Based on the results, we constructed a “blame index” to determine when girls would be believed. In a separate study of post-abortion services in Western Kenya, community norms about appropriate behavior seemed to be deterring young women from adopting contraception post-abortion, even when services were very youth-friendly. All told, these studies suggest that community norms in rural Kenya continue to hinder optimal adolescent health, even though transitional attitudes are occurring among health providers.