Access to Sexual and Reproductive Health Care Services by Adolescent Girls Aged 15-19 Years among Pastoral Communities In Narok County, Kenya
Njoki, Mbugua Leah
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The subject of adolescent sexual and reproductive health has acquired prominence more than ever before in recent years, dominating local and international forums deliberating on adolescent sexual and reproductive health. Most of the discussions, targeted interventions and researches undertaken on Adolescent Sexual and Reproductive Health (ASRH) have looked at the issue from infrastructural and resource capital allocation culminating into school-based reproductive health programs. Pastoral communities are characterized by a life of moving from place to place which complicates their access to basic facilities including static healthcare services. This study sought to establish access to sexual and reproductive healthcare services by adolescent girls among pastoral communities. The study was a cross-sectional descriptive study and was confined to the adolescent girls among pastoral communities in Narok South Sub-County which was purposively sampled to represent pastoral communities in Kenya. Simple random selection of households and individual respondents was done. Interviewer administered structured questionnaires, key informant interviews guides and focus group discussions guides were used to garner quantitative and qualitative data. Data analysis was performed using SPSS version 21 for quantitative data and content analysis was done for qualitative data. The study found out that there were no specific youth sexual and reproductive healthcare services. The factors that influenced access to SRH services by the adolescent girls included socio-cultural factors: cultural beliefs(27%) and restriction by family members(73%); individual barriers: shyness (14%) and fear (86%); unfriendly service providers (19.6%); economic factors: financial constraints (39%), long distances (32%) and lack of transport (29%); information barriers: ignorance and illiteracy (58%) and no knowledge of where services are offered (42%). There was significant association between access of SRH services and their use: SRH information (χ2 =15.064, df=1, p<0.001), condoms (χ2 =19.167, df=1, p<0.001), injections (χ2 =7.851, df=1, p=0.005),and prenatal care(χ2 =5.738, df=1, p=0.017). The study recommends that the government and other stakeholders set up of centres that offer adolescent-friendly SRH services and setting up of mobile clinics to serve adolescents in the interior marginalized areas who are unable to access static facilities due to financial constraints, distance and lack of transport.