Utilization and Health Facility Barriers of Sexual and Reproductive Health Services among Female Sex Workers in Nairobi City County, Kenya.
Bwabi, Beatrice Nangekhe
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Female sex workers(FSWS) are categorized as key population due to the high risk they face from their sexual behaviour, stigma from the society and discriminative laws that affect them in seeking preventive and curative health services. Sub Saharan countries report deaths from HIV, unsafe abortion, and unskilled deliveries. Studies in Nairobi county has revealed 25% of female sex workers. The female sex workers who contribute to 5% of reproductive health women are at risk of sexual reproductive health complications because of their weak negotiation power for safe sex and poor health seeking behaviors. The study was conducted in selected hot spots in Nairobi county through a cross-sectional design. The specific objectives included, to determine the influence of socio-demographic characteristics on SRHS utilization among FSWS, to assess the association of knowledge on SRHS and utilization among FSWS, to establish the perception of FSWS on SRHS utilization and to determine barriers faced by FSWS while accessing SRHS in Nairobi County. The self-determination theory was used to probe up internal motivators towards psychological growth among FSWS. Critical Medical Anthropology Theory was used to explain ways in which health services are differentially allocated based on social factors and perceptions. The determination of sample size was conducted through Fisher et al. formulae and attrition rate of 10%, which added to 421 respondents through snow ball sampling. The data collection was done using qualitatively and quantitative methods through structured questionnaires, focused group interview and key informants. The cleaned data was processed through SPSS software v.22. The study established that social demographic characteristics and knowledge have a relationship with sexual and reproductive health services utilization through the Chi-Square test of independence (P=0.01<0.05). The study further established that FSWS had perception towards SRHS utilization through content analysis of focused group interview and likert scale measurement. The perceptions towards utilizing sexual reproductive health services played a big role in seeking of the services by the female sex workers as evidenced by a high average mean (M- 4.22, SD- 0.96). Similarly, the respondents agreed that the rate of SRHS utilization was affected by many barriers, (M- 4.01, SD- 0.938) , poor quality services, lack of time and or inconveniencing clinic schedules. The study recommends that targeted health education on SRHS for FSWs be implemented consistently, sensitization of HCWs on friendly SRHs among FSWs, integration of SRHs among other programs like outpatient and maternal clinic to scale up utilization. To provide information, education and communication materials on SRHS to FSWS.