Socio-cultural determinants of pregnancy and the spread of sexually transmitted infections among adolescent residents of Kakuma refugee camp, northern Kenya

Abstract

The health status of refugees is one of the major concerns of the United Nations High commissioner for Refugees (UNHCR). Adequacy of reproductive health (RH) services among refugees has remained a difficult area for UNHCR to investigate due to the conflict between the nature of these services and the socio-cultural and religious backgrounds of refugees.

This investigation was a descriptive-cross-sectional study aimed at establishing the social cultural determinants of teenage pregnancy and the spread of sexual transmitted infections (STIs) among the adolescents in Kakuma refugee camp of the Rift Valley Province, Kenya. The data were collected using questionnaires; focus group discussions, interviews and participatory observations then analyzed using the Statistical Package for Social Science (SPSS). The findings were appropriately presented in the text supplemented with relevant Figures and Tables.

The results of the study demonstrated that the respondents aged between 12 and 19 years were sexually active and engaged in unplanned sexual intercourse in open places at night. The boys did not use condoms and the girls did not use pills or other methods of contraception largely because of ignorance and incorrect marketing strategies. Religious preaching and cultural exclusion including values attached to marriage, pre-marital and female genital mutilation strongly supported by elders created a barrier in addressing adolescent sexuality and utilization of reproductive health services (RHS).

Religion, the formal school system and some social services played an insignificant role in creating awareness on sexuality and sex-related matters among the respondents. Teenage pregnancy was linked to adolescent rebellion against cultural norms, early marriage or to forced marriage. Abortion was widely practiced among the adolescents in all the refugee communities and female genital mutilation (FGM) did not constitute any barrier to some girls who did not remain virgins till marriage. Many adolescents were lured into sexual relations by adults and most young boys engaged in sexual intercourse with older women who were either widowed, divorced or those whose partners/husbands failed to satisfy their sexual desire because of drug consumption.

Lack of rational utilization of RH services at Kakuma appeared to arise from a conflict between two generations. The adolescents in one hand who had no sexual right in the informed utilization of RH services and the elders who considered pre- marital sex as reserved and a taboo thereby hampering any attempts to educate the adolescents on their sexuality and utilization of RH services.

The results of this study have policy implications in the need to educate adolescent residents of Kakuma Refugee camp on their sexuality and utilization of RH services to reduce teenage pregnancy and the spread of STIs.