Determinants of Sexual and Reproductive Health among street adolescents in dagorretti district in Nairobi

Abstract

Background: Adolescents make up 80% of the world population and despite being the hardest hit by sexual and reproductive health challenges their sexual and reproductive health (SRH) needs are largely unmet. The challenges are more intense among certain groups, including street adolescents based on social, cultural and biological factors . Methods: A descriptive cross sectional study was carried out in Dagoretti district of Nairobi to determine the sexual and reproductive health behaviour risk factors among street adolescents. Data was collected through interviews from 195 adolescents and 10 key informants. Results: The study established that despite moderately high SRH knowledge among 79% of the participants, 55% of them were involved in high risk sexual behaviour. Majority of the children had sex by the age of 10 - 15 years (41.9%) with o lder partners and did not use condoms (74.4%). In the multivariate model, the following factors were found to be predictive of risky sexual behaviour, male gender (pv=0.006), age in years (pv=0.037), attendance to HIV testing (pv=0.011), parents/guardians as a source of SRH information and combination of number of drugs used (pv=0.001). Conclusion: This study recommends enactment of a comprehensive ASRH policy aimed at providing accurate, age - appropriate and comprehensive sexual and reproductive health education for all adolescents with specific focus on early adolescence (10yrs to 14yrs) and the male gender. It further recommends for the strengthening of parent al involvement in peer education, integration of SRH and sensitization in drugs and substances of abuse and improvement of health centres as education and service provision centres on ASRH. Further studies are recommended to understand the gap between know ledge and practice as well as the need to disaggregate data on street children by cohorts to ensure appropriate programming for the different groups of children in contact with the streets.