A young adolescent (YA) is a person aged between 10 and 14 years who is in the process of developing from a child into an adult. The YAs are constantly in a period of dramatic intellectual, physical, psychological, and social transformation from childhood to adulthood (Abrams, 2006, Bearinger et al., 2007). This group represents a unique sub-group of adolescents undergoing rapid physical, cognitive and emotional changes related to puberty. During this period, YAs develop a greater awareness of their social sphere, increase their ability to think logically and concretely, feel greater self-consciousness, and tend to depend less on parents and more on friends. The YAs start to feel pressure to conform – it is notable that early adolescence is the peak time when peer pressure rules. At this stage, they form values and make decisions that will impact them either positively or negatively for the rest of their lives (Patton and Viner, 2007, Resnick and Bowes, 2007).

While this fact is often neglected, it is also at this age that many YAs first engage in sexual activity. This leaves them vulnerable to unplanned pregnancies, sexual abuse and contracting STIs. It is therefore crucial for young adolescents to have access to sexual and reproductive health and rights information and services.

It is critical to address the SRH issues of YAs, not only from a human rights perspective, but also because YAs have the potential to be a positive force in society, now and for the future. Focusing on individuals while they are still in adolescence would allow them to adopt risk-avoiding and responsible attitudes and health behaviour and, in the long-term, the burden of disease in later life would be reduced, and they would be better equipped to contribute positively to society.

Deutsche Stiftung Weltbevoelkerung (DSW) in close collaboration with Bayer HealthCare Pharmaceuticals (BHP) implemented a four-year pilot intervention (2009 to 2012) in partnership with selected districts and schools in Masindi, Tororo and Wakiso Districts in Uganda. An evaluation conducted in 2011 showed that the holistic approach of addressing a whole school setting – including students, teachers, parents, and the surrounding community was highly effective. The organization, in partnership with BHP, purposed to build on and expand this experience by employing a similar approach in Kenya’s Coastal Region.

The baseline survey was conducted to establish sexual and reproductive health (SRH) knowledge, attitudes, practices, and behaviour of YAs in primary school and how these are related to their health and well-being. Specifically, the study sought to; collect data on knowledge, attitudes, and practices of YAs (10-14 years) towards sexual and reproductive health (SRH) with regard information and services; assess community leaders, teachers and parents’ opinions and perceptions on health information and service delivery to YAs in the target communities; and document the type and quality of youth friendly services provided by the healthcare system to YAs in the target communities.

Kilifi is the eighth most populated County in Kenya with a total population of more than one million people (Kenya Population Census Report, 2010). School drop-out rates as high as 26% have been reported, with early pregnancies and marriages being cited as a severe problem (National Coordinating Agency for Population and Development, 2005).

The baseline results clearly indicated general and specific gaps that needed to be addressed to ensure YAs take full advantage of SRHR information and services. Comprehensive knowledge on HIV/AIDS was also notably poor and in terms of children’s rights, there was a gap in recognition of the ‘higher order’ rights that go beyond survival including the right to life, play and identity. The frequency of discussion of SRH issues between teachers and pupils was found to be low based on the range of issues that they reportedly discussed with the YAs. The linkages between the teachers and health providers were also weak. Furthermore, there was the need to strengthen communication between the community and health facilities with respect to SRHR, as well as improve comprehensive understanding of HIV/AIDS to trigger community support for YAP Kenya.

The African Institute for Health and Development recommended that the YAP Kenya (Young Adolescents Project) team:

  • Design activities and develop/adopt SRHR toolkits that will provide information to the YAs on SRHR using multi-pronged approaches including working with teachers, parents and through peer support networks.
  • Facilitate mechanisms in schools where parents and teachers discuss the SRHR issues of the YAs. Use of PTA meetings to address SRHR could be negotiated with the schools.
  • Create linkages between the schools and the health facilities through facilitating the health providers to interact with the YAs on a regular basis in the form of talks, debates, theatre and in small discussion groups.
  • Support and/or strengthen youth to youth initiative (Y2Y) clubs through which the youth will be facilitated to access accurate SRHR information.
  • Organize community dialogue sessions that will create ‘safe spaces’ for adults (parents and community leaders) to share their concerns on the SRHR needs of the YAs and generate measures to address these concerns.
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