Why adults and teachers information about sexual behavior and its consequences does not prevent unplanned pregnancies among adolescents in Nairobi, Kenya

Context: Despite a high number of unwanted pregnancies in Kenya, contraceptive use among adolescents is very low. Establishing the nature of sexuality discussions is critical to determine perceptions and barriers affecting contraceptive use among adolescents. Methods: The study used systematic random sampling to collect data to examine sexuality information and knowledge that affect perception and barriers on contra-ceptive use among 1119 adolescents aged 15 - 19 years in Nairobi. The survey was conducted using the 2009 Kenya Demographic and Health Survey enumeration areas and projections based on the 1999 population census. Data were collected using structured interviews, focus group discussions (FGDs) and in-depth interviews (IDIs) among adolescents, parents and teachers. Quantitative data were analyzed using Statistical Package for Social Sciences (SPSS) software while qualitative information was analyzed using iT Atlas. Results: Although teachers were identified as a primary source of sexuality information, they were poorly prepared to teach the subject. While the study found negative perceptions on sexuality education, most FGDs and IDIs supported the need for its integration in the school curriculum. Most adolescents who used con- traceptives had perceptions that their parents approved. Source of sexuality information, living arrangement and perceptions on contraceptives for unmarried adolescents were statistically associated with contraceptive use. Conclusion: The study showed that sexuality information from parents and teachers was biased against adolescents using contraceptives. There is need to address attitudes in discussing contraceptive use for adolescents by parents and teachers to enhance positive perceptions and increase contraceptive use by adolescents.

“They Will Wonder What Kind of a Girl I Am”: Adolescent Perceptions towards Contraceptive Use in Nairobi

As in other developing countries, contraceptive use among adolescents is low and only one in twenty adolescents is reported to use contraceptives inKenya. Pregnancies early in life expose adolescents to health complications. Establishing perceptions that affect contraception and factors that influence those perceptions is important in developing appropriate programs and policies to increase contraceptive use prevalence among adolescents. We used primary data from a household survey using a systematic random sampling in eight administrative divisions inNairobiCountyin 2010. The study utilized information collected using structured interviews, focus group discussions (FGDs) and in-depth interviews (IDIs). The findings revealed that perceptions on parental approval, adolescent approval, ability to get contraceptives for self, knowledge of how to use contraceptives and sexual partner communication had significant effect on contraception. The narratives showed that parents, teachers and service providers had negative perceptions and discouraged contraception among adolescents thereby influencing use. Parents and teachers had inadequate knowledge and skills to communicate sexuality messages creating potential environment likely to have indirect negative influence on adolescents’ perceptions on contraception.