In Siaya County, teenage pregnancy (15-19 years)  has increased from 17% (KDHS 2014) to current 35% (KHIS2, 2018) against 18% nationally (KDHS, 2014).  About 1 in 5 girls (15-19 years) have begun childbearing – about same nationally. Specifically, 3.6% are pregnant with  first child, 13.6% have ever given birth, against 3.4% and 14.7% nationally (KDHS, 2014).

Teenage pregnancy (ages 12-19) remains serious health and social problem because it’s association with high maternal mortality and child morbidity. The risks include HIV/STI’s infections, early and forced marriages and

SGBV. At 27%, Siaya has high  fertility rates but low contraceptive use. The CPR 33%

among women aged 15-49 compared nationally 46%, (KDHS, 2009). An estimated 14%

of all pregnancies end in abortion and 1 in 5 maternal deaths are due to unsafe abortion. Hence need to address issues of unintended pregnancies, fertility reduction and access to CRH (Sedgh et al.  2007; WHO, 2007).

Objectives:

To determine the status of (AYSRHR) information and services in Bondo, Ugunja and Ugenya Sub Counties in Siaya.

The information generated would help health planners to design appropriate ASRHR programs  that would comprehensively address the needs of adolescents and young people in Siaya County.

Methodology/Interventions

The study used two methodologies; quantitative and qualitative.  The quantitative methodology involved the review of secondary data from the county health information system and other national sources including the 2014 (KDHS). 

The qualitative methodology involved focus group discussions, in-depth interviews, and KII. The UDI employed FGD, KII guides and documented case studies in healthfacilities purposively chosen where AYSRHR services are offered.  Non-probability andpurposive sampling were used to draw informants including sub county RH coordinators, HCWs and YPP. 

Five FGD comprising 11 participants each were conducted with adolescents and active YPP. Seven KIIs were conducted with purposively selected HCW.

Results

The study findings reveal that young people 49% get SRH information and services from health facilities while 21% from school. The type of information and services provided include; STIs and HIV/AIDS, contraceptives, SGBV, infertility, abortion, reproductive cancer, maternal and child health.

Majority of respondent were between age 10-19 years (10-14 -33%, 15-19-32%). It further showed that among (10-19 years), only 31%females and 18% males had knowledge on pregnancy prevention, a woman’s fertile period, able to reject misconceptions and familiar with atleast one modern method of contraception.

For (10-14 years) only 10%females and 6% males had same level of knowledge. Among the respondents, (40%) had discussed TP related matters with family members. Female were likely (34.9%) to discuss with their parents than male (5.1%). 

The AY  reported to be faced with challenges in accessing SRH/FP information and services. The study reveal that most 89% health facilities dont have Youth Friendly Services thus negative service provider attitude, lack of confidentiality among HCWs causes fear and embarrassment among AY to access services.

Other challenges include; fear of side effects, services cost, peer pressure to procure abortion, negative community perception, lack of parental guidance and ignorance, poverty and lack of disability friendly services.

Conclusions 

The study showed gaps in service delivery and information for AYSRHR. It provides information on areas health planners, designers, development partners need to invest in providing appropriate AYSRHR programs, CSE to AY in and out of school to empower them to make informed decisions about sexuality and sexual health.

Recommendations 

There is need for policymakers to prioritize, plan and mobilize resources to improve and increase universal access and uptake of high quality, affordable, youth friendly, stigma free, Sexual and reproductive health services and information by young people in and out of schools and parental guidance and counselling.