Accessibility of reproductive health services among women living in the informal settlements of Mathare slums, Nairobi City County, Kenya

Background: This study sought to determine the health facility-related factors and social factors associated with the accessibility of reproductive health services (RHS) among women living in the informal settlements of Mathare slums, Nairobi City County, Kenya. Methods: This cross-sectional study focused on Nairobi County, Kenya, specifically targeting Mathare slums, known for poor reproductive health (PRH) indicators among women. Three hundred women were randomly recruited from four villages (Mathare 3B, Mathare 4A, Kosovo, and Mathare village 2). Results: The majority of respondents were aged 18-29 years (48.7%), had primary education (61.7%), were married (58.7%), and unemployed (69.3%). Significant associations were observed between accessibility and the woman's age (?2=83.013, df=1, p<0.001), education level (p<0.001), marital status (p<0.001), and employment status (?p<0.001). Significant health facility barriers to accessibility encompassed long distances to health facilities (p<0.001), transportation cost constraints (p<0.001), difficult terrain (p<0.001), cost of services (p<0.001), services provided by health facilities (p<0.001), and availability of required medications (p<0.001). Discouragement by friends or family (p<0.001), the perceived influence of age on RHS accessibility (p<0.001), the perceived influence of education level on RHS choices (p=0.014), and the perceived role of a spouse in influencing RHS (p=0.002) were all significant social factors associated with accessibility to RHS. Conclusions: Health facilities and social factors presented complex challenges, including geographical barriers, transportation costs, and medication availability, while spouse involvement, education's influence, and familial discussions positively impacted accessibility.

Assessing accessibility of sexual reproductive health services among adolescents and young people living with HIV/AIDS in Kenya

Background: Sexual and reproductive health rights (SRHR) are fundamental human rights enshrined in national, regional, and international laws and agreements. This study aimed to determine the accessibility of SRHR services among young people living with HIV/AIDS in Kenya. Methods: The study was a cross-sectional study involving a sample of 224 adolescents and young people from Kenya. The study used both qualitative and quantitative methods of data collection and analysis. Before the study commenced, approvals were acquired from the Kenyatta University ethics and review committee, the National Commission for Science, Technology, and Innovation, County Governments, and selected county and sub-county health facilities in Kenya. Results: About 68.2% of adolescents and young people (AYP) living with HIV/AIDS accessed SRH services with a significant difference in proportion between study counties (Nairobi city and Homabay counties) in Kenya (?2=20.553; df=2; p<0.0001). Nevertheless, 33% of them reported that there were challenges that affected access to SRHR services and the unavailability of some services. Therefore, there is a need to ensure enough and constant supply of commodities and supplies for comprehensive care services. Conclusions: The study showed a statistically significant difference in the proportion of AYP living with HIV/AIDS who accessed SRH services in the study counties of Nairobi city and Homabay.