ABSTRACT
This article presents findings from a survey conducted in Kenya in 1985 of the reproductive health knowledge, attitudes, and practices among more than 3,000 unmarried Kenyan youth, students and nonstudents, between the ages of 12 and 19. The survey was designed to elicit information that would be useful in gauging the kinds of problems Kenyan adolescents face in order to design programs that meet their needs. The study shows that although a solid majority of adolescents appear to have received information on reproductive health, the quality of the information is generally low. Fewer than 8 percent could correctly identify the fertile period in a woman's menstrual cycle. A substantial proportion of the population surveyed, more than 50 percent, is sexually active, having initiated intercourse some time between 13 and 14 years of age, on average. In spite of a general disapproval of premarital sex (but approval of the use of contraceptives among the sexually active), most of the sexually active population--89 percent--have never used contraceptives. The many contradictions between attitudes and practices pose serious questions and demonstrate the need to reexamine the programs (and policies) that provide access to reproductive health services to adolescents in Kenya.
PIP: Not withstanding the concern for the health consequences of early sexual activity, early untimely pregnancy results in expulsion from school at the rate of 10% annually in Kenya and economic advancement practice, and reproductive health of 1513 females and 1803 males aged 12-19 was conducted in 1985 in 7 rural and 2 urban districts and represents the 8 major ethnic groups in Kenya. The simple random sample was analyzed with the statistical software package (SPSS). 12 subgroups were developed in spite of the small numbers by gender, age, and student status for students (81%: 78% females and 84% male), and educational level for nonstudents. This grouping and the use of the Family Health International/Pathfinder adolescent fertility questionnaire make it comparable to studies in other countries. The majority were raised in rural areas. The findings show that attitudes are changing toward age at marriage of 22 for women and 25.5 for men (women's responses); men's recommendations were lowers, and the lower educated nonstudents reported a lower age versus higher educated nonstudents. Age at birth of first child paralleled age at 1st marriage. Desired number of children was 4-5. In contract to the attitudes expressed, prior surveys of women 15-19 years old showed 75% married in these years. Current fertility is 8.1 children with most 1st births before age 20. This study also revealed a lack of knowledge of reproductive health, with less than 1 in 10 recognizing the fertility cycle, and only 50% knowing the pregnancy could occur at 1st intercourse. Knowledge appears to increase with level of education. Knowledge of at least 1 modern contraceptive was 75% and the majority approved of use, but actual ever use among the sexually active was 11%. The reasons given for nonuse were lack of information and difficulty in contraceptive access. 60-65% disapproved of premarital sexual relations, yet 51% reported sexual activity. The mean age of 1st experience was 13. Currently distribution of contraceptives among adolescents is disapproved of at the policy level. Abortion was not approved of, and it appears abortion is used in order to remain in school. A variety of educational approaches is suggested and 6 challenging questions are posed for those who implement policy. As the shadow of AIDs lengthens perhaps the issue of adolescent contraception will received proper attention.
