Young people face numerous health challenges during their transition to adulthood. These challenges include, among others, limited access to sexual and reproductive health (SRH) information and services. Unmet SRH needs among adolescents may contribute to sexually transmitted infections (STIs), including HIV, and unintended pregnancies. Adolescent pregnancies are associated with several adverse outcomes, such as miscarriage, unsafe abortion, obstructed labor, and other complications, which can result in long-term morbidity and even death. Additionally, poor sexual and reproductive health outcomes can especially impact the status of young women, as they may face stigma from the community as well as diminished educational and employment opportunities. The long-term impacts of unmet SRH are also felt at population level, as high prevalence of HIV and high fertility rates place strains on communities and nations. As the world undergoes rapid urbanization, these strains will be increasingly felt in urban populations. In Kenya, adolescents make up a considerable proportion of urban populations, and many of them live in the numerous informal settlements—or slums—in Nairobi. Adolescents living in the slums face a distinct set of challenges as they transition to adulthood in a hostile environment characterized by high levels of unemployment, crime, poor sanitation, substance abuse, poor education facilities, and lack of recreational facilities. While much has been done to provide insights into adolescents’ SRH outcomes in the country, little attention has been paid to understanding and meeting the SRH challenges and needs specific to adolescents living in resource-poor urban settings, such as the slums of Nairobi. This is a priority area for research, as the wellbeing of the urban poor will increasingly drive national development indicators, including health and poverty, in Kenya. This report is based on secondary analysis of data from the Transition to Adulthood (TTA) project among 12-22 years olds living in two informal settlements, Korogocho and Viwandani, in Nairobi, Kenya. The report highlights the SRH challenges faced by adolescents living in these slums, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The findings are expected to contribute guidance to the design and implementation of appropriate SRH intervention programs that respond to the unique needs of adolescent boys and girls living in poor urban settings.
African Population and Health Research Center
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