Research Article | | Peer-Reviewed

Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study

Received: 30 September 2024     Accepted: 29 October 2024     Published: 26 November 2024
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Abstract

Adolescent-friendly health services are essential for addressing the unique health needs of young people, particularly in informal settlements where access to quality healthcare is often limited. This study examined the utilization of AFHS among adolescents in the Mathare informal settlement, Nairobi, Kenya, with a focus on socio-demographic characteristics, health system factors, and adolescents' perceptions of service quality. A cross-sectional study design was employed, utilizing a structured questionnaire administered to a randomly selected sample of adolescents aged 15-19 years. Descriptive statistics were used to summarize the data, while logistic regression identified factors associated with AFHS utilization. Results showed significant associations between adolescent education level (χ2 = 4.54, p=0.033), type of school attended (χ2 = 24.05, p=0.001), religion (χ2 = 16.32, p=0.001), parent’s living status (χ2 = 28.71, p=0.001), and parent’s occupation (χ2 = 24.76, p=0.0001), as well as father’s (Fisher's exact p=0.001) and mother’s education levels (Fisher's exact p=0.001) with AFHS utilization. Health system factors, including waiting time (Fisher's exact p=0.049) and staff communication (χ2 = 63.22, p=0.0001), were also significantly associated with AFHS use. Additionally, the opportunity to ask questions in nearby health facilities was linked to higher utilization (χ2 = 20.42, p=0.0001). Perceived health risks among adolescents were significantly associated with AFHS use (Fisher's exact = 0.004). Key barriers identified included limited accessibility, insufficient healthcare worker training, and concerns about confidentiality. The findings underscore the need for targeted interventions, comprehensive policies by the MOH, improved resource allocation, and specialized training for healthcare workers. The study recommends the use of mobile clinics, awareness campaigns, and peer education programs to enhance service utilization. Collaborative efforts between AFHS centers, community leaders, schools, and youth organizations are essential for improving access and addressing socio-economic barriers in informal settlement

Published in Central African Journal of Public Health (Volume 10, Issue 6)
DOI 10.11648/j.cajph.20241006.14
Page(s) 257-265
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Adolescent Health Services, Informal Settlements, Socio-Demographic Factors, Health System Barriers, Perception of Health Risks, Service Utilization

References
[1] Adebola, O., Olufemi, S., & Kolawole, T. (2022). Factors Affecting Utilization of Adolescent Health Services in Urban Nigeria: A Systematic Review. Journal of Reproductive Health, 28(1), 115-124.
[2] Adione, O., Adeyemi, B., & Ajayi, O. (2023). Socio-demographic determinants of adolescent-friendly health service utilization in urban Nigeria. African Journal of Reproductive Health, 27(2), 65-75.
[3] Agina, C., & Ochieng, J. (2022). Accessibility of Adolescent Health Services in Kenya: Insights from Service Providers and Adolescents. International Journal of Public Health, 45(1), 78-89.
[4] Armitage, R. (2021). Gambling among adolescents: An emerging public health problem. The Lancet Public Health, 6(3), e143.
[5] Belay, G., Dadi, L., & Alemayehu, T. (2021). Adolescent-friendly health service utilization and associated factors: A meta-analysis in Ethiopia. BMC Public Health, 21(1), 341.
[6] Ibrahim, H., & Oluwatoyin, O. (2023). Youth-Friendly Health Services Uptake Among Adolescents in Northern Nigeria: Policy, Practice, and Gaps. Nigerian Journal of Public Health, 34(2), 89-96.
[7] Kenya National Bureau of Statistics (KNBS). (2020). Population and Housing Census 2019: Analytical Report on Education. KNBS Publications.
[8] Luvai, J., Mbugua, G., & Musyoka, R. (2017). Awareness and utilization of youth-friendly services among adolescents in Kenya's South Rift. East African Medical Journal, 94(4), 187-195.
[9] Mekonnen Munea, A., Gebretsadik, L., & Abebe, A. (2020). Risky sexual behavior among adolescents and its impact on social and economic well-being. BMC Public Health, 20(1), 354.
[10] Mutua, G., Wanjiku, N., & Muthoni, E. (2023). Barriers to Accessing Adolescent Health Services in Rural and Urban Kenya. East African Medical Journal, 100(2), 47-56.
[11] Oketch, A., Kilonzo, E., & Omondi, M. (2021). Adolescent-Friendly Health Services in Kenyan Informal Settlements: Barriers and Facilitators. African Journal of Health Studies, 15(3), 102-110.
[12] Okoth, C., Musyoka, J., & Ngugi, E. (2023). Policy review of adolescent-friendly health services in Kenya: Challenges and opportunities. Health Policy and Planning Review, 12(4), 205-213.
[13] Ssewanyana, D., Mwangala, P. N., & Marsh, V. M. (2021). Self-esteem and its influence on adolescent risk perceptions: A study in Sub-Saharan Africa. Journal of Youth and Adolescence, 50(6), 1220-1235.
[14] Zulu, E. M. (2002). Health risk behaviors among adolescents in urban informal settlements: Evidence from Nairobi, Kenya. African Population Studies, 17(1), 81-101.
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  • APA Style

    Musau, D., Kimani, H., Mwanzo, I. (2024). Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study. Central African Journal of Public Health, 10(6), 257-265. https://doi.org/10.11648/j.cajph.20241006.14

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    ACS Style

    Musau, D.; Kimani, H.; Mwanzo, I. Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study. Cent. Afr. J. Public Health 2024, 10(6), 257-265. doi: 10.11648/j.cajph.20241006.14

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    AMA Style

    Musau D, Kimani H, Mwanzo I. Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study. Cent Afr J Public Health. 2024;10(6):257-265. doi: 10.11648/j.cajph.20241006.14

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  • @article{10.11648/j.cajph.20241006.14,
      author = {Domitila Musau and Harun Kimani and Isaac Mwanzo},
      title = {Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study
    },
      journal = {Central African Journal of Public Health},
      volume = {10},
      number = {6},
      pages = {257-265},
      doi = {10.11648/j.cajph.20241006.14},
      url = {https://doi.org/10.11648/j.cajph.20241006.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20241006.14},
      abstract = {Adolescent-friendly health services are essential for addressing the unique health needs of young people, particularly in informal settlements where access to quality healthcare is often limited. This study examined the utilization of AFHS among adolescents in the Mathare informal settlement, Nairobi, Kenya, with a focus on socio-demographic characteristics, health system factors, and adolescents' perceptions of service quality. A cross-sectional study design was employed, utilizing a structured questionnaire administered to a randomly selected sample of adolescents aged 15-19 years. Descriptive statistics were used to summarize the data, while logistic regression identified factors associated with AFHS utilization. Results showed significant associations between adolescent education level (χ2 = 4.54, p=0.033), type of school attended (χ2 = 24.05, p=0.001), religion (χ2 = 16.32, p=0.001), parent’s living status (χ2 = 28.71, p=0.001), and parent’s occupation (χ2 = 24.76, p=0.0001), as well as father’s (Fisher's exact p=0.001) and mother’s education levels (Fisher's exact p=0.001) with AFHS utilization. Health system factors, including waiting time (Fisher's exact p=0.049) and staff communication (χ2 = 63.22, p=0.0001), were also significantly associated with AFHS use. Additionally, the opportunity to ask questions in nearby health facilities was linked to higher utilization (χ2 = 20.42, p=0.0001). Perceived health risks among adolescents were significantly associated with AFHS use (Fisher's exact = 0.004). Key barriers identified included limited accessibility, insufficient healthcare worker training, and concerns about confidentiality. The findings underscore the need for targeted interventions, comprehensive policies by the MOH, improved resource allocation, and specialized training for healthcare workers. The study recommends the use of mobile clinics, awareness campaigns, and peer education programs to enhance service utilization. Collaborative efforts between AFHS centers, community leaders, schools, and youth organizations are essential for improving access and addressing socio-economic barriers in informal settlement
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Utilization of Adolescent-Friendly Health Services in Mathare Informal Settlement, Nairobi, Kenya: Cross-sectional Study
    
    AU  - Domitila Musau
    AU  - Harun Kimani
    AU  - Isaac Mwanzo
    Y1  - 2024/11/26
    PY  - 2024
    N1  - https://doi.org/10.11648/j.cajph.20241006.14
    DO  - 10.11648/j.cajph.20241006.14
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 257
    EP  - 265
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20241006.14
    AB  - Adolescent-friendly health services are essential for addressing the unique health needs of young people, particularly in informal settlements where access to quality healthcare is often limited. This study examined the utilization of AFHS among adolescents in the Mathare informal settlement, Nairobi, Kenya, with a focus on socio-demographic characteristics, health system factors, and adolescents' perceptions of service quality. A cross-sectional study design was employed, utilizing a structured questionnaire administered to a randomly selected sample of adolescents aged 15-19 years. Descriptive statistics were used to summarize the data, while logistic regression identified factors associated with AFHS utilization. Results showed significant associations between adolescent education level (χ2 = 4.54, p=0.033), type of school attended (χ2 = 24.05, p=0.001), religion (χ2 = 16.32, p=0.001), parent’s living status (χ2 = 28.71, p=0.001), and parent’s occupation (χ2 = 24.76, p=0.0001), as well as father’s (Fisher's exact p=0.001) and mother’s education levels (Fisher's exact p=0.001) with AFHS utilization. Health system factors, including waiting time (Fisher's exact p=0.049) and staff communication (χ2 = 63.22, p=0.0001), were also significantly associated with AFHS use. Additionally, the opportunity to ask questions in nearby health facilities was linked to higher utilization (χ2 = 20.42, p=0.0001). Perceived health risks among adolescents were significantly associated with AFHS use (Fisher's exact = 0.004). Key barriers identified included limited accessibility, insufficient healthcare worker training, and concerns about confidentiality. The findings underscore the need for targeted interventions, comprehensive policies by the MOH, improved resource allocation, and specialized training for healthcare workers. The study recommends the use of mobile clinics, awareness campaigns, and peer education programs to enhance service utilization. Collaborative efforts between AFHS centers, community leaders, schools, and youth organizations are essential for improving access and addressing socio-economic barriers in informal settlement
    
    VL  - 10
    IS  - 6
    ER  - 

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Author Information
  • Department of Community Health and Epidemiology, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya

  • Department of Community Health and Epidemiology, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya

  • Department of Community Health and Epidemiology, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya

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