Adolescent reproductive health needs in Kakuma Refugee Camp, Kenya

Kakuma Refugee Camp in Kenya is home to over 150,000 refugees. Reproductive health education is limited and youth-friendly services nonexistent. In 2013-2014, JSI Research and Training Institute supported National Council of Churches of Kenya and three refugee-run CBOs to implement an education program for adolescent girls. We conducted cross-sectional surveys at baseline (n=322) and endline (n=306) among program participants and non-participants to assess the program and document existing needs. The 2014 survey showed positive signs: participants knew more about family planning (FP) methods and where to get them and communicated more about RH with parents and friends. Girls said they enjoyed the program and had learned a great deal, shared information with friends and improved their behavior. However abstinence messages were retained more than those about FP. Myths about FP were widespread among participants and non-participants alike: half thought FP causes infertility and is more dangerous for adolescents than pregnancy. Most girls said they preferred abstinence to FP, but one-third did not think they could refuse to have sex any time they did not want to. Although most said they themselves would refuse, more than half of all girls thought their friends would have sex in exchange for money or gifts. Adolescent girls in humanitarian settings are especially vulnerable to coercive sex. They may also choose to have consensual sex but want to protect themselves from infection and early pregnancy. Programs in Kakuma and other refugee camps should promote comprehensive RH, emphasizing the range of FP options and their safety.