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UNESCO HIV and Health Education Clearinghouse

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  1. Adolescent schoolgirls’ experiences of menstrual cups and pads in rural western Kenya: a qualitative study

    Poor menstrual hygiene management (MHM) among schoolgirls in low income countries affects girls' dignity, self-esteem, and schooling. Hygienic, effective, and sustainable menstrual products are required. A randomized controlled feasibility study was conducted among 14-16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls' perceptions and experiences six months after product introduction. …

  2. Challenges to implementing national comprehensive sexuality education curricula in low- and middle-income countries: case studies of Ghana, Kenya, Peru and Guatemala

    School-based comprehensive sexuality education (CSE) can help adolescents achieve their full potential and realize their sexual and reproductive health and rights. This is particularly pressing in low- and middle-income countries (LMICs), where high rates of unintended pregnancy and STIs among adolescents can limit countries’ ability to capitalize on the demographic dividend. While many LMICs have developed CSE curricula, their full implementation is often hindered by challenges around program planning and roll-out at the national and local level. …

  3. Cost-effectiveness analysis: educational interventions that reduce the incidence of HIV/AIDS infection in Kenyan teenagers

    This paper demonstrates a comprehensive and thorough application of an education cost-effectiveness analysis. Two interventions implemented in Western Kenya aimed to reduce the incidence of HIV/AIDS contraction in middle school girls. The cost-effectiveness of each intervention is assessed, ex post facto, by combining the results of the two programs’ evaluations with their costs. As few education evaluations consider cost, this article highlights a sound and disciplined method to use when detailed cost information is both readily available and unavailable. …

  4. Parents’ and teachers’ views on sexual health education and screening for sexually transmitted infections among in-school adolescent girls in Kenya: a qualitative study

    Background: To successfully develop and implement school-based sexual health interventions for adolescent girls, such as screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, it is important to understand parents’ and teachers’ attitudes towards sexual health education and acceptability of sexually transmitted infection (STI) screening interventions. Methods: In this qualitative study, we approached parents and teachers from three high schools to participate in in-depth interviews (IDIs) and focus-group discussions (FGDs). …

  5. Experimental evaluation of school-based HIV programs in sub-Saharan Africa

    School-based adolescent health education programs represent a durable strategy in reducing the spread of HIV because they can leverage pre-existing social and organizational structures to reach large fractions of students at critical life stages. Many evaluations of school-based HIV programs draw on multilevel study designs that assign schools to treatment conditions or assign students to treatment conditions within blocks defined by school membership. …

  6. Education, HIV, and early fertility: experimental evidence from Kenya

    A seven-year randomized evaluation suggests education subsidies reduce adolescent girls’ dropout, pregnancy, and marriage but not sexually transmitted infection (STI). The government’s HIV curriculum, which stresses abstinence until marriage, does not reduce pregnancy or STI. Both programs combined reduce STI more, but cut dropout and pregnancy less, than education subsidies alone. …

  7. Challenges of school re-entry among teenage mothers in primary schools in Muhoroni district, Western Kenya

    Much has been done towards attainment of gender equity in education as envisaged in the Millennium Development Goals (MDGs), yet gender disparities persist in many parts of the country. Studies indicate that most of girls who drop out of school do not return to class after childbirth despite provisions for it. The purpose of this study was to examine factors that influence re-entry of school girl mothers in primary schools in Muhoroni District, Kisumu County in western Kenya. …

  8. Connecting the private and the public: pregnancy, exclusion, and the expansion of schooling in Africa

    In a number of countries in Africa, young women who become pregnant are excluded from school. This article presents a critique of policy and practice in this area drawing partly on Diana Leonard's scholarship concerning the relational dynamic of gender, generation, social division, and household forms. Much of the policy prescription of large global organisations concerned with the expansion of secondary schooling in Africa does not sufficiently take account of the connection between the gender dynamics of the private and that of the public outlined in Leonard's work. …

  9. De-stigmatizing teenage motherhood: towards achievement of universal basic education in Kenya

    Teenage motherhood is a situation in which a girl in teenage years, that is, 13-19 years is a mother or has a child. Globally, a third of teenage mothers live in India whereas the least affected country by teenage motherhood in the world is Japan. In Africa, it is estimated that approximately 5.5 million girls between 15-19 years are mothers .Of these 62% live in Sub Saharan Africa. In Kenya, 13,000 girls leave school every year due to teenage pregnancy. …

  10. Unintended pregnancies among young women living in urban slums: Evidence from a prospective study in Nairobi City, Kenya

    Background: Despite the significant proportion of young people residing in slum communities, little attention has been paid to the sexual and reproductive health (SRH) challenges they face during their transition to adulthood within this harsh environment. Little is known about the extent to which living in extreme environments, like slums, impact SRH outcomes, especially during this key developmental period. …

  11. The girl with her period is the one to hang her head. Reflections on menstrual management among schoolgirls in rural Kenya

    Background. The onset of menstruation is a landmark event in the life of a young woman. Yet the complications and challenges that can accompany such an event have been understudied, specifically in resource-poor settings. As interventions aim to improve female attendance in schools, it is important to explore how menstruation is perceived and navigated by girls in the school setting. This research conveys rural Kenyan schoolgirls' perceptions and practices related to menstruation. Methods. Data were collected at six rural schools in the Nyanza Province of Western Kenya. …

  12. The Government of Kenya’s Cash Transfer Program Reduces the Risk of Sexual Debut among Young People Age 15-25

    The aim of this study is to assess whether the Government of Kenya’s Cash Transfer for Orphans and Vulnerable Children (Kenya CT-OVC) can reduce the risk of HIV among young people by postponing sexual debut. The program provides an unconditional transfer of US$20 per month directly to the main caregiver in the household. An evaluation of the program was implemented in 2007–2009 in seven districts. Fourteen Locations were randomly assigned to receive the program and fourteen were assigned to a control arm. A sample of households was enrolled in the evaluation in 2007. …

  13. The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya

    In this study, the authors explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. …

  14. Mother-daughter communication about sexual maturation, abstinence and unintended pregnancy: Experiences form an informal settlement in Nairobi, Kenya

    Parental communication and support is associated with improved developmental, health and behavioral outcomes in adolescence. This study explores the quality of mother-daughter communication about sexual maturation, abstinence and unintended pregnancy in Korogocho, an informal settlement in Nairobi, Kenya. We use data from 14 focus group discussions (n = 124) and 25 interviews with girls aged 12-17, mothers of teenage girls, and key informant teachers. …

  15. Factors associated with HIV infection among sexually experienced adolescents in Africa: a pooled data analysis

    The article examines the factors associated with HIV status among adolescents aged 15–19 years in 13 African countries. The data were derived from demographic and health surveys or AIDS indicator surveys conducted between 2004 and 2009. The levels of HIV prevalence among adolescents varied considerably across the countries. There was significantly higher HIV prevalence among female adolescents as compared with their male counterparts. For male adolescents, circumcision was the only variable significantly associated with HIV status. …

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