Sexual Health Seeking Behaviour among Youth in Secondary Schools in Mukuru Slum, Nairobi, Kenya

Abstract

Sexual reproductive health within the youth population is increasingly becoming a public health concern, more so low-income settings with overwhelmed healthcare systems. The aim of this study was to comprehensive investigate sexual health-seeking behaviours among adolescents and youth between 15 24 years in secondary schools within Mukuru slum, Nairobi Kenya. This was a descriptive cross-sectional design employing qualitative and quantitative methods. It targeted 327 students and collected data using stratified sampling, and a response rate was 97.3%. The study also used structured questions alongside focus group discussions in collecting data. The basis of this study is how youth in slum dwellings are at risks of developing sexually transmitted infections (STIs) and HIV from socio-economic challenges and limited healthcare service accessibility. Interventions exists but the prevalence of these infections are still at large. Central to this study was to also determine factors determining health-seeking behaviours among secondary school youths in Mukuru slums. Its objectives included: “(1) determine the socio-demographic characteristics of the youth, (2) assess their practices towards seeking sexual health services, (3) evaluate their attitudes towards these services, (4) examine the impact of sexual health service outlets, and (5) identify choices related to seeking sexual health services”. It used a cross-sectional design, with qualitative and quantitative methods used in collecting data. The participants included youths between 15 and 24 years attending secondary schools in Mukuru after consenting to participate and excluded those who declined consent. Besides, the study used stratified sampling to determine the sample size, with 336 students. Structured questionnaires, focus group discussions and key informant interviews were used in collecting data. It took over three months to collect data. Relevant institutional body provided the ethical approval and the study maintained confidentiality of the participants through anonymity. The researcher used SPSS to analyse the questionnaire data to obtain descriptive statistics and used thematic analysis for qualitative data analysis. The study found that 57.8% of respondents were female, with 18.9% of female respondents reporting sexual debut before age 10. Condom use was reported by only 20% of respondents aged 15-18 during their last sexual encounter. Among those who contracted STIs, 58.5% completed treatment, with the type of treatment outlet significantly associated with treatment completion (p = 0.033). The study revealed widespread engagement in unprotected sex and multiple sexual partnerships among youth, with attitudes towards sexual health significantly influencing their practices. A major conclusion from this study is the higher risks and vulnerability of youth in Mukuru slums as being at risk of developing STIs due to low condom usage, early sexual activity onset and multiple sexual partners. Both individual attitudes and systemic barriers shape their health-seeking behaviours. The study recommends the collaboration between the Ministry of Health and Ministry of Education in establishing and implementing school-based health clinics and interventions to offer comprehensive SRH services. They also need to target policy interventions on improved access and education on sexual health services within slum dwellings. The study has also considered why policy reforms are needed for improving sexual health education and services within slums. Such is also meant to ensure access, affordable and youth-friendly sexual health services.