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Campaign Profile

THE CAMPAIGN-KARHP

The Kenya Adolescent Reproductive Health Program (KARHP) is a program that was started in Kenya in 1999 and continued until 2003. KARHP was implemented and funded by the Program for Appropriate Technology in Health (PATH) and the USA-based Population Council/FRONTIERS.

KARHP chose two specific Western Provinces of Kenya, Vihiga and Busia, because of their particularly poor levels of youth reproductive health. These areas are rural and densely populated; and they contain little to no infrastructure and high levels of reproductive health issues among their youth,

In 1999, when the program was launched, there were no comprehensive educational services for children both in and out of school between the ages of 10 and 19 about reproductive health in these areas. Some main community concerns included controversy surrounding reproductive health services to adolescents, and a concern that sex education and contraceptive services would lead to promiscuity. Thus KARHP had to work around these issues while maintaining a sense of cultural responsibility to parents and family of its target audience.

Aside from general reservations about sex education and promiscuity, KARHP faced a number of social apprehensions among the Kenyan people. The guidelines and regulations for providing reproductive health services, especially contraceptives, to unmarried adolescents are deliberately ambiguous and open to interpretation. Although many guidelines and regulations were ambiguous, the Kenyan government mandated that schools provide information on HIV/AIDS during the time of the project.

Lead by PATH and FRONTIERS, KARHP targeted children in Vihiga and Busia, both those attending school and those not attending school, between the ages of 10 and 19 for its reproductive health project in Kenya. KARHP’s goal was to delay the onset of sexual activity, decrease and/or prevent high-risk sexual behaviors, and increase young people's knowledge of reproductive health. In order to achieve its goal, KARHP developed a strategy to use peer education, guidance and counseling in schools, and introduction of youth-friendly services in participating health facilities.

THE PARTNERS

PATH was started in 1978 and is headquartered in Seattle, Washington. PATH does work in over 100 countries on projects about reproductive health, vaccines and immunization, HIV, and children's health and nutrition. PATH’s work centers around advancing technology in underdeveloped nations, strengthening systems to support the new technology, and encouraging communities to become involved in social change and to break down stigma that may lead to poor health decisions.

Frontiers in Reproductive Health (FRONTIERS) is a program that conducts research on reproductive health services in developing countries and focuses on potential methods for improving the service and delivery of reproductive health services. FRONTIERS conducts the bulk of its research in sub-Saharan Africa, Asia and the Near East, Europe and Eurasia, and Latin America and the Caribbean. It has organized and implemented more than 146 projects in these regions, and supports the continued use of proven strategies, sharing lessons learned on certain projects with others, and using research findings to develop new programs and policies in developing areas.

THE STRATEGIES

KARHP used community-based and peer-based communication to begin its community wide health program. This communication included in-person communication on an individual level, and also group interventions aimed at increasing knowledge of sexual and reproductive health.

KARHP hired and trained a large group of peer educators to provide information to the youth and to encourage them to seek attention at the health centers in town. The peer educators reached their target audience by engaging them in group discussions, drama presentations, outreach meetings, condom demonstrations and distribution, one-on-one counseling, videos, and distribution of educational materials. The most frequent topics discussed during these contacts were sexually transmitted diseases, relationships, drug use, teen pregnancy, and contraceptives.

In addition, employees of the Department of Social Services and local religious leaders were trained to reach parents and the rest of the community. These delegates also acted as supervisors to the young peer educators, and often provided peer educators with locations at which to hold their youth meetings and counseling sessions.

As part of the health-facility based intervention, KARHP set up separate facilities within health centers where the young audience could meet with doctors to obtain information and services. There were also peer educators in each of these 'youth-friendly' rooms, as well as educational materials.

KARHP also recruited and trained more than 75 teachers and 600 peer educators to carry out its outreach programs in schools. They held organized group discussions, contests, educational videos, and one-on-one counseling sessions in schools. The flow of communication began with the student, who then contacted a peer educator who then brought a teacher into the discussion. By the end of the program, each participating teacher had counseled at least 26 schoolchildren on average, and each school launched KARHP clubs, which provided an on-going forum for students to meet after the end of the program.