Behaviour Change Evaluation of a Culturally Consistent Reproductive Health Programme for Young Kenyans

This is a ten-page evaluation of the Nyeri Youth Health Project in Kenya, a locally designed adolescent reproductive health programme. The project is a reproductive and sexual health information programme for in- and out-of-school youth in both rural and urban areas aged 10 to 24. The objectives of the project were to delay the onset of sexual intercourse among youth who are not yet sexually active; to prevent sexually experienced youth from suffering negative consequences of sexual activity and to create a reproductive health information and service environment responsive to the needs of youth. The project adapted the traditional Kikuyu system of atir - or respected adult counselor - to give young people information and support. It capitalised on existing groups of youth, used service providers they already frequented and engaged adults in improving the environment for young people.

Qualitative research was conducted among young people, their parents and community leaders to explore preferences regarding an information and services project for youth. This study reveals that both young people and parents preferred that adults, rather than peers, deliver such information. A quasi-experimental research design was used to measure behavioural changes associated with programme. Baseline and endline surveys were conducted in 1997 and 2001, respectively, in the project and control areas. Multivariate analysis was used to assess whether the project was associated with changes in young people's sexual initiation, safer-sex behaviour and discussion of reproductive health issues with adults.

The 36-month project was associated with considerable changes in young people's sexual and reproductive health-related behaviour, but behaviour change differed by gender. Females in the project site were significantly more likely than those in the control site to adopt secondary abstinence (odds ratio, 3.3) and less likely to have had three or more sex partners (0.1). Males in the project site were more likely to use condoms than those in the control site (3.7). Both males and females in the project site were more likely to discuss sexual and reproductive health issues with a nonparent adult than were young people in the control site (1.9 and 5.5, respectively).