Friends of Ngong Road (FONR) serves some of the most vulnerable children on the planet. They all have witnessed family members suffer or die from HIV/AIDS, yet many never learn about sexually transmitted diseases in an educational setting. In a study of secondary students across Kenya, only 2% reported learning about all of the components of a comprehensive sexual and reproductive health (SRH) program. The Kenyan education sector largely promotes abstinence-only curriculum, failing to emphasize important topics of contraception, sexually transmitted diseases, and HIV. The gap in knowledge perpetuates common myths, misinformed fears and enduring stigmas, for example, that long-acting reversible contraceptives (LARCs) jeopardize future fertility.
It is a global truth that many young people are sexually active, yet FONR adolescents are left without the resources and knowledge to make informed decisions. We also recognize that many young people are forced or coerced into sexual activity. Unwanted and unplanned pregnancies derail young women’s hopes of educational attainment and the chance to achieve economic self-sufficiency. Since FONR was founded in 2007, fifteen students have become pregnant. Twelve left the program and returned to living in poverty. The remaining three attended post-secondary programs, two successfully and one unsuccessfully. Further, one suffered complications from an illegal, unsafe abortion. Despite FONR’s commitment to support girls who become pregnant, this student did not reach out for assistance as she feared judgment, removal from the program and expulsion from school.
Girls from poverty often experience additional barriers to accessing information and resources, although the problem crosses all divisions in Kenyan society. One in five adolescent women in Kenya have begun childbearing.1 FONR is committed to finding a better way to serve students.
Based on student focus groups and extensive research on best practices in SRH education, FONR has developed a Youth Peer Provider (YPP) model to be implemented by Ngong Road Children Association (NRCA). Our model is derived from the Planned Parenthood Global YPP program, which was adapted to meet the unique challenges faced by students.2 While capitalizing on the foundational components that make peer education successful, our YPP model takes it a step further by giving students training and tools to provide counseling and resources for their peers.
Ten FONR post-secondary students, equally split male and female, will attend a fivesix day SRH training. YPPs will receive:
- accurate SRH information and coaching on how to disseminate knowledge to peers;
- workshop supplies and lesson plans;
- guidance on organizing peer-to-peer workshops;
- Condoms and vouchers for access to LARCs, emergency contraception and STI testing.
They will act as YPPs for two years and will be compensated every six months after completing one evaluation report (with anonymous peer information), at least one workshop, and peer counseling meetings as needed. A refresher training will be provided one year after the initial training.
Previous programs have been most successful when they had community buy-in and adult support at all stages of development.3 As such, the week before the YPP training, NRCA staff will receive a similar training on adolescent SRH. These staff members will organize monthly meetings with YPPs to facilitate collaboration among YPPs, address challenges, and help organize monthly workshops. By incorporating staff training and engagement, our program will create an environment in which YPPs can thrive with the support of trusted adults.
Peer education programs provide the opportunity for students to receive personalized reproductive health messages from trusted peers.3 However, when they create demand for contraception and testing without connecting them to a supply, they fail.4 Our YPP model allows students to provide their peers resources. We have identified a local service provider, Riruta Health Center, that will confer with students and provide the asked-for contraception during free consultations. The center will be monitored to ensure students are respected and are receiving accurate and nonjudgmental information and resources.
1 2017, Guttmacher Institute
2 2012, Youth Peer Provider Program Replication Manual
3 1993, Sloane, B. C., et al. The power of peer health education.
4 2014, Chandra-Mouli, V., et al. Contraception for adolescents in low and middle income countries.