Maggwa ABN Adolescent sexuality in Kenya
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Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.