Publications

Objective Little is known about the reproductive health or family planning needs of street-connected children and youth in resource-constrained countries. The study objective was to describe how street-connected children and youth (SCCY) in Eldoret, Kenya, perceive pregnancy. Methods This qualitative study was conducted between August 2013 and February 2014. A total of 65 SCCY aged 11–24 years were purposively sampled from the three referral points: 1) A dedicated study clinic for vulnerable children and youth at Moi Teaching and Referral Hospital (MTRH); 2) Primary locations in which street children reside known as “bases/barracks”; and 3) Street youth community-based organizations. In-depth interviews and focus group discussions were audio recorded, transcribed, and translated into English. Content analysis was performed after thematic coding by 4 independent coders. Results The majority of SCCY interviewed were male (69%) and sexually active (81.5%). None had gone beyond primary level of education. The strong desire for SCCY to go through conventional life experiences including marriage and child bearing was evident. Sub-themes around desired pregnancies included: sense of identity with other SCCY, sense of hope, male ego, lineage, source of income, and avoiding stigmatization. The desire for children was highly gendered with male SCCY more focused on their social status in the street community, while for females it was primarily for survival on the street. Female SCCY generally lacked agency around reproductive health issues and faced gender-based violence. Abortions (either assisted or self-induced), infanticide, and child abandonment were reported. Respondents described a lucrative market for babies born to SCCY and alleged that healthcare workers were known to abduct these babies following hospital deliveries. Conclusion Our findings indicate gender differences in the reasons why SCCY become pregnant and have children. We also noted gender inequalities in reproductive health decisions. SCCY friendly interventions that provide tailored reproductive health services are needed.

Diarrheal disease is one of the leading middle income countries. This study examined diarrheal
diseases among children in Uasin Gishu County’s childcare institutions per age, sex, duration of a child in a
childcare institution, and use of soap in hand washing after visiting the toilet. The study involved 202 children
between ages 6 to 20 years old. There were65.8% boy child and 34.2 girls, 71.3% of these children were
between 6-15 years old. The study found 64.4% children used soap to wash hands after toilet. Use of soap in
hand washing increased with increase in children’s age, with a girl using soap more in hand washing at the rate
of84.1% compared to a boy child. The study learned that 90.1% children had suffered from diarrheal diseases
within 28 days where61.4% boys had suffered from diarrhea. Chi-square analysis showed a significant
relationship between diarrheal diseases and children’s age (P<0.001) while there was a significant relationship
between diarrhea andgender (P<0.001). It was concluded that the prevalence of diarrheal diseases in Uasin
Gishu County child care institutions was 90.1% and that boys were affected more than the girls. Health
education on use of soap in hand-washing after toilet should be intensified as a means of decreasing diarrheal
diseases.