The Population Council evaluated and assisted in the development and expansion of a locally designed, culturally appropriate adolescent reproductive health project in Kenya.
The Population Council uses social science to identify local needs and tailor programs accordingly. Friends of Youth is an initiative for young people implemented by the Family Health Options of Kenya (FHOK) in collaboration with members of the community. FHOK used the results of Council research to develop a program to effectively reach young people in Nyeri, and later elsewhere in Kenya, with reproductive health and HIV information and services. The Council rigorously evaluated the project before it was expanded.
On the basis of the Council’s initial formative research, FHOK developed a program that reaches young people aged 10–24 years using a group of respected adults, called Friends of Youth. These Friends of Youth conduct various activities with young people, including group discussions, role playing, drama, and lectures. They tailor the curriculum to the age, preferences, and needs of the individual groups.
The project was locally designed and is consistent with Kikuyu culture, in which, traditionally, parents ask trusted adults to provide sexual and reproductive health information to their children as they undergo puberty rites.
Friends of Youth also trained a network of cooperating service providers, mostly from the private sector, on how to provide appropriate services to young people. Young people in need of services were given vouchers that entitled them to subsidized services from participating providers.
The Council rigorously evaluated the initiative and found that it increased condom use, increased the number of young people choosing to abstain from sexual activity after having been sexually active (“secondary abstinence”), and reduced the number of sex partners that young people had. It did not promote experimentation with sex, a fear that many policymakers have regarding sexuality education.
Girls who received Friends of Youth services were significantly more likely to adopt secondary abstinence and less likely to have had three or more sex partners, compared to girls in a comparison area where Friends of Youth was not implemented. Boys who received Friends of Youth services were significantly more likely to have used a condom at last sex.
The project also improved the ability of young people to communicate about reproductive health issues. 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 comparison site.
Friends of Youth has been expanded from Nyeri to urban areas in Central Province (Nyahururu and Thika) as well as slums in Nairobi. The project has added subsidized HIV voluntary counseling and testing services for young people in addition to the regular subsidized reproductive health services. Friends of Youth was one of the earliest voucher programs for young people. The program has been hailed by voucher experts and replicated in Latin America by other organizations.