Teenage Pregnancy and Sexually Transmitted Infections in Selected Urban Schools: Compliance in Implementing School Health and Re-Entry to School Policy in Kenya

Abstract

Background: Pregnancy-related and sexually transmitted infections (STIs) among teenage school girls contribute to significant morbidity and mortality in such a segment of the general global population. The Kenya National School Health Policy of 2022, 2018 & 2009 was developed to mitigate teenage pregnancy and facilitate continued pursuit of education post-pregnancy on a Return-to-School framework. The policy was expected to protect the girls from getting pregnant and support them if it occurred so as to enable them pursue their education on the basis of the Return-to-School Policy. However, despite this government led intervention, the extent of implementation of the National School Health Policy and its impact in reducing teenage pregnancies among girls in our schools has not been clearly documented. Purpose of the Study: This study was designed to determine compliance to the implementation of the re-entry policy on teenage pregnancy and health policy on sexually transmitted Infections in selected urban secondary schools in Kenya. The key objectives of this study were to identify the steps in the implementation of school health re-entry policy on teenage pregnancy and sexually transmitted infections. Methodology: This was an analytical cross-sectional study that triangulated quantitative and qualitative methods of study in 57 secondary schools that were co-education or girls’ schools only. A sample size of 174 pregnant or previously pregnant school teenage-girls’ was arrived at using Cochranes formular. Qualitative method was used to collect data on focus Group Discussions and Key Informant interviews. The target population consisted of school girls aged 15-19 years. Structured questionnaire was used to collect quantitative data. Multistage followed by cluster sampling techniques were used to identify selected urban towns for study while simple random sampling was used to identify girls or co-education schools. Teenage girls’ participants were purposely identified at the health facility during antenatal care attendance until a sample size of 174 participants was achieved. The variables under study were then extracted and recorded from the card. Data Analysis: Quantitative data was analysed using SPSS version 17 while association between variables and hypothesis testing was done by Chi-square test at 95% confidence interval. Findings of Focus Group Discussion and Key informant Interviews were transcribed and analysed thematically, content by content. Study Findings: The study found out that the school Re-entry implementation process had poor compliance by schools. Achi-square test of association set at 95% of confidence interval and 0.005 level of significance revealed that the responses the teachers and the affected students gave on its implementation were insignificant since the computed P-values (1.25 & 1.17) were greater than the set P-Value of 0.005. Conclusions: The re-entry policy was yet to succeed in schools. The was no compliance of the steps in the policy implementation. Recommendations: There is need to involve all stakeholders in all steps of the policy processes and sensitization of the same to all stakeholders.