This report surveys healthcare worker perspectives on the provision of adolescent-friendly health services in Kenya.
Access to sexual and reproductive health (SRH) services forms a crucial building block of health systems. Poor access to SRH services can result in early and unintended pregnancies, maternal mortality, HIV and sexually transmitted infections (STIs), as well as complications from untreated STIs, such as pelvic inflammation, specific types of cancer, and pregnancy and fertility issues. A health system is well equipped to provide SRH commodities and services when people are enabled to decide on pregnancy, have a healthy pregnancy and safe childbirth, protect themselves against STIs and HIV/AIDS, and are properly treated in a timely manner if transmission occurs. For a thriving society, it is also crucial that adolescents, a group often faced with additional challenges in accessing services, can access the SRH services they need to live healthy lives and protect themselves against key health risks.
Unfortunately, many challenges remain for the provision of adolescent-friendly health services in Kenya, especially in rural areas. This research was conducted to study the provision of AFSRH services and attitudes of healthcare workers (HCWs) in Isiolo, Mandera and Marsabit Counties in Kenya.
This study used an adjusted version of the HAI/World Health Organization (WHO) Methodology[1] and, through a cross-sectional survey design, gathered insight into the provision of AFSRH services in Kenyan health facilities. Teams of data collectors visited 86 health facilities in 2022 and 94 in 2025 from the public, private and faith-based sectors to assess:
- The type of SRH services being offered at the health facility.
- To whom these services were offered, and whether parent/guardian consent was needed.
- The measures in place at the health facility to improve access to SRH services for adolescents.
- The attitudes and perspectives of the HCW on AFSRH services.
- Indicators on the general state of the health facility.
The report reveals a paradoxical landscape where formal accreditation of “adolescent-friendly” facilities is increasing, yet the quality of the environment and the willingness of providers to serve younger adolescents is regressing. Policy clarity on age of consent, value-based provider training, and prioritising “last-mile” infrastructure for commodities is required as an urgent measure. The persistent lack of essential SRH commodities, combined with religious and moral bias among providers, creates a “silent barrier” for youth. Without addressing the fundamental infrastructure needs (water, cleanliness, privacy) and the specific policy restrictions for minors, accreditation remains a label rather than a functional reality for Kenyan adolescents in the surveyed counties.
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[1] Measuring Medicine Prices, Availability, Affordability and Price Components. 2nd edition. World Health Organization, Health Action International. (2008). Geneva: Switzerland.