Improving adolescent health in Kilifi County

Kilifi County, like many other regions across Kenya, faces persistent challenges in improving adolescent health outcomes. Despite a range of interventions targeting issues such as teenage pregnancy, sexual and reproductive health (SRH), and HIV prevention, many of these efforts have struggled to deliver sustained impact. A key constraint identified by the Kilifi County Health Management Team (CHMT) has been the lack of comprehensive, timely, and actionable data to inform decision-making. The County needs up-to-date, accurate data on adolescent health to effectively plan, prioritize, and allocate resources for health programs and to develop an effective Adolescent and Young People Health Strategy.

To bridge this data gap, IDinsight partnered with the Kilifi County Government to ensure the development of the Strategy was based on verifiable evidence. Through this partnership, IDinsight aims to assist in producing and utilizing data that underpin the county’s efforts to realize Universal Health Coverage and to strengthen adolescent and young people’s sexual and reproductive health programs.

Decision Maker’s Challenge

This project focused on evaluating adolescent health metrics in Kilifi, including healthcare accessibility, availability of sanitary products, substance abuse prevalence, sexual engagement rates, and access to health and wellness information. The objective was to fill existing data gaps, and provide the county leadership with a clear understanding of which interventions work best locally.

Our Approach

1. Theory of Change Review: We began by analyzing the current adolescent health strategy and its Theory of Change (ToC) with county stakeholders. The ToC review process highlighted the following findings:
   • The current ToC is heavily focused on the HIV/SRH aspect of adolescent health.
   • We found that the ToC did not consider the influence of other sectors on the outcomes of health programs targeting adolescents and young people.
   • A holistic approach to implementing the ToC would increase the chances of success for initiatives targeting adolescents and young people.
   • The ToC can be adjusted to align with the National Adolescent Health Survey.
     
2. Rigorous Data Collection: Guided by the ToC, we collected comprehensive data on the state of various indicators, interventions and facilities across the county. This rigorous data collection exercise included quantitative surveys of adolescents and young people aged 10 to 24 years, quantitative surveys of health facility heads or representatives and qualitative semi-structured school interviews with Parent Teacher Association (PTA) members. Sampling was designed to balance precision with feasibility, including representative samples for households and convenient sampling for health facilities and schools. Learn more about our approach to optimizing data quality from our roundtable discussion here.
3. Data Analysis and Reporting: We cleaned, anonymized, and weighted the data to produce accurate and representative results. The engagement is currently in the data analysis and reporting phase, after which the ToC will be refined with input from the Kilifi County Health Management Team based on evidence, enabling data-driven decisions to improve adolescent health outcomes.

Results

This project is currently ongoing.