Kilifi adolescent and young people health policy

Decision-maker’s challenge

You can’t fix what you can’t see. In Kilifi County, health officials were trying to improve the wellbeing of adolescents but they faced big data gaps. There wasn’t a complete picture of how young people were doing or how well health services were meeting their needs. As their 2020–2025 Adolescent and Young People Strategy came to an end, the County Department of Health needed solid evidence to guide the next five-year plan.

Impact opportunity

Adolescents and young people make up more than one in five people in Kilifi, about 300,000 out of a population of 1.45 million (KNBS, 2019). This generation holds the county’s future health and productivity in its hands yet without solid evidence, it’s hard to know where to focus resources or which interventions truly work. By generating reliable data on adolescent health and service readiness, the County Department of Health can now plan smarter, targeting programs that prevent disease, keep girls in school, and ensure every young person in Kilifi has a fair chance to thrive.

Our approach

We worked hand in hand with the Kilifi County Department of Health and local partners to build a comprehensive picture of adolescent health across all seven sub-counties. Our approach combined evidence synthesis, data collection and collaborative learning. First, we reviewed existing county and national policy documents and adolescent health information reports to inform the data collection. We then collected data from households, health facilities, and school communities, reaching over 3,600 adolescents and 122 public health facilities, to generate additional insights on adolescent well-being. Using this evidence, we collaboratively revisited and refined the county’s Theory of Change for adolescent health, ensuring it reflected on-the-ground realities and emerging county priorities. By embedding ourselves within county systems throughout the process, we ensured that the findings not only filled critical data gaps but also equipped Kilifi’s health leaders to act on evidence in real time.

The results

The data uncovered urgent adolescent health challenges in Kilifi. Specifically;

• Nearly half of adolescents showed signs of probable depression and 39% probable anxiety, revealing a silent mental health crisis. 
• While school attendance is high (96%), nearly half of adolescents had missed school in the last three months, often due to health or menstrual challenges
• One in ten girls aged 15–19 had been pregnant, and most dropped out during pregnancy.
• Access to information was high but uneven. Most adolescents learnt about sexual and reproductive health in school, yet topics like mental health and pregnancy care remain overlooked. 
• Early sexual activity and low contraceptive use continue, and while substance use is low overall, frequent cannabis use among a small group is worrying.
• Health facilities also show mixed readiness. Many lack privacy or feedback systems for youth.