By Rodney Alubokho
Over the past few years, the government of Kenya has made great strides in providing free sexual and reproductive health and rights (SRHR) services. Some of these include family planning, HIV testing, post-abortion care, and adolescent-friendly counselling. Yet, even with the elimination of financial barriers, a subtle but real challenge remains—distrust in the competence and attitude of healthcare providers within public facilities.
Young people and adolescents narrate tales of being judged, handled inappropriately, or advised wrongly when they seek SRHR services from public hospitals. The African Population and Health Research Center (APHRC) discovered in a 2022 report that over 45% of Kenyan youth prefer seeking services from private or NGO-run clinics, as they find them more confidential, welcoming, and professional. This, however, comes at a cost that most are not able to afford.
Most of the NGOs that target youth around the country still report increasing demand for their services, which is most commonly generated through word of mouth or social media referrals based on their non-judgmental and youth-friendly nature. Young people commonly report that they do not attend public hospitals for fear of being abused, judged, or given low-quality care. Although these NGOs address a vital gap, their capacity to reach large numbers is typically limited by their funding and geographical scope, and thus they are unable to cope with the increasing demand by themselves.
The state has attempted to establish adolescent-friendly corners in public health clinics and orient personnel on youth-friendly practices. However, gaps exist. Staff turnover, lack of supervision, and variable training standards compromise the continuity and quality of these services. Fear of stigma—especially in rural areas where providers are likely to know clients personally—also discourages youth from seeking care openly. This challenge requires a two-pronged solution. One, there should be ongoing investment in training for healthcare workers with a focus not just on technical competence but also on empathy, confidentiality, and non-discrimination. Two, the counties should actively solicit the feedback of adolescents on their experiences with public health facilities and use that information to inform improvements.
Trust does not develop overnight—it has to be won through continuous, respectful care. Until that time, the irony will continue: free SRHR services for everyone, yet out of reach for many who need them most.
Rodney Alubokho is a Youth Advocate at NAYA
