Across Kenya, youth-led programmes are doing what policies and conferences cannot, building the trust that changes behaviour.
Samuel is 17 years old and lives in Nairobi’s Kibera, an informal settlement. He fathered a child at 16 and received no guidance, not on responsibility, not on prevention, not on what came next. “Everyone focused on the girl,” he says. “No one asked me anything. I was just the boy who got someone pregnant.”
His experience points to one of the most persistent structural flaws in Kenya’s response to adolescent pregnancy and sexual health: boys are almost entirely missing from the conversation. And when they are excluded, responsibility becomes one-sided. Solutions become incomplete.
Selline Korir, who has run a youth mentorship programme in Kenya through the Rural Women Peace Link, puts it plainly: “Our programmes have historically focused on girls, which is understandable given the immediate consequences they face. But we’ve neglected the fact that boys are also navigating these same waters without a compass. We are surprised when they make poor choices, but we have never really given them the tools to make better ones.”
This gap sits within a broader policy landscape that is, by many measures, well-intentioned. Kenya has national strategies. High-level campaigns. Political will. Funding. The National Adolescent Sexual and Reproductive Health Policy, revised in 2022, provides a comprehensive framework. The “Triple Threat” campaign launched by the Ministry of Health (MoH) in 2021 has raised awareness. Policy changes in 2020 allowed school-age mothers to return to the classroom, a significant and meaningful step.
And yet implementation remains uneven. In some counties, health workers still turn away young people seeking contraception without parental consent. In many schools, comprehensive sexuality education is delivered inconsistently or not at all. In numerous communities, the social norms that fuel the Triple Threat remain largely unchallenged.
We have excellent documents sitting on shelves in Nairobi that have little impact on a 15-year-old in Turkana
“Policy change is necessary but not sufficient,” notes Dr Ruth Laiboni, former director at the National Syndemic Disease Control Council. “We have excellent documents sitting on shelves in Nairobi that have little impact on a 15-year-old in Turkana or Taita Taveta. The challenge is translation, turning policy into practice at the community level.”
The PEPFAR-supported DREAMS initiative offers both a model and a warning. At its peak, the programme reached hundreds of thousands of girls with a layered package of services combining HIV prevention, education support, mentorship, and economic strengthening. Evidence from implementation areas points to increased uptake of HIV testing, improved health-seeking behaviour, and measurable declines in new HIV infections among young women.
Participants also reported something harder to quantify but equally important: greater agency in relationships, safer decision-making, and stronger peer support systems.
“By tackling the interconnected drivers of HIV risk, poverty, gender inequality, school dropout, and violence, the programme showed that sustainable impact requires coordinated, multi-sector action,” says one senior health official involved in the initiative.
But where funding has not been sustained, the gains have eroded. Programmes scaled down. Safe spaces disappeared. Mentorship networks weakened. The structural vulnerabilities DREAMS sought to address began to resurface. Risky behaviours increased. School dropouts rose. Adolescent girls once again faced heightened exposure to HIV, unintended pregnancy, and violence.
Real change happens in much smaller, quieter spaces where questions are allowed without judgement
The lesson is clear but uncomfortable: without consistent, long-term investment, even the most effective interventions risk becoming temporary interruptions in an otherwise persistent pattern.
What works, the evidence suggests, is not the size of the intervention but its depth. Real change happens in much smaller, quieter spaces: a youth group meeting after school, a conversation between peers, a mentor listening without judgement, a safe space where questions are allowed.
In Kericho, the Konnect Youth Consortium (KYC) offers one example. Housed in a modest building, the centre has served as a haven for hundreds of adolescents who might otherwise have had nowhere to turn. Young people access accurate information about sexual health, receive counselling, and take part in activities that build confidence and life skills.
“What makes this work is trust,” explains Dan Rono, the KYC Centre Manager. “Young people know they won’t be judged here. They can ask anything, share anything. That trust is the foundation on which we build everything else.”
In Kisumu, organisations such as Impact Research and Development Organization and Family Health Options Kenya work with adolescent peer educators to reach thousands of young people with accurate information on sexual and reproductive health, relationships, and rights. In Nairobi, groups like Youth Alive! Kenya and Shujaaz Inc. use radio and comic storytelling to engage young people on sensitive topics in ways that resonate with their lived experiences.
Instead of designing programmes for young people, designing them with young people
“When young people lead these conversations, the impact is different,” says Grace Wanjiru, a youth peer educator from Mukuru slums involved in community outreach in Nairobi. “We speak the same language. We understand the pressures. We’re not just talking at them, we’re talking with them. That changes everything.”
The shift that is needed is not merely programmatic. It is philosophical. Instead of designing programmes for young people, the evidence points to designing them with young people. Instead of delivering information, facilitating dialogue. Instead of focusing solely on individual behaviour change, addressing the systems and structures that shape those behaviours.
14-year-old Mercy Egonanga, who became pregnant and then returned to school, is now studying to become a teacher. 17-year-old Peter from Mukuru, whose 16-year-old girlfriend became pregnant, became an advocate for male involvement in reproductive health.
These are not feel-good footnotes. They are proof that when young people are trusted with agency, when they are given honest information, real support, and spaces to ask questions, the story can change.
Not with another report. Not with another statistic. But with something simpler: a conversation. An honest one. In a place where a young person can finally ask, “What happens if…?” and instead of silence, receive an answer that could change everything.
Obwiri Kenyatta is a global health expert in community-led health equity, climate justice, SRHR and HIV programmes.
