Adolescent Health In Urban Informal Settlements: Findings From A Community-Led Women’s Health Initiative in Kibera, Kenya
*Presenting author
Nicole Tang*, Kyra Guy, Samyu Padisetti, Alyssa Ponrartana, Rose Okoyo Opiyo, Cecilia Alonyo, Emmanuel Balinda, Mike Wamaya, The Kibera Women's Health Ambassadors, Heather Wipfli
INTRODUCTION
Women and girls living in urban informal settlements face disproportionate barriers to health and well-being. Urbanization, poverty, and inadequate infrastructure have intensified social and gender inequities in communities such as Kibera, one of Africa’s largest informal settlements in Nairobi, Kenya. Gender disparities often widen during adolescence, leaving girls especially vulnerable to early pregnancy, school dropout, gender-based violence, and limited access to reproductive health services. The Global Research, Implementation and Training (GRIT) Lab partnered with Project Elimu, a community-based organization serving youth in Kibera, and Energy in Action, a global youth-led nonprofit, to conduct a community-based participatory research (CBPR) study focused on the health challenges faced by young women in Kibera.
STUDY OBJECTIVES:
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Collect data regarding knowledge, attitudes, and experiences with early pregnancy, domestic violence, menstrual hygiene, and mental health among adolescents living in Kibera.
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Demonstrate the value of youth-led, community-driven research approaches to advancing gender equity and health in informal settlements.
METHODS
Recruitment and Engagement of Women Health Ambassadors:
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The program recruited 20 women aged 18-24 in the Kibera community to serve as as co-researchers throughout all stages of the research process.
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Recruitment requirements included age, availability, English literacy, willingness to volunteer, and commitment to community work.
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Selected Women Health Ambassadors (WHAs) attended three workshops hosted at Project Elimu and facilitated by GRIT and EIA volunteers:
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Workshop 1: Training in public health domains including sanitation, risky behaviors, sexual and reproductive health, mental health, and gender equity. Participated in DELHI exercise to identify research priorities.
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Workshop 2: WHAs were introduced to research methodology and ambassadors led through the development of a research protocol, survey tools, and consent forms.
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Workshop 3: Data analysis and dissemination workshop, including stakeholder mapping.
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Community Based Health Assessment:
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In March 2025, WHA’s carried out a cross-sectional household survey across 6 villages in Kibera: Kianda, Lindi, Soweto West, Soweto East, Kisumu Ndogo, and Laini Saba.
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Survey participants were recruited through convenience sampling with eligible participants being (1) full time residents of one of the 6 villages, (2) between the ages of 13-19, and (3) literate in English.
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Interviews took place in privacy and incentives were provided to all participants (1 package of either soap, menstrual pads, sugar, or children’s diapers).
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Data were collected on paper, entered into qualtrics, and analyzed using R Software.
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All study materials were approved by the University of Southern California, University of Nairobi, and the Kenya National Commission for Science, Technology, and Innovation.
RESULTS
DISCUSSION & CONCLUSION
Adolescent girls in Kibera face intersecting challenges related to mental health, domestic violence, and early pregnancy, driven by poverty, gender inequities, and limited access to youth-friendly services. Findings reveal high rates of depression and emotional abuse, limited use of reproductive health services, and harmful gender norms shaping relationships and opportunities. Addressing these issues requires expanding free, adolescent-centered reproductive and mental health services; engaging men and boys in gender equity and mental health education; and strengthening vocational and mentorship programs to promote economic independence. The Women’s Health Ambassador Program demonstrated the value of youth-led, community-based initiatives for improving awareness, reducing stigma, and advancing gender equality in low-resource environments. Sustained investment in such participatory approaches can build lasting capacity and foster healthier futures for adolescents in informal settlements across Kenya and beyond.
REFERENCES AND ACKNOWLEDGEMENTS
“Adolescent Pregnancy.” World Health Organization, World Health Organization, 10 Apr. 2024, www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
Austrian, Karen, Eunice N. Muthengi, Taylor Riley, Joyce Mumah, Caroline W. Kabiru, and Benta Abuya. 2015
"Adolescent Girls Initiative-Kenya: Baseline report." Nairobi: Population Council
Kenya National Bureau of Statistics (Ed.). (2019). 2019 Kenya population and housing census. Kenya National Bureau of Statistics.
This project was implemented with the leadership of the Women’s Health Ambassadors in Kibera, including Hope Mbuangi, Mercline Atreno, Christabel Akoth, Mollen Akinyi, Janel Achieng, Keziah Nekesa, Ruth Otieno, Vivian Akimyi, Cynthia Otieno, Hellen Mutua, Mitchell Akoth, Faith Mueni, Irene Akinyi, Vallary Achieng, Lucy Atieno, Phenny Achieng, Nowell Atineo, Mercy Namayi, Maxine Adhiambo, Rhoda Straniz, who were trained as community researchers and carried out all data collection activities. We gratefully acknowledge the collaboration and support of the University of Nairobi and Project Elimu in facilitating local engagement and implementation. Technical support was provided by the University of Southern California, and funding was provided through the Dr. Tom Hall education grant awarded by the Consortium of Universities for Global Health (CUGH).