Table 2 Illustrative quotes related to barriers to accessing SRH information and services among the AY

Individual factors

Q1

Sometimes people feel shame approaching other people asking about these things. There is a kind of shyness in people that prevents them from asking. (Male FGD, 15–19 Years, Kilifi County)

Q2

There are some situations - not that one is prevented - but one feels shame to go to a place and ask for such information. They see it as shame, they have no confidence to sit with other people [and ask them] to give them such information. (Youth FGD, 20–24, Lamu County)

Parental factors

Q3

If I ask my mother now, ‘Can I do this? Or how can this be done?’ She will deny it. She will tell me she cannot give me such information until I get married. They also ask you, ‘Why do you want to know about that? What do you want to do?’ They advise you ‘Get married first, get a child, and we will tell you about that.’ If you want pads they will buy for you, but they will not give you information. (Adolescent girls FGD, 15–19 Years, Lamu County)

Q4

Sometimes a parent gives information to their children late when they are already in problems. (Boys FGD, 10–14 Years - Taita Taveta County)

Q5

I think only a few parents can give SRH information to their children because they think if they give them information about FP, they will go and test on that, a parent telling their children about the use of condoms is like they are encouraging them to use condoms.

(Youths FGD, 20–24 Years, Mombasa County)

Q6

Parents think if they tell you how to prevent pregnancy, you will engage into sex and then prevent yourself. (Boys FGD, 10–14 Years, Lamu County)

Q7

They think if they give you such information it is like they enable you to go and engage in sex without fear of getting pregnant. (Adolescent girls FGD, 15–19 Years, Kwale County)

Q8

Parents feel that if they give such information to their children is like encouraging them to engage into sex. For me personally I cannot tell my child that if you do this you will not get this, it is you - you are showing the child how to do it. (CHVs FGD, Mombasa County)

Q9

Mothers feel shy and ashamed discussing sexual information with their male children. (Girls FGD, 15–19 Year. Mombasa County)

Q10

Parents also see giving such information to their children as shameful. (CHVs FGD, Lamu County)

Q11

Some young people don’t have people to guide them, they don’t have parents and they don’t go to school. (Boys FGD, 10–14 Years, Kwale County)

Q12

Parents are busy, they go to work, every morning you wake up they are not there, and they come back late. (Adolescent girls FGD, 15–19 years, Taita Taveta County)

Q13

Parents go out early in the morning at 6:00 am and come back late in the evening at 9:00 pm when the children are asleep and does not get time to talk to them. (Youth FGD, 20–24 Years, Taita Taveta County)

Q14

Some parents don’t have time with their children because they are busy and always think there will be another day to share the information and the child continues to grow getting destroyed behaviorally but [parents] will never sit with them to give [SRH] information (CHVs FGD, Kilifi County)

Q15

Many people here are Muslims and mothers are not allowed to teach their sons such things. They may get such information from an uncle. (Adolescent girls FGD, 15–19 Years, Kwale County)

Q16

Like girls are not allowed to go out to be given such information, their parents are harsh. You find that a girl gets a chance only when the father is not at home, so they never get information. They can only get out when their parents are away. Because of that, they don’t get the information which they are supposed to be given as girls, you find a girl is not comfortable and doesn’t know anything. (Adolescent girls FGD, 15–19 years, Kilifi County)

Q17

Because culture does not allow [a mother] to give such information to her son (Adolescent girls FGD, 15–19 Years, Kilifi County)

Q18

Sometimes the parent and son may not be in good times. The son always comes back home under the influence of drugs and refuses to listen to the parent. (Boys FGD, 15–19 years, Taita Taveta County)

Q19

Parents assume that as youths we already have the information so there is no need for them to tell us anything about SRH. (Youth FGD, 20–24 Years, Taita Taveta County)

Q20

Another barrier is illiteracy. In most families you find the children are more educated than the parents. In that case a parent assumes that the child has all the information they require. (CHVs FGD, Kilifi County)

Health care worker and health institution factors

Q21

Sometimes you may want to inquire about safe sex from a dispensary but you find that whoever is there is an old man and cannot tell you about this. (Male FGD, 15–19 Years, Kilifi County)

Q22

It is not free because if you come to hospital, even just seeing the doctor to explain your problem is charged, if you go to lab, you also pay. (Adolescent girls FGD, 15–19 Years, Mariakani)

Q23

If you go to hospital and you don’t have money you will not get treated, you go back home with your illness. (Adolescent girls FGD, 10–14 Years, Lamu County)

Q24

Some hospitals don’t give services on Sundays, for example, I fell sick and went to hospital and they told me it was a Saturday, and they don’t give services. (Adolescent girls FGD, 10–14 Years, Lamu County)

Q25

There are no services during weekends - The doors are open, but they tell you they can only see emergency cases. (Youth FGD, 20–24 Years, Kwale County)

Q26

Services are given between 8:00 am and 4:00 pm, beyond that time [there are] no services. If you come, you are told they have closed. (Adolescent girls FGD, 15–19 Year Mombasa County)

Q27

Hospitals also lack enough doctors… You may take a patient there at 9:00 am but the doctor will arrive at the hospital at 1:00 pm. (Youth FGD, 20–24 Years, Taita Taveta County)

Q28

Some places in Lamu are far away from the hospital and transportation problem prevents people from coming here. (CHVs FGD, Lamu County)

Q29

Not all people can easily reach them [health facilities]. Some people live far away and must use transport to get to hospital. (Adolescent girls FGD, 15–19 years, Taita County)

Q30

Many of them live far away from hospitals and cannot easily reach there. (Boys FGD, 10–14 Years, Tana River)

Teacher/educator factors

Q31

It is this way, teachers give us information, but they say they cannot teach us some other things because they are not relevant at our age. (Adolescent girls FGD, 10–14 Years, Kwale County)

Q32

They don’t give enough information, things like STIs, they know we are students and cannot dwell on that. But we come from different backgrounds. Maybe some have already been involved in those things, but they decide not to tell them, and they could be already infected with gonorrhea. (Adolescent girls FGD, 15–19 Years, Kwale County)

Q33

I think they [teachers] are avoiding discussing some topics to avoid stigmatization from parents. When children are given such information, they also disclose to their parents who go to school to attack teachers. So a teacher cannot risk losing her job and that is why they avoid some topics. (Youths FGD, 20–24 Years, Mombasa County)

Q34

I think they have the information, but they fear if they give them full information, they will tell other people that the teacher told me this and that. (CHVs FGD, Tana River County)

Q35

We have inadequate time allocated for school’s SRH sessions (Male FGD, 15–19 Years, Mombasa County)

Contextual factors

Q36

…That is also the same even to our mothers, others cannot read, they don’t know anything, and this contributes a lot. (Adolescent FGD, 15–19 Years, Lamu County)

Q37

Normally as youths, we can discuss such things, but in some places, like in the rural areas, you will find youths are illiterate so none of them can give information to the other. (Youth FGD, 20–24, Lamu County)

Q38

Islamic religion does not allow discussion of such things. It’s not easy. It is not allowed because a girl who is not married is not allowed to have sex. (Adolescent girls FGD, 15–19 Years, Kwale County)

Q39

The boys are given information by their fathers or grandfathers and the girls are given information by their mothers or grandmothers. (Adolescent Boys FGD, 15–19 Years, Kwale County)

Q40

The poor are lonely most of the time because people look for friends who have similar social back grounds. (Adolescent girls FGD, 15–19 years, Taita County)

Q41

Once you have a lot of responsibilities, you don’t get time for other things…. Take an example of a girl whose parents are poor and she is left at home to do all house work as parents go out to look for a living, how will she get time?…Already her mind is blocked, she cannot think further. (Youth FGD, 20–24 Years, Mombasa County)

Q42

Children from poor families also go out to look for food for their families. Sometimes there could be a meeting in their areas that discusses SRH information, but because they have to go to work, they will miss that opportunity to attend. (Male Adolescent FGD, 15–19, Kilifi County)

Q43

If a young person is asked to come here but stays far away and does not have fare, there is no money at home, that person will not be able to come and get full information. (Adolescent girls FGD, 15–19 Years. Mombasa County)

Q44

The rich always have time with their children but the poor parents always go out to look for food. They go looking for work, but the rich are already employed and sometimes get free time to sit with their children and advise them. (Adolescent girls FGD, 15–19 Years, Kwale County)