Qualitative Evaluation of the Lea Toto Adolescent Program in Nairobi, Kenya Open Access

Madeline Plaster (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/0z708w45r?locale=en
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Abstract

Introduction: The Children of God Relief Institute is a faith-based organization (FBO) providing children and adolescents with the resources to manage infection with Human Immunodeficiency Virus (HIV) in Nairobi, Kenya. Their efforts under the Lea Toto Adolescent Program (LTP) were updated in 2015. Information on how the program is perceived by stakeholders will support program implementation moving forward.

Methods: In-depth interviews and focus group discussions were conducted with program participants, program graduates, caregivers, and program staff. A document review compared the LTP economic empowerment curriculum to a PEPFAR and USAID supported equivalent curriculum.

Results: Results were analyzed within the different populations and by the four main program components including sexual and reproductive health, life skills, economic empowerment, and clinic support. 1)Knowledge about HIV, sex, sexual development, romantic relationships, and contraception increased through participation in the program. The program provided important support in HIV disclosure between caregivers and participants. There was lack of practical guidance in disclosing to romantic partners and condom negotiation which limited the SRH component. 2) Extended program sessions away from LTP centers and talent shows were particularly important in promoting self-esteem, confidence, and relationships within the program. There was need for capacity building for program staff to have more cultural competence and ability to deal with the different stages of development. 3) Specific clinic days for age groups as well as home visits helped participants have good medication adherence, feel healthy, and have a normal appearance. Inadequate transportation, frequent turnover of staff, inadequate support with medication adherence when transitioning to secondary school, inconvenient appointments, and inadequate support during transition to adult care were limitations. 4) Financial support for rent, food, and education were important aspects of the program. However, the program lacked practical skill building in business plan execution, and budgeting.

Recommendations: Recommendations included improving economic empowerment curriculum to use more practical exercises and activities. Moreover, further investigation into how the contraception referral system is working could be helpful to further the program efforts in SRH. Finally, standardizing transition to adult care with use of facility visits and connections to LTP graduates and friends would be helpful for continuity of care.

Table of Contents

Introduction…………………………………………………………………………......4

Figure 1. Location of LTP centers in Nairobi, Kenya……………….....……….6

Literature Review…………………………………………………....………………….7

Methods………………………………………………………………………………..11

Results……………………………………………………………………………....…25

            Table 11. Strengths and Limitations of Program Components..........................26

Discussion……………………………………………………………………....……..81

Recommendations……………………………………………………………………..87

Works Cited…………………….....…………………………………………………...90

Appendix………………………………………………………………………………94

 

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