This document discusses constraints and opportunities of youth peer education as a strategy for HIV/AIDS control in Kenya. It identifies several constraints such as inadequate budgetary support, socio-cultural barriers, corruption, high turnover of peer educators, poor recruitment, gender inequality, loose structure of programs, political violence, underdeveloped health sector, and weak training curriculums. However, it also presents opportunities like devolved health services that allow for more local capacity building, and expanding information/communication technologies that allow peer educators to better connect and share information. The document concludes that youth peer education has potential but requires more government and stakeholder support to address challenges and better integrate it within the health system.

1. Constraints and Opportunities of Youth
Peer Education as a Strategy for HIV/AIDS
Control in Kenya
Christopher Nkonge Kiboro, Chuka
University, Kenya.
Email: kiboro82@gmail.com

2. INTRODUCTION
• HIV and AIDS still remains the greatest public health
challenge globally (Strauss and Thomas, 2008).
• It is undoubtedly a major cause of premature deaths
in many parts of the world with the poorest regions
being the most affected.
• The lack of an imminent cure or vaccine means that
more deaths and large disease burden are inevitable
(WHO, 2001).
• By the end of 2010, approximately 34 million people
globally were living with HIV infection.
• In the same year, nearly 2.7 million new infections
including slightly over 300,000 among children and 1.8
million AIDS related deaths occurred (UNAIDS,
2010).

3. Introduction cont’d…
• Sub-Saharan Africa remains the region most affected
by HIV/AIDS.
• In 2010, the region accounted for 68% of all HIV
infections in the world and 76% of HIV/AIDS related
deaths (UNAIDS, 2010).
• The region further accounted for 70% of new
infections in 2010.
• However, although the general statistics appear
alarming, the magnitude of HIV and AIDS problems
vary considerably across different parts of Sub-
Saharan Africa.
• Kenya, Uganda and Tanzania for example, have been
experiencing a decline in HIV incidence rates and a
steadiness in terms of HIV prevalence.

4. Introduction cont’d…
• Kenya's HIV prevalence declined from
approximately 15% in 1990s to 6%. Uganda also
experienced a significant decline.
• Despite the modest performance by Kenya and
Uganda, the recent HIV prevalence estimates
shows a re-emergence of the scourge (UNAIDS
and WHO, 2008).
• In Kenya, HIV prevalence is found to be higher
among the youth. KDHS (2010) found out that the
median age at first sexual intercourse is 17 years.

5. • The KDHS 2003 report shows that more than 75%
of AIDS cases occur between the ages of 20-45, and
at least 33% of all AIDS cases reported are among
the ages of 15-30 (CBS and ORC Macro, 2004).
• Muga et al., (2004) also indicated that over half of
all the new HIV infections in Kenya occurred
among young people between 15-24 years.

6. INTERVENTIONS
• In Kenya as elsewhere, many programmes have
sought to educate young people about the risks of
HIV and reduce behaviours that expose them to
risk.
• Apart from medical interventions such as
administering anti-retroviral drug therapy,
behavioural interventions have also been
increasingly emphasized in the prevention and
control of HIV/AIDS.
• Engaging in healthy behaviours is considered the
most effective way of combating the spread of HIV
and AIDS.

7. Prevention strategies that are exclusively designed to
alter behaviour include the following;
• voluntary counselling and testing (VCT);
• supply and social marketing of condoms;
• public information campaigns
• and a host of youth education programmes (Glick,
2010).
• In the quest to halt the spread of HIV, the government
of Kenya, international agencies and representatives of
civil society organizations have collaborated to develop a
range of approaches to respond to the AIDS pandemic
particularly among the youth.

8. • Although various approaches have been
developed, youth peer education has certainly
become the most preferred strategy
• This is the process by which well-trained and
motivated individuals lead organized educational
and skills-building activities with their peers to
support and improve young people’s health and
well-being FH I (2010:7).
• However, although youth peer education with
respect to HIV and AIDS control has become very
popular in Kenya and other countries in Africa,
evidence of its efficacy is at best implicit (Gallant
and Tyndale, 2004).

9. CONSTRAINTS OF YOUTH PEER
EDUCATION IN KENYA
Inadequate budgetary support and delays
 Undermines financing of operations and maintenance
Socio-cultural and religious imperatives
 Detrimental to the practical efforts put in place to reduce spread of HIV/AIDS.
Corruption and misappropriation of funds
 Government loses important source of funds that can be used to promote health sector
High turnover of peer educators
 Sustainability affected
Poor recruitment process of peer educators
 Allows entry and participation of poor actors in terms of capacity

10. Gender inequality
 Gender inequality and reproductive rights are
inextricably intertwined with sexual reproductive
health (Wang’ombe and Mugo, 2010).
 Kenya is a patriarchal society where boys are
given priority over girls.
 Discrimination against girls places them at a
disadvantage including denying them an
opportunity to access information related to sexual
and reproductive health needs of adolescents.
 Denying young women their civil liberties,
including access to sexual and reproductive health
information only accentuates the problem of
HIV/AIDS.

11. Loose structure
 Too often they acquire informal structure which does not
easily lend itself to systematic follow-up.
 In addition, most of the peer educators participate in the
program as volunteers.
 Therefore, they are not obliged to strict accountability of
their activities. This can easily make them fail to act
responsibly.
Political violence and insecurity
 Political violence and general state of insecurity in Kenya
disturbs the general social equilibrium. Consequently
movement of youth peer educators is curtailed due to
imminent insecurity. The immediate implication of this
state of affairs is that the scope of coverage by youth peer
educators is reduced considerably

12. Underdeveloped health sector
 The health sector in Kenya has not been able to
expand rapidly to ensure adequate coverage and
utilization of health services including
reproductive health and HIV/AIDS services. This
means that the medical personnel are too few to
adequately address the reproductive health
challenges of the youth.

13. Weak curriculum
 Lack of a comprehensive youth peer education training
curriculum presents some constraints to the trained peers at the
implementation point.
 In most cases, the time allocated for training peer educators is
not sufficient to cover all the critical areas of concern.
 Consequently, equipping them with information on reproductive
health and HIV is given priority at the expense of other equally
important skills. Possession of the relevant information is vital.
 However, it is not a sufficient condition for the success of peer
youth education.
 The curriculum should be designed to also address issues such
as planning for a session, building self-confidence and honing
their communication skills.

14. OPPORTUNITIES
Devolved health services
 Until recently when the devolved system of governance was
introduced in Kenya, health services were usually provided
through weak centralized institutions that were seen as
remote and ineffective by those they were supposed to
serve.
 This new development presents an excellent window of
opportunity for supporting capacity development at local
levels that could have major impact on youth peer
progammes. The youth should therefore take advantage of
the devolved system to enhance their programmes.

15. Expanding Information and Communication Technology (ICT)
sector
 Unlike in the past when almost everything was done manually,
today there is greater emphasis on e-government.
 To achieve the ideals of e-governance, the Kenyan government is
investing heavily in expanding Information and Communication
Technology (ICT) throughout the country.
 This will ensure that even the remotest parts of the country have
access to information.
 Youths in Kenya particularly those involved in peer education
programmes can take advantage of the expanding ICT sector to
reach out to their contemporaries with reproductive health
information.
 In addition, they can use ICT platform to network and share
experiences with other peer educators across the globe.

16. Conclusion
Youth peer education has great potential to address
the problem of HIV and AIDS in Kenya. However,
the programme is faced with myriad of challenges
that are beyond the ability of the youth alone. To
overcome the constraints discussed, the government
and other actors should integrate youth peer
education into the mainstream health policy and
ensure that the programme is well funded including
providing salaries to the peer educators to ensure
they remain motivated.

17. THANK YOU