Demographic and epidemiological transitions and burden of adolescent healthcare in sub-Saharan Africa: A review.

This review's main objective is to discuss how demographic and epidemiological transitions relate to the burden of adolescent healthcare in sub-Saharan Africa (SSA). The review explicitly discussed the burden of adolescent healthcare, the current African policies on adolescent healthcare, and gaps in the African policies compared with Europe and North America. We also examined how adolescent healthcare policies evolve and documented the recommended essential part of the policy for enhancing its sustainability. The burden of adolescent health is high in SSA with diseases and reproductive health-related problems prevailing among adolescents. However, variations exist in the burden of adolescent healthcare across countries in the region. While some SSA countries are currently undergoing demographic and epidemiological transition processes concerning adolescent health care, the majority are either at an early stage of the transition or yet to commence the process. Policy-makers should consider effective ways to improve adolescents' health in SSA through preventive mechanisms and a multi-dimensional approach.

Factors associated with risky sexual behaviour among out-of-school youth in Kenya.

This paper examines factors that may predispose unmarried and unemployed out-of-school youth to risky sexual behaviour. Data for analysis were derived from the Behaviour Surveillance Survey carried out in Kenya in late 2002. A total of 6129 male and female unmarried and unemployed out-of-school youth in the age range 15-24 years were successfully interviewed. However, for this paper only a sample of 3961 comprising sexually experienced youth in the 12 months preceding the survey was used. Methods of analysis included descriptive statistics and multinomial logistic regression. Results for males indicate that factors associated with low and high risk were whether they had fathered a child, district of residence and frequency of alcohol use, while current age and age at first sexual debut stood out for those with low risk alone. For females the district of residence and age of partner at sexual debut were the factors that predisposed them to low-risk sexual behaviour, while for high risk the district of residence, current age and ever being pregnant were significant. The results indicate that for these youth, contextual and probably social factors appear to be the main determinants of risky sexual behaviour for both males and females. The findings also support those of other studies that link risky sexual behaviour among youth, especially males, to alcohol consumption. Programmes for intervention therefore need to focus on these aspects. There is also a need for studies that can look at district-specific factors for more focused interventions.