Experiences of drought and flooding, resource insecurity, and sexual health among youth in Nairobi and Kisumu, Kenya: qualitative multi-method findings.

Abstract

Background: Growing evidence identifies linkages between drought and flooding and poorer sexual health outcomes, yet adolescents and youth are understudied in this research. We aimed to explore the lived experiences of adolescents and youth regarding the associations between drought/flooding, resource insecurity, and sexual health in Mathare and Kisumu, Kenya.

Methods: We conducted a multi-method qualitative study in Mathare, an urban informal settlement in Nairobi, and Kisumu and adjacent fishing communities, with a purposive sample of youth aged 16-24 years. We conducted SenseMaker individual interviews with the web-based tool, followed by group-based digital storytelling workshops. We conducted framework thematic analysis guided by the resource insecurity framework.

Results: SenseMaker participants included n = 20 youth (Kisumu: n = 10 women; Mathare: n = 5 women and n = 5 men), followed by four group-based digital storytelling workshops with 33 youth (Kisumu: n = 9 women; Mathare: n = 8 mothers, n = 8 men; n = 8 women). There were 42 unique participants. Participant narratives reflected the following themes: (1) drought and flooding exacerbate multiple resource insecurities (food, water, sanitation, menstruation); (2) increased resource insecurity-related transactional sex; (3) drought, flooding, and resource insecurities increase risks of sexual and gender-based violence; and (4) youth recommend structural- and community-level strategies for promoting sexual health.

Conclusions: Findings from a sample of youth in two climate-affected Kenyan settings identify complex pathways from drought and flooding to sexual health, particularly through resource insecurity, transactional sex, and sexual and gender-based violence. Findings can guide the integration of extreme weather and sexual health programming with youth to integrate economic empowerment and sexual and gender-based violence reduction to advance equity and rights.