At a government-run dispensary located in Nairobi's Kware informal settlement, 26-year-old nurse Steven Ngang'a attends to young mothers holding their babies. The girls, all aged between 15-19 years are here to access family planning and HIV services, after enrolling on Tiko, a digital platform that connects adolescents to youth-friendly sexual and reproductive health services. "On our busiest days, we serve up to 270 girls. Today we have served 150 girls, and most of them are here to access short-term family planning methods," says Nurse Nganga.
About 200 meters away at the St Clare Health Center, a private facility,18-year-old Jennifer has come to access services for the first time using the Tiko card. 'I moved to Nairobi a month ago after completing my high school education in Siaya County," she says. "My mum cannot afford to send me to college or vocational training so right now I am looking for ways to earn a living in the city." Jennifer was enrolled on the Tiko platform by a community mobilizer who recognized her as a new arrival to the densely populated Kware neighborhood. On this particular day, she visits the health center for a counseling session on contraception and prevention of HIV and sexually transmitted infections. "Girls like Jennifer are extremely vulnerable due to their dire economic situation. Having moved here from conservative rural communities, they often have little knowledge about their sexual and reproductive health " says Tiko mobilizer Anjeline Otieno.
Services offered through the Tiko Platform are provided free of charge through funding from the Adolescent Sexual and Reproductive Health Development Impact Bond. The first-of-its-kind program was launched in Kenya in 2023 to improve access to sexual and reproductive health information and services for adolescent girls. Since its roll-out in July 2023, the program has reached more than 227,000 girls with HIV and family planning information and services. 136 public sector facilities, 147 private sector facilities, and 45 pharmacies have been onboarded onto the Tiko platform, bringing services closer to adolescent girls in 10 counties experiencing the highest burden of teen pregnancy and HIV infections among the youth.
"In this new phase of implementation, we have also been able to enroll more than 129,000 new young people onto the Tiko platform through our network of community mobilizers and peer-to-peer referrals," says Tiko Africa Program Lead Lucy Kaigutha. By using their mobile phones, girls can see nearby health facilities offering free services, which helps them decide where and when to access services. They also receive notifications and reminders on their next appointments and can rate the quality of services provided.
Demand for Tiko services is high at both St Clare's Health Center and Kware Dispensary. "I attend to more than 20 girls daily through the Tiko platform, and most of them will return monthly for a refill on short-term contraceptives or HIV testing and counseling," says Lilian Mogaka, a nurse at St Clare's. The two facilities serve a catchment area of 52,000 residents living in the Kware locality, in addition to clients from the nearby Mukuru kwa Ruben and Mukuru kwa Njenga informal settlements, Tassia, and Donholm neighborhoods. "More than half of the girls we serve fall under the 16-17 year age group. Most of them are single mothers who have dropped out of school and are struggling to provide for their children," says Nurse Ngang'a.
For adolescent girls living in multi-dimensional poverty in Kware and the surrounding areas, having access to quality sexual and reproductive health information and services offered at no cost can alter the course of their lives. "Programs like the Adolescent Sexual and Reproductive Health Development Impact Bond are pivotal in breaking the cycle of poverty and vulnerability that many of these young girls face," says UNFPA Kenya Sexual and Reproductive Health and Youth Programmes Advisor Kigen Korir. "By providing them with the knowledge and resources to make informed choices, these services empower girls to pursue their education and life aspirations without the interruption of unplanned pregnancies or health issues."
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Backed by investments from the UN Joint SDG Fund and the Children's Investment Fund Foundation, the Adolescent Sexual Reproductive Health (ASRH) DIB is an initiative that brings together a joint United Nations team comprising UNFPA, WHO, UNAIDS, the UN Resident Coordinator Office, and the UN SDG Partnership Platform (SDG PP) and TIKO Africa, a non-profit implementing organization to mobilize private and public sector funding to tackle the challenge of teen pregnancy, new HIV infections, and AIDS-related deaths among adolescent girls. The two-year program aims to reach 300,000 vulnerable girls with high-quality, youth-friendly sexual and reproductive health and HIV services while improving service delivery in 150 public primary health facilities across the focus counties.
