Author:
Embleton L.,Shah P.,Gayapersad A.,Kiptui R.,Ayuku D.,Braitstein P.
Abstract
Abstract
Background
Street-connected children and youth (SCY) in Kenya disproportionately experience preventable morbidities and premature mortality. We theorize these health inequities are socially produced and result from systemic discrimination and a lack of human rights attainment. Therefore, we sought to identify and understand how SCY’s social and health inequities in Kenya are produced, maintained, and shaped by structural and social determinants of health using the WHO conceptual framework on social determinants of health (SDH) and the Convention on the Rights of the Child (CRC) General Comment no. 17.
Methods
This qualitative study was conducted from May 2017 to September 2018 using multiple methods including focus group discussions, in-depth interviews, archival review of newspaper articles, and analysis of a government policy document. We purposively sampled 100 participants including community leaders, government officials, vendors, police officers, general community residents, parents of SCY, and stakeholders in 5 counties across Kenya to participate in focus group discussions and in-depth interviews. We conducted a thematic analysis situated in the conceptual framework on SDH and the CRC.
Results
Our findings indicate that SCY’s social and health disparities arise as a result of structural and social determinants stemming from a socioeconomic and political environment that produces systemic discrimination, breaches human rights, and influences their unequal socioeconomic position in society. These social determinants influence SCY’s intermediary determinants of health resulting in a lack of basic material needs, being precariously housed or homeless, engaging in substance use and misuse, and experiencing several psychosocial stressors, all of which shape health outcomes and equity for this population.
Conclusions
SCY in Kenya experience social and health inequities that are avoidable and unjust. These social and health disparities arise as a result of structural and social determinants of health inequities stemming from the socioeconomic and political context in Kenya that produces systemic discrimination and influences SCYs’ unequal socioeconomic position in society. Remedial action to reverse human rights contraventions and to advance health equity through action on SDH for SCY in Kenya is urgently needed.
Funder
CIHR
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference71 articles.
1. Office of the United Nations High Commissioner for Human Rights. Protection and promotion of the rights of children working and/or living on the street. Geneva: United Nations, Office of the High Commissioner on Human Rights; 2012.
2. Office of the United Nations High Commissioner for Human Rights. General comment No. 21 (2017) on children in street situations. CRC/C/GC/21 Geneva, Switzerland; 2017.
3. Woan J, Lin J, Auerswald C. The health status of street children and youth in low- and middle-income countries: a systematic review of the literature. J Adolesc Heal. 2013;53:314–21 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23706729.
4. Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Addiction. 2013;108:1722–33 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23844822.
5. Embleton L, Lee H, Gunn J, Ayuku D, Braitstein P. Causes of child and youth homelessness in developed and developing countries: a systematic review and meta-analysis. JAMA Pediatr. 2016;170:435–44.
Cited by
17 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献