Children living on the street in semi-rural Kenya—a formative evaluation of community perceptions and children\u27s health outcomes

Research of street-involved children and youth in Sub-Saharan Africa has largely focused on urban centers. This dissertation is a secondary analysis of formative evaluation data gathered in May and June 2014 by Maua Methodist Hospital to inform the planning and development of a rescue and rehabilitation project for children and youth living on the streets of semi-rural Meru County, Kenya. Qualitative and quantitative methods were employed to explore 1) community perceptions surrounding why children and youth migrate to the street and adoption or fostering of children and youth living on the street and 2) the health risk and protective factors of street-involved children and youth on the streets of two major towns. Community members identified multiple ecological levels of influence, including intrapersonal, interpersonal, household, peer, community and environmental factors contributing to children and youth\u27s migration to the streets. Regarding reasons for and against adoption of street-involved youth, community members discussed immediate financial barriers and interpersonal conflicts between spouses and other household members, immediate material and emotional benefits to the adopted child as well as the household, long term positive outcomes for the family following adoption and long term negative outcomes for the community if children were left on the street. Results of the surveys with children and youth identified a high prevalence of adverse childhood events and poor psychosocial health. Orphan status, specifically maternal and double orphanhood, may be a risk factor for adverse childhood events and depression. Implications for program planners and community stakeholders and leaders are discussed