Children and youth in street situations in Nairobi. A study for a comprehensive model of care

Journal title RICERCHE DI PSICOLOGIA
Author/s Marzia Ravazzini, Massimiliano Reggi, Elena Magoni, Paolo Inghilleri
Publishing Year 2024 Issue 2023/1
Language English Pages 26 P. 57-82 File size 0 KB
DOI 10.3280/rip2023oa16123
DOI is like a bar code for intellectual property: to have more infomation click here

View article Download Open Access article

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

We investigated the profiles of children and youth in street situations in Mlango Kubwa slum in Nairobi. Through a quanti-qualitative questionnaire, we collected the responses of 300 children and youth, starting from the social determinants of health as indicators of vulnerability. The foremost objective is to understand their social and health conditions as vulnerable/at-risk street groups. The secondary goal is to identify the populations’ strengths, inspecting protection mechanisms, survival strategies and dreams. The data show a complex situation: experiences of trauma, violence, conflict and abandonment; ambivalent family ties, school drop-out, lack of legal and physical protection, homelessness, living below the limit of extreme poverty. The street has activated survival strategies, mostly on an individual level, but functioning as a “base system” the street seems to act as a protective system and a possible scenario in which to create a different future together with youth workers: reconnecting with the family, liaising with expert figures in order to return to school or look for suitable training. Working with children and youth in street situations highlights the complexity of their vulnerability. This could be addressed through an integrated approach and a comprehensive primary health care model.

Keywords: ; Children and youth in street situations; Social determinants of health; Primary health care; Vulnerability

  1. Kisirkoi, F.K., Mse, G.S. (2016). Education Access and Retention for Street Children: Perspectives from Kenya. Journal of Education and Practice , 7(2), 88-94.
  2. Barr, V.J., Robinson, S., Marin-Link, B., Underhill, L., Dotts, A., Ravensdale, D., Salivaras, S. (2003). The expanded chronic care model: An integration of concepts and strategies from Population Health Promotion and the Chronic Care Model. Healthcare Quarterly, 7(1), 73-82.
  3. Biehl, J., Petryna, A. (2013). When people come first, critical studies in global health, Princeton University Press: Princeton.
  4. Bindè, J. (2000). Towards an Ethics of the Future. Public Culture, 12(1), 51-72. DOI: 10.1215/08992363-12-1-51.
  5. Bircher, J., Kuruvilla, S. (2014). Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health. Journal of Public Health Policy, 35(3), 363-386. DOI: 10.1057/jphp.2014.19.
  6. Boldt, J. (2019). The concept of vulnerability in medical ethics and philosophy.Philos Ethics Humanit. Med. 14:6. DOI: 10.1186/s13010-019-0075-6.
  7. Camfield, L., McGregor, A. (2005). Resilience and wellbeing in developing countries. In Hungar, M. (Ed.) Handbook for Working with Children and Youth. Pathways to Resilience Across Cultures and Contexts, (pp. 189-203). Sage: Newbury Park.
  8. Cottrell-Boyce, J. (2010). The role of solvents in the lives of Kenyan street children: an ethnographic perspective. African Journal of Drug and Alcohol Studies, 9, 2, 93-102.
  9. CYC (2004). Street Children and Homelessness, CYC - online, issue 68, september, p.1. https://cyc-net.org/cyc-online/cycol-0904-homelessness.html.
  10. Dahlgren, G. and Whitehead, M. (2006). European strategies for tackling social inequities in health, WHO.
  11. Ezeh, A. Oyebode, O., Satterthwaite, D., Chen, Y-F., Ndugwa, R., Sartori, J., Mberu, B., Melendez-Torres, G. J., Haregu, T., Watson, S. I., Caiaffa, W., Capon, A., Lilford, R.J. (2017). The history, geography, and sociology of slums and the health problems of people who live in slums, The Lancet, 389(10068), 547-558, DOI: 10.1016/S0140-6736(16)31650-6).
  12. Farmer, P. (2003), Pathologies of power. Health, human rights and the new war on the poor, Berkeley and Los Angeles: University of California Press.
  13. Fayehun, O., Ajisola, M., Uthman, O., Oyebode, O., Oladejo, A., Owoaje, E. et al. (2022). A contextual exploration of healthcare service use in urban slums in Nigeria. PLoSONE, 17(2), e0264725. DOI: 10.1371/journal.pone.0264725.
  14. Huber, M., Knottnerus, J.A., Green, L., Horst, H., Jadad, A.R., Kromhout, D., et al. (2011). How should we define health?. TheBMJ, 343, d4163; DOI: 10.1136/bmj.d4163.
  15. Indexmundi (2019). http://www.indexmundi.com/kenya/demographics_profile.html.
  16. Kenia Vision (2018). http://www.vision2030.go.ke.
  17. Maciocco, G. (2010). Assistere le persone con condizioni croniche. In Nasmith, L, Ballem, P, Baxter, R, et al. (Eds.) Transforming care for Canadians with chronic health conditions: Put people first, expect the best, manage for results. Ottawa, ON, Canada: Canadian Academy of Health Sciences, 2010. https://www.saluteinternazionale.info/2011/06/assistere-le-persone-concondizioni-croniche.
  18. Marmot, M. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/43943/9789241563703_eng.pdf.
  19. Mberu, B. U., Haregu, T. N., Kyobutungi, C., Ezeh, A.C. (2016). Health and health-related indicators in slum, rural, and urban communities: a comparative analysis, Global Health Action, 9(1), 33163, DOI: 10.3402/gha.v9.33163.
  20. Merriam Webster Dictionary (2018). Entry “vulnerability”, https://www.merriamwebster.com/dictionary/vulnerability. Accessed 30 Dec 2018.
  21. Nugent, N. R., Sumner, J. A., & Amstadter, A. B. (2014). Resilience after trauma: From surviving to thriving [Editorial]. European Journal of Psychotraumatology, 5, 25339.
  22. Riva, E., Rainisio, N., Boffi, M. (2014). Positive change in clinical settings: flow experience in psychodynamic therapies, In Inghilleri P., Riva, G., Riva, E. (eds.), Enabling Positive Change: Flow and Complexity in Daily Experience (pp.74-90). De Gruyter, Warsaw-Berlin.
  23. Rogers, W., & Veale, B. (2000), Primary Health Care and General Practice. A scoping report. National Information Service of the General Practice Evaluation Program, Department of General Practice, Flinders University Bedford Park SA, Australia, published by the National Information Service Department of General Practice Flinders Medical Center.
  24. Solar, O., Irwin, A. (2010). A Conceptual Framework for Action on the Social Determinants of Health, Paper 2 Policy and Practice, WHO, Geneva.
  25. The National Council for Children’s Services (NCCS) (2015). National Plan of Action for Children in Kenya 2015-2022, Nairobi: National Council for Children Services. http://www.childrenscouncil.go.ke/images/documents/Policy_Documents/National-Plan-of-Action-for-Children-in-Kenya-2015.pdf.
  26. UNICEF (1978). World Health Organization., & International Conference on Primary Health Care. Declaration of Alma Ata: International Conference on Primary Health Care, Alma Ata, USSR, 6-12. Geneva: World Health Organization.
  27. UNICEF (2017). Committee on the Rights of the Child, General comment No. 2. UNICEF (2018a). A Study on Street Children in Zimbabwe, Orphans and Other Vulnerable Children and Adolescents in Zimbabwe at https://www.unicef.org/evaldatabase/files/ZIM_01-805.pdf.
  28. UNICEF (2018b). Situation Analysis of Children and Women in Kenya 2017. UNICEF, Nairobi, Kenya. https://www.unicef.org/kenya/media/136/file/SITAN-report-2017-pdf.pdf.
  29. United Nations (2007). UN Committee on the Rights of the Child: Consideration of Reports Submitted by States Parties Under Article 44 of The Convention Concluding Observations: Kenya, 19 June 2007, CRC/C/KEN/CO/2.
  30. United Nations (2020) - https://sustainabledevelopment.un.org/sdgs.
  31. United Nations (2020b) https://www.who.int/news-room/fact-sheets/detail/primary-health-care.
  32. Volpi, E. (2002). Street Children: Promising Practices and Approaches,World Bank Institute,http://documents.worldbank.org/curated/en/344301468763803523/pdf/263 880WBI0Street0children.pdf.
  33. Wilkinson, R.G.; Marmot, M. (2003). Social determinants of health. The solid facts, 2nd edition. WHO Europe. https://www.euro.who.int/data/assets/pdf_file/0005/98438/e81384.pdf.

Marzia Ravazzini, Massimiliano Reggi, Elena Magoni, Paolo Inghilleri, Children and youth in street situations in Nairobi. A study for a comprehensive model of care in "RICERCHE DI PSICOLOGIA" 1/2023, pp 57-82, DOI: 10.3280/rip2023oa16123