Enhancing Adolescent Sexual &
Reproductive Health in Kenya

A UN-supported development impact bond

Background

Kenya experiences significant challenges with teen pregnancy and HIV infections, which have severe consequences on the health and future opportunities of adolescents, particularly girls. One in six adolescent girls between 15 and 19 years old either becomes pregnant or is already a mother, resulting in over 260,000 pregnancies annually. In 2022, an estimated 73,00 new HIV infections occurred among adolescents and young people aged 15-24, accounting for 41% of all new infections in the country. Adolescent girls and young women are particularly vulnerable, accounting for 78% of new HIV infections (2023 estimates).

According to the Kenya Demographic and Health Survey 2022, slightly more than half of young people (54% of women and 55% of men) know about HIV prevention methods. Adolescents face multiple barriers to accessing sexual and reproductive health (SRH) and HIV services, including limited access to correct information, financial obstacles, long distances to health facilities, socio-cultural factors, and legal and policy-related challenges. Even when services are available, concerns about provider biases, privacy, and confidentiality discourage adolescents from seeking help. This situation highlights the urgent need to address the underserved and under-equipped state of adolescents in terms of their sexual and reproductive rights.
Targetted Counties

The Adolescent Sexual & Reproductive Health Development Impact Bond


A collaborative United Nations team, comprising UNFPA, WHO, UNAIDS, the UN Resident Coordinator's Office, and the UN SDG Partnership Platform (SDG PP), has partnered with Triggerise, a nonprofit implementing organisation, to address the challenges of adolescent pregnancy, new HIV infections, and AIDS-related deaths among adolescent girls in high-burden counties in Kenya. This initiative aims to mobilise private and public sector financing through the use of a development impact bond (DIB) to improve adolescent health outcomes.

Bridges Outcomes Partnerships is providing upfront funding and support to Triggerise to enable the delivery of high-quality, youth-friendly SRH services, including HIV testing and treatment, to adolescent girls aged 15-19. The Pooling Facility has raised $9.9m to repay the upfront funding only when specific outcomes linked to the improvement of adolescent health are achieved. The project will be implemented in ten counties across Kenya: Nairobi, Mombasa, Kisumu, Homa Bay, Bungoma, Migori, Kisii, Nyamira, Kakamega, and Busia, all of which experience a significant burden of adolescent pregnancy and HIV.
This concept builds on a successful DIB model previously implemented by the Children's Investment Fund Foundation (CIFF), FCDO, and Triggerise over an 18-month period from 2020 to 2022. During this first phase, the availability and uptake of SRH services among adolescents in Kenya were expanded, reaching a total of 362,000 girls with SRH services, far surpassing the target of 244,445. Notably, the number of repeat service visits exceeded the initial target by 262%, with a total of 118,058 girls receiving repeat visits against an initial target of 45,000.
2 Years
Pay-for-success programme
SRH & HIV
500,000 girls reached
Budget
$9.9m Budget

The Tiko platform

This DIB will be implemented using the Tiko platform, a free digital platform that connects adolescents to existing local private and public service providers. Through Tiko, adolescents gain access to free, youth-friendly SRH and HIV-related services.

1,000,000+
Services provided
990,000+
Girls enrolled
750,000+
Girls accessed services
122,000+
HIV services accessed
340+
Clinics and pharmacies
82%
Girls rated service positively

Expected impact

Sexual Reproductive Health Rights
Increased agency of adolescent girls to exercise their SRH rights
utilization of quality SRH & HIV information
Increased uptake of quality SRH and HIV information and services in the public sector
availability of public and private resources for ASRH and HIV services
Increased resources for SRH and HIV services
Reduction in new HIV infections among adolescents
Reduction in new adolescent HIV infections
Reduction in AIDS-related deaths among adolescents
Reduction in adolescent AIDS-related deaths
Reduction in adolescent pregnancies
Reduction in adolescent pregnancies
" The development impact bond is a unique approach to development financing that allows for a performance-based process of determining outcomes and results. Our goal is to reach over 500, 000 vulnerable adolescent girls with SRH and HIV services and contribute to the overall improvement of services in over 300 primary health facilities located in 10 high-burden counties in Kenya. "
UNFPA Kenya Representative Anders Thomsen
" This project will foster collaboration among stakeholders across the spectrum including the government, donor agencies, and the private sector and unlock additional external resources and financing that are critical to not only improving adolescent health outcomes but also the attainment of the sustainable development goals. "
UN Resident Coordinator in Kenya, Dr Stephen Jackson.

Our partners

Structuring of the Development Impact Bond

Structuring of the DIB
1: Design a programme model which is innovative, scalable and measurable
2A: Obtain an Outcome Funder, who provides funding to Pooling Facility
2B: Obtain a Social Investor, who prefinances the programme by providing funding to the Service Provider
3: The Service Provider delivers interventions and is assessed by the Independent Evaluator, based on pre-assigned targets defined in an M&E framework
4: The Independent Evaluator provides feedback to the Pooling Facility
5: The Pooling Facility pays the premium to the Social Investor, based on the results and using the outcome funding

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