Beyond medical care: Dandora Youth Friendly Center, a safe space for young people from Nairobi's disadvantaged neighborhoods

Unassuming from the streets of Eastlands area of Nairobi, the Dandora 2 Public Health Center harbors a hidden treasure. Beyond a small green gate lies the bustling activity of the Youth Friendly Center, a collaborative project between the Nairobi County Department of Health and Médecins Sans Frontières (MSF). MSF provides human resources, expertise, medical supplies, and works with the public health center for referrals and sensitization on youth friendly service delivery.

Established in 2021, the Dandora Youth Friendly Center serves as a safe space for young people between ages 10 to 24, offering more than just medical care. This vulnerable population grapples with urban violence, substance abuse, and socio-economic challenges such as unemployment and poverty. "Safe spaces enable you to express yourself freely without fear of contradiction, intimidation, coercion or anything else,” explains Daniel Katavi, one of the youths benefiting from the center’s services.

Operating seven days a week, with Sundays reserved for targeted activities for specific vulnerable groups, the center provides both medical and psycho-social services alongside recreational facilities. The medical side consists of two medical consultation rooms and a psychologist’s room, with services provided by nurses, a psychologist, a social worker, and community health educators.

In 2023 alone, the youth center team provided 5,316 medical service consultations including mental health consultations, with 21,661 youth having accessed the social and recreational services. The heath care services focus on sexual and reproductive health (SRH) including family planning services, HIV prevention, counselling and testing with linkage to care, antenatal care, post- abortion care, treatment for sexually transmitted infections, care for sexual and gender-based violence survivors, and mental health -psychosocial counselling and referral.

Beyond medical care, the youth center offers a wide range of social support services such as health educational talks, life skills and mentorship training, career development training, computer classes, library services, pool table, board games and linkages to other organizations.

A main pillar of the center is the participatory approach in designing and delivering the services, in which the youth have vital role in advising the management through continuous dialogue and feedback. “If we bring our own solutions, it cannot be sustainable. Youth are creative and able to find solutions to their issues. We ensure they are actively involved in the planning and implementation of the activities.” Claire Lungahi, a community health educator at the center who oversees these activities asserts.

Parents also get involved in bringing their children to the center. “I trust the information here. I know my twelve-year-old son receives health education when he comes to the clinic. He comes to study and uses the library services," Purity Toyo, a parent to a youth explains.

“I believe that youth should be taught the truth on sexual reproductive health and gender-based violence, since we know that they are susceptible to abuse and violence. I believe he may be more open to speak about issues he goes through with the health care workers in the clinic than with me sometimes.”

Purity, who became a mother at 15 years old, recognises the importance of comprehensive sexual reproductive health education for youth. “I want my son to do better. I have introduced more young people to the youth center as it has a positive influence on them, especially during school holidays, to keep them engaged. They also have an opportunity to find health services while at the clinic.” She affirms.

For young key populations and vulnerable groups like domestic workers, the center’s Sunday sessions are set to accommodate their specific health needs. “As domestic workers, we work from Monday to Saturday, and getting permission within the week is a hurdle. Having a set day on Sundays allows us to access the services quickly when we come to the hospital,” says Sylvia Wambui, a domestic worker.

MSF works with other organizations like the Initiators of Common Awareness (ICA), a youth group based in Dandora, that seeks to enhance mental health care messaging to young people and link them to services. “Youth in Dandora go through many challenges like unemployment, poor sanitation conditions and other social challenges. Our intent is to ensure we find ways to overcome these and link our peers to a psychologist,” says Matthew Ogoti, ICA chairperson.

Despite its modest size, the center behind the green gate has become a familiar place for the youths, addressing their unique needs and significantly impacting their lives by reducing barriers to healthcare access.