Background Kenya’s policies on population, family planning (FP) and reproductive health (RH) often receive weak adherence. This undermines their implementation. The youth form the majority of the Kenyan population. The Adolescent RH and Development (ARH&D) policy, formulated in 2003, gives direction on meeting reproductive and developmental needs of the youth.

Methods The research done in June 2012, was hospital based, cross sectional, with qualitative and quantitative aspects. Research instruments included questionnaires, check lists and key informant interviews. The sample size comprised of 119 HCPs chosen randomly and 53 adolescent clients sampled purposively.

Data analysis was done using the statistical package of social scientists (SPSS) computer. Inferential statistics were done by chi square and Fisher’s exact to compare percentages and association between adherence to the ARH&D policy and HCP characteristics.

Results The HCP adherence rate to the ARH&D was 62.2% while the adolescent client RH service satisfaction was about 94%. Adherence was higher among HCPs that were younger (p = 0.005), Christians (p = 0.006), and those supervised frequently (p = 0.047). Severity of infibulation has reduced among the Somali but is still at grade 4 among the Malakote. Consanguineous marriages, drug addiction, poverty are common. HIV and AIDS and FP stigmatisation is high.

Conclusion Adherence to the ARH and D policy, which was about 60%, was influenced by frequency of staff supervision, religious affiliation and the age the HCPs. Client satisfaction level was about 34%.