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      Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania

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          Abstract

          Background

          Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students’ and teachers’ perceptions of the relevance of curriculum-based SRH education.

          Methods

          A qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed.

          Results

          The majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health.

          Conclusion

          Despite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs.

          Abstract

          Sexual and reproductive health (SRH) education integrated into school curricula has proven effective in addressing risky sexual behaviors (RSBs) among in-school adolescents. Adolescents attending secondary schools, are susceptible to RSBs such as early sexual activity, multiple partners, unprotected intercourse, and unsafe abortions, leading to adverse health outcomes such as teenage pregnancies and HIV/AIDS. Despite the integration of SRH education into secondary school syllabi, these behaviors are still evident among students. There is a lack of data on the impact and relevance of curriculum-based SRH education on RSBs. To explore the relevance and effectiveness of SRH education in addressing RSB patterns, in-depth interviews were conducted among secondary school students and civics and biology teachers focusing on their perceptions and practical outcomes of SRH education in reducing RSBs. After conducting a thematic content analysis three main themes were discovered: (1) Student’s understanding of curriculum-based SRH education in coping with RSBs (2), Perceptions of curriculum-based SRH education in coping with RSBs and (3) Utilizing curriculum-based SRH education in coping with RSBs. Majority of secondary school students (56%) had a limited understanding of SRH narrowed to aspects concerning married individuals and pregnancy. Teachers provided varying opinions regarding the efficacy of curriculum-based SRH education, with Civics instructors believing there is relevance while Biology teachers considered it limited. Students acknowledged using the available knowledge to address RSBs but expressed a desire for supplementary strategies to achieve a more thorough understanding of SRH. Improving the SRH education provided in schools will help reduce the consequences of RSBs.

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          Most cited references15

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          Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world.

          This paper reviews 83 studies that measure the impact of curriculum-based sex and HIV education programs on sexual behavior and mediating factors among youth under 25 years anywhere in the world. Two thirds of the programs significantly improved one or more sexual behaviors. The evidence is strong that programs do not hasten or increase sexual behavior but, instead, some programs delay or decrease sexual behaviors or increase condom or contraceptive use. Effective curricula commonly incorporated 17 characteristics that describe the curricula development; the goals, objectives, and teaching strategies of the curricula themselves; and their implementation. Programs were effective across a wide variety of countries, cultures, and groups of youth. Replications of studies also indicate that programs remain effective when implemented by others in different communities, provided all the activities are implemented as intended in similar settings.
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            Barriers to sexual reproductive health services and rights among young people in Mtwara district, Tanzania: a qualitative study

            Background In Tanzania over 1/3 of the population is under 24 years. Nationwide 23% of teenagers have started childbearing. However, Mtwara Region has the highest percentage (25.5%) of teenagers who begin childbearing early. Mtwara District has a teenage pregnancy rate of 11% with young people utilizing sexual reproductive health services (SRHS) less frequently than adults.This study aimed at gaining insights on barriers to the utilization of SRHS in Mtwara district. Methods A qualitative study was carried out using focus group discussions, facility assessment interviews and case studies. A total of nine focus group discussions (comprising 8 to10 persons per group) were conducted among girls (10-18 years), community leaders and adults. Data was transcribed using pattern matching methods then merged into relevant themes for analysis and interpretation. Results The study revealed that a good number of health facilities do not have skilled service providers (SPs) on sexual reproductive health rights. Girls start sexual intercourse between 9 and12 years. Services sought included; education, family planning and voluntary counseling and testing. However, the services were inaccessible due to lack of privacy, confidentiality, equipments and negative attitudes from SPs. Initiation ceremonies, early marriages and gender disparities were mentioned as social-cultural barriers to SRH rights. Conclusion This study has demonstrated that factors such as lack of youth friendly services, gender disparity and unfavorable socio-cultural practices may create barriers to accessing adolescent SRHS and rights. Therefore, there is a need to integrate youth friendly services in health facilities and advocate for behavior change.
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              Prevalence of self-reported symptoms of sexually transmitted infections, knowledge and sexual behaviour among youth in semi-rural Tanzania in the period of adolescent friendly health services strategy implementation

              Background Global evidence shows that sexually transmitted infections (STIs) prevalence and sexual risk behaviours are high among youth, and knowledge about STIs is low. In Tanzania, there is limited recent evidence regarding these issues. The aim of this study was to describe the health seeking behaviour of youth reporting STI symptoms in semi-rural Tanzania and to evaluate the association of socio-demographic characteristics, STI knowledge and sexual risk behaviour with STI symptom reporting. Methods This was a cross-sectional study involving 2251 sexually experienced youth (15–24 years), who participated in a larger baseline survey of a cohort within Ifakara town. Interview data were electronically collected by trained field workers. Logistic regression analysis was used to identify factors that influence the risk of reporting STI symptoms within the past year, using Stata 12.1. Results The prevalence of self-reported STI symptoms in the past year was 19.9%. Almost all of youth had heard of STIs and 32.7% of youth could mention at least one sign. 34.4% had sought care for their STI symptoms, the majority at private facilities. Only 20% of HIV-STI co-infected youth was aware of their HIV status. Youth with more knowledge of STI symptoms reported to have had symptoms more often (OR = 1.28; 95% CI 1.01–1.62), and those reporting having first sex at 16 or under were more likely to report STI symptoms than those who delayed to 17–19 years (OR 1.27; 95% CI 1.003–1.62). Conclusion These findings highlight the need to improve the implementation of Adolescent Friendly Health Services available in Tanzania (especially in semi-rural areas). The inclusion of private facilities and pharmacies in AFHS scale-up would potentially raise the level of STI knowledge, lower the STI prevalence and reduce HIV incidence among youth.
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                Author and article information

                Contributors
                ngngissa@gmail.com
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                29 April 2024
                29 April 2024
                2024
                : 21
                : 58
                Affiliations
                [1 ]Department of Clinical Research Program, National Institute for Medical Research, ( https://ror.org/05fjs7w98) Mwanza, Tanzania
                [2 ]Department of Physiology, Catholic University of Health and Allied Sciences, ( https://ror.org/015qmyq14) Mwanza, Tanzania
                [3 ]Department of Anthropology, University of Dar es Salaam, ( https://ror.org/0479aed98) Dar es Salaam, Tanzania
                Article
                1798
                10.1186/s12978-024-01798-x
                11059714
                38685069
                54514f46-494a-420c-b89d-629c6f2c0413
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 February 2024
                : 20 April 2024
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                © BioMed Central Ltd., part of Springer Nature 2024

                Obstetrics & Gynecology
                curriculum-based sexual and reproductive health,risky sexual behaviors,secondary school students,relevance,tanzania

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