Acceptability of youth clubs focusing on comprehensive sexual and reproductive health education in rural Zambian schools: a case of Central Province

Abstract

Background: The youths in Zambia have limited access to information concerning Sexual Reproductive Health (SRH) and this puts them at risk of unwanted pregnancies. Talking about other methods of preventing pregnancy or sexually transmitted infections than abstinence is regarded as culturally unacceptable. The Research Initiative to Support the Empowerment of Girls (RISE) is a cluster randomised controlled trial testing the effectiveness of different support packages on teenage pregnancies, early marriages and school drop-out rates. One of the support packages included youth clubs focusing on Comprehensive Sexual and Reproductive Health Education (CSRHE). Although similar interventions have been implemented in other settings, their integration process has been complex and comprehensive assessments of factors shaping acceptability of CSRHE are lacking. This article qualitatively aimed at identifying factors that shaped the acceptability of CSRHE youth clubs in rural schools in Central Province. Method: A qualitative case study was conducted after the youth clubs had been running for a year. Data were gathered through eight focus group discussions with grade eight pupils and eight individual interviews with teachers. Data were analysed using thematic analysis. Results: The perceived advantage and simplicity of the clubs related to the use of participatory learning methods, films and role plays to communicate sensitive reproductive health information made the learners like the youth clubs. Further, the perceived compatibility of the content of the sessions with the science curriculum increased the learners' interest in the youth clubs as the meetings also helped them to prepare for the school examinations. However, cultural and religious beliefs among teachers and parents regarding the use of contraceptives complicated the delivery of reproductive health messages and the acceptability of youth clubs' information among the learners. Conclusion: The study indicated that CSRHE youth clubs may be acceptable in rural schools if participatory learning methods are used and head-teachers, teachers as well as parents appreciate and support the clubs.

A decade of Acceptability Research with Adolescents in Africa: Systematic review and evidence map

“…The supplementary table S2 provides information on study characteristics and overall findings for the entire list of eligible studies, and by each type of intervention category (as indicated below) in separate sheets. Most (41) study samples included male and female participants, while 11 studies worked only with females and three with males only. 44 studies worked with samples that fell entirely within the specified age range (10-24), while 11 included studies worked with broader samples (e.g., youth and adults) but disaggregated the results and reported findings specifically for the age group of interest.…”

“…While our inclusion criteria focused on primary acceptability research with adolescents and young adults, it should be noted that 25 studies also collected acceptability data from other stakeholders. These include caregivers or other family members (32-40), teachers, facilitators (26, 41, 42), community leaders or gate keepers, (28, 43), peer mentors, service providers and healthcare workers (29, 44-51).…”

Girl Champ in eSwatini: A Strategic Marketing Campaign to Promote Demand for Sexual and Reproductive Health Services Among Young Women

“…The value of engaging community leadership and participatory intervention development is well-known in promoting HIV and sexual health services, and Girl Champ illustrated the critical role such leadership can play in disseminating health communication campaigns to adolescents [58][59][60]. In particular, schools play an important role in youth lives and sexual and reproductive health, as a venue for accessing services, information, and support [61][62][63][64][65][66][67][68].…”

Effectiveness of school-based interventions in delaying sexual debut among adolescents in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

“…For instance, schools are being targeted as sites for provision of ageappropriate comprehensive sexuality education that facilitates improved self-efficacy, knowledge and life skills. [37][38][39] Other related school-based interventions such as school fees waivers, supply of menstrual products for girls, school feeding programmes for vulnerable populations are also being implemented. 40 41 However, impact evaluations of school-based interventions on delaying sexual debut suggest mixed findings.…”