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Experiences of teachers and community-based health workers in addressing adolescents’ sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia
Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, Zambia.
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, Zambia.
Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, Zambia.
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Department of Health Policy and Education, School of Public Health, University of Zambia, Lusaka, Zambia.ORCID-id: 0000-0003-1189-7194
2023 (Engelska)Ingår i: BMC Public Health, E-ISSN 1471-2458, Vol. 23, nr 1, artikel-id 335Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Adolescents in low-and-middle-income countries like Zambia face a high burden of sexual, reproductive, health and rights problems including coerced sex, teenage pregnancies, and early marriages. The Zambia government through Ministry of Education has integrated comprehensive sexuality education (CSE) in the education and school system to contribute towards addressing Adolescents sexual, reproductive, health and rights (ASRHR) problems. This paper sought to explore teachers and community based health workers (CBHWs)’ experiences in addressing ASRHR problems in in rural health systems in Zambia.

Methodology: The study was conducted under Research Initiative to Support the Empowerment of Girls (RISE) community randomized trial that aims to measure the effectiveness of economic and community interventions in reducing early marriages, teenage pregnancies, and school dropout in Zambia. We conducted qualitative 21 in-depth interviews with teachers and CBHWs involved in the implementation of CSE in communities. Thematic analysis was used to analyse teachers and CBHWs´ roles, challenges, and opportunities in promoting ASRHR services.

Results: The study identified teachers and CBHWs roles, and challenges experienced in promoting ASRHR and suggested strategies to enhance delivery of the intervention. The role of teachers and CBHWs in addressing ASRHR problems included mobilizing and sensitizing the community for meetings, providing SRHR counseling services to both adolescents and guardians, and strengthening referral to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of the boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution.

Conclusion: This study provides significant insight on the important roles that teachers CBHWs can play in addressing adolescents SRHR related problems. Overall, the study emphasizes the need to fully engage adolescents in addressing adolescents SRHR problems.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2023. Vol. 23, nr 1, artikel-id 335
Nyckelord [en]
Comprehensive Sexuality Education, Reproductive Health, Rights, RISE, Rural health systems, Sexual
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-205179DOI: 10.1186/s12889-023-15199-5ISI: 000934877600010PubMedID: 36793027Scopus ID: 2-s2.0-85148114600OAI: oai:DiVA.org:umu-205179DiVA, id: diva2:1739942
Tillgänglig från: 2023-02-28 Skapad: 2023-02-28 Senast uppdaterad: 2023-09-05Bibliografiskt granskad

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Mulubwa, ChamaMalizgani, Chavula Paul

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