Combining photo-elicitation and discourse analysis to examine adolescents’ sexuality in rural Zambia

Abstract

Introduction This article aimed to analyse constructions of adolescents’ sexualities and sexual health and the consequences of these discourses for adolescents’ exercise of their sexual reproductive health and rights (SRHR) in rural Zambia. Methods Interpretative repertoires, which is rooted in discursive psychology was used to analyse data from photo-elicitations interviews and focus group discussions. Our participants included 25 adolescents who participated in a SRHR intervention that aimed to reduce adolescents’ pregnancies and early marriages. Results We identified three interpretative repertories: 1) sex is for mature people in which adolescents positioned themselves as ‘immature, and young to engage in sex; 2) gendered respectful behaviours in which what was considered disrespectful (and respectful) behaviour in relation to sexuality were strongly influenced by gender, and more clearly defined for girls than it was for boys. Sexuality was not only about individual choices but about being respectful to parents; and 3) acquiring and using knowledge about sexuality in which adolescents conflicted between having and applying SRHR knowledge. Conclusion These repertories offer an important context that shape how adolescents negotiate, adopt and resist SRHR interventions. Future interventions that target adolescents’ SRHR must aim to address the sexual scripts that serve to erect barriers against positive sexual behaviours, including access to SRHR services that promote safer sex.

Specifying implementation strategies used in delivering services for HIV, gender-based violence and sexual and reproductive health to adolescent girls and young women in community health systems in Zambia

“…These ndings are in line with other studies in Zambia, which have shown that many social cultural factors affect the ability of adolescents and young people to seek SRH services(9, 10, 14, 46, 47). To enhance implementation and reduce further marginalization of AGYW, it is important to uncover wider structural systems that worsen inequalities in implementation processes (10). Thus, it is vital to adopt a critical perspective during implementation processes, as it facilitates analysis or recognition of injustices they may have internalized as 'natural' (25).…”

“…AGYW in Zambia continue to experience several HIV, SRH, and GBV challenges (9). For instance, teenage pregnancy has been consistently high: 29.0% in the two most recent rounds of the Demogaphic and Health Surveys 2013-2014 and 2018 (10,11). In 2021, 5.9% of young women and 1.8% of young men aged 20-24 years were living with HIV (12,13).…”

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

“…Hence involvement of CBHWs is key to ensure that they comprehensively deliver these services to young people [ 6 ]. Adolescent and young people may also not be comfortable and freely discuss SRHR with any of these facilitators due to the social scripts and discourses sounding adolescent sexuality in Zambian [ 7 ]. Adolescent with a history of child pregnancy, marriages and abuse may feel stigmatized to social values [ 22 ].…”

“…Implementation of CSE in both schools and communities has not been without challenges. Firstly, engagement of parents and stakeholders has been limited, impacted by resistance, and normative discourses that un-married adolescents are too young to discuss sexual related issues [ 6 , 7 ]. Adolescents especially girls in Zambia still face challenges early marriages, pregnancy, and school dropout.…”

Conducting research with young people at the margins – lessons learnt and shared through case studies in Cambodia, India, Sweden and Zambia

“…Both the qualitative (textual) and visual data were analysed using the analytical approach of interpretative repertoires, which is rooted in discursive psychology [ 32 ]. After analysing constructions of young people’s sexualities and sexual health and the consequences of these discourses for young people exercising their sexual and reproductive rights, the results were published in a peer-reviewed journal [ 33 ].…”