Evaluation of a School-Based Reproductive Health Education Program in Rural South Western, Nigeria

Abstract

This quasi-experimental study compared the relative efficacy of teacher instructions alone, peer education alone, and a combination of these two on reproductive health knowledge, attitude, perceived self-efficacy and sexual practices among secondary schools students in the Ibarapa district of Southwestern Nigeria. A baseline questionnaire was administered to a systematic sample of students in four schools that were randomized into four treatment arms: teacher instructions alone (E1), peer education alone (E2), combination of teacher instruction and peer education (E3), and control. The results were used to design the contents of the interventions, which were implemented for one academic session. A follow-up survey using the same sampling procedures as baseline was conducted to measure the outcome of the intervention. The control group had superior reproductive health knowledge at baseline. By follow-up survey however, all three intervention schools showed significant knowledge gains, while the control school students' mean score increased slightly. Increase in knowledge was greatest among E3 (+5.0 points), followed by E2 (+3.4), E1 (+1.4) and C (0.3). The intervention schools showed a significant positive shift in attitude towards use of contraceptives with mean increase of 0.6, 0.5, and 0.9 points in E1, E2 and E3 respectively. Scores that measured the students' perceived self-efficacy for safe sex increased significantly among E1 (from 10.8 to 11.8) and E3 (from 10.4 to 12.6). Reported condom use was significantly higher among E2 (from 16.7 % to 62.8%) (p<0.05) and E3 (from 22.8% to 53%) (p<0.05) compared to E1 (28.6% to 47.4%) (p>0.05) and control (from 25% to 45.8%) (p>0.05). Overall, the students from E3 showed more improvement in knowledge, attitude and self-efficacy, than their counterparts from E2 and E3 and control. RÉSUMÉEvaluation d'un programme de l'éducation de la santé de reproduction basé sur l'école au sud-ouest rural, Nigéria Cette etude quasi-expérimental a comparé efficacité relative de seules les instructions de l'enseignant, l'éducation de pairs uniquement et une combinaison des deux sur la connaissance de la santé de reproduction, l'attitude, l'auto-efficacité perçue et les pratiques sexuelles parmi les étudiants de secondaire dans le district d'Ibarapa au sud ouest de Nigéria. Un questionnaire de ligne de base a été administré à un échantillon systématique d'étudiants dans quatre écoles réparties en quatre bras de traitement: seule les instructions de l'enseignement (E1), seule l'éducation des pairs (E2) la combination de l'instruction de l'enseignant et l'éducation des pairs (E3) et le témoin. On a dessiné le contenu des interventions à partir des résultats. Les interventions ont été mises en application pendant une année scolaire. Une enquête de suivi a été menée à l'aide des mêmes modalitiés de prélèvement que la ligne de base pour évaluer le résultat de l'intervention. Le groupe témoin avait une connaissance supérieure de la santé sur la ligne de base. A travers l'enqête de su...

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