Impact of Timing of Sex Education on Teenage Pregnancy in Nigeria: Cross-sectional Survey of Secondary School Students

Abstract

The objective of this study was to explore whether the time at which sex education was provided had any impact on reported cases of unintended pregnancies. A cross-sectional survey of secondary school students and their teachers was conducted using self-administered questionnaires. The participants were 1,234 students aged 14-17 years and 46 teachers in 5 secondary schools in South Eastern Nigeria. The outcome measures were reported pregnancies within the last 3 years by type of school and class level; class level at the time of receiving sex education at school; and age at the time of receiving sex education at home. In all schools, sex education was provided at all the junior and senior secondary school levels (JSS and SSS, respectively). Overall, reported cases of unintended pregnancies were highest among the junior students. In the private schools, four in ten teachers reported pregnancies among JSS 3 students. Almost four in ten teachers in public schools reported pregnancies among JSS 2 students. Of all the students, about three in ten reported pregnancies among JSS 2 and 3 students respectively. At home, sex education was provided at the mean age of 16 years (SD ± 2.2). All participants cited financial need and marital promise as major predisposing factors. About four in ten students did not use contraceptives during their first sexual experience. This study highlights the need to introduce sex education much earlier, possibly before the JSS levels. At home, sex education may have greater impact if provided before the age of 14 years. Efforts should be made to address the factors predisposing to teenage pregnancy.

Predictors of pregnancy among young people in sub-Saharan Africa: a systematic review and narrative synthesis

“…In another study from Ghana, 74.6% of girls who were highly resilient to pregnancy cited their parents as a source of social support compared with 38.6% of low-resilience girls 36. Family instability, breakdown and parental divorce were cited as predictors in three of the studies 30 31 38. In a study in Ethiopia, respondents whose parents lived together had lesser odds of having sexual activities than those with divorced or separated parents 38.…”

“…In a South African study, lack of employment and job opportunities was found to be associated with teenage pregnancy 33. Sexual abuse and rape were cited as a predictor in three of the studies 29 31 32. In a Tanzanian study, girls reported rape as a cause for concern 29…”

“…Sexual coercion or pressure from male partners was cited as a predictor of teenage pregnancy in 6 of the 15 studies 26–31. In one study conducted in South Africa, pressure from one’s partner to not use contraceptives or to have a baby was stated by numerous young women as the reason why they became pregnant as an adolescent 28.…”

“…In another study, teenage girls engaged in sexual relations with men in exchange for gifts and money or due to relentless pressure from the man to have sex 29. Peer influence and the need to maintain one’s social status among peers was cited as a predictor in four of the studies 26 27 30 31. In one study, teenage mothers cited trying to fit in with friends as a reason for engaging in sexual activity 26.…”

“…In one study, teenage mothers cited trying to fit in with friends as a reason for engaging in sexual activity 26. In a Nigerian study, girls cited pressure from peers to get married as a contributor to teenage pregnancy 31…”