Addressing Learner-Centred Barriers to Sexuality Education in Rural Areas of South Africa: Learners' Perspectives on Promoting Sexual Health Outcomes

Learners' perspectives on the prevention and management of pregnancy school dropout: a Namibian case

Background

Namibia has had a problem with the high rate of learner pregnancy and school dropout for many years, despite implementing education sector policy on preventing and managing learner pregnancy. This study aimed to explore the perspectives of school-going learners in Namibia regarding the factors contributing to learner pregnancy and school dropout and propose interventions to address them.

Methods

This qualitative research employed interpretative phenomenological data analysis, with seventeen individual and ten focus group interviews involving 63 school-going learners: adolescents, pregnant learners, and learner parents.

Results and findings

Emerging factors driving learner pregnancy and school dropout in rural Namibian schools include older men and cattle herders preying on young girls, long school holidays, the proximity of alcohol sites near school premises, and age restrictions after maternity leave. The learners proposed interventions include prohibiting learners' access to alcohol establishments, strengthening collaborations between stakeholders, sensitizing girls and cattle herders, and ongoing advocacy efforts. Findings indicate community hostility, lack of infrastructure and resources, and learner unawareness. It is essential to mitigate community hostility and raise awareness. Incorporating the perspectives of learners in policy interventions remains crucial for effectively addressing the high rates of learner pregnancy and school dropout in rural Namibian schools.

Exploring quality standards implementation at a South African municipality's health facilities

BACKGROUND

 Despite government initiatives to ensure the delivery of safe and high-quality care in health establishments, most health establishments in the City of Tshwane Metropolitan Municipality, South Africa were non-compliant with the National Core Standards. This study explored the experiences of quality assurance managers regarding quality standards implementation in these establishments.

OBJECTIVES

 This study aimed to explore and describe factors affecting the implementation of quality standards at public health facilities based on quality assurance managers' lived experiences in the research setting.

METHOD

 This qualitative study used phenomenological design by conducting individual in-depth interviews with nine purposively selected quality assurance managers in 2021. The collected data were analysed using Colaizzi's phenomenological analysis framework.

RESULTS

 The study's findings revealed that the legislative framework and the policy environment were motivators for quality standard compliance among the participants. Furthermore, human resources, materials-related issues and poor infrastructure were found to be barriers to the implementation of quality standards in health facilities.

CONCLUSION

 The explored and described barriers must be addressed to improve compliance with the National Core Standards at public health facilities in the City of Tshwane Metropolitan Municipality. In addition, capacity-building for quality assurance managers should be ongoing to ensure the highest quality implementation standards and to strengthen the enforcement of quality standard regulations.Contribution: The study's findings explored and described the factors that influence the implementation of quality standards. Addressing these factors could improve the quality of healthcare delivery in the research setting's health facilities.

Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review

BACKGROUND

Comprehensive sexuality education (CSE) plays a critical role in promoting youth and adolescent's sexual and reproductive health and wellbeing. However, little is known about the enablers and barriers affecting the integration of CSE into educational programmes. The aim of this review is to explore positive and negative factors influencing the integration of CSE into national curricula and educational systems in low- and middle-income countries.

METHODS

We conducted a systematic literature review (January 2010 to August 2022). The results accord with the Preferred Reporting Items for Systematic Reviews and Meta-analysis standards for systematic reviews. Data were retrieved from the PubMed, Cochrane, Google Scholar, and Web of Hinari databases. The search yielded 442 publications, of which 34 met the inclusion criteria for full-text screening. The review is guided by an established conceptual framework that incorporates the integration of health innovations into health systems. Data were analysed using a thematic synthesis approach.

RESULTS

The magnitude of the problem is evidenced by sexual and reproductive health challenges such as high teenage pregnancies, early marriages, and sexually transmitted infections. Awareness of these challenges can facilitate the development of interventions and the implementation and integration of CSE. Reported aspects of the interventions include core CSE content, delivery methods, training materials and resources, and various teacher-training factors. Reasons for adoption include perceived benefits of CSE, experiences and characteristics of both teachers and learners, and religious, social and cultural factors. Broad system characteristics include strengthening links between schools and health facilities, school and community-based collaboration, coordination of CSE implementation, and the monitoring and evaluation of CSE. Ultimately, the availability of resources, national policies and laws, international agendas, and political commitment will impact upon the extent and level of integration.

CONCLUSION

Social, economic, cultural, political, legal, and financial contextual factors influence the implementation and integration of CSE into national curricula and educational systems. Stakeholder collaboration and involvement in the design and appropriateness of interventions is critical.