The media as a critical determinant of the sexual and reproductive health of adolescents in Ibadan, Nigeria

Familiarity with the internet and health apps, and specific topic needs are amongst the factors that influence how online health information is used for health decisions amongst adolescents

BACKGROUND

Many adolescents believe that online health information is reliable, particularly when they are familiar with the source of information.

OBJECTIVE

To analyse the degree of influence of online health information on high school students' health decisions and examine whether socio-demographic characteristics, digital literacy, use of different websites and interest in specific health topics are associated with a stronger influence of online health information on adolescents' health-related decisions.

METHODS

Participants were students from four public high schools in Belgrade, Serbia. Socio-demographic and behavioural questionnaire as well as the e-health literacy scale (eHEALS) were used to collect data.

RESULTS

The study sample comprised 702 students. A total of 79.6% of students reported that online health information influenced their health decisions to a certain extent (from 'a little' to 'a lot'). Being a boy, using the internet since younger age, better self-perceived e-health literacy, using health apps, Google, health forums, websites of health institutions, social media and YouTube, being interested in diet/nutrition, sexually transmitted infections and cigarettes were the characteristics associated with a stronger influence of online health information on students' health decisions.

CONCLUSION

This study provides clues about how online health-related information can be used to adjust and enhance health promotion amongst adolescents.

Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis

Introduction

Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia.

Methods

A community-based cross-sectional study involved 1172 adolescents selected through stratified sampling. Structured face-to-face interviews were employed for data collection. Multilevel mixed logistic regression was fitted to identify factors and latent class analysis was conducted to understand population heterogeneity.

Results

The findings of this study reveal that 198 (16.89%) adolescents (95% CI: 14.8%-19.2%) utilized SRH services within the past 12 months. Factors significantly associated with SRH service utilization included good knowledge about SRH rights (AOR = 4.65; 95% CI: 2.68, 8.07), belonging to one-parent families (AOR = 4.13; 95% CI: 2.39, 7.12), engaging in parental discussions regarding SRH issues (AOR = 3.17; 95% CI: 1.89, 5.29), high family support (AOR = 1.96; 95% CI: 1.09, 3.51), and enrolling in school (AOR = 0.19; 95% CI: 0.11, 0.33). Additionally, access to social media was associated with increased SRH service utilization among adolescents (AOR = 1.98; 95% CI: 1.25, 3.15). Latent class analysis identified four groups: rural school-enrolled adolescents living with parents, urban school-enrolled adolescents with both parents, urban disadvantaged female adolescents, and early adolescents with limited social media access.

Conclusions

In conclusion, our study sheds light on the utilization of SRH services among adolescents, revealing that 16.89% of the participants accessed these services within the past year. Significant factors associated with SRH service utilization included good knowledge about SRH rights, belonging to one-parent families, engaging in parental discussions regarding SRH issues, high family support, and enrollment in school. Interestingly, access to social media was also linked to increased utilization of SRH services among adolescents. Furthermore, our latent class analysis identified four distinct classes of adolescents based on socio-demographic indicators, highlighting the heterogeneity within this population. These findings underscore the importance of tailored interventions and targeted approaches to address the diverse needs of adolescents in accessing and utilizing SRH services.

Knowledge and attitude of sex education among secondary school students in south-western Nigeria: A cross-sectional study

Sex education helps in preparing adolescents to have responsible attitudes and behaviour towards sex for a harmonious sexual life. This study assessed the level of knowledge and attitude towards sex education among secondary school students in an urban south-western Nigeria. The study adopted a descriptive cross-sectional design. Multistage sampling technique was used to select a sample size of 378 students from a population of 3674 students in public secondary schools. A pre-tested self-administered questionnaire with Cronbach' Alpha value of 0.76 was used for data collection. The approval of the study was obtained from the Human Research Ethics Committee of Lagos University Teaching Hospital. Data were analyzed using SPSS version 20. Chi-square test and multiple logistic regression were used for test of association among the variables at p < 0.05. Majority of the respondents 338 (89.9%) were between age 14-17 with mean age of 16 ± 5.22 years. Majority of the respondents 309 (82.1%) had a good knowledge of sex education. More than half, 216 (57.5%) of the respondents had positive attitude towards sex education. There was a significant relationship between knowledge and attitude of the respondents towards sex education (p = 0.01). Knowledge of sex education increases as class of students increases to SS2 = (OR = 7.750; 95% CI [3.268-18.378] and SS3 = (OR = 2.219; 95% CI [1.067-4.613] respectively. The study concluded that the respondents had good knowledge of sex education and there was a significant relationship between students' knowledge and attitude towards sex education. There is need for awareness and effective sex education among secondary school students. Teachers and parents should create the view of improving the attitude of secondary school students towards sex education.

Adolescents' Perceptions About Dating and Sexual Permissiveness in Ebonyi State, Nigeria: What Can Be Done to Enhance Adolescents' Sexual Health and Well-Being

Introduction: Adolescent sexual and reproductive health (SRH) issues constitute key health concerns as some adolescents are directly or indirectly involved in sexual engagements, with increased risks and health consequences. The study aims to explore adolescents' perceptions about dating and permissive sexual behaviors which will contribute to designing sexual and reproductive health interventions. This paper adds to knowledge on adolescents' perceptions about dating, pre-marital, casual, transactional and age-disparate sex in southeastern, Nigeria.

Methods: A qualitative study was undertaken in the three senatorial zones of Ebonyi state, south eastern Nigeria. The study population comprised unmarried in- and out-of-school adolescents aged 13–18 years. Data were collected using a pre-tested focus group discussion (FGD) guide. There were six FGDs for boys and six FGDs for girls. A thematic framework approach was used for data analysis.

Results: Adolescents' views about dating and other sexual behaviors were varied. The dominant view is that hugging, touching and kissing are inappropriate for unmarried adolescents. Similarly, pre-marital, casual, transactional, and age-disparate sex were viewed as unacceptable. However, some adolescents perceived pre-marital abstinence as a hindrance to the attainment of sexual satisfaction and reproductive capacity in marriage. Some boys and girls indicated that casual sex is good, because it enables girls from poor homes to socialize with more privileged boys/men, and that such relationships could lead to marriage. Some considered transactional and age-disparate sex as a means of survival from poverty and unemployment. Boys were more permissive in their views about sexual behaviors compared to the girls.

Conclusion: Adolescents' perceptions of sexual behaviors as acceptable/unacceptable vary and are gendered. This should be considered in designing innovative strategies to improve adolescents' sexual health and well-being.

“Antibiotics Can Work as a Contraceptive:” Contraceptive Knowledge and Use Among University Students in Calabar, Nigeria

Introduction: Many sexually active youths who wish to delay pregnancy are not using any form of modern contraceptives. In sub-Saharan Africa, less than 1 in 5 sexually active youth do not use contraceptives. In Nigeria, 48.4% of all sexually active unmarried women have an unmet need for contraception. Although the literature is replete with information on structural barriers to modern contraceptives, there is limited scholarship on contextual factors that may inhibit modern contraceptive use among Nigerian youth. This study uses a qualitative research approach to assess knowledge and use of natural, modern, and folkloric contraceptive methods among a sample of university students in Calabar, Nigeria.

Methods: This study used data from focus group discussions among women and men in university halls of residence, all of whom were unmarried. Also, three male pharmacists and three female community health workers were interviewed. All focus group discussions and interviews took place in August 2017 and were conducted in Calabar Metropolis, Cross River State, Nigeria. The audio recordings were transcribed into detailed summaries of the interviews and focus group discussions. All data analysis was completed using Atlas.Ti (version 8).

Results: University men and women have limited knowledge of and application of natural and modern contraception. Participants listed folkloric methods of contraceptives, including repurposing pharmaceuticals (e.g., antibiotics, quinine, and Andrews Livers Salt-a laxative) as contraceptive agents. Respondents also discussed the use of non-pharmaceuticals such as water, salt solution, and squatting after intercourse as contraceptives. Generally, university students defaulted to withdrawal, calendar method, and emergency contraceptives as preferred methods of contraception. Lastly, condoms were used among participants in causal sexual encounters. In dating relationships, however, both male and female students cited their partners' hesitancy to condom use as such act could indicate distrust.

Conclusion: Awareness and use of modern contraceptives are limited among university students in Calabar, Nigeria. The use of folkloric contraceptives could lead to bodily harm and unintended pregnancy. Further research is needed to elucidate factors that promote use of folkloric methods of contraceptives. Integration of contraceptive awareness into health promotion services for young people may help to dispel myths about folkloric methods of contraceptives while promoting awareness and use of safe and effective contraception.

Why medical journalism wins public health journalism: systems thinking recommendations for health-promoting media

Purpose

Health-related issues are widely covered in news agencies by medical and health journalists. The quantity, format and quality of their coverage influence the general public as well as policymakers and professions. Current studies and observations suggest that news agencies are more dominated by medical topics (disease, symptoms, epidemiology, treatment and medicines) than general public health issues (risk prevention, health protection, education and promotion). This study explores the causes of the current situation in Iran and generates solutions for supporting health-promoting media that may also prove beneficial for other countries.

Design/methodology/approach

A qualitative study was conducted to explore the coverage of health-related topics in selected news agencies. Stakeholders, including health journalists, health professionals and public relations staff at the Iranian Ministry of Health and Medical Education were interviewed. Data were collected until data saturation was reached. The transcripts of all the 17 interviews conducted were analyzed using conventional content analysis.

Findings

Four groups of causes were identified, including individual factors, organizational factors, socioeconomic factors and the different nature of medicine and public health. The participants proposed several solutions that were classified into three categories, including the empowerment of stakeholders through capacity development, organizational change and mutual communication and culture change.

Originality/value

Creating health-promoting media is a complex but urgent task, and providing a comprehensive and deep understanding of the dynamic interdependencies of the multiple factors at play in it and developing and implementing the most effective interventions for it requires a systematic approach.

Access to Adolescent Pregnancy Prevention Information and Services in Ghana: A Community-Based Case-Control Study

Background: Pregnancy among girls 10-19 years remains a challenge that requires critical resolution all over the world. Despite this worrying sexual phenomenon, research pertaining to prevention information and related services in Sub-Saharan nations like Ghana is sparse. This study sought to determine the influence of access to pregnancy prevention information and services on adolescent pregnancy in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana. Methods and Results: Adopting a matched case-control research design with a 1:1 mapping, female adolescents aged between 15 and 19 years in the KEEA Municipality were selected using a facility based sampling technique. Results from both bivariate and multivariate analyses revealed that non-pregnant adolescents were about two times more likely to have access to pregnancy prevention information from health workers compared to pregnant adolescents [OR = 0.57, 95% CI = (0.33-0.96), p = 0.036]. Likewise, pregnant adolescents were five times more likely to have access to pregnancy prevention information from media compared to non-pregnant adolescents [OR = 5.44, 95% CI = (2.64-11.23), p = 0.000]. Additionally, non-pregnant adolescents were two times more likely to receive information on pregnancy prevention from school compared to pregnant adolescents [OR = 0.48, 95% CI = (0.28-0.81), p = 0.006]. Conclusion: Sexuality and reproductive health (SRH) programme organizers should target specific intervention programmes that focus on training health workers and/or other analogous staff to enhance their awareness, attitudes, and skills to more effectively meet with the specific needs of adolescents. Specific health workers training and redesign of health facilities to foster more adolescent user friendly working environment (e.g., extension in operational times, reduction in fees of SRH services, transforming physical design to promote privacy or confidentiality) ought to be encouraged. Different media outreach programmes should also combine other community level events [e.g., informative methods through schools (e.g., focus group discussions, participatory learning), assisting connections to health services, community information network (e.g., use of sirens)] to provide well-tailored advocacy that would help modify SRH and sociocultural norms that hinder positive sexual behaviors among young people.

Gender disparities in the experience, effects and reporting of electronic aggression among secondary school students in Nigeria

Background

Electronic aggression is the use of electronic communication technologies to harass others. It is a problem among adolescents and young people worldwide. There is a dearth of information on this problem in developing countries in spite of the increasing use of electronic media technology in these countries.

Objective

To explore gender differences in the prevalence, effects and reporting of electronic aggression among secondary school students in Oyo state, Nigeria.

Methods

A cross-sectional study was conducted using mixed methods (a quantitative survey of 653 students and 18 in-depth interviews with victims and/or perpetrators). Survey students were selected using multi-stage sampling and in-depth interviewees were selected purposively. History of electronic aggression (as a perpetrator and/or victim) in the 3 months preceding the study was obtained. Respondents also provided information on the effects of the last incident of bullying on them and whether or not they reported this incident.

Results

25.8% of males and 22.1% of females had perpetrated electronic aggression, while 42.7% of females were victims compared to 36.8% of males. More females (58.1%) than males (40.3%) perpetrated electronic aggression via phone calls and more males (33.8%) than females (22.6%) perpetrated electronic aggression via chatrooms. 45.4% of male victims and 39.4% of female victims felt angry following the last cyberbully incident. Findings from the in-depth interviewees corroborated the survey findings and a male victim reported feeling very sad and even tried to stay away from school following repeated episodes of electronic aggression. More female (59.1%) than male (42.7%) victims reported the incident to someone (p=0.035).

Conclusions

Incidents of electronic aggression were common and the experiences of male and female students were comparable, although more female victims reported the incidents they had experienced. Victims, especially males, should be encouraged to report incidents so that the relevant authorities can institute interventions to address the problem.

Using photovoice in adolescent health research: a case-study of the Well-being of Adolescents in Vulnerable Environments (WAVE) Study in Ibadan, Nigeria

Photovoice is a participatory action research method in which people are given cameras and asked to take pictures of specific issues within their community. It is often used among marginalised populations. This method helps people capture specific issues within their community using photographs, critically discuss these issues within a group and present their findings to inform policies within their community. Photovoice has been used in developed countries and among adult participants; however, the extent to which it has been used in developing countries and among adolescent participants is yet to be extensively reported. In this paper, we describe the use of photovoice among male and female adolescents aged 15-19 years who participated in the qualitative phase (phase I) of the Well-being of Adolescents in Vulnerable Environments (WAVE) study in Ibadan, Nigeria. The main study was conducted among adolescents residing in disadvantaged communities within five global cities (Baltimore, USA; Ibadan, Nigeria; Johannesburg, South Africa; New Delhi, India and Shanghai, China). Our findings revealed that adolescents in Ibadan were very eager to participate, remained fully engaged throughout the process and the data obtained were rich and detailed. Some challenges encountered with using this method were that younger adolescents had a tendency to attain saturation when taking pictures much earlier than older adolescents; however, they equally discussed the pictures taken enthusiastically. Overall, our findings affirm that photovoice as a data collection method can be successfully used in research among adolescents in developing countries like Nigeria.