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Mudhune V, Winskell K, Bednarczyk RA, Ondenge K, Mbeda C, Kerubo E, Ndivo R, Arego J, Morales M, Halliburton B, Sabben G. Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data. SAHARA J 2024; 21:2320188. [PMID: 38388022 PMCID: PMC10885754 DOI: 10.1080/17290376.2024.2320188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices.Trial registration: ClinicalTrials.gov identifier: NCT04437667.
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Affiliation(s)
- Victor Mudhune
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Kate Winskell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ken Ondenge
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Calvin Mbeda
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Emily Kerubo
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Richard Ndivo
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Judith Arego
- HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Marissa Morales
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Brianna Halliburton
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Gaëlle Sabben
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Ndum NC, Trippler L, Mohammed UA, Ali AS, Hattendorf J, Utzinger J, Ali SM, Knopp S. Capacities and needs of health care facilities for schistosomiasis diagnosis and management in elimination settings. Parasit Vectors 2024; 17:263. [PMID: 38886811 PMCID: PMC11184784 DOI: 10.1186/s13071-024-06311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Schistosomiasis is a debilitating neglected tropical disease endemic in sub-Saharan Africa. The role of health facilities in the prevention, diagnosis, control, and elimination of schistosomiasis is poorly documented. In a setting targeted for schistosomiasis elimination in Zanzibar, we assessed the prevalence of Schistosoma haematobium among patients seeking care in a health facility and investigated schistosomiasis-related knowledge of staff, and health facilities' capacities and needs for schistosomiasis diagnosis and management. METHODS We conducted a health facility-based mixed-method study on Pemba Island from June to August 2023. Patients aged ≥ 4 years seeking care in four health facilities were screened for S. haematobium infection using urine filtration and reagent strips. Those patients aged ≥ 10 years were additionally interviewed about signs and symptoms. Staff from 23 health facilities responded to a questionnaire assessing knowledge and practices. Ten staff participated in a focus group discussion (FGD) about capacities and needs for schistosomiasis diagnosis and management. RESULTS The prevalence of S. haematobium infection in patients attending the health facilities, as determined by the presence of eggs in urine, was 1.1% (8/712). Microhaematuria was detected in 13.3% (95/712) of the patients using reagent strips. Among patients responding to the questionnaire, pelvic pain, pain during sex, and painful urination were reported by 38.0% (237/623), 6.3% (39/623), and 3.2% (20/623), respectively. Among the health facility staff, 90.0% (44/49) and 87.8% (43/49) identified blood in urine and pelvic pain, respectively, as symptoms of urogenital schistosomiasis, 81.6% (40/49) and 93.9% (46/49) reported collecting a urine sample and pursuing a reagent strip test, respectively, for diagnosis, and 87.8% (43/49) administered praziquantel for treatment. The most reoccurring themes in the FGD were the need for more staff training about schistosomiasis, requests for diagnostic equipment, and the need to improve community response to schistosomiasis services in health facilities. CONCLUSIONS The prevalence of S. haematobium infection in patients seeking care in health facilities in Pemba is very low and similar to what has been reported from recent community-based cross-sectional surveys. The health facility staff had good schistosomiasis-related knowledge and practices. However, to integrate schistosomiasis patient management more durably into routine health facility activities, scalable screening pathways need to be identified and capacities need to be improved by regular staff training, and an unbroken supply of accurate point-of-care diagnostics and praziquantel for the treatment of cases.
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Affiliation(s)
- Naomi C Ndum
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lydia Trippler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ulfat A Mohammed
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Anisa S Ali
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Said M Ali
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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Leung J, Lim C, Belete H, Mcclure-Thomas C, Foo S, Chan GCK. Regional and Country Prevalence Estimates of Unsafe Sex Among Adolescents in 68 Low-Income and Middle-Income Countries. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2337-2346. [PMID: 38637452 PMCID: PMC11176239 DOI: 10.1007/s10508-024-02861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
Prioritizing adolescent health is a public health priority to achieve the sustainable development goals, including reducing the risk of unsafe sex. Data on unsafe sex have remained scarce among adolescents in low-and middle-income countries (LMICs). To estimate the prevalence of unsafe sex in LMICs, we conducted secondary data analysis on the Global School-based Student Health Surveys among 244,863 students aged 13-17 years from 68 countries across five World Health Organization regions. The overall prevalence of ever had sex was 16.2%. The highest to lowest regional prevalence estimation of ever had sex was 30.5% (28.9-32.1) in the Americas, 28.6% (26.8-30.4) in Africa, 10.9% (9.2-12.6) in the Eastern Mediterranean, 9.6% (8.8-10.5) in South-East Asia, and 8.0% (6.8-9.1) in the Western Pacific. The highest prevalence of sexual intercourse before age 14 and practicing sexual intercourse without condom use were 36.5% (34.5-38.5) and 32.2% (30.1-34.3) in Africa, respectively. Findings suggest that current interventions are inadequate in promoting the uptake of safe sexual behaviors and an urgent intervention is needed.
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Affiliation(s)
- Janni Leung
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Carmen Lim
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Habte Belete
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia.
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Caitlin Mcclure-Thomas
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Shaun Foo
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Gary Chung Kai Chan
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
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Bolgrien A, Levison D. Tanzanian adolescents' attitudes toward abortion: innovating video vignettes in survey research on health topics. Reprod Health 2024; 21:66. [PMID: 38773597 PMCID: PMC11110338 DOI: 10.1186/s12978-024-01809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/08/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The purpose of this study was to pilot an innovative cartoon video vignette survey methodology to learn about young people's perspectives on abortion and sexual relationships in Tanzania. The Animating Children's Views methodology used videos shown on tablets to engage young people in conversations. Such conversations are complicated because abortion is highly stigmatized, inaccessible, and illegal in Tanzania. METHODS The cartoon video vignette methodology was conducted as a part of a quantitative survey using tablet computers. Hypothetical situations and euphemistic expressions were tested in order to engage adolescents on sensitive topics in low-risk ways. Qualitative interviews and focus groups validated and further explored the perspectives of the young respondents. RESULTS Results indicate that 12-17 year-olds usually understand euphemistic expressions for abortion and are aware of social stigma and contradictory norms surrounding abortion from as young as age twelve. Despite the risks involved with abortion, this study finds adolescents sometimes view abortion as a reasonable solution to allow a girl to remain in school. Additional findings show that as adolescents wrestle with how to respond to a schoolgirl's pregnancy, they are considering both the (un)affordability of healthcare services and also expectations for gender roles. CONCLUSIONS Digital data collection, such as the Animating Children's Views cartoon video vignettes used in this study, allows researchers to better understand girls' and boys' own perspectives on their experiences and reproductive health.
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Affiliation(s)
- Anna Bolgrien
- Institute for Social Research and Data Innovation, University of Minnesota Twin Cities, 225 - 19th Avenue South, Minneapolis, MN, 55455, USA.
| | - Deborah Levison
- Hubert H. Humphrey School of Public Affairs, University of Minnesota Twin Cities, 301 - 19th Avenue South, Minneapolis, MN, 55455, USA
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Chow DWS, Goi A, Salm MF, Kupewa J, Mollel G, Mninda Y, Ambonisye J, Malongo A, Ketang’enyi E, Sanga E, Ngowi H, William R, Msuya E, Mmbaga BT, Mpili A, Dow DE. Through the looking glass: empowering youth community advisory boards in Tanzania as a sustainable youth engagement model to inform policy and practice. Front Public Health 2024; 12:1348242. [PMID: 38476491 PMCID: PMC10927807 DOI: 10.3389/fpubh.2024.1348242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
More young people are living in the world than ever before, 90% of whom reside in low and middle income countries (LMICs). To address their needs, it is critical to have sustainable youth engagement when determining policy and to advance effective implementation of youth-focused interventions. Youth Community Advisory Boards (CABs) are a sustainable mechanism to achieve this goal. This paper describes engagement with youth CAB members across four locations in Tanzania. To set youth CAB meeting agendas and priorities, we asked youth CAB members to write (using free text) the top five challenges faced by young people in their communities (highest to lower priority). The Google Forms survey link was presented at the May 2023 youth CAB meeting and disseminated through WhatsApp. The survey was completed by smartphone, tablet, or paper provided to the youth liaison for data entry. Results were translated from Swahili to English and coded using excel. Findings were then presented back to the youth CABs at the September 2023 meeting. At that meeting, youth CAB members were then asked to write (free text) potential solutions to the most commonly described challenges. The surveys had response rates of 90% (84/93) for challenges and 78% (71/93) for solutions. The number one reported challenge was unemployment and financial instability (45%). Gender based violence (13%), sexual reproductive health issues (8%), and alcohol and drug use (8%) were in the top four both by priority and frequency of report. Other important challenges included physical and mental health, malnutrition, relationships, education, and societal and environmental norms, among others. Solutions included job creation, improved education, expanded legal systems, youth-friendly health care services, and increased social support through peer networks and community support. The National Accelerated Action and Investment Agenda for Adolescent Health and Wellbeing (NAIA-AHW) 2021/22-2024/25 includes most, but not all, of these top challenges and solutions. Ensuring young people have a seat at the policy table is critical to effective youth-empowerment in health and other related programs. Including a youth CAB member to represent this collective in youth-related government activities is a sustainable model to achieve this goal.
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Affiliation(s)
| | - Angelina Goi
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Maeve F. Salm
- Duke Global Health Institute, Durham, NC, United States
| | - Juma Kupewa
- Ifakara Health Institute Youth Community Advisory Board Liaison, Ifakara, Tanzania
| | | | - Yassin Mninda
- Mbeya Youth Community Advisory Board Liaison, Mbeya, Tanzania
| | | | - Alan Malongo
- Mwanza Youth Community Advisory Board Liaison, Mwanza, Tanzania
- Baylor College of Medicine Children’s Foundation Tanzania, Mwanza, Tanzania
| | - Eunice Ketang’enyi
- Baylor College of Medicine Children’s Foundation Tanzania, Mwanza, Tanzania
| | - Erica Sanga
- Mwanza Research Centre, National Institute of Medical Research, Mwanza, Tanzania
| | - Happyness Ngowi
- Kilimanjaro Christian Medical Center-Duke Collaboration, Moshi, Tanzania
| | - Robert William
- Kilimanjaro Christian Medical Center-Duke Collaboration, Moshi, Tanzania
- Moshi Youth Community Advisory Board Liaison, Moshi, Tanzania
| | | | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Duke Global Health Institute, Durham, NC, United States
- Kilimanjaro Christian Medical Center-Duke Collaboration, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Amos Mpili
- Tanzania Ministry of Community Development, Gender, Women and Special Groups, Coordinator NAIA-AHW, Dodoma, Tanzania
| | - Dorothy E. Dow
- Duke Global Health Institute, Durham, NC, United States
- Kilimanjaro Christian Medical Center-Duke Collaboration, Moshi, Tanzania
- Department of Pediatrics, Infectious Diseases, Duke University Medical Center, Durham, NC, United States
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Massae AF, Mgopa LR, Bonilla ZE, Mohammed I, Rosser BRS, Mushy SE, Ross MW, Mwakawanga DL, Mkonyi E, Lukumay GG, Wadley J, Mkoka DA, Trent M. Addressing sexual health concerns in Tanzania: perceived barriers among healthcare professionals and students in the "training for health professionals" study. CULTURE, HEALTH & SEXUALITY 2024:1-15. [PMID: 38284804 DOI: 10.1080/13691058.2024.2306227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
Little is known about the factors that may prevent healthcare professionals as key stakeholders from exploring sexual health issues in Tanzania. This study examined healthcare professionals' perspectives on the barriers to addressing sexual health concerns in practice. In June 2019, we conducted an exploratory qualitative study involving 18 focus group discussions among healthcare professionals (n = 60) and students (n = 61) in the health professions (midwifery, nursing, medicine) in Dar es Salaam, Tanzania. Study participants and design were purposively selected and stratified. We used a focus group discussion guide in Kiswahili. Data were transcribed in Kiswahili and translated into English. A thematic analysis approach was used for data analysis. Two themes were developed: (1) differences between health care professional and patient socio-demographic characteristics; (2) health care system and patients' backgrounds, such as communication barriers, lack of confidentiality and privacy within health facilities, type of clinical presentation and complaint, patient behaviours, and their clinical background. Several key barriers prevented sexual health communication between healthcare professionals and patients, affecting the quality of sexual health service delivery. Additional sexual health clinical training is warranted for health professions students and professionals to optimise sexual health care delivery in a culturally conservative country like Tanzania.
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Affiliation(s)
- Agnes F Massae
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lucy R Mgopa
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Zobeida E Bonilla
- School of Public Health, Division of Epidemiology and Community Health, University of MN, Minneapolis, MN, USA
| | - Inari Mohammed
- School of Public Health, Division of Epidemiology and Community Health, University of MN, Minneapolis, MN, USA
| | - B R Simon Rosser
- School of Public Health, Division of Epidemiology and Community Health, University of MN, Minneapolis, MN, USA
| | - Stella E Mushy
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Michael W Ross
- School of Public Health, Division of Epidemiology and Community Health, University of MN, Minneapolis, MN, USA
| | - Dorkasi L Mwakawanga
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ever Mkonyi
- School of Public Health, Division of Epidemiology and Community Health, University of MN, Minneapolis, MN, USA
| | - Gift G Lukumay
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - James Wadley
- Counseling and Human Services Department, Lincoln University, Philadelphia, PA, USA
| | - Dickson A Mkoka
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Maria Trent
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD, USA
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Millanzi WC, Osaki KM, Kibusi SM. Attitude and prevalence of early sexual debut and associated risk sexual behavior among adolescents in Tanzania; Evidence from baseline data in a Randomized Controlled Trial. BMC Public Health 2023; 23:1758. [PMID: 37689638 PMCID: PMC10492380 DOI: 10.1186/s12889-023-16623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/25/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Unsafe sexual behaviours and associated sexual ideas among adolescents may contribute to adverse health consequences for sexual health in adulthood. The patterns of sexual ideology and sociodemographic factors profiles on adolescents' sexual behaviours have not been the subject of a definite consensus in research. The purpose of this study was to investigate the attitude and prevalence of early sexual debut and associated risk sexual behavior among adolescents in Tanzania as the evidence from baseline data in a Randomized Controlled Trial. METHODS The study included 647 randomly chosen in-school adolescents from Tanzania and used an analytical cross-section survey in a quantitative research approach. Sexual-risk Behaviour Beliefs and Self-esteem Scale from previous studies were the main data collection tool. According to the Statistical Analysis Software (SAS), computer software version 9.4 descriptive analysis established respondents' socio-demographic profiles, attitudes, prevalence, and determinants linked to teenagers' early sexual debut. The link between the variables was established via multivariate logistic regression at a 5% significance level and a 95% confidence interval. RESULTS The mean age was 15 ± 1.869 years while 57.5% of adolescents were females. 69.7% of adolescents were sexually active whereas 44.8% of them practised sexual behaviours willingly against 24.9% who practised coerced sexual behaviours. The majority (44.4%) and 16.2% of them initiated sexual behaviours during the early and middle adolescence stages respectively. Most adolescents had the ideology that sex was okay to them even before the age of 18 years. Their odds of practicing sexual behaviours were significantly high with the ideology that sex was okay to them even before 18 years of age (AOR = 1.293; p < 0.05; 95%CI: 0.689, 2.989), exposure to drug abuse (AOR = 1.210; p < 0.05; 95%CI: 0.803, 2.130), using media (AOR = 1.006; p < 0.05; 95%CI: 0.748, 2.667) and/or exposure to social groups [Jogging, Gym, health clubs, betting, Games] (AOR = 1.032; p < 0.05; 95%CI: 0.889, 2.044). CONCLUSION Findings suggest that holding a positive attitude towards early sexual debut is a precursor to early sexual activity among adolescents. Unsafe sex, coercive sex, and other risky sexual behaviors are not uncommon among adolescents starting sex before the age of 18 years. Exposure to drug abuse, online sexual content, and/or social groups significantly influenced early sexual debut irrespective of other known factors. Age-appropriate school-based sexuality education programs should be promoted and implemented to address the most prevalent positive attitude towards early sexual debut and associated risk sexual behaviour among adolescents in Tanzania and other similar settings.
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Affiliation(s)
- Walter C Millanzi
- Department of Nursing Management and Education, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.
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Shimpuku Y, Hirose N, Chen S, Mwakawanga DL, Madeni N, Madeni F, Komada M, Teshima A, Morishima M, Ando Y, Takahama K, Nishida A. The long-term effects of reproductive health education among primary and secondary school students: a longitudinal quasi-experimental study in rural Tanzania. Reprod Health 2023; 20:127. [PMID: 37644457 PMCID: PMC10466836 DOI: 10.1186/s12978-023-01662-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Adolescent pregnancy remains a major global health issue, increasing the risk of complications during pregnancy and childbirth in mothers and babies. In Tanzania, adolescent pregnancy threatens girls' education and makes it difficult for them to obtain a proper job; hence, the majority fall into poverty. Previous studies have developed and conducted reproductive health education for adolescent students; however, they evaluated only the effect immediately after education. Therefore, this study investigated the effects of reproductive health education on attitudes and behaviors toward reproductive health among adolescent girls and boys one year after the intervention in rural Tanzania. METHODS A longitudinal quasi-experimental study was conducted with 3295 primary and secondary students (2123 in the intervention group, 1172 in the control group) from three purposefully selected wards in Korogwe District. In the intervention group, the students received reproductive health education. We used paper-based questionnaires to evaluate the effect of the adolescent education program on attitudes and behaviors toward reproductive health education. To analyze the association between the intervention and each outcome, mixed-effect multiple regression analyses was conducted. RESULTS The mean age, primary school proportion, and female proportion of the intervention and the control group was 13.05 (standard deviation (SD) 1.59), 14.14 (SD 1.7), 77.9% and 34.3%, and 54.2% and 52.6%, respectively. There was no statistically significant effect of reproductive health education on adolescent health attitudes and behaviors in the multiple regression analyses (coefficient: - 0.24 (95% confidence interval (CI): - 0.98 to 0.50), coefficient: 0.01 (95%CI: - 0.42 to 0.43)). CONCLUSION A statistically significant effect of reproductive health education on adolescent health attitudes and behaviors was not found. An effective reproductive health education intervention to improve the attitude and behaviors of reproductive health among Tanzania adolescents in the long term remain to be determined, particularly in real-world settings. Trial registration The National Institute for Medical Research, Tanzania (NIMR/HQ/R.8a/Vol. IX988).
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Affiliation(s)
- Yoko Shimpuku
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
| | - Naoki Hirose
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Dorkasi L Mwakawanga
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Frida Madeni
- The New Rural Children Foundation, Dar es Salaam, Tanzania
| | | | | | | | | | | | - Atsushi Nishida
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Cherenack EM, Rubli J, Melara A, Ezaldein N, King A, Alcaide ML, Raccamarich P, Fein LA, Sikkema KJ. Adolescent girls' descriptions of dysmenorrhea and barriers to dysmenorrhea management in Moshi, Tanzania: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001544. [PMID: 37410763 DOI: 10.1371/journal.pgph.0001544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/22/2023] [Indexed: 07/08/2023]
Abstract
Dysmenorrhea (menstrual pain) is common among adolescent girls globally, but many girls in Sub-Saharan Africa do not receive effective treatment. Qualitative interviews were used to describe adolescent girls' experiences of dysmenorrhea and identify sociocultural barriers to dysmenorrhea management in Moshi, Tanzania. From August to November 2018, in-depth interviews were conducted with 10 adolescent girls and 10 adult experts (e.g., teachers, medical providers) who have experience working with girls in Tanzania. Thematic content analysis identified themes related to dysmenorrhea, including descriptions of dysmenorrhea and the impact of dysmenorrhea on well-being, as well as factors influencing the use of pharmacological and behavioral pain management strategies. Potential barriers to dysmenorrhea management were identified. Dysmenorrhea negatively impacted the physical and psychological well-being of girls and hindered girls' ability to participate in school, work, and social events. The most common pain management strategies were resting, drinking hot water, engaging in physical activity, and taking paracetamol. Barriers to dysmenorrhea management included beliefs that medications are harmful to the body or can hinder fertility, limited knowledge about the benefits of hormonal contraceptives to manage menstruation, little continuing education for healthcare providers, and a lack of consistent access to effective medications, medical care, or other supplies necessary for pain management. Medication hesitancy and inconsistent access to effective medication and other menstrual supplies must be addressed to improve girls' ability to manage dysmenorrhea in Tanzania.
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Affiliation(s)
- Emily M Cherenack
- Department of Public Health Sciences, University of Miami, Miami, Florida, United States of America
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | | | - Abraham Melara
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, United States of America
| | - Nada Ezaldein
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, United States of America
| | - Aisha King
- Graduate School of Public Health and Health Policy, City University of New York, New York, New York, United States of America
| | - Maria L Alcaide
- Department of Public Health Sciences, University of Miami, Miami, Florida, United States of America
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, United States of America
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami, Miami, Florida, United States of America
| | - Patricia Raccamarich
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, United States of America
| | - Lydia A Fein
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami, Miami, Florida, United States of America
| | - Kathleen J Sikkema
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Sociomedical Sciences, Columbia University, New York, New York, United States of America
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10
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Mkonyi E, Silla NB, Rohloff CT, Lukumay GG, Ross MW, Kohli N, Mgopa LR, Massae AF, Mohammed IS, Mushy SE, Mwakawanga DL, Rosser BRS, Trent M. Not Lost in Translation: The Use of Standardized Patients Technology among Health Professional Students in Tanzania. EAST AFRICAN JOURNAL OF HEALTH AND SCIENCE 2023; 6:149-161. [PMID: 38046829 PMCID: PMC10691444 DOI: 10.37284/eajhs.6.1.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Health professionals in Tanzania report a perceived need for sexual and reproductive health communication training to meet patient needs and reduce disparities. Simulation optimizes clinical performance and public entrustment. The study describes the development, feasibility, and acceptability measures of evidence-based, Afrocentric, standardized patient scenarios to train nursing, medical, and midwifery students in sexual and reproductive health in Tanzania. Standardized patient simulation cases with embedded cultural, language, gender, age, sexuality, and legal complexity issues were identified by stakeholders in Dar es Salaam centering on;1) adolescent health, 2) women's health, and 3) male health cases. Twenty-four health professional students evenly split across nursing, midwifery, and medicine were recruited and enrolled to participate in a pilot trial of the standardized patient simulations conducted in Kiswahili and the results recorded. Videos were evaluated by trained bilingual research staff using standardized behavioral checklists. Descriptive statistics and bivariate analyses were used to assess the pilot data. The study found that seventy-five percent (N =18) of baseline participants (N=24) returned for the 3-month follow-up simulation assessment. While not powered for statistical significance, students showed improvement in all cases and a significant improvement in the male erectile dysfunction concerns case for both interpersonal communication (t (17) = -3.445, p < .005) and medical history taking checklist (t(17)= -3.259, p < .005). Further, most students found the opportunity to practice using the simulations helpful or very helpful in their sexual and reproductive health education. It was therefore concluded that preliminary sexual and reproductive health simulation data using standardized patients demonstrated feasibility and acceptability among student participants.
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Affiliation(s)
- Ever Mkonyi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Ndeye Boury Silla
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205, USA
| | - Corissa T. Rohloff
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA
| | - Gift Gadiel Lukumay
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Michael W. Ross
- Program in Human Sexuality, Department of Family Medicine, University of Minnesota, 420 Delaware St. SE. Minneapolis, MN, 55455 USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA
| | - Lucy Raphael Mgopa
- Department of Psychiatry, School of Medicine, Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar Es Salaam, Tanzania
| | - Agnes Fredrick Massae
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Inari S. Mohammed
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Stella Emmanuel Mushy
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Dorkasi L. Mwakawanga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied, Sciences (MUHAS), United Nations Rd, Dar es Salaam, Tanzania
| | - Brian Robert Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2 St., Minneapolis, MN, 55454 USA
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University Schools of Medicine, 1800 Orleans Street Baltimore, MD, 21287 USA
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11
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Hirose N, Sanmei C, Okamoto M, Madeni FE, Madeni N, Teshima A, Ando Y, Takahama K, Yoshikawa M, Kunimoto Y, Shimpuku Y. Associated factors for multidimensional attitudes and behaviors of reproductive health toward pregnancy among early and late adolescents in Tanzania: a cross-sectional study. Reprod Health 2023; 20:44. [PMID: 36918903 PMCID: PMC10012580 DOI: 10.1186/s12978-023-01583-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 02/13/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Adolescent pregnancy is a serious reproductive health problem in Tanzania. However, the risk factors for multidimensional attitudes and behaviors of reproductive health toward pregnancy in Tanzanian adolescents remain unexplored. METHODS We collected baseline characteristics and information on attitudes and behaviors of reproductive health from 4161 Tanzanian adolescents in all 54 primary and secondary schools in the Korogwe district. We applied mixed effect multiple regression analyses stratified by sex to find the factors related to reproductive health attitudes and behaviors toward pregnancy. RESULTS In female students, regarding the attitudes of reproductive health, higher age, hope for marriage in the future, a talk with a parent about sex or pregnancy, and a higher hope score were significantly associated with a lower score. For the behaviors of reproductive health, higher age, a talk with a parent about sex or pregnancy, time to talk with a parent about daily life, and a higher hope score were significantly associated with a lower score. In male students, regarding the attitudes of reproductive health, a higher hope score was significantly associated with a lower score. For the behaviors of reproductive health, higher age, time to talk with a parent about daily life, and a higher hope score was significantly associated with a lower score. CONCLUSIONS The heterogeneous factor-outcomes association between female and male students suggested that sex-specialized interventions may be required to change their risky attitudes or behaviors of reproductive health. Although we cannot conclude as points of intervention, our study suggested that it may be practical to improve parent-adolescents communication about sex or reproductive health and change adolescents' views of pregnancy or marriage for gaining financial or social status.
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Affiliation(s)
- Naoki Hirose
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8553, Japan.
| | - Chen Sanmei
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8553, Japan
| | | | | | | | - Ayaka Teshima
- Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Yasunobu Ando
- National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | | | | | - Yu Kunimoto
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8553, Japan
| | - Yoko Shimpuku
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8553, Japan
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12
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Ochieng Arunda M, Agardh A, Larsson M, Asamoah BO. Survival patterns of neonates born to adolescent mothers and the effect of pregnancy intentions and marital status on newborn survival in Kenya, Uganda, and Tanzania, 2014-2016. Glob Health Action 2022; 15:2101731. [PMID: 36018071 PMCID: PMC9423851 DOI: 10.1080/16549716.2022.2101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Adolescent pregnancy and associated neonatal mortality are major global health challenges. In low-income settings where 90% of the 21 million global adolescent pregnancies occur, half are unintended and a fifth experience unsafe abortion. In Kenya, Uganda, and Tanzania, the survival patterns of neonates born to adolescents are unclear. Objectives To assess survival patterns among neonates born to adolescents and the effect of pregnancy intentions and marital status on survival in Kenya, Uganda, and Tanzania. Methods Cross-sectional data from demographic and health surveys in Kenya, Uganda, and Tanzania 2014–2016 were used. Kaplan-Meier estimates investigated patterns of neonatal survival among adolescent mothers, aged 15–19 years, compared to mothers aged 20–29 years. Cox proportional hazards regression determined the hazard ratios (HR) for the predictors of neonatal survival. Results About 50% of adolescent pregnancies were unintended and neonatal death rate was twice as high than older mothers (26.6 versus 12.0 deaths/1000 live births). The median survival time was two days for adolescent-born babies and four days among older mothers. The hazard of death for all adolescent-born neonates was about twofold that of 20–29 years-old-mothers, HR 1.80 (95% CI 1.22–2.63). Among married adolescents with unintended newborn pregnancies, the HR was 4-folds higher than corresponding older mothers, HR 4.08 (95% CI 1.62–10.31). Among married, primiparous adolescents with unintended pregnancies, the HR was six times higher than corresponding older mothers. Conclusion Our findings reveal how unintended pregnancies and deaths of neonates born to adolescents contribute substantially to preventable neonatal deaths in East Africa. Full implementation of existing adolescent health policies and utilization of contraceptives should be ensured. Partnership with youths and novel efforts that address sociocultural norms to reduce adolescent pregnancies or marriage should be supported. Regulations requiring adolescents’ obstetric care conducted by only skilled personnel should be introduced and implemented.
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Affiliation(s)
- Malachi Ochieng Arunda
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Markus Larsson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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13
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C. Millanzi W. Adolescents’ World: Know One Tell One against Unsafe Sexual Behaviours, Teenage Pregnancies and Sexually Transmitted Infections Including Chlamydia. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.109048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Addressing adolescents’ sexual and reproductive health (SRH) matters using multidisciplinary pedagogical innovations may assure the proper development and well-being of adolescents so that they reach the adulthood stage healthy and strong enough to produce for their future investment. This is in response to sustainable development goal number 3, target 3.7, and SDG4, target 4.7 in particular emphasizes the universal availability and accessibility of sexual information and education among people and knowledge and skills for gender equality, human rights and sustainable lifestyles by 2030, respectively. Yet, the innovative strategies may respond to a call stated by SGD5 (gender equality), target 5.3 which advocates the elimination of child, early, and forced marriages, and target 5.6 which focuses on ensuring universal access to SRH and rights to all by 2030.
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14
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Chidwick H, Baumann A, Ogba P, Banfield L, DiLiberto DD. Exploring adolescent engagement in sexual and reproductive health research in Kenya, Rwanda, Tanzania, and Uganda: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000208. [PMID: 36962492 PMCID: PMC10022240 DOI: 10.1371/journal.pgph.0000208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/23/2022] [Indexed: 06/18/2023]
Abstract
Adolescent sexual and reproductive health (ASRH) in East Africa has prioritized research on the barriers to care, communication, and ASRH knowledge, attitudes, and practices. However, there is little research examining the extent to which meaningful adolescent engagement in research is achieved in practice and how this influences the evidence available to inform ASRH services. This review offers a critical step towards understanding current approaches to adolescent engagement in ASRH research and identifying opportunities to build a strengthened evidence base with adolescent voices at the centre. This scoping review is based on Arksey and O'Malley's (2005) framework, employing a keyword search of four databases via OVID: Medline, Global Health, Embase and PsycINFO. Two reviewers screened title, abstract and full text to select articles examining ASRH in Tanzania, Rwanda, Kenya, and Uganda, published between 2000 and 2020. After articles were selected, data was extracted, synthesized, and thematically organized to highlight emerging themes and potential opportunities for further research. The search yielded 1201 results, 34 of which were included in the final review. Results highlight the methods used to gather adolescent perspectives of ASRH (qualitative), the content of those perspectives (knowledge, sources of information, gaps in information and adolescent friendly services), and the overall narratives that frame discussions of ASRH (risky sexual behaviour, stigma, and gender norms). Findings indicate the extent of adolescent engagement in ASRH research is limited, resulting in a lack of comprehensive evidence, consistent challenges with stigma, little information on holistic concepts and a narrow framing of ASRH. In conclusion, there is opportunity for more meaningful engagement of adolescents in ASRH research. This engagement can be achieved by involving adolescents more comprehensively throughout the research cycle and by expanding the range of ASRH topics explored, as identified by adolescents.
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Affiliation(s)
- Hanna Chidwick
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Baumann
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Patricia Ogba
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Deborah D. DiLiberto
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
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15
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Millanzi WC, Kibusi SM, Osaki KM. Effect of integrated reproductive health lesson materials in a problem-based pedagogy on soft skills for safe sexual behaviour among adolescents: A school-based randomized controlled trial in Tanzania. PLoS One 2022; 17:e0263431. [PMID: 35192640 PMCID: PMC8863272 DOI: 10.1371/journal.pone.0263431] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/19/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescents are currently becoming sexually active before their 18th birthday during which they have to battle with unsafe sexual behaviours, teenage pregnancies, sexually transmitted infections (STIs), and school dropouts. The trend is linked with low soft skills (self-esteem and assertiveness skills) for them to make informed, reasoned, and responsible decisions over sexual activities. This study designed and tested the effect of integrated reproductive health (RH) lesson materials in a problem-based pedagogy (PBP) to enhance soft skills for safe sexual behaviour among adolescents in Tanzania. METHODS A double-blinded clustered randomized controlled trial was conducted between September 2019 and September 2020 among 660 randomly selected adolescents. A Sexual-risk Behaviour Beliefs and Self-esteem Scale adopted from previous studies measured soft skills for safe sexual behaviour. A descriptive statistical analysis was performed by using the statistical analysis software programme version 9.4. The effect of the intervention was determined using Linear Mixed Model set at α error probability = 5% significance level (95% confidence interval) and a β error probability = 0.80. FINDINGS Adolescents' mean age was 15±1.869 with 57.5% females. The end-line findings indicated that the coefficient of soft skills was significantly higher among adolescents in the hybrid PBP (β=9.0986, p<0.01; 95%CI: 4.7772, 14.2311) and pure PBP (β =8.7114, p<0.01; 95%CI: 3.9990, 10.1208) than in the control group. The retention rate of soft skills was still significantly higher at 3-months follow-up (β=2.0044; p<0.01; 95%CI: 1.0234, 4.1182) and at 6-months follow-up (β=1.9803; p<0.01; 95%CI: 0.8399, 3.1099) compared to the baseline and immediate post-intervention assessments. CONCLUSION The intervention substantially enhanced soft skills for safe sexual behaviour among adolescents of both sex. Despite the fact that scores for soft skills varied across the study timelines, adolescents demonstrated significant intentions to abstain from sexual intercourse, delay sexual relationships, negotiate condom use, and withstand sexual coercions. The PBP may need to be incorporated in ordinary level secondary school curricula as a formal guide to teachers and or health workers to optimally prepare adolescents for their healthy adulthood.
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Affiliation(s)
- Walter C. Millanzi
- Department of Nursing Management and Education, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Stephen M. Kibusi
- Department of Public Health, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Kalafunja M. Osaki
- Centre for Pedagogy, Education, Development, Writing and Editing Documents, St. Augustine University of Tanzania, Mwanza, Tanzania
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16
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Ohnishi M, Leshabari S, Tanaka J, Nishihara M. Factors associated with the awareness of contraceptive methods, understanding the prevention of HIV/AIDS and the perception of HIV/AIDS risk among secondary school students in Dar es Salaam, Tanzania. J Rural Med 2020; 15:155-163. [PMID: 33033535 PMCID: PMC7530594 DOI: 10.2185/jrm.2020-001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/30/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: To assess the awareness of contraceptive methods, understanding
of HIV/AIDS prevention and the perception of HIV/AIDS risks among secondary school
students in Tanzania. Methods: An anonymous self-administered questionnaire survey was conducted
among secondary school students in Tanzania. The questionnaire included sociodemographic
characteristics, awareness of contraceptive methods, an understanding of HIV/AIDS
prevention, and the perception of HIV/AIDS risks. Three secondary schools were selected by
considering the gender balance and location, which included the urban and surrounding
areas. The research objectives, methods, and ethical considerations were explained, and
the students voluntarily completed the questionnaire. Results: A total of 233 responses were collected, and 204 responses were
considered valid for the analysis. The mean and standard deviation of age were 18.5 ± 1.0.
Regardless of the gender, age, religion, and major course of study, the maternal
educational status (adjusted odds ratio [AOR]: 3.129; 95% confidence interval [CI]: 1.324,
7.398; P=0.009) and the number of information sources (AOR: 7.023, 95%
CI: 3.166, 15.579, P<0.001) demonstrated associations with the
awareness of contraceptive methods. Respondents who lived outside a dormitory (AOR: 3.782;
95% CI: 1.650, 8.671; P=0.002) and who currently had a partner (AOR:
3.616; 95% CI: 1.486, 8.800; P=0.005) were associated with a high level
of understanding of HIV/AIDS prevention regardless of gender, age, religion, and major
course of study. Respondents with few information sources were associated with a high
level of perception of HIV/AIDS risks (AOR: 0.293; 95% CI: 0.115, 0.747;
P=0.010), regardless of gender, age, religion, and major course of
study. Conclusion: Factors associated with the awareness of contraceptive methods,
the understanding of HIV/AIDS prevention, and perception of HIV/AIDS risks were not
consistent. To ensure the improvement of these factors among secondary school students,
sexual health education should be integrated into educational programs and provided
holistically.
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Affiliation(s)
- Mayumi Ohnishi
- Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Sebalda Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Junichi Tanaka
- Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Mika Nishihara
- Nagasaki University Graduate School of Biomedical Sciences, Japan
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