A comprehensive sexual and reproductive health programme for secondary school learners in Capricorn and Mopani Districts of Limpopo Province, South Africa

Abstract

Sexual and reproductive health services include family-planning or contraception, pre-natal care, safe births and post-natal care, safe and accessible post-abortion care and where legal, access to safe abortion services, prevention and treatment of sexually transmitted infections and cervical cancers, sexual health information, and counselling. Adolescents face many sexual and reproductive health risks, ranging from teenage pregnancy, early unprotected sex, and sexually transmitted infections. Every year one in twenty young people worldwide contracts sexually transmitted infections, and currently, fifty percent of HIV infections occur in young people aged 15-24 years. Teenage pregnancy is at alarming rate among school girls. The overall aim of this study was to develop a comprehensive sexual and reproductive health programme for secondary school learners in Capricorn and Mopani Districts of Limpopo Province, South Africa. Three objectives which guided programme development were: 1. to assess the knowledge of secondary school learners about SRH issues, 2. to assess teachers’ views about the impact of the existing SRH programmes for adolescents and 3. to explore the perceptions of parents towards the provision of SRH services in schools. Sequential mixed methods approach was used where the initial quantitative phase was followed by qualitative phase. Three steps were used as the basis for developing the programme. Step 1 used quantitative descriptive survey to assess the knowledge of learners about sexual and reproductive health issues. Step 2 also used quantitative descriptive survey to assess teachers’ views about the impact of the existing sexual and reproductive health programmes provided in schools. An exploratory qualitative method was used in step 3 to explore the perceptions of parents towards the provision of sexual and reproductive health services in schools. The study population comprised of learners, teachers and parents. Probability and non-probability sampling methods were used. Self-administered questionnaires were used to collect quantitative data from learners and teachers, while in-depth face-to-face interviews were used to collect qualitative data from parents. Quantitative data was analysed using Statistical Package for the Social Sciences version 23. Qualitative data was analysed using Techs’ technique. Reliability and validity as well as trustworthiness were ensured. Ethical principles were adhered to throughout the study. Results indicated that (63%; n=69) learners were sexually active lacked knowledge about contraception (80%; n=40), STIs (38%; n=32) and (33%; n=37) had been pregnant and the mean age was 17. Eighty six (86%; n= 97) reported inaccessibility to sexual and reproductive health services. About (55%, n= 19) teachers were found to be inadequately trained and lacked training manuals. Most teachers reflected ineffectiveness of the existing programmes as evidenced by high pregnancy rates. Parents reflected difficulty in communicating sexual and reproductive health issues with teenagers and lack of knowledge, thus indicating the importance of the programme in schools. Parents also indicated the relevancy of teachers in facilitating the programme and collaboration between the Department of Education and the Department of Health. Dickoff’s six elements of the survey list was used to develop the programme. Programme validation was done by involving participants to evaluate it by completing questionnaires. The programme will empower learners to deal with sexual and reproductive health issues, resulting in decreased teenage pregnancy and other sexual risks. Collaboration and support were the recommendations directed to both the Department of Education and the Department of Health. Further research was also recommended.