1. Experiences of teachers and community-based health workers in addressing adolescents’ sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia
- Author
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chilambe, Kunda, Mulubwa, Chama, Zulu, Joseph Mumba, and Malizgani, Chavula Paul
- Subjects
Rural health systems ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Reproductive Health ,Sexual ,Public Health, Environmental and Occupational Health ,Public Health, Global Health, Social Medicine and Epidemiology ,Comprehensive Sexuality Education ,RISE ,Rights - Abstract
Background Adolescents in low-and-middle-income countries like Zambia face a high burden of sexual, reproductive, health and rights problems including coerced sex, teenage pregnancies, and early marriages. The Zambia government through the Ministry of Education has integrated comprehensive sexuality education (CSE) in the education and school system to contribute towards addressing adolescent sexual, reproductive, health and rights (ASRHR) problems. This paper sought to explore teachers and community based health workers (CBHWs) experiences in addressing ASRHR problems in rural health systems in Zambia. Methodology The study was conducted under the Research Initiative to Support the Empowerment of Girls (RISE) community randomized trial that aimed to measure the effectiveness of economic and community interventions in reducing early marriages, teenage pregnancies, and school dropout in Zambia. We conducted 21 qualitative in-depth interviews with teachers and CBHWs involved in the implementation of CSE in communities. Thematic analysis was used to analyse teachers and CBHWs´ roles, challenges, and opportunities in promoting ASRHR services. Results The study identified teachers and CBHWs roles, and challenges experienced in promoting ASRHR and suggested strategies to enhance delivery of the intervention. The role of teachers and CBHWs in addressing ASRHR problems included mobilizing the community for meetings, providing SRHR counseling services to both adolescents and guardians, and strengthening referrals to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of the boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution. Conclusion This study provides significant insight on the important roles that teachers and CBHWs can play in addressing adolescents SRHR related problems. Overall, the study emphasizes the need to fully engage adolescents in addressing adolescent SRHR problems.
- Published
- 2023