Promoting sexual and reproductive health among adolescents in southern and eastern Africa – mobilizing schools, parents and communities

Curriculum based intervention for targeting learners aged 12-14 in primary school years 5 and 6 aimed at: 1. Delaying sex initiation 2. Increasing sexual health communication peer-to-peer and peer to responsible adults 3. Increasing safer sex practices amongst sexually active young adolescents; is delivered as three components: two implemented in school by trained teachers and peer educators and one implemented by health care providers during class visits to youth friendly health service clinics. The in-school components include 9 lessons, three of which are peer-led, taught over 19 hours (11 hours teacher led complemented by 8 hours peer-led sessions). Each class-room session lasting 40 or 80 minutes is taught over 8.5 weeks, as 16 two times a week interactive teaching and learning sessions suited for large classes with some didactic lessons and as part of the science curriculum; one hour duration peer-led sessions are taught once weekly over 8.5 weeks (9 sessions) as after school life skills. Lessons:1. Self awareness; 2. My sexuality; 3. Puberty*; 4. Relationships; 5. What influences my sexuality? 6. Risk taking sexual behaviours and consequences; 7. Decision making skills* 8. Self-protection; 9. Self-protection skills*. Lessons in asterisk are peer-led. In class sessions build on a previous intervention developed using social cognitive theories, evaluation of which showed effects in delaying sex initiation. Peer-led sessions complement in-class sessions, are interactive held outdoors as part of after-school life skills training curriculum with trained teachers available to offer support when requested. These individual skills sessions utilize experiential learning approaches using scenarios derived from formative phase narratives, role-play and drama and are aimed to empower learners to work with adults in order to change the secrecy surrounding sexuality and sexual health communication. Safe sex demonstrations and discussions occur during class visits to youth friendly services furthering the study aim to facilitate healthy sexuality messages and actions to peers and adults in young person’s lives. Each intervention class made one visit to a youth friendly service for one hour after the class room session on my protection with the following objectives: 1. To know the location of the closest (YFHC); 2. Active learning of what is meant by youth friendly; 3. Type of services offered; 4. Discussion on safe sexual health; 5. Self-protection (Condoms demonstrations) In monitoring the implementation of the intervention and adherence of students the following strategies were employed. 1. Lesson Plan: Each classroom teacher developed lesson plans for all 16 sessions. Each plan was later reviewed in relation to what was actually implemented 2. Student’s note book: At the end of each teacher led sessions students are asked to answer questions on their notebooks. 3. Activity records: Each activity conducted was documented 4. Peer leaders’ Diary 5. Observation: In each school one of teacher led sessions were observed and one of peer led.