Abstract
Ugandan adolescents lack sufficient reproductive health knowledge, which accounts in part for the staggering rates of teen pregnancies and sexually transmitted (STI) infections in this population. This study aimed to (1) examine Ugandan adolescents’ baseline STI and contraceptive knowledge; (2) determine whether this knowledge varies by demographic factors, prior sexual experience or school grade; and (3) evaluate the effectiveness of an educational program to increase and retain STI and contraceptive knowledge among Ugandan adolescents. This study surveyed 129 adolescents (ages 15–19) regarding knowledge of STIs and contraceptive methods at schools and community non-governmental organizations at three time points. Findings demonstrated that at baseline the mean test scores for contraceptive knowledge and STI knowledge were 44% and 72%, respectively. Participants in higher secondary school grade-levels had greater odds of having prior STI knowledge (OR=19.6, 95% CI 2.0–187.6); participants who had previously engaged in sex had greater odds of having prior contraceptive knowledge (OR=4.62, 95% CI 1.45–14.72). A higher grade level was not associated with better knowledge of contraception; and being sexually active was not associated with better knowledge of STI information. Participants’ knowledge of STIs and contraceptives improved after the education session (p<0.001), and knowledge was retained 3-weeks later (p<0.001). Findings suggest that Ugandan adolescents do not have adequate education regarding contraceptive methods and that implementation of reproductive health modules by an outside party can be effective in improving knowledge.
Acknowledgments
The authors acknowledge the technical support of Dr. Charles McCulloch and Dr. Angkana Roy in the statistical analysis of this paper. We would also like to acknowledge Dr. Colette Auerswald for her important and critical comments on earlier drafts of this manuscript. This research was made possible by the collaboration between the Mount Sinai Global Health Program and Soft Power Health.
References
1. Uganda Demographic and Health Survey 2011. Calverton, Measure DHS, ICF International, 2011. Available at: http://dhsprogram.com/pubs/pdf/PR18/PR18.pdf. Accessed on April 1, 2015.Search in Google Scholar
2. Neema S, Musisi N, Kibombo R. Adolescent sexual and reproductive health in Uganda: a synthesis of research evidence. New York: The Alan Guttmacher Institute, 2004. Available at: https://www.guttmacher.org/pubs/2004/12/20/or14.pdf. Accessed on April 1, 2015.Search in Google Scholar
3. The National Policy Guidelines and Service Standards for Reproductive Health Services. Kampala: The Reproductive Health Division, Community Health Department, Ministry of Health, 2004. Available at: http://www.youth-policy.com/Policies/UGAyouthpol2004.pdf. Accessed on April 1, 2015.Search in Google Scholar
4. Progress for children: a report card for adolescents. New York: United Nations Children’s Fund, 2012. Available at: http://www.unicef.org/media/files/PFC2012_A_report_card_on_adolescents.pdf. Accessed on April 1, 2015.Search in Google Scholar
5. Ssengooba F, Neema S, Mboyne A, Sentubwe O, Onama V. Makarare University Institute of Public Health, Maternal Health Review. Uganda: Health Systems Development Programme, 2004. Available at: http://r4d.dfid.gov.uk/PDF/Outputs/HealthSysDev_KP/04-03_uganda.pdf. Accessed on April 1, 2015.Search in Google Scholar
6. Youth Reproductive Health Policy Country Brief Series No. 5. Washington DC: Policy Project, 2005. Available at: http://www.policyproject.com/pubs/YRHCBS/Uganda%20country%20brief.pdf. Accessed on April 1, 2015.Search in Google Scholar
7. Råssjö E, Kambugu F, Tumwasigye M, Tenywa T, Darj E. Prevalence of sexually transmitted infections among adolescents in Kampala, Uganda and theoretical models for improving syndromic management. J Adolesc Health 2006;38:213–21.10.1016/j.jadohealth.2004.10.011Search in Google Scholar
8. Nalwadda G, Mirembe F, Byamugisha J, Faxelid E. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives. BMC Public Health 2010;10:530.10.1186/1471-2458-10-530Search in Google Scholar
9. Gallant M, Maticka-Tyndale E. School-based HIV prevention programmes for African youth. Soc Sci Med 2004;58:1337–51.10.1016/S0277-9536(03)00331-9Search in Google Scholar
10. Rijsdijk L, Bos A, Ruiter R, Leerlooijer J, De Haas, et al. The world starts with me: a multilevel evaluation of a comprehensive sex education programme targetting adolescents in Uganda. BMC Public Health 2011;11:334.10.1186/1471-2458-11-334Search in Google Scholar PubMed PubMed Central
11. The National Policy Guidelines and Service Standards for Reproductive Health Services. Kampala: Reproductive Health Division, Community Health Department, Ministry of Health, 2001. Available at: http://www.youth-policy.com/Policies/Uganda%20National%20Policy%20Guidelines%20and%20Service%20Standards%20for%20Reproductive%20Health%20Services.pdf. Accessed on April 1, 2015.Search in Google Scholar
12. Wallace A. Adolescent Pregnancy and Policy Responses in Uganda. AFRICAPORTAL BACKGROUNDER. Canada: The Centre for International Governance Innovation, 2011 Nov. Available at: http://dspace.africaportal.org/jspui/bitstream/123456789/32416/1/Backgrounder%20No.%2014.pdf?1. Accessed on April 1, 2015.Search in Google Scholar
13. Harrison A, Newell M-L, Imrie J, Hoddinott G. HIV prevention for South African youth: which interventions work? A systematic review of current evidence. BMC Public Health 2010;10:102.10.1186/1471-2458-10-102Search in Google Scholar PubMed PubMed Central
14. Wegner L, Flisher AJ, Caldwell LL, Vergnani T, Smith EA. Healthwise South Africa: cultural adaptation of a school-based risk prevention programme. Health Educ Res 2008;23:1085–96.10.1093/her/cym064Search in Google Scholar PubMed PubMed Central
15. Reproductive Health Assessment Toolkit for Conflict-Affected Women. Atlanta: CDC, 2007. Available at: http://www.cdc.gov/reproductivehealth/Global/PDFs/Intro_TAG508.pdf. Accessed on April 1, 2015.Search in Google Scholar
16. Kinsman J, Nakiyingi J, Kamali A, Whitworth J. Condom awareness and intended use: Gender and religious contrasts among school pupils in rural Masaka, Uganda. AIDS Care 2001;13:215–20.10.1080/09540120020027387Search in Google Scholar PubMed
17. Kinsman J, Harrison S, Kengeya-Kayondo J, Kanyesigye E, Musoke S, et al. Implementation of a comprehensive AIDS education program for schools in Masaka district, Uganda. AIDS Care 1999;11:591–601.10.1080/09540129947749Search in Google Scholar PubMed
18. Twa Twa J. The role of the environment in the sexual activity of school students in Tororo and Pallisa districts of Uganda. Health Transit Rev 1997;7:67–82.Search in Google Scholar
19. Onyeonoro UU, Oshi DC, Ndimele EC, Chuku NC, Onyemuchara IL, et al. Sources of sex information and its effects on sexual practices among in-school female adolescents in Osisioma Ngwa LGA, south east Nigeria. J Pediatr Adolesc Gynecol 2011;24:294–9.10.1016/j.jpag.2011.05.002Search in Google Scholar PubMed
20. Agardh A, Tumwine G, Östergren P-O. The impact of socio-demographic and religious factors upon sexual behavior among Ugandan university students. PLoS One 2011;6:e23670.10.1371/journal.pone.0023670Search in Google Scholar PubMed PubMed Central
21. Adeokun LA, Ricketts OL, Ajuwon AJ, Ladipo OA. Sexual and reproductive health knowledge, behaviour and education needs of in-school adolescents in northern Nigeria. Afr J Reprod Health 2009;13:37–49.Search in Google Scholar
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