The Effect of School-Linked Module-Based Friendly-Health Education on Adolescents’ Sexual and Reproductive Health Knowledge, Guji Zone, Ethiopia - Cluster Randomized Controlled Trial

Abstract

Background

Although access to sexual and reproductive health information is the right and a critical component of health policy, it is not well addressed in pastoral communities. This study assessed the effect of School-Lined Module-based friendly health education on adolescents’ sexual and reproductive health knowledge in the pastoral community of Guji Zone, Ethiopia.

Methods

A two-arm cluster Randomized control trial study with pre-post evaluation was conducted among interventions (n=375) compared with control (n=384) in Gorodola and Wadara high schools. Comparing an intervention to a control group, pre-posttests, and post-posttests were used to evaluate the effectiveness of the intervention. The data was collected using 25 Self-administered questionnaires and analyzed using paired-sample independent t-tests and linear regressions to study the relationship between the outcome and independent variables.

Results

We collected the data from 759 adolescents among 15 intervention and 15 control clusters. The results have shown that as compared to control arms, the mean sexual and reproductive health Knowledge score was significant higher in the intervention clusters (375) 73.3%, vs (384) 66.5%%, p<0.001, 95% CI, (0.05395–0.08347). Information (β: 0.038, 95% CI: 0.028–0.052), confidence (β: 0.045, 95% CI: 0.033–0.057), knowledge (β: 0.05, 95% CI: 0.035–0.066), and compassionate care (β: 0.107, 95% CI: 0.092–0.122) were significantly associated with SRH knowledge prediction. The proportion of SRH knowledge increased from 168(44%) baseline to 244(65%) end line in the intervention versus 235(60% to 238(62%) in control arms.

Conclusion

The execution of school-linked module-based friendly health education has proved to have a significant effect on mean SRH knowledge. Individual-level and behavioral-level factors significantly explain variability in enhancing SRH knowledge in the pastoral community. We recommend scaling up the School-Linked Module-based friendly health education intervention.

Trial Registration

We registered clinical trial PACTR202107905622610 on 16 July 2021.

Keywords:

• adolescent
• SRH knowledge
• education
• intervention
• pastoral community

Abbreviations

AFHS, Adolescent Friendly Health Services; AFSRH, Adolescent Friendly Sexual and Reproductive Health; FHS, Friendly Health Services; MBFHEP, Module Based Friendly Health Education program; MoH, Ministry of Health; HCP, Health Care Providers; RHB, Regional Health Bureau; RH, Reproductive Health; MoH, Ministry of Health; SRH, Sexual and reproductive health.

Data Sharing Statement

All data in this study were already available in this article. However, suppose additional specific data and other study documents are required. In that case, we can share the data via a link after the publication of the manuscript after the deidentification of specific individual information.

Ethical Consideration

We obtained ethical clearance from Jimma University (Ref.No IHRPCA/721/202, dated 17/08/2020) and the Health Bureau of Oromia Region (Lakk/Ref No BEFO/MBTF/2081, dated 27/01/2013, ETC. or 07/10/2020). We confirmed that our study complies with the Declaration of Helsinki, and participants and parental informed consent included publication of anonymized response. The study protocol of the study included verbal informed consent and parents/guardians provided provided informed consent on the behalf of the study participants under age of 18, which was already approved by Ethical Review Board.

Acknowledgment

The authors gratefully acknowledge Jimma University, the Ministry of Health Ethiopia, the Oromia Regional Health Bureau, and Guji Zonal and Districts Health and Education offices for their irreplaceable support in this study. Additionally, we thank all study contributors, high school directors, homeroom teachers, data collectors, and supervisors.

Disclosure

The authors report no conflicts of interest in this work.