OUTCOME OF REPRODUCTIVE HEALTH EDUCATIONAL INTERVENTION ON DROP-OUT RATE DUE TO PREGNANCY AMONG SELECTED RURAL SECONDARY SCHOOL STUDENTS IN OSUN STATE, NIGERIA

Abstract

In Nigeria, many secondary school students engage in risky sexual behaviour, which predisposes them to undesirable consequences, including unwanted pregnancy and school drop-out. To address this problem, three methods (Peer education, teachers' instructions and use of services of health workers) intervention have been used by researchers either independently or as a combination. However, none had used a combination of the three intervention. Based on the findings from a baseline survey, this study was designed to compare the relative effectiveness of four interventions using peer education, teachers' instructions, health workers and a combination of these three methods on drop-out rate due to pregnancy among female secondary school students in two rural schools in Osun State, Nigeria. The study utilized quasi-experimental design which consisted of five experimental schools in Ife-North Local Government Area (LGA) and four control schools from Isokan LGA. The two LGAs were randomly selected from the 30 existing LGAs in the state (Osun State) which were in turn randomly assigned into experimental and control groups. The five schools in the experimental group were randomly selected from 11 existing schools while the four in the control group were selected from the five existing schools in the LGA. The five schools in the experimental LGA were allocated into four intervention methods. The allocations were randomly done as follows; two schools (i.e. CAC Grammar School and L.A Grammar both at Ipetumodu) to peer education (Expt, 1), Origbo Grammar School, Moro to teachers' instruction (Expt.2), CAC Grammer School, Edunabon to health workers (Expt. 3) and Anglican Grammar school, Edunabon to mixed interventions (Expt. 4). Finally, systematic random sampling were used to select the students that filled the questionnaire in the two groups. Baseline information on reproductive health knowledge, sexual experience and causes of drop-out rate due to pregnancy were collected from the students and some Science teachers using pre-tested focus group discussion guide, indepth interview guide and a questionnaire. The results obtained were used to design the contents of the intervention programme which were implemented for two and half school calendar terms (November 2002 to June 2003), in the experimental schools only. A post- intervention assessment was administered using the same instruments as baseline. Drop-out rate due to pregnancy were also assessed in both groups at pre-and-post-intervention, using a review of school records and home visits. A total of 476 duly filled questionnaire from all the experimental schools and 532 from the control group were used for data analysis at baseline. At post-intervention, 420 questionnaires from the experimental schools and 482 from the control group were analyzed. The students' age ranged from 10-24 years in both groups and their mean ages were 14.7 (SD=2.3) and 15.1 (SD=2.3) years respectively in the experimental and control groups. On reproductive health knowledge, there was no significant difference in the knowledge among the schools at baseline on the constructed 33-point scale. At post-intervention however, all the four intervention schools showed significant gains over baseline, while the control recorded a slight increase. The amount of gain was greatest among Expt, 4 (+9.19 points), followed by Expt. 2(+8.82), Expt. 3 (+7.72), Expt, 1(+3.43) and control group (+0.78) (P<0.05). Alt intervention schools also showed a significant percentage increase in the use of contraceptives at post-intervention. The percentage increase were from 37.3% to 65.1%, 44.1% to 60.9%, 39.1% to 57.3% and 37.5% to 51.7% in Expt. 4, Expt. 2. Expt.1 and Expt.3 respectively. In comparison, the control group recorded a slight increase from 31.5% to 32.1% (P<0.05). On drop-out rate due to pregnancy, a sharp drop in the proportion of students who dropped out due to pregnancy was obtained at post-intervention in all intervention schools compared with control group which recorded a slight change. The changes were from 55.6% to 11.1% (Expt. 4), 50.0% to 20.0% (Expt. 3), from 63.6% to 42.9% (Expt, 2) and from 60.0% to 31.3% (Expt.1), while the control was from 64.5% to 55.0% (P<0.05). In conclusion, the study shows that a mixed intervention method had the greatest impact on reduction of school drop-out due to unwanted pregnancy.