Stakeholders Perspectives on Condom Promotion in Schools in Zambia: A Grounded Theory Approach of Four Selected Schools in Lusaka District

Abstract

Background: Adolescents in several LDCs, including Zambia experience early sexual debut resulting in STIs and unplanned pregnancies. The use of condom has been identified as one of the major steps aimed at reducing these negative SRH problems. The study explores stakeholders’ perspectives on condom promotion in schools in Zambia with regard to Stakeholders in support of condom promotion and against condom promotion in schools. Methods: This study is a qualitative research driven by a grounded theory design. The population was restricted to key stakeholders in education, including pupils from Kamwala, David Kaunda, Matero Boys and Kamulanga Secondary schools within Lusaka district of Zambia. In order to select and identify participants, purposive sampling was used which was combined with theoretical sampling to build up a theory. Seventeen (17) interviews were conducted with various stakeholders and seven (7) Focus Group Discussions (FGDs) with pupils were used as methods. The data were analyzed by means of grounded theory. Results : One core category emerged “selective condom promotion in schools” which connected other categories ’health related benefits ’, educational and empowerment reasons’, and ‘social and economical reasons on one hand and ‘against culture and sexual norms ’, ‘promoting immoral sexual behavior among pupils, against Christian teachings and ‘affect pupils academic performance,’ on the other hand. In this setting, stakeholders preferred selective condom promotion in schools as opposed to targeting all the pupils. Stakeholders were of the view that in schools some pupils are sexually active while others are young and may not be sexually active. Pupils who are sexually active must be given a choice by providing them with knowledge and information so that they are able to make a decision whether to use condom or not while those who are young and not sexually active should not be exposed to condom promotion. Therefore condom promotion should only target pupils who need the service so that they can make a decision on whether to protect themselves against STIs and unwanted pregnancies or not. Acceptability of condom promotion among many stakeholders was problematic because of the dominance of culture and religious issues which have placed a negative connotation on condom promotion. Conclusion: Although it was evident from the study that many youths were not abstaining from sexual activities, many stakeholders still felt that abstinence is the way to go because it was acceptable by society as opposed to condom promotion which many stakeholders believe is at variance with societal norms and beliefs. Issues of culture and religion had a huge influence on Stakeholders perspectives on condom promotion in schools. Key theoretical constructs that guide decisions regarding promotion of condoms in schools revolved around health related benefits considerations, educational and empowerment reasons, social and economic dynamics, moral and religious values as well as academic performance concerns. Key words: Grounded theory, Stakeholders, perspectives, condom promotion, Zambia