Acceptability of youth clubs focusing on comprehensive sexual and reproductive health education in rural Zambian schools: a case of Central Province

Abstract

Youths in Zambia have limited access to information concerning Sexual Reproductive Health (SRH) and this puts them at risk of unwanted pregnancy. The Research Initiative to Support the Empowerment of Girls (RISE) is a cluster randomized testing the effectiveness of different support packages on teenage pregnancies, early marriages and school dropout. One of the support packages included youth clubs focusing on comprehensive sexual and reproductive health education (CSRHE). Although similar interventions have been implemented in other settings, their integration process has been complex and comprehensive assessments of factors shaping acceptability of youth clubs is lacking. Through the use of diffusions of innovations theory, this paper qualitatively aimed to identify factors that shaped the acceptability of CSRHE youth clubs in rural schools in Central Province. A qualitative case study was conducted in which data gathered through eight focus group discussions from grade eight pupils, eight key informant interviews with teachers and document review were analyzed using thematic analysis. The perceived relative advantage of youth clubs and the simplicity related to the use of participatory learning methods, films and role plays to communicate sensitive reproductive health information and made the learners like the youth clubs. Further the perceived compatibility of the content of the sessions with the science curriculum increased the learners’ interest in the youth club as the meetings also helped them prepare for the school exams. However, cultural and religious beliefs among teachers and parents regarding the use of contraceptives complicated the delivery of reproductive health messages and the acceptability of youth club information among the learners. The study has demonstrated that acceptability of SRH interventions such as youth clubs in some schools of Central Province may be successful if pupils and teachers use interventions that depict real life. Teachers and pupils appreciated the introduction of CSRHE youth clubs and the provision of economic support to girls and their families that led to the reduction of early marriages, school drop-out and early pregnancies. Key words: Comprehensive sexual and reproductive health education, youth clubs, acceptability