EFFECTS OF EDUCATIONAL INTERVENTION ON KNOWLEDGE, ATTITUDE AND PRACTICE OF REPRODUCTIVE HEALTH AMONG SELECTED SECONDARY SCHOOL STUDENTS IN OYO STATE, NIGERIA.

Abstract

In Nigeria, risky sexual behaviours are widespread among adolescents, placing many in this population at high risk of unwanted pregnancies, sexually transmitted infections and associated complications. Schools provide an opportunity for adolescents to learn new knowledge and acquire relevant skills that will enable them prevent the undesirable consequences of unprotected sex. This can be done by formal teaching of existing curriculum and extra-curricular approach such as peer education. Studies have documented the value of peer education, but none have compared its effects with that of instructions provided by teachers. The goal of this study was to compare the effects of three interventions, peer education, classroom instructions and a combination of both on the knowledge, attitudes and practices of reproductive health among secondary school students in rural Oyo State. The study was quasi-experimental in design and consisted of three experimental and one-control schools. Four schools in Eruwa, Lanlate, Igbo-Ora and lgangan in the lbarapa district were randomly allocated among the study groups. At Akolu High School in Eruwa (El), students received teacher instruction. Students of Oke Aako High School Igangan (E2) were exposed to peer education. Igbo-ora Grammar School (E3) students were provided with both instruction and peer education, while those from Bioku High School in Lanlate served as the control group (C). A baseline questionnaire was administered to a systematic sample of 240 male and female students in each school. The results were used to design the contents of the interventions, which covered one academic year (January 19997 through March 1998). A follow-up survey used the same sampling procedures as baseline. We constructed a 34-point reproductive health knowledge score. There was significant difference in knowledge among the schools at baseline. During the follow-up survey however, all three intervention schools showed significant gains over baseline, while the control school students' mean score increased slightly. The amount of improvement among the intervention schools was greatest among E3 (+5.0 points), followed by E2 (+3.4), E1 (+1.4) and C (0.3). The intervention schools showed a significant shift in attitude towards use of contraceptives. The mean increases were 0.6, 0.5. and 0.9 points in E1, E2 and E3 respectively. Scores that measured the students'self-confidence in adopting safe sex practices increased significantly in E1 (from 10.8 to 11.8) and E3 (from 10.4 to 12.6). Reported condom use was significantly higher in E2 (from 16.7% to 62.8%) (p<0.05) and E3 (from 22.8% to 53%) (p<0.05) students compared to E1 (28.6% to 47.4%) (p>0.05) and control (from 25% to 45.8%) (p>0.05). On a ranking of performance, students from the school with the mixed intervention were top with 12 points, followed by those with peer education with 10 points, instructions with 5 points and the control with 2 points. In conclusion, the present study shows that a mixed intervention approach has the greatest potential for influencing the reproductive health practices of in-school adolescents.