http://doi.org/10.33698/NRF0036 – Angur Badhu, Badri Badhu
Abstract : Development of knowledge and attitude takes place during the adolescent period, which can have lifelong effects on the individual, family and society. Proper education in this age group is important for prevention of untoward social and health related problems especially related to reproductive health. Hence an experimental study was carried out in four selected schools with similar settings in Dharan town of Nepal to find out the effectiveness of structured teaching program in improving knowledge and attitude of school going adolescents on reproductive health. A total of 100 adolescent school students were included. The mean (±SD) pretest score of the experimental group on knowledge of reproductive health was 39.83 (± 16.89) and of the control group was 39.47(±10.08). The difference in score of experimental group after administration of the structured teaching program (84.60±12.60) and of the control group with conventional teaching method (43.93±10.08) was statistically significant (p<0.001). Similarly, the post-test scores of knowledge of the groups on responsible sexual behaviour and their attitude towards reproductive health were better in the experimental group than in the control group (p<0.001). Hence it was concluded that the knowledge of adolescent school students on reproductive health is inadequate. The use of structured teaching program is effective in improving knowledge and attitude of the adolescents on reproductive health.
Key Words :
Adolescents, reproductive health, structural teaching programme.
Correspondence at :
Mrs Angur Badu,
Department of Community Health Nursing College of Nursing
BP Koirala Institute of Health Sciences Dharan, Sunsari, Nepal
Adolescence is a period of transition from childhood to adulthood. One fifth of the world’s population is represented by them1. Development of knowledge and attitude takes place during this period, which can have lifelong effects on the individual, family and society2. Changes in the pattern of thinking attitude, relationships, moral standards and abilities take place in this period3. Premarital sex resulting in adolescent pregnancy, unwanted pregnancy and induced abortion are not uncommon4. Reproductive health is relatively a new concept that includes teenage pregnancy, sexually transmitted diseases (STDs), HIV and AIDS, freedom from risk of sexual diseases, right to regulated one’s own fertility and full knowledge of contraceptive choices5. The strategy on education for responsible and healthy sexuality; safe and appropriate contraception; services for sexually transmitted diseases, pregnancy, delivery and abortion is important6. Effective means of teaching should be identified for improvement in knowledge and attitude of the adolescents. Present study was carried out to find out the effectiveness of structured teaching program in improving knowledge and attitude of school going adolescents on reproductive health.
Materials and Methods
A quasi – experimental study with pre- test – post-test control group design was carried out in four selected schools of Dharan town with similar settings. All the subjects were divided into two groups: experimental and control group each comprising of two subgroups of 25 boys and 25 girls. Structured teaching program consisted information on human reproductive system particularly sexual growth and development during puber ty and responsible sexual behaviour. Interpretation of scores for knowledge was done as follows.
- 76 – 100% Adequate
- 51 – 75% Moderately adequate
- <50% Inadequate
Sampling was done by cluster sampling technique. Data was collected in three phases. In phase I, pretest was carried out in both the groups (experimental and control). Experimental group comprised of 50 students from school No.1(25 boys + 25 girls) and 50 students from School No.2(25 boys + 25 girls). Control group comprised of 50 students in School No.3(25 boys + 25 girls), and 50 students from School No.4(25 boys + 25 girls). Consent from the school authorities and individually from the students was obtained. For assessing knowledge and attitude a questionnaire on reproductive health was used and for assessing attitude on reproductive health a modified Likert scale (0 – 10 point scale) was used. In Phase II, the structured teaching program was administered to the experimental group, whereas conventional teaching method was used for the control group. In Phase III, post- test was carried out after three days in both the groups. Data was analysed and interpreted in percentages and paired‘t’ test was applied to know the significance.
A total of 100 adolescent school students were included in this study from four selected schools of Dharan. The pretest mean scores of the experimental group and control group on knowledge of reproductive health were 39.83(±16.89) and 39.47 (±10.08) respectively. After administration of the structured teaching program in the experimental group the mean score was 84.60±12.60 and after the use of conventional teaching method in the control group the mean score was 43.93±10.08 (Table – 1). The pre-test and post-test differen ce in results of the groups and between the groups was statistically significant (p<0.001). Similarly, the post-test scores of knowledge (Table -1) of the experimental group on responsible sexual behaviour and their attitude (Table – 2) towards reproductive health were better than those of the pretest (p<0.001), whereas the same of the control group was not significantly different (p>0.05).
Table – 1: Knowledge on reproductive health and responsible sexual behaviour
|Experimental Group||Control Group|
|Pre-test Mean ±SD||Post-test Mean ±SD||p-value||Pre-test Mean ±SD||Post-test||p-value|
|Reproductive health||39.83± 16.89||84.60± 12.60||<0.001||39.47± 10.08||43.93±10.08||>0.05|
|Responsible Sexual behavior||
Table – 2 : Pre-test and post test attitude score difference
In this study gross inadequacy of knowledge on reproductive health and responsible sexual behaviour among the school going adolescents was found. Adolescents having inadequate factual information on reproductive health may face problems due to too little guidance, because of which they get exposed to serious health risks. Several studies have shown that premarital sex, unwanted pregnancies7-10 and unsafe abortions are common among the adolescents11. Abortions due to unwanted pregnancies are common in adolescents with more than primary level education11, which is obviously due to inadequate or inefficient education method. Walker E et al have reported that consensual sexual intercourse has the most prominent mode of transmission of HIV in adolescents7. There can be a coerced sexual intercourse among the adolescents10 with serious social and health related consequences.
Etuk S J et al and Ozvaris SB et al have emphasized the need of sexuality education that the education centers can play an impor tant role in meeting sexual and reproductive health needs of the adolescents9,12. It is important to realize the problems and take adequate measures to improve the knowledge and attitude of adolescents on reproductive health and responsible sexual behaviour with the purpose to prevent many serious health problems.
It is concluded that the knowledge on reproductive health and responsible sexual behaviour among the school going adolescents is inadequate. Structured teaching program is effective in improving the knowledge and attitude of the adolescents in these issues. Since significant improvement was found in knowledge and attitude on reproductive health and responsible sexual behaviour after education by using structured teaching program, hence incorporation of such teaching programmes into the school curriculum is recommended.
- Friedman Reproductive health in adolescence. World Health Statistics: Quarterly 1994; 47:31-35.
- Francis PT, Gill JS, Knowledge, beliefs and attitudes regarding AIDs, STDs and human sexuality among senior
secondary students in Delhi. Indian Journal of Community Medicine 1994; 39:17 – 20.
- Herman Sex education for adolescents. Lancet 1995; 34: 86 –88.
- Sai FT, Nassim The need for a reproductive health approach. Suppl International Journal of Gynaecology and Obstetrics Abstracts 1989; 3: 103 – 113.
- Nag Premarital sex: sexual behaviours and AIDs in India. Indian Journal of Community Medicine 1997; 34: 45 – 46.
- Rao Abortions among adolescents in rural area. Journal of Obstetrics and Gynaecology 1990; 40: 739 – 741.
- Walker E, Mayes B, Ramsay H et Socio-demographic and clinical characteristics of Jamaican adolescents with HIV/AIDs. West Indian Med J 2004; 53 (5): 332-338.
- Jones RK, Purcell A, Singh S, Finer Adolescents’ reports of parental knowledge of adolescents’ use of sexual health services and their reactions to mandated parental notification for prescription contraception. JAMA 2005; 293 (3) : 340 – 348.
- Etuk SJ, Ihejiamaizu EC, Etuk Female adolescent sexual behaviour in Calabar, Nigeria. Neger Postgrad Med J 2004; 11(4):269-273.
- Koenig MA, Zablotska I, Lutalo T, et Coerced first intercourse and reproductive health among adolescent women in Rakai, Uganda. Int Fam Plan Perspect 2004; 30(4): 156-163.
- Kapil AM, Van Ginneken J, Razzaque Factors associated with adolescent abortion in a rural area of Bangladesh. Trop Med Int Health 2005; 10(2):198-205.
- Ozvaris SB, Akin L, Akin The role and influence of stakeholders and donors on reproductive health services in Turkey: a critical review. Reprod Health Matters 2004; 12 (24): 116- 127.