Training guidelines for promoting adolescents' knowledge and perceptions on sexual and reproductive health rights and services in rural Arsi Zone, Ethiopia

Abstract

Adolescents face various challenges regarding sexual and reproductive health rights (SRHRs) and services, mainly due to lack of knowledge and misperceptions. Therefore, the purpose of the study was to develop training guidelines for promoting adolescents’ knowledge and perceptions on SRHRs and services in rural Arsi Zone, Ethiopia. The study was conducted at five secondary schools and two health centres in the Zone. The justification of this study was to contribute a complete and comprehensive picture of the adolescents’ SRHRs and services at rural schools. The information generated would contribute to identifying potential areas of intervention and equip policymakers with evidence to support focused interventions. The researcher used a mixed methods approach of sequential explanatory design to collect, analyse, and integrate quantitative and qualitative data. The study was conducted in three phases. The first phase was conducted to investigate the knowledge, perceptions and service utilisation among 800 adolescents on SRHRs and service. Data were collected by pre-tested and structured self-administered questionnaires and analysed by Statistical Package for Social Sciences (SPSS) version 25 software. Bivariate and multivariate logistic regressions were done to identify the association of factors with sexual and reproductive health service utilisation. The statistical significance level was determined by odds ratios at 95% confidence interval and p-value less than 5%. For the second phase, purposely selected 24 adolescents and 12 key informants participated. The qualitative data analysis was done by thematic analysis using Atlas ti version 8. For the third phase, based on the findings of Phases 1 and 2, training guidelines for promotion of adolescents’ knowledge and perceptions on SRHRs and services were developed. Finally, the developed training guidelines were validated by experts and literature. During data collection at each phase the ethical principles were briefly described and implemented. Validity and reliability of the quantitative tools were assured before and during data collection procedures. To ensure the trustworthiness of the qualitative study, the four measuring (credibility, transferability, dependability and conformability) points were implemented. Overall, the study found limited knowledge, low-level services utilisation and misperceptions of adolescents on SRHRs and services. The findings also revealed that training curriculum didn’t include adolescents’ SRHRs and services. Based on the study findings and literature support, the training guidelines were developed. The developed training guidelines for promoting adolescents’ knowledge and perceptions on SRHRs and services recommended to incorporate SRHRs and services in Ethiopian education system. The developed training guidelines cover eight major topics. It is expected that the developed final training guidelines will address most of the challenges encountered by rural school going adolescents on the issues of SRHs utilisation. These guidelines are valuable resources that should always be easily accessible and available.