Strategies to promote responsible sexual behaviour among school-going adolescents in Mpumalanga province of South Africa

Abstract

The purpose of the study was to develop strategies to promote responsible sexual behaviour among school-going adolescents in the Mpumalanga Province of South Africa utilising a sequential explanatory mixed-method design. The study was conducted in two phases. Phase I (quantitative) included 252 school-going adolescents from two high schools aged 15 to 19 years. A pre-tested self-administered questionnaire was utilised to collect data. The study explored the school-going adolescents’ sexual behaviour patterns, sexual and reproductive health knowledge and information, attitudes towards responsible sexual behaviour, and utilisation of sexual and reproductive health services. Quantitative data were analysed using Statistical Package for Social Sciences (SSPS) version 20 software. According to Chi-square test results, the p-value of 0.562 suggested no statistically significant relationship between adolescents’ gender and attitudes towards responsible sexual behaviours. However, there was a statistically significant association between adolescents’ age and attitudes, and level of schooling and attitudes towards responsible sexual behaviours at a 5% significant ratio and a p-value of 0.000. There was another association between drinking alcohol and attitudes towards responsible behaviour (p-value 0.003 at a 5% significant level). The Chi-square test suggested acceptance of the existence of an association between getting drunk, getting drugged and casual sex and employing pregnancy prevention measures. In Phase II, a nested sample of 14 school-going adolescents participated in two qualitative focus group discussions, and 30 key stakeholders participated in face-to-face interviews using interview schedules as data collecting tools. The phase explored the challenges adolescents face in maintaining responsible sexual behaviour and key stakeholders’ views on adolescent sexual behaviours. Creswell’s thematic data analysis approach was used to analyse the qualitative data. The findings revealed that though adolescents showed an excellent understanding of sexual responsibility, there was a high inclination to engage in risky sexual behaviours. Gaps in adolescents’ knowledge of SRH and lack of open communication between adolescents’ parents and partners put them at risk of sexual malpractice. Identified sources of information for SRH, such as religion, media, peers and significant others like teachers, health professionals and non-governmental organisations, played an important role in moulding adolescents’ sexual behaviour, both positively and negatively. The integrated results of Phase I and Phase II, together with literature control, were used to develop the proposed strategies to promote responsible sexual behaviour among school-going adolescents. These were validated by field experts. The study supported evidence that there are challenges adolescents meet in their effort to maintain responsible sexual behaviours. Hence the proposed twelve strategies to promote responsible sexual behaviour among school-going adolescents.