University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Western University, Faculty of Health Sciences, London, Ontario, Canada.
Afr J Reprod Health. 2023 Apr;27(4):16-23. doi: 10.29063/ajrh2023/v27i4.2.
Adolescent pregnancies that occur in schools remain a major public concern in Rwanda. Sexual and Reproductive Health and Rights (SRHR) school based programs are less effective and discussing sexual health with adolescents is considered as taboo in Rwandan societies. Yet, adolescents still seek information about SRHR from their peers and research shows that peers are often incorrectly informed about SRHR topics. One of the effective strategies to reduce adolescent pregnancies in secondary schools is equipping adolescents with accurate and reliable knowledge. In 2019, we conducted our first network event with different stakeholders. The stakeholders included: school directors, head teachers, biology teachers, local political delegates, religious people among others to help gain insights into SRHR. A survey was conducted and administered to in-school adolescents in Kirehe district (S3 - S6 level, n=563) with the aim of examining adolescents' level of knowledge and attitudes regarding SRHR. In addition, six focus group discussions (FGDs) were conducted to obtain a deeper understanding of the SRHR needs and the possible contributions and content of a peer -to- peer education program (PEP). The lessons learned included: a) engaging parents in the network event and development of PEP; b) constant communication utilizing the different social media platforms, c) enhanced collaboration between the project implementers and stakeholders a facet of bottom-up approaches to expedite this project; and d) the project should have better anticipated on possible and unforeseen external barriers. Implementing a PEP in Kirehe secondary schools resulted in substantive changes such as positively transforming peer educators (PEs) and the elimination of teenage pregnancies in the selected schools. Overall, the number of PEs was not adequate to cover the number of students and anti-bullying training should have been provided to all students before the project implementation.
在卢旺达，学校中发生的青少年怀孕仍然是一个主要的公众关注问题。性与生殖健康和权利（SRHR）学校为基础的项目效果不佳，在卢旺达社会中，与青少年讨论性健康问题被视为禁忌。然而，青少年仍然会从同龄人那里寻求关于 SRHR 的信息，研究表明，同龄人在 SRHR 主题方面的信息往往是不正确的。在中学减少青少年怀孕的有效策略之一是为青少年提供准确可靠的知识。2019 年，我们与不同的利益相关者首次举办了网络活动。这些利益相关者包括：学校校长、班主任、生物教师、当地政治代表、宗教人士等，以帮助深入了解 SRHR。我们在基里希区（S3-S6 年级）的在校青少年中进行了一项调查，目的是检查青少年对 SRHR 的知识水平和态度。此外，还进行了六次焦点小组讨论（FGD），以深入了解 SRHR 的需求以及同伴教育计划（PEP）的可能贡献和内容。得出的经验教训包括：a）让家长参与网络活动和 PEP 的制定；b）利用不同的社交媒体平台保持持续沟通；c）增强项目执行者和利益相关者之间的合作，这是加速这一项目的自下而上方法的一个方面；d）该项目应该更好地预测可能和不可预见的外部障碍。在基里希中学实施 PEP 带来了实质性的变化，例如积极改变同伴教育者（PE）和消除选定学校的青少年怀孕现象。总体而言，PE 的数量不足以覆盖学生人数，并且应该在项目实施之前向所有学生提供反欺凌培训。
