Inadequate information hindering sexual and reproductive health in schools

Sexual and Reproductive Health (SRH) programmes in Ghana are not providing the full range of information adolescents need, a recent study shows. The study, “From Paper to Practice: Sexuality Education Policies and Implementation in Ghana” was conducted jointly by researchers at the University of Cape Coast (UCC) and the U.S.-based Guttmacher Institute, a release made available to the Ghana News Agency has said.

The research team undertook an analysis of policies and curricula regarding SRH education in Ghana and their implementation in senior high schools, focusing on three geographically diverse regions: Greater Accra, Brong Ahafo and Northern Region.

It said a comprehensive SRH education is integral to ensuring that adolescents are equipped with the information they need to achieve healthy sexual and reproductive lives and to avoid negative health outcomes.

Programmes that recognize that sexual activity among adolescents is normal; that seek to ensure adolescents practice safe sex; that actively engage their participants; and that focus on rights, gender equality and empowerment, have been shown to have a positive impact on several aspects of adolescents’ lives.

It said government has demonstrated a strong commitment to SRH education by implementing programmes in schools nationwide.

The release said according to international standards, comprehensive SRH education should cover a range of topics, which fit into five key categories identified by the study team: sexual and reproductive physiology; HIV/STI prevention; contraception and unintended pregnancy; values and interpersonal skills; and gender and sexual and reproductive rights.

The authors of the report found that three-fourths of surveyed students have been exposed to at least one topic in each of the five categories, but only eight percent of students reported learning about all of the topics that constitute a comprehensive programme.

Adolescents reported that they need practical information about how to prevent STIs (including HIV), how to prevent unintended pregnancies, and how to communicate and negotiate within relationship,- issues not adequately covered in abstinence-focused curricula.

It said while SRH education in Ghana is advanced, compared to that in other countries in the region, information is often presented from a reactive perspective and focuses on the importance of abstinence and the dangers of sexual activity.

Melissa Stillman, a Guttmacher researcher, said “abstinence-only education programs have shown little evidence of improving adolescents’ sexual and reproductive health outcomes.”

“Rather, the adolescents surveyed report that they need practical information about how to prevent STIs, including HIV, how to prevent pregnancy, and how to communicate and negotiate within relationships.”

The study found that 23 percent of female and 27 percent of male students had already had sex at the time of the survey, and some likely did so before they were taught the skills and knowledge they need to practice safe sex and lead healthy sexual and reproductive lives.

The authors recommend that age-appropriate SRH education start early in schools, well prior to sexual initiation.

It said primary and junior high schools are important points of entry for comprehensive SRH education, given that 85–90 percent of adolescents in Ghana attend these levels, but only half (48 per cent) attend senior high school.

“Nearly half of the students we surveyed reported that they would have preferred to have had sexual and reproductive health education sooner than they did,” Dr Kofi Awusabo-Asare of the University of Cape Coast, said.

“It is critical that this education begins early, prior to sexual initiation, to provide adolescents with age-appropriate, comprehensive and accurate information to make healthy choices.”

Teachers are the main source of information for students in Ghana, and the quality of teaching depends on their preparedness, confidence, knowledge and skills. Teachers from various disciplines cover SRH topics, leading to variability in emphasis.

The authors of the report also recommended that teacher training be standardized and improved to adequately prepare educators with the skills they need to teach these programs effectively.

To ensure the healthy development of adolescents and to support their transition to adulthood—as well as to match the strong commitment that the Government of Ghana has shown over the years—the comprehensiveness of SRH education offered in core curricula must be improved to meet international standards, and appropriate resources must be provided to ensure adequate teacher preparation.

The government, school heads, teachers, students and community members, show strong support for the provision of SRH education in schools.

The study was funded by grants from the Dutch Ministry of Foreign Affairs and the Swedish International Development Cooperation Agency.