Assessment of Selected Secondary School Students in Ibadan North Lga, on Their Knowledge, Perception and Relevance of Sex Education

NAME: MATRIC NO: PROJECT TOPIC:

FALADE Felicia Olufunmbi 129093077 ASSESSMENT OF SELECTED SECONDARY SCHOOL STUDENTS IN IBADAN NORTH LGA, OYO STATE ABOUT THEIR KNOWLEDGE, PERCEPTIONS AND RELEVANCE OF SEX EDUCATION

SPICE
Setting – Population – Educational Institutions Secondary school students in Ibadan North L.G.A, Oyo State, Nigeria

Intervention – None Comparison – Association between sex education and perceptions of the students towards premarital sex Evaluation Students’ knowledge and perception of sex education in formal school settings

INTRODUCTION The Nigerian society today has to grapple with many behavioural problems of its youth. Such problems include truancy, disobedience, drug offences, assault, insult, stealing, violent demonstrations, vandalism, examination malpractices, robbery, and secret cult activities. 1 Apart from these widely publicized behavioural problems, heterosexual activities are also listed among types of behavioural problems prevalent in Nigerian secondary schools. These are variously named in the literature as sex abuse, sex offences, sexual misconduct, sexual immorality, sexual promiscuity, and sexual maladjustment. It has been observed that in terms of behavioural problems, sex abuse appeared to be one of the most serious offences committed by children and adolescents. 1 This has been supported with a United Nation’s information on reproductive health, which shows that many Nigerian girls are known to start involvement in active sex at the early age of thirteen years. 2 The age of initial sexual experience and involvement thus becomes younger than fifteen years as found in the past. 3 Today’s situation shows a sharp contrast to the traditional Nigerian societal context in which girls avoided pre-marital sexual experiences for fear of social punishments usually meted out to girls who lost their virginity before marriage. Over 50% of the global cases of HIV and AIDS were recorded for persons aged 15 - 24 and over 60% of the cases occurred in sub-Saharan Africa, which constitutes 10% of the world population4. Nigeria has an estimated population of 140 million with an annual growth rate of 1.99% 5. Nigeria, the most populous country in Africa, has a predominantly youthful population. One quarter (25%) of all Africans and one-third of the continents’ adolescent population live in Nigeria.6 Adolescent constitute a high risk group in terms of sexual and reproductive health problems. The adolescence stage is a time when many young people exhibit risky sexual behaviors that are life-changing such as sex initiation, multiple and concurrent partnership, low contraceptive use and risky sexual practices. All these predispose young people to HIV and sexually transmitted infections. This has been argued to be often overlooked or viewed through a lens of cultural values that limit care.7

About 30 million women are in the reproductive age group and contraceptive prevalence rate is 15%.8 Nigeria has a high total fertility rate of 5.78 and about 610,000 unsafe abortions occur annually. 9 A major issue of concern is that more than 60% of teenagers are sexually active and of the 610,000 induced abortions in Nigeria, 60% are attributed to young persons. 10 In Nigeria, more than 60% of new HIV infections occur in youths ages 15 to 25. This takes place against a background in which one-third of the country’s population of about 160 million is aged 10-24 years.11 It has been reported that there is minimal access to proven sexuality, family life or HIV and AIDS education that would help them become sexually healthy adults, practice safe sexual behavior, and reduce unintended pregnancy and Sexually Transmitted Diseases (STDs) including HIV. 6 Also noted are lack of information and lack of voice, which continue to be primary causes of infection among the worst affected groups of women and youth adolescent. They also face multiple barriers to accessing reproductive and sexual health services and maintaining their reproductive health. 12 These include lack of information and education, lack of youth-specific services, concern about confidentiality affordability and access to services social pressures and taboos. In Nigeria, problems associated with adolescents’ sexual health include high rates of teenage pregnancy13; a rising incidence of sexually transmitted diseases 14, 15, high rates of abortion mortality16, etc. Medical problems associated with adolescents’ sexual behaviour are a major health burden to Nigerians. Problems are not confined to pregnancy but include secondary infertility and development of cervical abnormalities in adolescents16. Early sexual activity has negative consequences for young people. Adolescents who become sexually active enter an arena of high-risk behaviour that leads to physical and emotional damage17. Each year, influenced by a combination of a youthful assumption of invincibility, and a lack of guidance (or misguidance and misleading information), millions of adolescents ignore those risks and suffer the consequences. These and other evidence in the literature show that a real problem exists. Observers blame this state of affairs on parents. Basically, the task of educating children, especially adolescents, about sex is seen as the responsibility of parents. The traditional Nigerian society, however, is

quite conservative on matters of sex. Consequently, parent-child discussion on sexual matters is beclouded by parental inhibitions and inter-generational tensions. Questions bordering on sexuality and girl-boy relationships are usually hushed up and regarded as taboos 17. Most Nigerian parents shy away from such discussions because it is generally believed that it will make the adolescent attempt to experiment on what they have been told.18 Studies have shown that in most African homes, children rarely receive information on sexual matters from their parents and even when they do, parents are not fully equipped to answer questions on sexual matters usefully. Even those who try to, pass on faulty information to their children. 19 The whole subject thus becomes surrounded by secrecy and the children now become too embarrassed to discuss these matters with their parents. The consequence of this action is that Nigerian adolescent boys and girls find answers to sex-related questions on their own, often from questionable sources that are likely to give them wrong information14, 17, making them more likely to indulge in reckless and unguarded sexual experimentation. Some adolescents lack adequate communication and assertiveness skills to negotiate safer sex.20 Some feel unable to refuse unwanted sex or feel compelled to exchange sex for money.15,
21

Because young people experiment sexually13 and because of the consequences of

indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. This is the focus of this study. Sex education is regarded as essential to eliminate the problems associated with young people’s sexual health. Several overviews of sexual health programmes for adolescents have concluded that sex education can beneficially affect behaviours. Most United Kingdom secondary schools have teachers designated to deliver sex education as part of the curriculum and this is the most suitable and sustainable mode of delivery22. This method is supported by other researchers23, who opined that sex education should be done in the classroom setting. However, in Nigeria today, sex education is yet to be

incorporated into the curricula of secondary school education. 24 Thus, the high prevalence of HIV/AIDS,

teenage pregnancy and rape among young people is related to the misconceptions about sex and lack of curriculum for sexuality education in schools25. It is in this regard that I wish to conduct an assessment of some selected secondary school students in Ibadan North Local Government Area of Oyo State, Nigeria, about their knowledge, perception and relevance of sex education. This study is designed to explore the reproductive health knowledge, sexual behaviour and sexuality education needs of in-school adolescents. Research questions i. What are students’ attitudes towards sex education? ii. Is there an association between sex education and premarital sex? iii. Are students willing to formally learn about sex education? iv. What are the barriers to the formal teaching of sex education? Aim of the study To assess the students’ reproductive health knowledge, perceptions and relevance of sex education in the school curriculum. Objectives of the Study 1. To assess the knowledge of the students on their Reproductive Health. 2. To identify sexual and reproductive health practices among the students. 3. To identify the students’ sources of information on reproductive health. 4. To identify the barriers to teaching sex education in secondary schools.

REFERENCES 1. Nnachi, R. O. (2003). “Causes, consequences and control of behaviour problems among Nigerian children” in Nnachi, R. O. and Ezeh, P. S. E. (Eds.). (2003). The behaviour problems of the Nigerian Child. Awka. The Nigerian Society for Educational Psychologists (NISEP). 2. Obiekezie-Ali, M. C. (2003). “Sexual behaviour problems of secondary school girls and women empowerment” in Nnachi, R. O. and Ezeh, P. S. E. (Eds.) (2003). The behaviour problems of the Nigerian child. Awka. The Nigerian society for Educational Psychologists (NISEP). 3. Esen, A. J. A. (1974). “A study of adolescent sexuality in Nigeria”. West African Journal of Education. 18 (18) pp 445 – 453. 4. World Health Organization (2004). Coming of age from facts to actions for adolescent sexual and reproductive health. Geneva: WHO. 5. C.I.A (2010). Population Growth Rate, Nigeria. The fact book Publications. http://www.cia.gov/library/publications/theworldfactbook. Accessed 11/09/2010. 6. Obono Oka and Modupe Mohammed .2010. “The liminality of adolescent sexual and reproductive behavior in Ibadan southern Nigeria” The Nigerian Journal of Sociology and Anthropology Volume: 8 pages 55-85. 7. Population Reference Bureau: 2003 8. Nigeria Demographic and Health Survey (NDHS) 2008. National Population Commission (Nig) and Macro. USA. 2009. http://pdf.usaid.gov/pdf_docs/PNADQ923.pdf. Accessed 11/09/2010. 9. Osemwenkha S.O. (2004). Gender issues in contraceptive use among educated women in Edo state, Nigeria. Afr. Health Sci., 4(1): 40-49. 10. Oye-Adeniran B.A., Adewole I.F. and Odeyemi K.A. (2005). Contraceptive Prevalence among Young Women in Nigeria. J. Obstet. Gynaecol., 25(2): 182-185. 11. National Population Commission 2007: “Final Result of the 2006 census” Abuja: National Population Commission. ICF

12. Forman Lisa. 2003. “HIV/AIDS, Information and communication in Africa” APC Theme Discussion Paper, 2003 13. Adegoke, A. A. (2003). Adolescents in Africa: Revealing the problems of teenagers in contemporary African society. Ibadan: Hadassah Publishing. . 14. Abogunrin, A. J. (2003). Sexual behaviour, condom use and attitude towards HIV/AIDS among adolescents in Nigeria. An Unpublished Ph.D thesis, University of Ilorin, Nigeria. 15. Nwabuisi, E.G. (2004). Support networks and adjustment needs of HIV/AIDS patients in the .Zonal ‘hotspots’ in Nigeria. An unpublished Ph. D Thesis, University of Ilorin. 16. Akingba, J. B. (2002). Abortion mortality and other health problems in Nigeria. Nigeria Medical Journal, 1(4), 465 -471. 17. Esere, M. O. (2006). HIV/AIDS awareness of in-school adolescents in Nigeria: Implications for adolescence sexuality. Journal of Psychology in Africa, 16(2), 255 – 258. 18. Durojaiye, M. O. A. 1972. “Guidance through sex education in: Psychological guidance of the school-child:, Evans Brothers Ltd. 19. Egbochuku O.E. and Ekanem I.B, Attitude of Nigerian Secondary School Adolescents Toward Sexual Practices: Implications For Counselling Practices, European Journal of Scientific Research ISSN 1450-216X Vol.22 No.2 (2008), pp.177-183 20. Maduakonam, A. (2001). Sex education in schools: A panacea for adolescent sexuality Problems. In R. U. N. Okonkwo & Romy Okoye (Eds.) The Nigerian Adolescent. In Perspective. Awka: Theo and Sons Publishers, pp 74-82. 21. Ayoade, C. A. (2006). Relationships among leisure, social self image, peer pressure and at-risk behaviour of adolescents in Nigeria. An unpublished Ph.D thesis, University of Ilorin, Nigeria. 22. Daniel W., Gillian R., Marion H., Charles A., Katie B.H., Graham and Sue S. (2002). BMJ ,324 (7351):1430 Onwuka

23. Martin J., Is Classroom Sex Education fit for Purpose? From The Times and The Sunday Times archives (2009). Times Newspapers Ltd 2010 Registered in England No. 894646 Registered office:1 Virginia Street, London, E98 1XY. 24. Mary Ogechi Esere (June 2008). Effect of sex education programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria. African Health Sciences Vol 8 No 2. pp. 120-125. 25. Akeem Ayofe Akinwale (May, 2009) Manifestation of human sexuality and its relevance to secondary schools in Nigeria. International Journal of Sociology and Anthropology Vol. 1(1) pp. 001-005 Available online http://www.academicjournals.org/ijsa

METHODOLOGY
Respondents The study is a cross-sectional descriptive design. The participatory secondary schools would be purposively selected from the forty three secondary schools in Ibadan North Local Government Area of Oyo State, Nigeria. However, the senior secondary school three (SSS 3) and junior secondary school three (JSS3) students will be exempted due to the fact that they would be very busy. The students would be stratified into strata based on history of formal sex education and classes. Systemic sampling would then be used to select individual participants. Data Collection Tools Comprehensive questionnaires with open-ended and closed-ended questions would be designed to elicit information such as demographic and socio-economic characteristics, knowledge about sexual and reproductive health, pregnancy prevention, puberty signs, sexually transmitted infections, attitudes towards premarital sex, sexual activities, sources of information and sex education needs from students in the selected secondary schools. They would be asked to indicate by identifying reason for their choice as contained in the questionnaire. Face and content validity would be confirmed by questionnaire professionals. These questionnaires would be pre-tested in a similar population and would be modified appropriately. Data Collection After obtaining permission from the schools’ authorities and the consent of participating students, questionnaires would be administered to the selected consenting students with the help of trained Corper Peer Education Trainers (CPETs) in each school, and under the supervision of Oyo State NYSC CPETs club Schedule Officer. Questionnaire administration would be conducted in a classroom and participants would be instructed to sit separately from one another to ensure privacy when responding to the questionnaires. It would be explained that there would be anonymity concerning their responses. No names would be placed on the questionnaires. These students will fill them and returned immediately afterwards. Participants would insert completed questionnaires in a large envelop as they leave the classroom.

Data Analysis Completed questionnaires would be collated and entered, cleaned and analyzed appropriately, using the appropriate statistical software. Correlation analysis would be carried out to confirm significant relationships between variables of interest.

References: 1. Nnachi, R. O. (2003). “Causes, consequences and control of behaviour problems among Nigerian children” in Nnachi, R. O. and Ezeh, P. S. E. (Eds.). (2003). The behaviour problems of the Nigerian Child. Awka. The Nigerian Society for Educational Psychologists (NISEP). 2. Obiekezie-Ali, M. C. (2003). “Sexual behaviour problems of secondary school girls and women empowerment” in Nnachi, R. O. and Ezeh, P. S. E. (Eds.) (2003). The behaviour problems of the Nigerian child. Awka. The Nigerian society for Educational Psychologists (NISEP). 3. Esen, A. J. A. (1974). “A study of adolescent sexuality in Nigeria”. West African Journal of Education. 18 (18) pp 445 – 453. 4. World Health Organization (2004). Coming of age from facts to actions for adolescent sexual and reproductive health. Geneva: WHO. 5. C.I.A (2010). Population Growth Rate, Nigeria. The fact book Publications. http://www.cia.gov/library/publications/theworldfactbook. Accessed 11/09/2010. 6. Obono Oka and Modupe Mohammed .2010. “The liminality of adolescent sexual and reproductive behavior in Ibadan southern Nigeria” The Nigerian Journal of Sociology and Anthropology Volume: 8 pages 55-85. 7. Population Reference Bureau: 2003 8. Nigeria Demographic and Health Survey (NDHS) 2008. National Population Commission (Nig) and Macro. USA. 2009. http://pdf.usaid.gov/pdf_docs/PNADQ923.pdf. Accessed 11/09/2010. 9. Osemwenkha S.O. (2004). Gender issues in contraceptive use among educated women in Edo state, Nigeria. Afr. Health Sci., 4(1): 40-49. 10. Oye-Adeniran B.A., Adewole I.F. and Odeyemi K.A. (2005). Contraceptive Prevalence among Young Women in Nigeria. J. Obstet. Gynaecol., 25(2): 182-185. 11. National Population Commission 2007: “Final Result of the 2006 census” Abuja: National Population Commission. ICF 12. Forman Lisa. 2003. “HIV/AIDS, Information and communication in Africa” APC Theme Discussion Paper, 2003 13. Adegoke, A. A. (2003). Adolescents in Africa: Revealing the problems of teenagers in contemporary African society. Ibadan: Hadassah Publishing. . 14. Abogunrin, A. J. (2003). Sexual behaviour, condom use and attitude towards HIV/AIDS among adolescents in Nigeria. An Unpublished Ph.D thesis, University of Ilorin, Nigeria. 15. Nwabuisi, E.G. (2004). Support networks and adjustment needs of HIV/AIDS patients in the .Zonal ‘hotspots’ in Nigeria. An unpublished Ph. D Thesis, University of Ilorin. 16. Akingba, J. B. (2002). Abortion mortality and other health problems in Nigeria. Nigeria Medical Journal, 1(4), 465 -471. 17. Esere, M. O. (2006). HIV/AIDS awareness of in-school adolescents in Nigeria: Implications for adolescence sexuality. Journal of Psychology in Africa, 16(2), 255 – 258. 18. Durojaiye, M. O. A. 1972. “Guidance through sex education in: Psychological guidance of the school-child:, Evans Brothers Ltd. 19. Egbochuku O.E. and Ekanem I.B, Attitude of Nigerian Secondary School Adolescents Toward Sexual Practices: Implications For Counselling Practices, European Journal of Scientific Research ISSN 1450-216X Vol.22 No.2 (2008), pp.177-183 20. Maduakonam, A. (2001). Sex education in schools: A panacea for adolescent sexuality Problems. In R. U. N. Okonkwo & Romy Okoye (Eds.) The Nigerian Adolescent. In Perspective. Awka: Theo and Sons Publishers, pp 74-82. 21. Ayoade, C. A. (2006). Relationships among leisure, social self image, peer pressure and at-risk behaviour of adolescents in Nigeria. An unpublished Ph.D thesis, University of Ilorin, Nigeria. 22. Daniel W., Gillian R., Marion H., Charles A., Katie B.H., Graham and Sue S. (2002). BMJ ,324 (7351):1430 Onwuka 23. Martin J., Is Classroom Sex Education fit for Purpose? From The Times and The Sunday Times archives (2009). Times Newspapers Ltd 2010 Registered in England No. 894646 Registered office:1 Virginia Street, London, E98 1XY. 24. Mary Ogechi Esere (June 2008). Effect of sex education programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria. African Health Sciences Vol 8 No 2. pp. 120-125. 25. Akeem Ayofe Akinwale (May, 2009) Manifestation of human sexuality and its relevance to secondary schools in Nigeria. International Journal of Sociology and Anthropology Vol. 1(1) pp. 001-005 Available online http://www.academicjournals.org/ijsa METHODOLOGY Respondents The study is a cross-sectional descriptive design. The participatory secondary schools would be purposively selected from the forty three secondary schools in Ibadan North Local Government Area of Oyo State, Nigeria. However, the senior secondary school three (SSS 3) and junior secondary school three (JSS3) students will be exempted due to the fact that they would be very busy. The students would be stratified into strata based on history of formal sex education and classes. Systemic sampling would then be used to select individual participants. Data Collection Tools Comprehensive questionnaires with open-ended and closed-ended questions would be designed to elicit information such as demographic and socio-economic characteristics, knowledge about sexual and reproductive health, pregnancy prevention, puberty signs, sexually transmitted infections, attitudes towards premarital sex, sexual activities, sources of information and sex education needs from students in the selected secondary schools. They would be asked to indicate by identifying reason for their choice as contained in the questionnaire. Face and content validity would be confirmed by questionnaire professionals. These questionnaires would be pre-tested in a similar population and would be modified appropriately. Data Collection After obtaining permission from the schools’ authorities and the consent of participating students, questionnaires would be administered to the selected consenting students with the help of trained Corper Peer Education Trainers (CPETs) in each school, and under the supervision of Oyo State NYSC CPETs club Schedule Officer. Questionnaire administration would be conducted in a classroom and participants would be instructed to sit separately from one another to ensure privacy when responding to the questionnaires. It would be explained that there would be anonymity concerning their responses. No names would be placed on the questionnaires. These students will fill them and returned immediately afterwards. Participants would insert completed questionnaires in a large envelop as they leave the classroom. Data Analysis Completed questionnaires would be collated and entered, cleaned and analyzed appropriately, using the appropriate statistical software. Correlation analysis would be carried out to confirm significant relationships between variables of interest.