Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Reproductive Health
Published in: Reproductive Health 1/2024

Open Access 01-12-2024 | Research

The effectiveness of an m-Health intervention on the sexual and reproductive health of in-school adolescents: a cluster randomized controlled trial in Nigeria

Authors: Oluwatosin Wuraola Akande, Moise Muzigaba, Ehimario Uche Igumbor, Kelly Elimian, Oladimeji Akeem Bolarinwa, Omotosho Ibraheem Musa, Tanimola Makanjuola Akande

Published in: Reproductive Health | Issue 1/2024

Login to get access

Abstract

Background

The implementation of the country-wide comprehensive sexuality education (CSE) curriculum among in-school adolescents remains abysmally low and mHealth-based interventions are promising. We assessed the effect of a mHealth-based CSE on the sexual and reproductive health (SRH) knowledge, attitude and behaviour of in-school adolescents in Ilorin, northcentral Nigeria.

Methods

Using schools as clusters, 1280 in-school adolescents were randomised into intervention and control groups. Data was collected at baseline (T0), immediately after the intervention (T1) and 3 months afterwards (T2) on SRH knowledge, attitude and practice of risky sexual behaviour (RSB). Data analysis included test of associations using Chi-square, independent t-test and repeated measures ANOVA. Predictors were identified using binary logistic regression.

Results

In the intervention group, there was a statistically significant main effect on mean knowledge score (F = 2117.252, p =  < 0.001) and mean attitude score (F = 148.493, p =  < 0.001) from T0 to T2 compared to the control group which showed no statistically significant main effects in knowledge (p = 0.073), attitude (p = 0.142) and RSB (p = 0.142). Though the mean RSB score declined from T0 to T2, this effect was not statistically significant (F = 0.558, p = 0.572). Post-intervention, being female was a positive predictor of good SRH knowledge; being male was a positive predictor of RSB while being in a higher-class level was a negative predictor of RSB.

Conclusion

The mHealth-based CSE was effective in improving SRH knowledge and attitude among in-school adolescents. This strategy should be strengthened to bridge the SRH knowledge and attitude gap among in-school adolescents.
Trial registration Retrospectively registered on the Pan African Clinical Trial Registry (pactr.samrc.ac.za) on 19 October 2023. Identification number: PACTR202310485136014
Appendix
Available only for authorised users
Literature
1.
2.
3.
Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, Bcheraoui CE, Moradi-Lakeh M, et al. Global burden of diseases, injuries, and risk factors for young people’s health during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387(10036):2383–401.PubMedCrossRef
4.
5.
United Nations Educational, Scientific and Cultural Organization. Revised edition: International technical guidance on sexuality education- an evidence-informed approach. France: United Nations Educational, Scientific and Cultural Organization; 2018 p. 142.
6.
7.
Udegbe BI, Fayehun F, Isiugo-Abanihe UC, Nwagwu W, Isiugo I, Nwokocha E. Evaluation of the implementation of family life and HIV Education Programme in Nigeria. Afr J Reprod Health. 2015;19:79–92.PubMed
8.
National Agency for the Control of AIDS (NACA). National Gap Analysis Meeting on AIDS Response. 2014.
9.
Istepanian R, Laxminarayan S, Pattichis C. M-Health: emerging mobile health systems. United States of America: Springe; 2006.CrossRef
10.
World Health Organisation. Global diffusion of eHealth: making universal health coverage achievable: report of the third global survey on eHealth. 2016.
11.
Akinfaderin-Agarau F, Chirtau M, Ekponimo S, Power S. Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian States. Afr J Reprod Health. 2012;16(2):219–30.PubMed
12.
Ajike AK, Nwakoby NP. The impact of social networking sites on teenagers in Nigeria. Int J Public Policy Adm Stud. 2016;11(1):35–64.
13.
Ghanbari S, Ramezankhani A, Montazeri A, Mehrabi Y. Health literacy measure for adolescents (HELMA): development and psychometric properties. PLoS ONE. 2016;11(2): e0149202.PubMedPubMedCentralCrossRef
14.
Borzekowski DLG, Fobil JN, Asante KO. Online access by adolescents in Accra: Ghanaian teens’ use of the internet for health information. Dev Psychol. 2006;42(3):450–8.PubMedCrossRef
15.
16.
Dreyhaupt J, Mayer B, Keis O, Öchsner W, Muche R. Cluster-randomized Studies in educational research: principles and methodological aspects. GMS J Med Educ. 2017;34(2): Doc26.PubMedPubMedCentral
17.
18.
Federal Ministry of Education. National School Health Policy. Federal Ministry of Education, Nigeria; 2006. file:///Users/oluwatosinakande/Desktop/Final%20School%20Health%20Policy%20-%20Copy.pdf
19.
20.
Nik Farid ND, Mohd Arshad MF, Yakub NA, Ahmad Zaki R, Muhamad H, Abdul Aziz N, et al. Improving Malaysian adolescent sexual and reproductive health: an Internet-based health promotion programme as a potential intervention. Health Educ J. 2018;77(7):837–48.CrossRef
21.
22.
23.
24.
Taber KS. The use of Cronbach’s Alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018;48(6):1273–96.CrossRef
25.
Sieving RE, Oliphant JA, Blum RW. Adolescent sexual behavior and sexual health. Pediatr Rev. 2002;23(12):407–16.PubMedCrossRef
26.
Titiloye MA, Ajuwon AJ. Knowledge and quality of adolescents reproductive health communication between parents and their adolescents children in Ibadan, Nigeria. J Public Health Afr. 2017;8(1):688.PubMedPubMedCentralCrossRef
27.
Gaferi S, Al-Harbi M, Yakout S, Soliman A. Knowledge, attitude and practice related to reproductive health among female adolescents. J Nurs Educ Pract. 2018;8(8):53.CrossRef
28.
Taylor-Seehafer M, Rew L. Risky sexual behavior among adolescent women. J Soc Pediatr Nurses JSPN. 2000;5(1):15–25.CrossRef
29.
Adeokun L, Rickettts O, Ajuwon A, Ladipo O. Sexual and reproductive health knowledge, behaviour and education needs of in-school adolescents in Northern Nigeria. Afr J Reprod Health. 2009;13(4):37–49.PubMed
30.
Aderibigbe S, Araoye M. Effect of health education on sexual behaviour of students of public secondary schools in Ilorin, Nigeria. Eur J Sci Res. 2008;1(24):33–41.
31.
32.
Nwaorgu OC, Onyeneho NG, Okolo M, Obadike E, Enibe G. Reproductive health knowledge and practices among junior secondary school grade one students in Enugu State: threat to achieving millennium development goals in Nigeria. East Afr J Public Health. 2008;5(2):126–32.PubMed
33.
Ab Rahman A, Ab Rahman R, Ibrahim MI, Salleh H, Ismail SB, Ali SH, et al. Knowledge of sexual and reproductive health among adolescents attending school in Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2011;42(3):717–25.PubMed
34.
Adejimi AA, Omokhodion FO, OlaOlorun FM. Sexual behaviour and knowledge of prevention of sexually transmitted infections among students in coeducational and non-coeducational secondary schools in Ibadan, Nigeria. J Fam Med Prim Care. 2020;9(7):3288–98.CrossRef
35.
Finlay JE, Assefa N, Mwanyika-Sando M, Dessie Y, Harling G, Njau T, et al. Sexual and reproductive health knowledge among adolescents in eight sites across sub-Saharan Africa. Trop Med Int Health. 2020;25(1):44–53.PubMedCrossRef
36.
37.
Vadhariya A, Sansgiry SS. Use of health belief model to understand knowledge, attitudes and behaviors of people towards the Ebola outbreak. Value Health. 2015;18(3):A241.CrossRef
38.
Agofure O, Iyama M. Knowledge of puberty, sexually transmitted infections, and sexual behavior among very young female adolescent students’ 10–14 years in Agbor Metropolis, Nigeria. Niger J Health Sci. 2016;16(1):27–32.CrossRef
39.
Joshi A. Multiple sexual partners: perceptions of young men in Uganda. J Health Organ Manag. 2010;24(5):520–7.PubMedCrossRef
40.
Ankomah A. Sex, love, money and AIDS: the dynamics of premarital sexual relationships in Ghana. Sexualities. 1999;2(3):291–308.CrossRef
41.
Watsi L, Tarkang EE. Demographic determinants of risky sexual behaviours among senior high school students in the Hohoe municipality, Ghana. PAMJ Clin Med. 2020;2(81)
42.
Slap GB, Lot L, Huang B, Daniyam CA, Zink TM, Succop PA. Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students. BMJ. 2003;326(7379):15.PubMedPubMedCentralCrossRef
43.
Okpani AO, Okpani JU. Sexual activity and contraceptive use among female adolescents–a report from Port Harcourt, Nigeria. Afr J Reprod Health. 2000;4(1):40–7.PubMedCrossRef
44.
Amazigo U, Silva N, Kaufman J, Obikeze DS. Sexual activity and contraceptive knowledge and use among in-school adolescents in Nigeria. Int Fam Plan Perspect. 1997;23(1):28–33.CrossRef
45.
46.
Dzah SM, Tarkang EE, Lutala PM. Knowledge, attitudes and practices regarding HIV/AIDS among senior high school students in Sekondi-Takoradi metropolis, Ghana. Afr J Prim Health Care Fam Med. 2019;11(1):e1-11.PubMedCrossRef
47.
Alex-Hart B, Okagua J, Opara P. Sexual behaviours of secondary school students in port harcourt. Br J Med Med Res. 2015;6(3):325–34.CrossRef
48.
49.
Esere MO. Effect of sex education programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria. Afr Health Sci. 2008;8(2):120–5.PubMedPubMedCentral
50.
Huaynoca S, Chandra-MouliYaqub VN Jr, Denno DM. Scaling up comprehensive sexuality education in Nigeria: from national policy to nationwide application. Sex Educ. 2014;14(2):191–209.CrossRef
51.
Green J, Oman RF, Vesely SK, Cheney M, Carroll L. Beyond the effects of comprehensive sexuality education: the significant prospective effects of youth assets on contraceptive behaviors. J Adolesc Health. 2017;61(6):678–84.PubMedCrossRef
52.
53.
Pringle J, Doi L, Jindal-Snape D, Jepson R, McAteer J. Adolescents and health-related behaviour: using a framework to develop interventions to support positive behaviours. Pilot Feasibility Stud. 2018;4:69.PubMedPubMedCentralCrossRef
54.
Rahimi-Naghani S, Merghati-Khoei E, Shahbazi M, Khalajabadi Farahani F, Motamedi M, Salehi M, et al. Sexual and reproductive health knowledge among men and women aged 15 to 49 years in Metropolitan Tehran. J Sex Res. 2016;53(9):1153–64.PubMedCrossRef
55.
Bergström AS, Guevara WJU, Colombo PE, Källestal C. Knowledge about sexual and reproductive health among school enrolled adolescents in Tololar, Nicaragua, a cross-sectional study. J Public Health Int. 2018;1(2):27.CrossRef
56.
Ullah R, Ullah H. Boys versus girls’ educational performance: Empirical evidences from global north and global south. Afr Educ Res J. 2019;2(7):163–7.CrossRef
57.
58.
Durowade KA, Babatunde OA, Omokanye LO, Elegbede OE, Ayodele LM, Adewoye KR, et al. Early sexual debut: prevalence and risk factors among secondary school students in Ido-ekiti, Ekiti state, South-West Nigeria. Afr Health Sci. 2017;17(3):614–22.PubMedPubMedCentralCrossRef
59.
Peltzer K, Pengpid S. Risk and protective factors affecting sexual risk behavior among school-aged adolescents in Fiji, Kiribati, Samoa, and Vanuatu. Asia Pac J Public Health. 2016;28(5):404–15.PubMedCrossRef
60.
Croisant SAP, Haque Laz T, Rahman M, Berenson AB. Gender differences in risk behaviors among high school youth. Glob Adv Health Med. 2013;2(5):16–22.PubMedPubMedCentralCrossRef
61.
62.
Udigwe IB, Adogu PO, Nwabueze AS, Adinma ED, Ubajaka CF, Onwasigwe C. Factors influencing sexual behavior among female adolescents in Onitsha, Nigeria. Open J Obstet Gynecol. 2014;04(16):987–95.CrossRef
Metadata
Title
The effectiveness of an m-Health intervention on the sexual and reproductive health of in-school adolescents: a cluster randomized controlled trial in Nigeria
Authors
Oluwatosin Wuraola Akande
Moise Muzigaba
Ehimario Uche Igumbor
Kelly Elimian
Oladimeji Akeem Bolarinwa
Omotosho Ibraheem Musa
Tanimola Makanjuola Akande
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2024
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-023-01735-4

Other articles of this Issue 1/2024

Reproductive Health 1/2024 Go to the issue

Research

Contraceptive behavior of women in India after induced abortion

Research

Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey

Research

"I don't want my marriage to end": a qualitative investigation of the sociocultural factors influencing contraceptive use among married Rohingya women residing in refugee camps in Bangladesh

Research

What is the impact of endometriosis and the AFS stage on cumulative pregnancy rates in IVF programs?

Research

A qualitative assessment of the impact of a community-embedded intervention on beneficiaries' attitudes and beliefs about adolescent sexual reproductive health in Ebonyi State, Southeast, Nigeria

Research

Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia