Evidence map›Paper›PMID 31558168›Full record

ArticleInternational journal for equity in health2019

Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia.

Joseph Mumba Zulu, Astrid Blystad, Marte E S Haaland, Charles Michelo, Haldis Haukanes, Karen Marie Moland

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in International journal for equity in health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06330428 (Investigation of the Effect of Sexuality-Based Family Planning Education Given to Women Via Podcast on Contraceptive Method Selection and Sexual Life Quality), which is not on this map. Cited by 46 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 1 pooled it
15.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06330428 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Investigation of the Effect of Sexuality-Based Family Planning Education Given to Women Via Podcast on Contraceptive Method Selection and Sexual Life Quality

TypeinterventionalSponsorMarmara UniversityRan2024 to 2024Enrolled176ConditionsContraceptionArmsSexuality-Based Family Planning Education via Podcast
3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 1 synthesis or guideline pooled it, 124 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Joseph Mumba ZuluSchool of Public Health, University of Zambia, Lusaka, Zambia.
Astrid BlystadCentre for international Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Marte E S HaalandCentre for international Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. marte.haaland@uib.no.ORCID http://orcid.org/0000-0001-8253-2841
Charles MicheloSchool of Public Health, University of Zambia, Lusaka, Zambia.
Haldis HaukanesDepartment of Health Promotion and Development, University of Bergen, Bergen, Norway.
Karen Marie MolandCentre for international Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
University of Bergen · NOUniversity of Zambia · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReproductive health problems such as HIV, unwanted pregnancy and unsafe abortion among adolescents are closely linked to insufficient knowledge about sexuality and reproduction and lack of access to contraceptives. Supported by international agencies, Zambia has introduced an ambitious nation-wide program for comprehensive sexuality education (CSE) to be implemented into ordinary school activities by teachers. The curriculum is firmly based in a discourse of sexual and reproductive rights, not commonly found in the public debate on sexuality in Zambia. This paper explores how teachers perceive the curriculum and practice discretion when implementing the CSE in mid-level schools in Nyimba district in Zambia.

methodsUsing a case study design, data were collected through in-depth interviews with 18 teachers and analyzed thematically drawing upon theories of discretion and policy implementation.

resultsIndividual teachers make decisions on their own regarding what and when to teach CSE. This discretion implies holding back information from the learners, teaching abstinence as the only way of preventing pregnancy or cancelling sexuality education sessions altogether. Teachers' choices about the CSE program were linked to lack of guidance on teaching of the curriculum, especially with regards to how to integrate sexuality education into existing subjects. Limited prioritization of CSE in the educational sector was observed. The incompatibility of CSE with local norms and understandings about adolescent sexuality combined with teacher-parent role dilemmas emerged as problematic in implementing the policy. Limited ownership of the new curriculum further undermined teachers' motivation to actively include CSE in daily teaching activities. Use of discretion has resulted in arbitrary teaching thus affecting the acquisition of comprehensive sexual and reproductive health knowledge among learners.

conclusionThe CSE had limited legitimacy in the community and was met with resistance from teachers tasked with its' implementation. In order to enhance ownership to the CSE program, local concerns about the contents of the curriculum and the parent-teacher role dilemma must be taken into consideration. Not addressing these challenges may undermine the policy's intention of increasing knowledge about sexuality and reproduction and empowering adolescents to access contraceptive services and avoid unwanted pregnancies.

Indexed as

Choice BehaviorRural PopulationAdolescentAdultCurriculumFemaleHumansMaleMiddle AgedOrganizational PolicyPregnancyQualitative ResearchSchoolsSchool TeachersSex EducationZambiaComprehensive sexuality educationDiscretionSchoolsZambia

Identifiers

PMID31558168
PMCPMC6764121
OpenAlexW2975324835

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.