| dc.description | INTRODUCTION
Sexually Transmitted Infections (STIs) including
HIV/AIDS and unintended pregnancies are among the
major Sexual and Reproductive Health problems facing
adolescents in Sub-Saharan Africa. About 60% of all HIV
infected people in the world are young people aged 15-24
years in which 63% of them are living in Sub-Saharan
Africa (UNAIDS, 2004; Wagbatsoma and Okojie, 2006;
Biddlecom et al., 2007; Bello et al., 2009). Furthermore,
Demographic and Health Surveys (DHS) in 20 countries
of Sub-Saharan Africa carried out in 2004 indicated that
between 1-11% of sexually-experienced 15-24 year old
females and 2-16% of males reported to have STIs within
the past 12 months prior to the survey interview
(Biddlecom et al., 2007). Unintended pregnancies have
also been uncommon among youths in Sub- Saharan
Africa. Unintended pregnancies have been associated with
unsafe abortions among female adolescents (Fayorsey and
Henry, 2002). It is estimated that 4.4 million abortions are
sought by adolescent girls each year. (WHO, 1999; Ilika
and Anthony, 2004), and further that more than one quarter of unsafe abortions in Africa are experienced at
the age of 15-19 years (Biddlecom et al., 2007).
Pregnancies at early age have also been associated with
increased risk of maternal mortality and birth related
complications such as excessive bleeding, anemia,
obstructed labour, stillbirth and infant death (Fayorsey
and Henry, 2002). Other consequences of early
pregnancies by adolescents include school drop- out and
abandonment by family.
Interventions to reverse this situation require
thorough understanding of adolescents’ sexual behaviours
and factors for prevalence of sexual activity among them
across various social-economic, demographic and cultural
groups (Sunmola et al., 2002; Madu 2002; Erulkar et al.,
2005; Okonofua, 2007). However, as in other Sub Saharan Africa countries existing studies on adolescents
sexual behaviours in Tanzania have been concentrated in
urban adolescents, specifically in-schools adolescents
(Adu-Mireku, 2003; Mwambete and Mtaturu, 2006;
Morhason-Bello et al., 2008). Limited information is
available for their rural counterpart, despite presence of
substantial proportion of adolescents in rural areas, taking
into consideration that majority of citizens in the country
resides in rural areas (Nkonya, 2006). Furthermore,
following a special program by Government of the United
Republic of Tanzania, there has been an increase in
number of secondary schools (i.e., community secondary
schools) in rural areas of the country in recent years
Curr. Res. J. Soc. Sci., 3(4): 374-380, 2011
375
which absorbs significance proportion of rural adolescents
(URT, 2008). Targeting these schools on issues related to
Sexual and Reproductive Health would serve life, health
and wellbeing of substantial proportion of rural
adolescents. To best of our knowledge no study has been
carried in the country on sexual behaviours among
adolescents on these newly established community
secondary schools in rural areas. Therefore, this study was
carried out with objectives of assessing knowledge on
some issues related to Sexual Reproductive Health, sexual
practices and factors for prevalence for sexual activity
among adolescents in these newly established schools in
rural areas of Central Tanzania, a case of Bahi District.
MATERIALS AND METHODS
Study area: This research was carried out in community
secondary schools located in Bahi division, in Bahi
district, Dodoma region, Central Tanzania. The division
is among the four divisions of the district. Other divisions
include Mwitikira, Chipanga and Mundemu. The district
is found on the southwest part of Dodoma region and has
a total area of 542,844 Ha extending between latitude 4º
and 8º South and between longitude 35º and 37º North.
The total population of the district is 178,981 and the
population density is 33/km2
(URT, 2008). The area is
semi- arid and receives annual rainfall of between 500 to
800mm. The dominant ethnic group is Gogo involved in
both crop and livestock production. The choice of the
study area (Bahi division) was based on easiness in
accessibility and presence of high number of community
secondary schools in the area (i.e. at least one in each
ward) (URT, 2008).
Study design: This study was carried out in the study
area between July to August, 2010. The study involved a
cross- sectional survey in four Secondary Schools from
four randomly selected wards out of five in the division
with one secondary school from each ward. The wards
include Bahi, Ibihwa, Mpamantwa and Kigwe. The study
involved students from Form I to Form IV sampled using
systematic random sampling. Sample size for this study
included 202 students. In estimating sample size, the
following formula was used;
( ) ( ) n Z PP = α −
λ
2
2
2
1
where; by n = sample size; P = percentage of in-school
adolescents in community secondary schools in the study
area that are involved in sexual activity; 8=maximum
error; since P was not known for the study population, its
value was assumed to be 50% as it ensures maximum
Table 1: Distribution of respondents by some demographic
characteristics (n = 202)
Variable Frequency Percent
Age
<14 3 1.5
14-16 63 31.2
> 17 - 19 136 67.3
Sex
Male 99 49.0
Female 103 51.0
Ethnicity
Gogo 170 84.2
Others 32 15.8
Living arrangements
With parent (s) 72 35.6
With Guardian 31 15.3
Ghetto/friends 99 49.0
sample size (Nwankwo and Nwoke, 2009). By assuming
confidence interval of 95% for the estimated population
maximum error of 10% and design effect of 2 (Kisinza
et al., 2008) that is n×2 and non response rate of 5%, a
final sample was calculated to be 202 students.
Approximately equal number of students from each
school and Form (class) were picked i.e., around 50 and
12 students from each secondary school (ward) and Form
(class), respectively. Data from these students were
collected using a pre-tested semi-structured questionnaire.
Pre- testing of questionnaire was done in rural community
secondary schools not involved in the study. Furthermore,
in each of the secondary schools under study, two focus
group discussions with students (FGDs), one for each sex,
making a total of 8 FGDs; as well as in-depth interviews
with some key informants were also carried out to collect
qualitative information for the study and to verify some
responses from Questionnaire. Key informants for the
study included Matrons, Headmasters/mistress and
Discipline master/mistress.
Data analysis: Data collected were verified, coded and
then analyzed for descriptive statistics such as percentages
using Statistical Package for Social Sciences (SPSS)
program. On the other hand, content analysis was used to
analyze qualitative information.
RESULTS AND DISCUSSION
General characteristics of respondents: Results from
Table 1 indicate two-third of respondents (67.3%) were
between 17 to 19 years of age while nearly one-third
(31.2%) of them aged between 14-16 years, and very few
(1.5%) were below 14 years, indicating majority of
respondents were already reached sexually active age
(Okonta, 2007; Bankole et al., 2007) and hence most
likely to engage in sexual activities. Results from Table
also indicate both sex were equally represented with 49%
being males and 51% being females. Most of the
Curr. Res. J. Soc. Sci., 3(4): 374-380, 2011
376
Table 2: Distribution of respondents by knowledge on sexual and reproductive health
Variable Frequency %
Awareness of HIV/AIDS (n = 202)
Aware 191 94.6
Not aware 11 5.4
Awareness of other STIs (n = 202)
Aware 157 77.7
Not aware 45 22.3
STIs known other than HIV/AIDS (n = 157)*
Gonorrhea 131 83.4
Syphilis 125 79.6
Others (i.e fungal infections) 20 12.8
Knowledge on ABC (Abstinence, Be faithful and use Condom ) as methods for preventing STIs (n = 202)
Don’t know any method 33 16.3
Know one method 114 56.4
Know two methods 51 25.2
Know all three methods 4 2.0
Specific ABC method known (n = 169)
Abstinence 52 30.8
Be faithful 42 24.9
Use condom 133 78.7
Knowledge on contraceptive methods for preventing pregnancies (n = 202)
Know 140 69.3
Don’t know 62 30.7
Specific contraceptive methods known (n = 140)*
Condom 121 86.4
Pills 46 32.9
Injection 36 26
Others 21 15
Source of information on Sexual and Reproductive Health issues (n = 202)*
Parents/older member of the family 43 21.3
Sibling 29 14.4
Older friends 16 7.9
Peers 57 28.2
Teachers 81 40.1
Radio 62 30.7
television 17 8.4
*: A variable allowed respondent to have multiple responses
respondents (84.2%) were from Gogo ethnic group, a
dominant ethnic group in the study area (URT, 2008). As
with most other parts of the country, all community
secondary schools under study had no
Dormitories/Hostels for students, consequently students
coming from distant places are compelled to organize
themselves and rent rooms (Ghettos) from local people
surrounding the school. It can be noted from Table 1 that
nearly half (49%) of interviewed students were living in
Ghettos. Since parental/teachers control is most likely to
be minimal in Ghettos, these students are prone to sexual
activities.
Knowledge on some issues related to sexual and
reproductive health among adolescents: Findings from
Table 2 reveal that more than 90% of the interviewed
respondents were aware of HIV/AIDS pandemic, and
further that 77.7% of respondents were also aware of
other sexual transmitted disease apart from HIV/AIDs.
The most known STIs were gonorrhea and syphilis
although detailed knowledge on their symptoms in male
and female were lacking. In addition, most of respondents
were also aware of the preventive measure for HIV/AID
and other STIs. Results from Table 2 shows that more
than 80% of the respondents knew at least one method for
preventing HIV/AIDs and other STIs that is abstinence,
be faithful and use of condom (ABC). The most
commonly ABC method known was use of condom
indicated by 78.7% of respondents. Most of the
interviewed respondents (69.3%) were also
knowledgeable on methods for preventing pregnancies
with condom being the most known method indicated by
86.4% of respondents. Other methods, such as pills and
injections were least known probably due to lack of
reproductive health services in the health system for
unmarried adolescents in the country as it has been
observed in other studies in other countries (Munirat,
2005; Okonta et al., 2007; Biddlecom et al., 2007).
Source of information on issues related to Sexual and
Reproductive Health by most of the respondents were
teachers (40%) during class (in Bilology and Civics
subjects) or parade, radio (30.7%) and peers (28.2%).
Teachers as the main source of information on Sexual
and Reproductive Health were also noted in all focus
Curr. Res. J. Soc. Sci., 3(4): 374-380, 2011
377
Table 3: Distribution of respondents by sexual practices
Variable Frequency %
If ever had sexual intercourse (n = 202)
Yes 127 62.9
No 75 37.1
When had last sex (n=127)
Within 3 months prior to survey 48 38.4
Within 6 months prior to survey 27 21.6
Within 12 months prior to survey 18 14.4
More than 12 months prior to survey 34 25.6
How many times had sex (n=127)
Once 37 29.1
Twice 23 18.1
Three times 23 18.1
More than three times 44 34.6
Age at first sex (n=127)
<13 22 17.3
13-15 43 33.9
16-18 51 40.1
>18 11 8.7
If ever had sex with casual partner (n=127)
Yes 26 20.5
No 101 79.5
Number of sexual partner (n=127)
One 99 78.0
Two 14 11.0
More than two 14 11.0
If used condom in the last sexual encounter (n=127)
Yes 81 63.8
No 46 36.2
If ever used other contraceptives other than condom (n= 72)
Yes 10 13.9
No 62 86.1
group discussion. The following quote from one
participant of FGDs illustrate;
“During the parade our teachers tell us about STIs/
HIV and consequences of early pregnancy, they are
discouraging having bond (partners) so as to avoid to
get STIs/HIV and pregnancies. We also learn issues
related to Sexual and Reproductive Health from
Civics and Biology subject.” (A form four girl from
Ibihwa secondary school).
Parents/adult members of the family and other
sources seemed not to be the major sources of information
on Sexual and Reproductive Health among adolescents in
the study population (mentioned by less than 25% of
respondents) despite the fact that parents/adult members
of family are usually considered as the most influential
individuals in the society/social system to adolescents’
behaviour including sexual practices through their
guidance/monitoring and information provided about real
world (Oladeji, 2007; Osakinle, 2007). Taboos and
culture for most African societies, which restrict free
discussion/talking of sex and related issues between a
child and parent/adults (Ayanguna and Oyewo, 2007) can
be among of the factors for lack of communication
between parents and children on issues related to Sexual
and Reproductive Health observed in this study.
Sexual practices among adolescents: Despite most
adolescents had knowledge (were aware) on some issues
related to Sexual and Reproductive Health, however, high
sexual activity and risky sexual behaviours by significant
proportion of adolescents in rural community secondary
schools in the study area were noted in this study. Result
from Table 3 indicates most of the respondents (63%) had
ever experienced sex, with age at first sex by half (51.2%)
of respondents being 15 years and below. One third of
respondents (34%) had sex more than three times. Data
further show that nearly forty percent (38.4%) that is four
in every ten adolescents had sex within the past three
months prior to survey. These observations reflect high
level of sexual activity by adolescents in a study
population. Similar observations were reported in other
studies conducted in other African countries (i.e. Nigeria,
Uganda, Ethiopia and Ghana) for both in-school and out
of school adolescents, specifically in urban areas (Adu Mireku, 2003; Seifu et al., 2006; Bankole et al., 2007). In
these studies it was observed that median age at first
sexual encounter by adolescents to range between 14-15
years and by the time they complete high school more
than 70% are already sexually active.
Moreover findings from Table 3 also reveal that 22%
of the respondents who had ever experienced sexual
intercourse, (that is one in every five adolescents in that
group) had two or more sexual partner (i.e., multiple
Curr. Res. J. Soc. Sci., 3(4): 374-380, 2011
378
Table 4: Distribution of adolescents that have ever had sex by reasons for having sex (n = 127)
Reason Frequency %
Peer pressure 52 35.4
Just for fun (To meet sexual desire) 60 47.2
Financial/material gain 32 25.2
To retain the partner (To please partner) 12 9.4
sexual partners). Similar proportion (21%) also ever had
sex with casual partner. In addition it can also be observed
from Table 3 that a sizeable number of respondents (36%)
who have ever had sex didn’t use condom in the last
sexual encounter, again reflect risky sexual behaviour by
a number of adolescents in a study population. The
observation support findings by Rondini and Krugu,
(2009) in Ghana where it was found that proportion of
adolescents in secondary schools that used condom in last
sexual encountered to be 29.6%. This behaviour
predisposes adolescents in a study area to a risk of
contracting HIV/AIDs and other STIs. Others
contraceptive use was also extremely low, again,
predispose girls to the danger of early pregnancies.
Factors for prevalence of sexual activity among
adolescents in the study population: Results from
Table 4 indicate considerable proportion of respondents
(47.2%) had a sexual intercourse just for fun/ to fulfill
sexual desire. This was also revealed in all focus group
discussions in which it was observed that controlling
sexual emotions among adolescents could be difficult. For
example, one member of focus group discussions from
Kigwe secondary school argued that;
“We do sex for fun and to fulfill our body desire of
doing sex, sometimes you fail to control your body
and you feel to have sex. Therefore, it is good to have
a partner who can please you when you feel to have
a sex.” (A form four boy from Kigwe secondary
school).
This finding is in agreement with a study by Okereke
(2010) in which it was observed that a noticeable number
of adolescents aged 14-19 years were sexually-active due
to body transition from childhood to adulthood.
Peer pressure also seemed to be another important
factor for adolescents to engage in sexual activity. This
was indicated by at least one third (35.4%) of total
respondents who had ever experienced sexual intercourse.
Morhason-Bello (2008) argued that peers/ friends had a
great chance of influencing adolescent in sexual activity.
If close friends are sexually active, likelihood of
adolescent to engage in sexual activity is also high.
Peer pressure as a factor for sexual activity by
adolescents also featured during focus group discussions.
The following quote from one participant illustrate;
“Most of students engage in sex because of influence
of their friends, if you don’t have a
girlfriends/boyfriends they regard you as uncivilized.
Others thought that you might not be normal,
meaning that your reproductive systems may not be
functioning well. In other words I can say practicing
sex is a sign of civilization and a prove that you are
grown up” (A form three boy from Bahi secondary
school).
Findings from Table 4 indicate quarter (25.2%) of
total respondents that ever had sex (specifically girls), did
so for financial or material gain. This observation
corroborate with findings in Table 3 in which it was noted
that among respondents who had ever experienced sexual
intercourse, at least one adolescents in every five had
multiple sexual partners and ever had sex with casual
partner. Engagement in sexual activity for financial and
material gain by significant portion of respondents
observed in this study could be attributed to high
prevalence of poverty in rural areas. Studies elsewhere
have indicated adolescents coming from poor families are
more likely to engage in sexual activity in order to get
support in terms of money or other materials to sustain
life (Kumi-Kyeremi et al., 2007; Morhason-Bello et al.,
2008). On the other hand, retaining partner as reason for
adolescents to engage in sexual activity accounted for
little percent (9.4%) (Table 4).
In-depth interviews with key informants revealed that
living in Ghettos by students could also contribute to high
sexual activity by adolescents. Key informants admitted
that it is difficult to control behaviours of students living
Ghetto. The following quote from matron from one of the
school illustrate;
“It is very difficulty to monitor a student during non class hours if she/he is living in a Ghetto. Close
follow up of their behaviours while in Ghettos is
difficult as these Ghettos are highly sparse and
sometimes you may not be given maximum
cooperation by landlords (owners of the houses)”
(Matron from Ibihwa secondary school)
This observation is in agreement with studies in
several other African countries which revealed that lack
of control by parents, teachers or adult members of the
family to some adolescents contribute significantly to
Curr. Res. J. Soc. Sci., 3(4): 374-380, 2011
379
increased sexual activity and unsafe sexual behaviours,
which lead to high rate of STDs/HIV, unintended and
unwanted pregnancy that result to Illegal abortions
(Bankole et al., 2007; Okonofua, 2007; Nwaorgu et al.,
2009).
In- depth interviews with key informants revealed
cultural factors also could be one of the factors
influencing adolescents to engage in sexual practices.
“Sexual practices is a normal things for teenagers for
Gogo people. Neither parents nor elder people in the
society discourage young people from engaging in
sexual practices. Sometimes other parents used to
find partners for their children. This is mostly done
during night dances after harvesting period. It is also
normal for parents to exchange partners with their
friends, therefore young ones learn from their elders”
(Discipline master from Bahi Secondary school).
CONCLUSION
Majority of in-school adolescents in the study area
were aware of several issues related to Sexual and
Reproductive Health such as HIV/AIDS and some other
STIs specifically Gonorrhea and Syphilis and their
preventive measures though detailed knowledge on
symptoms for these other STIs in males and females
among them were lacking. Most of the adolescents were
also aware of preventive measures for pregnancy with
most known method being use of condom. Despite of
being aware on some issues related to Sexual and
Reproductive Health by majority of adolescents in the
study population, however, levels of sexual activity and
risky sexual behaviours were observed to be substantially
high among adolescents. Main factors for prevalence of
sexual activity among adolescents in the study population
included failure by adolescents to control their sexual
emotions (i.e. sex to meet sexual desire, just for fun), peer
pressure, financial/material gain, cultural practices, and
living arrangement (i.e., living in Ghettos) where parental/
teachers control is minimal.
RECOMMENDATION
Based on findings of this study, it is recommended
that government should consider building of hostels or
dormitories for community secondary school in rural
areas; Parents and teachers should collaborate in
educating the students/adolescents on the Sexual and
Reproductive Health matters and these issues should be
discussed in an open and more a comprehensive way;
Frequent meeting between parents/teachers and students,
specifically girls (the most vulnerable group) for the
purpose of counseling them should be encouraged in these
community secondary schools; There should be
promotion of youth friendly forum in schools in which
various issues related to Sexual and Reproductive Health
can be discussed. Owners of the houses where students
rents rooms (Ghettos) should cooperate with teachers and
parents to control behaviours of students in Ghettos.
Furthermore, sports in these schools should be
strengthened and every student should be encouraged to
participate as this will reduce idleness and sexual
emotions and hence reduced sexual activity.
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