Trends in reproductive health knowledge following a health education intervention among adolescents in Zimbabwe.

BACKGROUND Unwanted teenage pregnancy, sexually transmitted infections and the attendant morbidity and mortality necessitate the need for understanding factors influencing adolescent sexuality and the implementation of programmes designed to improve their knowledge, reproductive behaviour, sexual and reproductive health. OBJECTIVE To determine the impact of an intervention package on knowledge levels of various reproductive health issues through trend analysis. DESIGN Randomized controlled trial of a health education intervention in schools stratified for representativeness. SETTING Rural and urban secondary schools in Zimbabwe. SUBJECTS 1,689 students recruited from 11 secondary schools in Mashonaland Central. MAIN OUTCOME MEASURE Knowledge level before and after intervention. RESULTS The demographic characteristics of the pupils at baseline, five months and nine months were comparable between the two groups. There was an overall increase in knowledge on menstruation. Students from the intervention schools were more likely to have correct knowledge over time on aspects of reproductive biology. A significant linear trend (p = 0.017) was observed in the area of family planning and contraception. A linear decreasing trend (p = 0.001) was observed on pregnancy risk. Though not significantly linear, the general trend of knowledge levels in all the areas of reproductive health, pregnancy risk, STDs and HIV/AIDS showed an upward trend, from 20% to 96%. Worth noting was that in all the areas the intervention group had knowledge above that in the control group. CONCLUSION The reproductive health education intervention had an impact on aspects of reproductive biology and contraception as measured by the increased scoring at follow up when comparing intervention and control schools. The overall findings point to the need for early school based reproductive health education programmes incooperating correct information on reproductive biology and the prevention of subsequent reproductive morbidity by imparting information on non-risk behaviour during the early developmental years.