Can a school health club-based intervention significantly influence the drivers of gendered sexual norms and ideologies among in-school adolescents in southeast Nigeria?

Ifeyinwa C. Akamike, Ifunanya C. Agu, Chibuike Agu, Irene I. Eze, Godstime O. Eigbiremolen, Chinyere O. Mbachu, Obinna Onwujekwe

Abstract

Individual experiences, social policies, and environmental exposure shape beliefs, norms and ideologies about sexuality. The objective of this study was to determine the effectiveness of a school health club training programme in improving adolescents’ knowledge and perceptions of gender norms and ideologies about sexuality. This was an intervention study among in-school adolescent boys and girls in 12 secondary schools in Ebonyi State, southeast Nigeria. The intervention was the establishment of school health clubs in six schools (intervention), while the six other schools served as controls that did not have school health clubs. Data was collected using a pre-tested interviewer-administered questionnaire. Bivariate and multivariate logistic regression analyses were used to analyse the data. More than half of the adolescents in the intervention (58.3%) and non-intervention (56.1%) schools believed that men need sex more than women. About 90% of adolescents in school (in both arms) agreed that both boys and girls should remain virgins until marriage. Majority of adolescents in both intervention and non-intervention schools disagreed with the notion that “it is justifiable for a boy to hit his girlfriend”. Female gender (OR: 1.6; CI 1.1-2.4), senior secondary school level (OR: 1.6; CI 1.0-2.5), and urban residence (OR: 1.7; CI: 1.1-2.5) were associated with the perception that boys do not respect girls who agree to have sex with them. Working for pay decreases the likelihood of having the perception that girls should remain virgin until they marry (OR: 0.4; CI: 0.2-0.9), while living in the urban area increases the likelihood of having the perception that boys should remain virgins until marriage (OR: 2.1; 1.1-4.1). Female gender (OR: 0.7; CI: 0.5-1.0) and urban residence (OR: 0.6; 0.4-0.9) decrease the likelihood of having the perception that men need sex more frequently than women do. In the intervention arm, female gender was associated with perception that boys do not respect girls who agree to have sex with them (OR: 2.4; CI: 1.3-4.3) while older age was associated with the perception that men need sex more frequently than women in the intervention arm (OR:1.2; CI:1.0-1.4). No predictor was found in the non-intervention arm. Although both intervention and non-intervention arms had positive perceptions of gendered sexual norms and ideologies, a school health club-based intervention could influence the drivers of these norms.

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References

Cislaghi B and Heise L. Gender norms and social norms :

differences , similarities and why they matter in

prevention

science.

;42(2):407–22.

Sociol

Health

Illn.

Planned Parenthood. What are gender roles and stereotypes?

Available

from:

https://www.plannedparenthood.org/learn/gender

identity/sex-gender-identity/what-are-gender-roles

and-stereotypes. Accessed Jan 27 2022

Gendered innovations in Science, Health & Medicne,

Engineering, and Environment Available from:

https://genderedinnovations.stanford.edu/terms/gen

der.html. Accessed Jan 27 2022

World Health Organisation. Gender and Health. Available

from:

https://www.who.int/health

topics/gender#tab=tab_1. Accessed Jan 27 2022

Palermo T, Chzhen Y, Balvin N, Kajula L and Tanzanian

Adolescent Cash Plus Evaluation Team. Examining

determinants of gender attitudes : evidence among

Tanzanian adolescents. BMC Womens Health.

;20:195.

World Health Organisation. Defining Sexual Health.

Available from: https://www.who.int/teams/sexual

and-reproductive-health-and-research/key-areas-of

work/sexual-health/defining-sexual-health.

Accessed Jan 27 2022

Achen S, Rwabukwali BC and Atekyereza P. Socio-cultural

perceptions of sexuality influencing the sexual and

reproductive health of pastoral adolescent girls in

Karamoja sub-region in Uganda. Soc Sci Humanit

Open. 2021;4(1):100191.

Cislaghi B, Shakya H and Diego S. Social Norms and

Adolescents ’ Sexual Health : An Introduction for

Practitioners Working in Low and Mid-income

African countries. Afr J Reprod Health.

;(March).

Harrison A. Culture , Health & Sexuality : An International

Journal for Research , Intervention and Care Hidden

Love : Sexual ideologies and relationship ideals

among rural South African adolescents in the

context of HIV / AIDS. Cultrue, Heal Sex An Int J Res Interv Care. 2008;10(2):175–89.

Somech A and Drach-zahavy A. Gender Role Ideology. In:

Naples NA, editor. The Wiley Blackwell

Encyclopedia of Gender and Sexuality Studies. First

Edit. John Wiley & Sons, Ltd.; 2016.

Kane EW and Schippers M. Men ’ s and Women ’ s Beliefs

about

Gender and Sexuality. Gend Soc.

;10(5):650–65.

Baldwin J and Baldwin J. Sexual Behavior. In:

Encyclopedia of Human Behavior. Second. San

Diego: Academic Press; 2012. p. 418–24.

Baumeister RF, Catanese KR and Vohs KD. Is There a

Gender Difference in Strength of Sex Drive?

Theoretical Views, Conceptual Distinctions, and a

Review of Relevant Evidence. Personal Soc Psychol

Rev. 2001;5:242.

Vu L, Pulerwitz J, Burnett-zieman B, Banura C, Okal J and

Yam E. Inequitable Gender Norms From Early

Adolescence to Young Adulthood in Uganda : Tool

Validation and Differences Across Age Groups. J

Adolesc Heal. 2017;60(2017):S15–21.

Izugbara CO. The Socio-Cultural Context of Adolescents

Notions of Sex and Sexuality in Rural South

Eastern Nigeria. SAGE Publ. 2005;8(5):600–17.

Mooijman A, Esseku H and Tay V. School Health Clubs

in Ghana. Ghana Educ Serv. 2013;1–19. Available

from: https://www.washghana.net/. Accessed Jan 4

IRC. Guide for formation & strengthening of school health

clubs.

Available

from:

https://www.ircwash.org/resources/field-guide

formation-strenthening-school-health-clubs.

Accessed Dec 29 2023

UNESCO. Model health clubs to promote health in

schools.

Available

from:

https://www.unesco.org/en/articles/model-health

clubs-promote-health-schools. Accessed Dec 29

Darko NAK and Glozah FN. Adolescents’ perceptions of

sexual and reproductive health: Does the adolescent

school health club intervention matter? Ghana Heal

Serv.

;1–14.

Available

https://doi.org/10.21203/rs.3.rs-1026286/v1.

Accessed Dec 29 2023

from:

Mbachu CO, Agu IC and Onwujekwe O. Collaborating to

co-produce strategies for delivering adolescent

sexual and reproductive health interventions:

Processes and experiences from an implementation

research project in Nigeria. Health Policy Plan.

;35:II84–97.

Charan J and Biswas T. How to calculate sample size for

different study designs in medical research? Indian J

Psychol Med. 2013;35(2):121–6.

Cleland J. Illustrative questionnaire for interview-surveys

with young people. Asking Young People about

Sexual and Reproductive Behaviours. Illustrative

Core Instruments, Geneva: World Health

Organization. 2001.

Iyer P and Aggleton P. ‘ Virginity is a Virtue : Prevent

Early Sex ’ – Teacher perceptions of sex education

in a Ugandan secondary school. Br J Sociol Educ.

;35(3):432–48.

Bhana D. Virginity and virtue : African masculinities and

femininities in the making of teenage sexual

cultures. Sexualities. 2016;19(4):465–81.

Sabia JJ and Rees D. The effect of adolescent virginity

status on psychological well-being ଝ. J Heal Econ J.

;27(2008):1368–81.

Ott MA, Pfeiffer EJ and Fortenberry JD. Perceptions of

Sexual Abstinence among High-Risk Early and

Middle

Adolescents.

;39(2006):192–8.

J

Adolesc

Heal.

Silverman JG, Raj A, Mucci LA, Jeanne E and Hathaway.

Dating Violence Against Adolescent Girls and

Associated Substance Use, Unhealthy Weight

Control, Sexual Risk Behavior, Pregnancy, and

Suicidality. JAMA. 2001;286(5):572–9.

Stöckl H, March L, Pallitto C, Garcia-moreno C and WHO

Multi-country Study team. Intimate partner violence

among adolescents and young women : prevalence

and associated factors in nine countries : a cross

sectional study. BMC Public Health. 2014;14:751.

Chirwa ED, Sikweyiya Y, Addo-Lartey AA, Ogum AD,

Coker-Appiah D and Adanu RMK. Prevalence and

risk factors of physical or sexual intimate violence

perpetration amongst men in four districts in the

central region of Ghana: Baseline findings from a

cluster randomised controlled trial. PLoS One.

;13(3):e0191663.

Akamike IC, Uneke CJ, Uro-chukwu HC and Chukwu OE.

Predictors and facilitators of gender-based violence

in sub-Saharan Africa : a rapid review. J Glob Heal

Reports. 2019;3:e2019076.

Ngubane SJ. Gender Roles in the African Culture:

Implications for the Spread of HIV/AIDS. Available

from:

https://core.ac.uk/download/pdf/37323864.pdf.

Accessed Mar 21, 2022.

van Anders SM. Testosterone and Sexual Desire in Healthy

Women and Men. Arch Sex Behav. 2012;

Cunnien KA, Martinrogers N and Mortimer JT. Adolescent

Work Experience and Self-efficacy Keith. Int J

Sociol Soc Policy. 2009;29(3/4):164–75.

Mortimer JT. The Benefits and Risks of Adolescent

Employment. Prev Res. 2010;17(2):8–11.

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