EFFECTS OF A RANDOMIZED HEALTH-EDUCATION INTERVENTION ON ASPECTS OF REPRODUCTIVE HEALTH KNOWLEDGE AND REPORTED BEHAVIOR AMONG ADOLESCENTS IN ZIMBABWE

Unwanted teenage pregnancy and the attendant morbidity and mortality n ecessitate an understanding of the factors influencing adolescent sexu ality and the implementation of programmes designed to improve their k nowledge and reproductive behaviour. A randomized controlled study on reproductive health knowledge and behaviour was undertaken among adole scent pupils drawn from a multi-stage random cluster sample. A self-ad ministered questionnaire was used to assess aspects of reproductive he alth knowledge and behaviour at baseline followed by a health educatio n intervention, except for control schools. Results are based on 1689 responses made up of 1159 intervention and 530 control respondents. Th ere was a significant increase in correct knowledge about aspects of m enstruation in intervention as compared with control schools [cdds rat io (OR) = 4.5, 95% confidence interval (CI) = 3.4-6.1). Significantly, (OR = 2.0, 95%CI = 1.1-3.9) more pupils from intervention than contro l schools scored correctly on practice relating to menstruation. Pupil s from intervention schools were more likely (P < 0.001) to know that a boy experiencing wet dreams could make a girl pregnant and that a gi rl could get pregnant at her first sexual intercourse (OR = 1.4, 95%CI = 1.1-1.9). Knowledge of family planning was low in both groups at ba seline but was high at five months follow-up in the intervention schoo ls. The findings point to the need for early school-based reproductive health education programmes, incorperating correct information on rep roductive biology and the subsequent prevention of reproductive ill he alth. Copyright (C) 1997 Elsevier Science Ltd