Application of community dialogue approach to prevent adolescent pregnancy, early marriage and school dropout in Zambia: a case study.
Adolescent pregnancy
Community dialogue
Early marriage
Poverty
School dropout
Sexual and reproductive health
Journal
Reproductive health
ISSN: 1742-4755
Titre abrégé: Reprod Health
Pays: England
ID NLM: 101224380
Informations de publication
Date de publication:
31 Jan 2022
31 Jan 2022
Historique:
received:
10
04
2021
accepted:
11
01
2022
entrez:
1
2
2022
pubmed:
2
2
2022
medline:
3
2
2022
Statut:
epublish
Résumé
Adolescent pregnancy carries both health and economic risks for the pregnant girl and resulting baby, and it is common in Zambia. Providing alternative methods of preventing early pregnancy than abstinence is regarded as culturally and religiously unacceptable in most parts of the country. The community dialogue approach is being tested to address norms and beliefs around early pregnancy, marriage and school dropout, and is based on Paulo Freire's transformative communication approach. The objective of this paper was to understand parents' perspectives on the application of the community dialogue approach in addressing adolescents' early pregnancy and school dropout in a cluster randomized controlled trial in rural Zambia. This was a case study design. We nested the study in the community dialogue intervention arm of the Research Initiative to Support the Empowerment of Girls trial in Zambia. Dialogue meetings were held and economic support was provided for a period of 27 months from September 2016 until November 2018. We held focus group discussions in November 2018 with guardians/parents in six schools in Chibombo District of Central Province. All the discussions were audio recorded and transcribed verbatim. Thematic analysis was used to analyze the data. The guardians/parents perceived the community dialogue to be a relevant approach for addressing social and cultural norms regarding early pregnancy, marriage and school dropout. It was embraced for its value in initiating individual and collective change. The facilitators' interactive approach and dialogue in the community meetings coupled with the use of films and role plays with the parents, lead to active participation and open discussions about sexual and reproductive health (SRH) topics during the community dialogue meetings. Group interactions and sharing of experiences helped parents clarify their SRH values and subsequently made them feel able to communicate about SRH issues with their children. However, cultural and religious beliefs among the parents regarding some topics, like the use of condoms and contraceptives, complicated the delivery of reproductive health messages from the parents to their children. The study indicated that the community dialogue was appreciated by the parents and helped in addressing cultural barriers to discussing SRH issues between generations.
Sections du résumé
BACKGROUND
BACKGROUND
Adolescent pregnancy carries both health and economic risks for the pregnant girl and resulting baby, and it is common in Zambia. Providing alternative methods of preventing early pregnancy than abstinence is regarded as culturally and religiously unacceptable in most parts of the country. The community dialogue approach is being tested to address norms and beliefs around early pregnancy, marriage and school dropout, and is based on Paulo Freire's transformative communication approach. The objective of this paper was to understand parents' perspectives on the application of the community dialogue approach in addressing adolescents' early pregnancy and school dropout in a cluster randomized controlled trial in rural Zambia.
METHODS/DESIGN
METHODS
This was a case study design. We nested the study in the community dialogue intervention arm of the Research Initiative to Support the Empowerment of Girls trial in Zambia. Dialogue meetings were held and economic support was provided for a period of 27 months from September 2016 until November 2018. We held focus group discussions in November 2018 with guardians/parents in six schools in Chibombo District of Central Province. All the discussions were audio recorded and transcribed verbatim. Thematic analysis was used to analyze the data.
RESULTS
RESULTS
The guardians/parents perceived the community dialogue to be a relevant approach for addressing social and cultural norms regarding early pregnancy, marriage and school dropout. It was embraced for its value in initiating individual and collective change. The facilitators' interactive approach and dialogue in the community meetings coupled with the use of films and role plays with the parents, lead to active participation and open discussions about sexual and reproductive health (SRH) topics during the community dialogue meetings. Group interactions and sharing of experiences helped parents clarify their SRH values and subsequently made them feel able to communicate about SRH issues with their children. However, cultural and religious beliefs among the parents regarding some topics, like the use of condoms and contraceptives, complicated the delivery of reproductive health messages from the parents to their children.
CONCLUSION
CONCLUSIONS
The study indicated that the community dialogue was appreciated by the parents and helped in addressing cultural barriers to discussing SRH issues between generations.
Identifiants
pubmed: 35101082
doi: 10.1186/s12978-022-01335-8
pii: 10.1186/s12978-022-01335-8
pmc: PMC8805275
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
30Subventions
Organisme : Diku- Norpart programme
ID : 2016/10380
Organisme : Research Council of Norway
ID : 248121
Organisme : Research Council of Norway
ID : 223269
Informations de copyright
© 2022. The Author(s).
Références
Reprod Health. 2018 Aug 28;15(1):145
pubmed: 30153839
J Pediatr Adolesc Gynecol. 2009 Jun;22(3):189-92
pubmed: 19539206
Reprod Health. 2010 May 12;7:6
pubmed: 20462413
J Epidemiol Community Health. 2015 Sep;69(9):918-24
pubmed: 26034047
Int J Equity Health. 2019 Sep 27;18(1):116
pubmed: 31558168
Reprod Health. 2019 Aug 13;16(1):122
pubmed: 31409362
BMC Health Serv Res. 2020 Jan 16;20(1):42
pubmed: 31948452
BMC Med Ethics. 2019 Jul 4;20(1):45
pubmed: 31272489
BMC Health Serv Res. 2015 Jan 28;15:38
pubmed: 25627456
Reprod Health. 2020 Jan 8;17(1):1
pubmed: 31915022
BMC Health Serv Res. 2018 May 31;18(1):390
pubmed: 29855292
J Adolesc Health. 2013 May;52(5):517-22
pubmed: 23608717
Int Fam Plan Perspect. 2008 Dec;34(4):189-97
pubmed: 19201679
Reprod Health. 2014 Nov 07;11(1):77
pubmed: 25380684
Cult Health Sex. 2019 Jan;21(1):46-62
pubmed: 29613849
Reprod Health. 2020 Aug 8;17(1):119
pubmed: 32771028
Glob Health Action. 2019;12(1):1685808
pubmed: 31735121
PLoS One. 2016 Apr 28;11(4):e0153907
pubmed: 27124177
South Afr J Demogr. 1990 Jul;3:11-20
pubmed: 12317578
BMC Public Health. 2007 Jul 02;7:133
pubmed: 17697333
BMC Health Serv Res. 2019 Oct 17;19(1):710
pubmed: 31623612
PLoS One. 2017 Mar 23;12(3):e0172062
pubmed: 28333963
Reprod Health. 2015 Mar 07;12:16
pubmed: 25889521
Trials. 2016 Dec 9;17(1):588
pubmed: 27938375
Reprod Health. 2012 Aug 16;9:13
pubmed: 22898627
BMC Health Serv Res. 2020 Aug 8;20(1):728
pubmed: 32771022
BMC Public Health. 2013 Apr 17;13:354
pubmed: 23590640
J Health Commun. 2016 May;21(5):554-63
pubmed: 27123984
Int J Gynaecol Obstet. 2016 Jan;132(1):1-3
pubmed: 26613822
J Sex Res. 2008 Jul-Sep;45(3):262-76
pubmed: 18686155
Trop Med Int Health. 2012 Jul;17(7):796-807
pubmed: 22594660
Trop Med Int Health. 2015 Dec;20(12):1639-56
pubmed: 26412363
Health Educ Res. 2011 Jun;26(3):542-55
pubmed: 20965911