CHAPTER ONE

INTRODUCTION

• INTRODUCTION

This research paper has three main goals. First, it aims to highlight key contextual factors that influence how sex education can reach and benefit young people. It also provides evidence on selected key indicators of behaviours and knowledge among young girls in Cameroon. Information is presented separately for young women. Finally, the research paper uses this evidence to highlight the nature and extent of need for sex education among young girls and the advantages and disadvantages of indicators commonly used to measure effectiveness of programs and interventions.

Sex-education programs, if well implemented, can be a corner stone in reducing adolescent sexual-risk behaviors and promoting sexual health. A review by Kirby at al . (2006) evaluated the impact of sex education programs, demonstrated that sex education programs have a significant positive impact on young people’s risky sexual behaviors. Sex education programs have proved to be of real importance in promoting responsible sexual behaviors among youths, regardless of nation or community settings. They have been found to be particularly effective in reducing reported risky behaviors in school-going adolescents in developing societies.

• Background of the Study:

Adolescent pregnancy is a complex phenomenon that affects families, health care services, education, governments, and the youths themselves. About 16 million girls aged 15 to 19 and some 1 million girls under 15 years give birth every year, mostly in low and middle-income countries. A considerable percentage of adolescent pregnancy is planned in low and middle-income countries where several women still marry early. However, even intended pregnancies to undeveloped women in limited resource settings are a matter of public health concern because of the dangers associated with it. Complications during pregnancy and childbirth are the second cause of death for 15–19-year-old girls globally. Evidence suggests that young adolescents are prone to experiencing obstructed labour, fistula, and premature childbirth and to deliver low birth weight babies than older women. Babies of adolescent mothers are at higher risk of dying than those of women aged 20 to 24 years because those children are at risk of malnutrition, low mental and physical development, inappropriate social connection with parents and poor education.

There are numerous factors associated with adolescent pregnancies. These factors include early marriages, inadequate social and economic support. Curiosity and peer pressure, poor sex education, insufficient reproductive health services and health workers unprofessionalism to providing contraceptive services for adolescents. In addition, unmet need for contraceptives by adolescents and the myth of contraceptive side effects reduces contraception the uptake. Also, low-risk perceptions, poor skills of adolescents to negotiate safer sex options as well as early sexual debut have all contributed to adolescent pregnancy.

• Statement of Research Problem:

Adolescents (10-19 years old) and young adults (20-24 years old) represent 34% of the national population according to the extrapolations of the last general census of population and housing (BUCREP 2010) in Cameroon. Their health, a key potential for national development, is vulnerable to various factors, such as reproductive and sexual health (SRH / DROS, 2013), which are of concern because of the efforts made and the resources mobilized. Early fertility is high at a rate of 119-127 ‰ among-19yearolds, 15twice the global average in the same age group (MICS, 2014). One in four teenagers (25.6% of 15-19 year olds) have already started their reproductive life: 21% have had at least one child and 4% are pregnant with the first child. The median age at first intercourse of girls who attended school until the end of primary school is 15.9 years, compared to 18.6 years for those who have completed secondary and higher education. Seroprevalence of HIV among adolescents (10-19 years) is 1.2% and young adults (20-24 years) are 2.2% (MINSANTE, 2019).

Identified reproductive health issues for this segment of the population include: early sexual intercourse, unwanted early pregnancy, sexually transmitted infections, early marriages, sexual violence and abuse, clandestine abortions, and multiple partners (World Bank, 2017). Fifty-five percent (55.4%) of sexual abuse victims are in pre-puberty and puberty (Biyong 1990, MbassaMenick et al 2004). The average age of victims of child prostitution was 16.6 years with extremes of 9 years and 20 years (MbassaMenick et al 2009). It is reported in a survey that 37.3% of girls and 29.9% of boys experienced forced sexual initiation in Bamenda in the North West Province (WHO Report 2002). A study by MINAS / UNICEF (2004) identified cases of sex tourism in Kribi and Limbe involving victims between 12 and 18 years old.

• Sexuality at Risk of Adolescents and Young Adults:

Multi-partnership (up to 49% for boys) would justify HIV prevalence estimated at 1.2% among 15-19-year-olds. This vulnerability is all the more complex because its engines are poorly documented: STIs; poor access to adolescent friendly health services; sexual violence; prostitution (diffuse or real); the trivialization of risky sexual practices (anal, oral, plural, homosexual, etc.); the consumption of various drugs, racketeering; addictions to games, etc.

These reproductive health problems result, on the one hand, from a gross lack of preparation for sexuality – lack of comprehensive education in sexuality and sexual abuse (Woog and Kågesten, 2017) – and on the other hand from the approximate identification of specific needs in reproductive health. Studies of attitudes, sexual behavior and risk factors among adolescents aged 10 to 14 are almost non-existent (UNFPA, 2012). The main underlying factors identified are: (i) inadequate level of knowledge and skills in reproductive health, (ii) inappropriate use of STI / HIV / AIDS protection methods and contraceptive methods, (iii) poor access to reproductive health services for adolescents and young adults, (iv) reliance on sources of information of questionable reliability in reproductive health, (v) sexualization of social media, (vi) depravation of morals and, (vii) the failure of schools, family and community education related to reproductive health, even though school enrollment rates have improved and family life education curricula on population and HIV-AIDS (EVF-EMP-HIV-AIDS) have been in existence for over ten years

• Research Objectives

• General Objective:

The study seeks to evaluate students ‘exposure to sex education, to get their preferred sources of information on sexual and reproductive health, obstacles of their access to this information and their opinions on the teaching of sex education in schools.

• Specific Objective:

The specific objectives are as follows:

1. To determine the level of gender and exposure in the study.
2. To assess the level of knowledge about sexuality and reproduction health.
3. To identify protective skills and attitudes against sexual risk behaviours.
4. To determine the level of those indulged in sexual activities.
   • Research Questions:

What is the level of knowledge of the female adolescent’s students in GHS Batoke on Sex education and Unwanted Pregnancy?