ABSTRACT
The was designed to develop and validate ’ youth–friendly reproductive programme for adolescents in Enugu State. Eight specific objectives were formulated with eight research questions and four postulated hypotheses to guide the study.
The research and (R & D) design was used for the study. The for the study was 1, 124, 842 adolescents and 6,200 health experts in Enugu State. Multi–Stage sampling procedure was employed to select 400 adolescents and 400 experts which formed sample for the study, using Taro Yamen formula for sample size.
Three researcher designed instruments, Adolescents’ Reproductive Health Needs Assessment Questionnaire (ARHNAQ) Focus Group Discussion Guide (FGDG), and Adolescents’ Youth-Friendly Reproductive Health Programme Questionnaire (AYFRHPQ) were used for data collection.
The instruments were validated by five experts, three from the Department of Health and Physical Education and two from Science Education, University of Nigeria, Nsukka.
Split–half method employing Cronbach Alpha statistic was used to establish the internal consistency of ARHNAQ and AYFRHPQ with reliability indices of .79 and .76 respectively.
Means and Standard deviations were used in answering all the research questions. t–Test was used in testing Ho1and 3, while analysis of variance (ANOVA) was used in testing Ho2 and 4. The major findings of the study include eight reproductive health needs of adolescents.
Both male and female adolescents of different levels of education indicated that the listed health needs and problems were their reproductive health needs and problems. There was no significant difference in the reproductive health needs of male and female adolescents for majority of the items.
There was significant difference in the reproductive health needs of adolescents with primary, secondary and tertiary education regarding majority of the items. Scheffe’s test analysis indicated significant difference between tertiary and secondary education for the items.
There was no significant difference in the reproductive health problems of adolescents based on gender. There was significant difference in the reproductive health problems of adolescents based on level of education.
Scheffe’s test analysis indicated significant difference in the reproductive health problems of adolescents between secondary and tertiary education.
Based on the findings, adolescents’ youth-friendly reproductive health programme (AYFRHP) was developed and validated for adolescents in Enugu State.
Recommendations were made, among which include that State Ministries of Health and Education should try to adopt the adolescents’ youth-friendly reproductive health programme that was developed in the course of this study.
TABLE OF CONTENTS
Title Page i
Approval Page ii
Certification Page iii
Dedication iv
Acknowledgments v
Table of Contents vi
List of Tables ix
List of Appendices x
Abstract xi
CHAPTER ONE: Introduction
Background to the Study 1
Statement of the Problem 13
Purposes of the Study 14
Research Questions 14
Hypotheses 15
Significance of the Study 15
Scope of Study 17
CHAPTER TWO: Review of the Related Literature
Conceptual Framework 18
· Reproductive health and components of reproductive health 19
· Reproductive health needs and problems of adolescents 37
· Health services and youth – friendly health service 38
· Adolescents 41
· Porgramme development and validation 43
· Examples of adolescents’ reproductive health programme 45
· Schematic representation of the conceptual framework 51
Theoretical Framework 52
· Precede – proceed model 52
· Social cognitive theory 53
· The theory of reasoned action (TRA) 54
· Wheeler’s curriculum model 54
· Schematic representation of theoretical framework 56
Empirical Study on Development and Validation of Adolescents’ Youth – Friendly
Reproductive Health Programme Reviewed under:57
· Studies on adolescents’ reproductive health; 57
· Studies on youth – friendly reproductive health science; and 64
· Studies on programme development 66
Summary of Literature Review 70
CHAPTER THREE: Methods
Research Design 74
Area of the Study 75
Population of the Study 75
Sample and Sampling Technique 75
Instruments for Data Collection 76
· Validity of the instruments 77
· Reliability of the instruments 77
Method of Data Collection 78
Method of Data Analysis 78
CHAPTER FOUR: Results and Discussion
Results 80
Summary of the Findings 119
Discussion of Findings 122
· Reproductive health need of adolescents 122
· Reproductive health problems of adolescents 127
· Appropriateness of Adolescents’ Youth-Friendly Reproductive Health Programme (AYFRHP) 128
· Differences in the reproductive health needs and problems of adolescents 129 Adolescents’ Youth-Friendly Reproductive Health Programme (AYFRHP) in Enugu State 131
CHAPTER FIVE: Summary, Conclusions and Recommendations
Summary 235
Conclusions 139
Recommendations 241
References 242
INTRODUCTION
Reproductive health is an essential aspect of health that ensures healthy reproductive and sexual life for all ages.
The quality of reproductive and sexual health for a
ll (male and female, young and old) irrespective of race or creed is indeed a global issue resulting from an increase in the reproductive health problems such as teenage pregnancy, abortion and sexually transmitted infections (STIs) including HIV and AIDS.
World Health Organization- WHO (1995) reported that reproductive ill health accounts for 30 per cent of the overall burden of diseases in women and 12 per cent for men.
This implies that women are mostly affected by reproductive health problems. United Nations Population Fund, UNFPA, (2008) stated that about 200 million women mostly in developing countries suffer from life- threatening complications and disabilities from pregnancy related and other reproductive health problems.
Nigeria, being a developing country, is faced with challenges of reproductive health. The Federal Ministry of Health, FMOH, (2009) stated that available statistics show that the reproductive health situation in Nigeria is poor.
UNFPA (2008) reported that 1 in 20 adolescents contracts a sexually transmitted disease each year, and half of all cases of HIV infection take place among people under age 25. This implies that the incidence of sexually transmitted infection is high among adolescents.
World Bank (2012) stated also that many female adolescents die from pregnancy related complications like severe bleeding after child birth, infections, and unsafe abortion.
WHO (2001) had earlier reported that 1,000,000 conceptions and 350,000 sexually transmitted infections (STIs) occur each day among adolescents, about 50 per cent of the conceptions were unplanned and about 25 per cent were definitely unwanted, resulting in about 150,000 induced abortions and 500 deaths every day.
The risk of injury and death from pregnancy-related complications is higher among teenage mothers or adolescents because they are more likely to experience a higher risk of complications at birth due to underdeveloped reproductive organs.
REFERENCES
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Adegboyega, J.A. & Olanipekun, J.A. (2011). Pre-marital coitus experience and contraceptive practice among in-school adolescents in Nigeria. Nigerian Journal of Health Education, 15 (1), 318 – 328.
Adesokan, F.O.O. (2010). Reproductive health for all ages. Ado-Ekiti: Sammy Prints.
Agampoli, S.B., Agampoli, E.C. & Piyaseeli, U.K.D. (2008). Adolescents perception of reproductive health care services in Sri Lanka. BMC Health Service Research, 8, 98- 110.
Ajali, U. & Inya-Agha, S. (2006). HIV and AIDS: Scientific, health and social aspects. Enugu: Rhyce Kerex Publishers.
Alcala, M. J. (1994). Action for the 21st century health and rights for all. New York: Family Care International.
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