Background The objective of this formative research was to engage multiple stakeholders to identify specific factors that may influence program development for Project Prepare Tanzania- an innovative, school-based sexual health curriculum for young adolescents in Tanzania.
Methods Focus group discussions (FGDs) and structured interviews were used to elicit data for program development from students, teachers, parents, and healthcare workers. 12 FGDs were conducted with male and female adolescents (n=90) from 6 randomly selected schools in Dar es Salaam, Tanzania. Individual interviews (n=16) were conducted with boys (n=8) and girls (n=8). Key informant interviews were conducted with teachers (n=12) and parents (n=12). Community social workers (n=6) and healthcare workers (n=4) also participated in key informant interviews. Interview and FGD guides were designed to elicit data on: sexuality communication, self-efficacy, parenting and sexuality, inclusion of sexual health education in schools and knowledge, attitudes, and perceptions related to peer-education and skills-building for sexual health. NVivo 8 software was used to analyse data and help develop salient qualitative themes.
Results Salient themes were related to sexuality communication, attitudes towards skills building for condom use and negotiation of safe sex, access to correct information for sexual health, and partnership building to strengthen links between stakeholders. Factors that may influence communication about sexual health among adolescents include: fear associated with talking to parents, fear of being perceived as immoral, and inadequate opportunities to discuss sexuality including puberty. Parents and teachers reported needing skills to discuss puberty, sexually transmitted infections and sexual health. Teachers indicated that curricula should be expanded to include a sexual health component. There is a need for values clarification between parents and teachers regarding teaching about condoms and healthy sexual scripts for negotiation of safe sex. All participants suggested strengthening links between stakeholders to promote more communication.
Conclusions Project Prepare Tanzania will address the facilitators and barriers identified in this formative research to develop a culturally acceptable, innovative and sustainable sexual health curriculum for adolescents.