Health consequences of sexuality education on selected secondary school adolescents

Scientific Study, 2010

35 Pages, Grade: 1.0







Background Information about Respondents
Analysis of Research question
Hypotheses Testing




This study was designed to examine the health consequences of sexuality education among senior secondary school adolescent in select school in Epe Area of Lagos State.

It was five chapters, thorough and well researched project work.

Each of the chapters of the study work contained a new and fresh information on the study.

The chapter one of the study examined the introductory part as in statement of the problem, objectives of the study, research questions, hypotheses, delimitation, limitation and scope of the study.

In chapter two, related and relevant topics to the study were reviewed to serve as theoretical framework to the study. The chapter three was succulently written to discuss the methods and procedures adopted in the course of conducting the study it also revealed the research instrument used, how it was administrated and analysed, were also discussed.

A total number of seven hundred were randomly selected as sample for the study, having used eight senior secondary school adolescent in Epe area of Lagos State.

The chapter four was analytically and descriptively written to present the data sourced through the use of questionnaire for analysis and hypothesis testing.

The findings, showed that the respondents had adequate knowledge about sexuality education and its health consequences, was attributed to the various campaigns being mounted by government and non-governments organisation and by extension, the respondents exhibited some positive sexual behaviours.



Sex education is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, contraption and other aspects of human sexual behaviour. Common avenues for sex education are parents or caregivers, school programs, and public health campaigns.

Sex education may also be described as sexuality education which means that it encompasses education about all aspects of sexuality, including information about family planning, reproduction fertilization, conception and development of the embargo and fetus, through to childbirth plus information about all aspects of one’s sexuality including; body image, sexual orientation, sexual pleasure, values, decision making, communication, dating relationship. Sexuality transmitted infection (STIS) and how to avoid them and birth control methods (World Health Organisation 2002).

Sexuality education is defined as an age appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information sexuality education provides opportunities to explore one’s own values and attitudes and to build decision making, communication and risk reduction skills about many aspect of sexuality education (United Nations Educational, Scientific and cultural organisation 2002).

Sexuality education provides accurate information about human sexuality including: growth and development; sexual anatomy and physiology; reproduction contraception; pregnancy and childbirth, HIV and AIDS; STIS, family life and interpersonal relationships, culture and sexuality; human rights empowerment, non-discrimination, equality and gender roles, sexual behaviour; sexual diversity; sexual abuse; gender- based violence and harmful practices.

Sexuality is the total expression of which we are, as human beings, it encompasses our whole psychosocial development, our entire self-concept and it begin from birth and ends at death. It is a construct, multifaceted and needs understanding. Its understanding should start as soon as a child is ready for it (Action Health incorporated, 2003). Adolescence is the stage of life when a child grows and develops into an adult. In terms of age, it begins at 10-12 years old and continues until the age of 18-19 years. During adolescence period, physical, biological, psychological changes occur and there is the need for social adjustment. (Arkutu, 1995).

Few young people receive adequate preparation for their sexual lives. This leaves their potentially vulnerable to coercion, abuse and exploitation, unintended pregnancy and sexually transmitted infections (STIS), including HIV/AIDS (UNAIDS, 2008).

Many young people approach adulthood faced with conflicting and confusing messages about sexuality and gender.

This is often exacerbated by embarrassment, silence and disapproval of open discussion of sexual matters by adults, including parents and teachers, at the very time when it is mostly needed, Joint United Nations Programme on HIV/AIDS (UNAIDS. 2008). There are many settings globally where young people are becoming sexually mature and active at an earlier age. They also marrying later, thereby extending the period of time from sexual maturity until marriage. It means exposure to teaching of sexuality education does not mean the children will get into early marriage (UNAIDS, 2008).

There is an urgent need to address the gap in knowledge about STIS and HIV/AIDS among young people aged 15-24, with 60 percent in this age range not able to correctly identify the ways of preventing HIV/AIDS transmissions (Joint United Nations Programme on HIV/AIDS, 2008). A growing number of countries have implemented or are scaling up sexuality education programmes, including China, Kenya Lebanon, Nigeria and Viet Nam, a trend confirmed by the minister of education and health from countries in Latin America and the Caribbean at a summit held in August 2008. These efforts recognize that all young people need sexuality education, and some are living with HIV or are more vulnerable to HIV/AIDS infection than others. Particularly, adolescent girl marries as children, those who are already sexually active, and those with disabilities (USAIDS, 2008).

Effective sexuality education can provide young people with age appropriate, culturally relevant and scientifically accurate information.

Effective sexuality education is a vital part of HIVS/AIDS prevention and is also critical to achieving Universal Access target for reproductive health and HIV/AIDS prevention, treatment, care and support, Joint United Nation Programme on (HIV/AIDS 2006). While it is not realistic to expect that an education programme alone can eliminate the risk of HIV/AIDS and other (STIS) sexual transmitted infections, unintended pregnancy, Coercive or abusive sexual activity and exploitation, properly designed and implemented programmes can reduce some of these risks and underlying vulnerabilities.

Effective sexuality education is important because of the impact of cultural values and religious beliefs on all individuals, and especially on young people, in their understanding of this issue and in managing relationships with their parents, teachers, other adults and their communities (UNAIDS, 2006).

The issue of sexuality is first of all a personal matter, all cultures especially in Africa, we see pre-marital sex as taboo that should be frowned at and those who practice it or favour it are seen as deviants of much concern also is the attendant consequences of teenage pregnancy like clandestine, abortion, vesico-vagina fistula and ruptured uterus (Moronkola and Oyebade, 2005). Motives for premarital sex according to experts may and not be unconnected with poverty, inequality in gender, and pressures for young people in relying on sexual relationship to meet their needs (Smith, 2004).


Realizing the danger and colossal consequential effect of sexually transmitted diseases and HIV/AIDS. On the populace, the Federal Government established an agency (NACA) to help in educating the public on the disease. Sequel to that, institutions, non-governmental organisations, philanthropic organizations are taking cue by establishing their own AID/STI awareness campaign. Recently, the Nigerian Police Force launched their own HIV/AIDS campaign unit within their own organisation POWA Seminar (2005).

In spite of all these fact, people still indulge in sexual promiscuity. Many young boys and girls still engage in the behaviors that expose them, to the risk of unwanted pregnancy, sexually transmitted disease and HIV/AIDS. Therefore, it is important to examine the effectiveness of the health effect of sexuality education among selected secondary school adolescents in Epe Local Government Area of Lagos State.


The purpose of this study is to look at the health effect of sexuality education on senior secondary student in Epe local Government Area of Lagos, state.

Children and teenagers are exposed to barrage of information related to sexuality which will require guidance from families and schools for healthy sexual development and responsible behaviour and.

1. Reduce misinformation about sexuality and its effect on the adolescents.
2. To provide accurate information about topics that children and young peoples are curious about and which they have a need to know.
3. Provide children and young people with opportunities to explore values, attitudes and norms concerning sexual and social relationship.
4. Encourage children and young people to assume responsibility for their own behaviour and to respect the rights of others.
5. As a comprehensive package, all learning objectives address children’s and young people’s need for information and right to education.

However, while only some of these learning objectives are specifically designed to reduce risky sexual behaviours, other will attempt to change social norms, facilitate communication of sexual issues, remove social and attitudinal barriers to sexuality education and increase knowledge.


This study stand to buttress the meaning of sexuality as the social construction of a biological drive, World Health Organization (WHO, 2002) which often deals with issues such as whom one has sex with, in what ways, why, under what circumstances and with what outcomes a person engages in sex (NACC, 2002). This study will increase and improve the knowledge about sexuality.


This study sought to find answers to the following research questions

i. What is sexuality education and why is it important?
ii. What are the benefits of sexuality education?
iii. Why target young person?
iv. What are the goals of sexuality education?


The research hypotheses that were formulated and tested are

1. Age will not significantly influence sexuality education among senior secondary school students.

i. Culture will not significantly influence sexuality education among student.

2. Religion will not significantly influence sexuality education among secondary school student.

3. Parental attitude will not significantly affect the teaching of sexuality education among senior school student.

i. Peer pressure will not affect the teaching of sexual education among secondary school student.

4. Economic background will not influence the teaching of sexuality education among secondary school student.

5. Teacher's attitude will not significantly influence the teaching of sexuality education among secondary school students.


The researcher was limited due to the fact that respondents were not forthcoming in their responses to the questionnaire due to the peculiarity of the subject of sexual behaviour.

Some respondents did not return some copies of the questionnaire.


The scope of this study was delimited to selected secondary school Adolescent in Epe Area of Lagos State.

1. Secondary school students in Epe Local Govt. Area of Lagos state.
2. Descriptive survey research method.
3. Modified participation motivation questionnaire (PMQ) as research instrument for data collection.


The significance of this study is as follows:

i. To reduce the frequency of unprotected sexual activity
ii. Abstain from or delay debut of sexual relations
iii. Reduce the number of sexual partners; and –increase the use of protection against unintended pregnancy and STIS during sexual intercourse.
iv. To promote and sustains risk-reducing behaviour.


- Sexuality Education - Awareness teaching of the feelings and activities connected with a person's sexual desires.
- Knowledge - This is the level of awareness possessed as regards something.
- Promiscuous - Having many sexual partners; promiscuous behaviour or life style, to be sexuality promiscuous especially without careful thought.
- Exploitation - It is a situation in which somebody treats somebody else in an unfair way.
- NACA: National Action Committee on AIDS
- PEP: Post-Exposure Prophylaxis
- PFA: Programme of Action
- SIECUS: Sexuality Information and Education Council of the United States
- SRE: Sex and Relationship Education
- UNAIDS: Joint United Nations Programme on HIV/AIDS.
- UNESCO: United Nations Educational, Scientific and Cultural Organisation
- UNFPA: United Nation Population Fund
- UNICEF: United Nations Children’s Fund.
- VCT: Voluntary Counseling and Testing (for HIV)
- WHO: World Health Organization
- IPPF: International Planned Parenthood Federation
- UNFPA: United Nations Population’s Fund
- CEDAW: Convention on the Elimination of all forms of Discrimination Against Women
- CRC: Convention on the Right of the child
- HIV: Human Immunodeficiency Virus
- AIDS: Acquired Immune Deficiency Syndrome
- STI: Sexual Transmitted Infection
- STD: Sexual Transmitted Disease
- POWA: Police Officers Wives Association



The review of related literature for this study will be discussed under the following sub-headings

1. Adolescent

i. Premarital sex
ii. Abortion

2. Concept of sexuality

i. Conflict in discussion sexuality issues
ii. Knowledge about reproductive health

3. Perceived self-efficacy to adopt safe practice

4. Change in attitude

i. Sexual behaviours
ii. The challenges
iii. Parental attitude


Adolescence is a time when young people experience changes in their bodies among which is the development of new sexual feeling, which they may not understand. This is also the period when most of them are in the secondary or high schools. They therefore, will need information and assurance about what is happening to them. The incidence of adolescent sexual activity in Nigeria is high and increasing although adolescents are given little information for making informed decision about it (Birungi, Mugishs, & Nyombi, 2007).

Children and teenagers are exposed to a barrage of information related to sexuality which will require guidance from families and schools for healthy sexual development and responsible behaviour. Due to impact of western civilization, there is need to supplement the training of young people in the art of family life by their parents and family members with a school-based sexuality programme. This promoted the federal government of Nigeria in 1999 though the National Council on incorporate sexuality into the National school curriculum. This has generated heated debates especially among parents. There is also the likelihood that even teachers might not perceive sexuality education in the light of reducing sexual promiscuity and its attendant complication like sexuality transmitted disease and HIV/AIDS. Therefore this study aimed at determining the health effect of sexuality education among selected secondary school Adolescent in Epe Local Government Area of Lagos state. World Health Organization/United Nation Population Fund/United Nations Children's Fund (1999) defined adolescence as the period of life between 10-19 years and young people as those between 10-24 years. The United Nation's (1989), concentration on the right of the child considers children to be under the age of eighteen. Sexual activity in Nigeria is high and increasing, although adolescents are given little information for making informed decision about it.

Sexual and reproductive ill-health is a higher contribution to the burden of disease among young people. Ensuring the sexual and reproductive health of young people makes social and economic sense; HIV/AIDS infection, other STIS, unintended pregnancy and unsafe abortion, all place substantial burden on families and communities and upon scare government resources, and yet such burden are preventable and reducible.

Promoting young people's sexual and reproductive health; including the provision of sexuality in schools, is thus a key strategy towards achieving the Millennium Development Goal (MDGs), especially MDGs (achieving gender equally and empowerment of woman), MDG 5 (reducing mortality and achieving universal access to reproductive health) and MDG 6 (combating HIV/AIDS).

The sector has a critical role to play in preparing children and young people for their adult roles and responsibilities. (Delors et al, 1996); this transition adulthood requires becoming informed and equipped with the appropriate knowledge and skills to make responsible choices in their social and sexual lives. Moreover, in many countries, young people have their first sexual experiences while they are still attending school, making the setting even more important as an opportunity to provide about sexual and reproductive health.

In most countries, children between the ages of five and thirteen, in particular spend relatively large amounts of time in school. Thus, schools provide a practical means of reaching large numbers of young people from diverse backgrounds in ways that are replicable and sustainable (Gordon, 2008). School systems benefit from an existing infrastructure, including teachers likely to be a skilled and trusted source of information, and long-term programming opportunities through formal curricular. School authorities have the power to regulate many aspect of the learning environment to make it protective and supportive, and school can also act as social support centres, trusted institutions that can link children, parents, families and communities with other services (for example, health services). However, schools can only be effective if they can ensure the protection and well-being of their learners and staff, if they provide relevant learning and teaching interventions, and if they link up to psychological, social and health services.

Evidence from UNESCO, WHO, UNICEF and the World Bank (WHO, UNICEF, 2003) point to a core set of cost-effective legislative, structural, behavioural and biomedical measures that can contribute to making schools healthy for children. The sexual development of a person is a process that comprises physical, psychological, emotional, social and cultural dimensions. It is also inextricably linked to the development of one's identity and it unfolds within specific socio-economic and cultural contexts. The transmission of cultural values from one generation to the next forms a critical part of socialization; it includes values related to gender and sexuality. In many communities young people are exposed to several sources of information and values (e.g. from parents, teachers, media and peers).

These often present them with alternative or even conflicting values about gender, gender equality and sexuality. Furthermore, parents are often reluctant to engage in discussion of sexual matters with children because of cultural norms, their own ignorance or discomfort.

According to the World Health Organization (2002), in many cultures puberty represent a time of social, as well as physical change for both boys and girls. For boys, puberty can be a gateway to increased freedom, mobility and social opportunities. This may also be the cause for girls, but in other instances puberty for girls may signal an end to schooling and mobility, and the beginning of adult life, with marriage and child bearing as expected possibilities in the near future.


The primary goal of sexuality education is that children and young people become equipped with the knowledge, skills and values to make responsible choices about their sexual and social relationships in a world affected by HIV. Sexuality education programmes usually have several mutually reinforcing objectives.

- To increase knowledge and understanding;
- To explain and clarify feelings, values and attitudes
- To develop or strengthen skills and
- To promote and sustain risk-reducing behaviour.

In context where ignorance and misinformation can be life threatening, sexuality education is part of the responsibility of education and health authorities and institutions. In its simplest interpretation, teachers in the classroom have a responsibility to act in partnership with parents and communities to ensure the protection and well-being of children and young people. At another level, the international Technical Guidance calls for political and social leadership from education and health authorities to support parents by responding to the challenge of giving children and young people access to the knowledge and skills they need in their personal, social and sexual lives. When it comes to sexuality education, programme designer, researchers, and practitioners sometimes differ in the relative importance they attach to each objective and to the overall intended goal and focus. For educationalist, sexuality education tends, to be increasing knowledge e.g. about prevention of unintended pregnancy and HIV (AIDS) is valued as well as being a first step towards, adopting safer behaviour. For public health professional, the emphasis tends to priorities reducing sexual risk behaviour

Sexuality education is a central aspect of being human throughout life. According to the World Health Organization (WHO 2002). Sexuality education encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality education is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Sexuality education is often broadly defined as the social construction of a biological drive which often deals with issues such as whom one has sex with, in what ways, why under what circumstances and with what outcomes a person engages in sex. Thus, sexuality pertains to the totality of being human-being a female or male-and this suggests a n perspective of the concept of sexuality which is shaped by biological, economic, political, social, cultural and religious factors operating within a particular culture in each society (WHO, 2002).

Sexuality education is a process of learning about how an individual can be comfortable about all aspects of being human. Sexuality education can also be described as a process of providing information, skills and services that enable persons adopt safe sexual behaviors including abstinence, non-penetrative sex such as hugging, holding hands, as well as correct and consistent use of condoms. Sexually healthy behaviors also include seeking care from trained health workers during incidence of any reproductive morbidity such as sexually transmitted infections (STI) unwanted pregnancy, and infertility. Although people of all age groups can benefit from sexuality education, this paper pays particular attention to sexuality education among young persons in Nigeria. The paper justifies the need for sexuality education in young persons and provides evidence of the benefits of sexuality education in this population. (WHO, 2002)


In an attempt to address the unmet sexuality education needs of young persons, several governmental, non-governmental agencies and individuals have implemented various programmes targeting different categories of young persons including secondary school students, physically challenged youths, apprentices and hawkers across the country. The outcome of some of these programmes have been well evaluated and published others have not. The data on which the discussion in this section is based were derived from surveys that were well designed and evaluated. All the studies cited adopted a design that included experimental (intervention) groups and comparison (control) populations. Consequently, the findings are generalized. The data shows that the resources invested in implementing sexuality education programmes for young persons are worth every Naira spent because such programmes had led to improvement in the reproductive health status of the young persons who had participated in them. Evidence of this improvement can be found using six key indicators. These indicators are listed below:

1. Comfort in discussing sexuality issues
2. Knowledge of reproductive health
3. Perceived self-efficacy to adopt safe behavior
4. Attitudes towards adopting safe sex behavior and attitude towards persons living with HIV/AIDS
5. Sexual behaviour
6. Reproductive health outcomes including unwanted pregnancy


Surveys confirm that participation in sexuality education programmes increased young persons comfort level to discuss sexuality-related issues. For example, the number of participants in a rural school-based peer-led sexuality programme in Oyo State who had discussed a reproductive health issue with someone rose significantly from 182 persons at baseline to 382 at follow-up (Ajuwon, 2000). Female hawkers trained as peer educators in Ibadan counseled and (or) informed 428 persons on sexuality-related issues (Ajuwon et at, 2003). This is an important benefit given the fact that discussion of sexuality issues is generally considered a taboo subject in Nigeria. The opportunity for open discussion of sexuality issues is also advantageous because it helps many young persons clarify doubts and misconceptions they have about sexuality.


All the projects reviewed in this paper found increase in knowledge and understanding of reproductive health issues among programme beneficiaries (Osowole, 1998; Fawole et al, 1999; Ajuwon, 2000; Briegeretal, 2001; Ajuwon et al, 2003; Oladepo et al, 2004). For example, students who participated in the peer-led sexuality programme of the West African Youth initiative (WAYI) implemented in selected states in Nigeria and Ghana during 1995-1997 had superior mean reproductive health knowledge score (8.6) than comparison group (7.3) (Brieger et al, 2001) This improvement is not only encouraging but also desirable because acquisition of knowledge is usually the first stage in the process of behavior change. However, knowledge alone is often not sufficient in itself to produce change in sexual behavior in most people (Coates. 1991).


Perceived self-efficacy (PSE) is someone's perception of his/her ability to carry out a behavior. Bandura (1969) developed this concept and it has been increasingly applied in several surveys to gauge the extent to which young persons have the ability or confidence to adopt safer sexual behaviors including abstinence, purchase of condom distribution of condoms, and use of condoms. According to this theory the higher a person's PSE to adopt safer sexual behavior the higher the probability that he /she will actually put into practice such behavior. Thus, intervention programmes must stress not only the cognitive aspect of learning but also boost young persons' confidence to perform safer sex practices. Studies show that programme beneficiaries have acquired higher PSE to adopt safer sex practices including use of contraceptive and to adopt abstinence and use of condoms (Brieger et al, 2001; Ajuwon, 2000). For example, PSE scores with regard to condom use among students participating in a sexuality education programme in rural schools in Oyo state rose from 10 at baseline to 13 at follow-up. The scores of their counterparts who did not receive sexuality declined from 11.1 baseline to 10.9 at follow-up (Ajuwon 2000) Similarly PSE scores of experimental high school students involved in the WAYI project were superior (3.27) to those of their counterparts who were in the control group (2.17) (Brieger et al, 2001)


Another benefit of sexuality among young persons is positive change in attitude towards use of contraceptives and to persons living with HIV/AIDS (PLWHA) As shown in the study by Fawole among high school students in Ibadan, more programme beneficiaries (79%) expressed positive attitudes towards PLWA after exposure to sexuality than control group (14%).


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Health consequences of sexuality education on selected secondary school adolescents
Bowdoin College
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Blessing Adegoke (Author), 2010, Health consequences of sexuality education on selected secondary school adolescents, Munich, GRIN Verlag,


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