Burden of Reproductive Health Illiteracy in Eritrea

Reproductive health (RH) is state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. In East Africa including Eritrea, adolescents comprise more than a quarter of the population. The region holds the highest rates of sexually transmitted diseases, HIV, unwanted pregnancy and unsafe abortion with its complications. Young girls carry the highest burden of reproductive health problems due to their risk taking behavior, lack of knowledge, peer pressure, physiologic immaturity and low socioeconomic status. The purpose of this study is to assess the burden of reproductive health illiteracy on adolescent high school girls in Eritrea. Descriptive cross-sectional study is conducted between February and March 2013. Qualitative data was also collected using FGD and individual interview. Three high Schools, located in the central highlands of Eritrea were purposively selected, for their homogeneity and proximity to a health centre. Thirty female students from each school were randomly selected for the survey. The central highland is one of the four distinct topographic regions in Eritrea containing 50-60% of the nation’s population. The schools: are public secondary schools serving several villages in their catchment. Data was collected using a predesigned, pretested questionnaire emphasizing on reproductive health knowledge, attitude and practice. Students in public schools are homogeneous, thus 30 female students were randomly selected from each school for the survey. Purposively selected 75 persons participated in the Focus Group Discussion and individual interview. Data were checked for completeness on site, coded, entered in to a computer, cleaned and analyzed using SPSS, proportions were used to present data. The qualitative data was analysed through coding describing and deriving themes. The results shows that ninety female students in grade nine participated in the study. Mean age was16 ± 1.5 years, 75% lived with both parents and majority (68%) of participants’ mothers have very low educational level. Parents (62%) are mentioned as primary source of reproductive health information. The volunteers’ knowledge on, female reproductive system, sexually transmitted infection and family planning was (36%; 22%; 36%) respectively. Reproductive health practice and attitude were (13%, and 56%) respectively. The individual (100% of them) and FGD (80%) participants stated though “heterosexual relationships, unsafe sex and unplanned pregnancy are rampant in Eritrea; young girls lack the knowledge and skills to protect themselves”. More Direct quotations are incorporated in the results. In the conclusion we can say that the majority of the students lack the knowledge and good attitude towards reproductive health. Moreover young girls never used the available health services. Most importantly the FGD and individual interview participants expressed their concerns on the challenges young girls are facing due to their lack of knowledge and skills. Therefore the efficacy of school based peer reproductive health education should be tested so that it can be a stepping stone for a bigger scale national intervention.