Sexual and reproductive health among adolescents living in orphanages in Dar es Salaam

Abstract

Background: Sexual and Reproductive Health (SRH) is a women’s right, It is important to all women especially the adolescent who are facing some critical changes in their body and lack knowledge on how to handle such changes. Adolescent orphans are more likely to be illiterate on the issues related to SRH than their peer. They live in the orphanages with little or no parental guidance from low skilled caregivers; some of them are not attending schools and lack health care. In Tanzania, Little is known about knowledge, attitude and practice (KAP) of adolescent orphans regarding sexual SRH. Therefore this study determined the KAP on sexual and reproductive health among adolescents living in orphanages in Dar es Salaam, Tanzania. Objective of the study: The broad objective of this study was to determine the level of knowledge, attitude and practice on SRH among adolescent orphans in Dar es Salaam. Material and Methods: A cross sectional study was conducted in the three districts of Dar es Salaam involving 418 adolescent orphans aged 12 -18 years. The selection of orphanages was done purposively where in each district three centers were selected. Structured interviews and observation were done at nine orphanages; Data were collected by trained interviewers using structured questionnaire and observational checklist covering socio-demographic information as well as KAP regarding SRH. Data were entered into computer software for cleaning and analyzed using Statistical Package for Social Science (SPSS) version 20. Statistical associations were tested using chi –square test and p- value at 5% significance level. Knowledge were assessed in three levels: ―good knowledge‖ with 80-100%, ―moderate knowledge‖ with 50- 79% and ―poor knowledge‖ with <50%. Results: Among 418 adolescent orphans 55.3% were male and 44.7% were female. Only 48% of adolescent orphans were aware of SRH services. Brochures/journals 43.1%, friends 42.6% and television/radios 41.4% were found to be the source of information to adolescent orphans. More than two –third 64.3% of adolescent orphans had moderate knowledge about ways of HIV and AIDS prevention and transmission. Age group (chi- square 43.10 p=0.00), education level (chi square 41.04 p=0.00) was significantly associated with reproductive health knowledge on family planning. Conclusions: Generally, the study revealed that there is poor knowledge, appropriate practice and favorable attitude of adolescent orphans regarding different SRH-related issues. Socio-demographic characteristics found to have association with knowledge level on family planning methods and HIV/ AIDS prevention. Recommendation: It is important to educate adolescents about issues related to SRH, so that they can safeguard themselves against various sexual transmitted infections and unwanted pregnancies. Also the government should put strategies to increase awareness and knowledge on SRH in orphanage centers that are tailored to the need of adolescent orphans Key words: Adolescent, orphan, Sexual and reproductive health