School-Based Sexual and Reproductive Health Services for Prevention of Adolescent Pregnancy in the Hoima District, Uganda: Cluster Randomized Controlled Trial.

Gloria Kirungi Kasozi,Gloria Kirungi Kasozi,Miph Musoke,Frank Pio Kiyingi,Julius Kasozi

doi:10.3390/mps2010021

Gloria Kirungi Kasozi, Gloria Kirungi Kasozi + Show 3 more

Open Access

https://doi.org/10.3390/mps2010021

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Abstract

Uganda has persistently had high adolescent pregnancy prevalence; 25% for the last 10 years. This protocol presents the design of a Cluster Randomized Controlled Trial (CRCT) to investigate the effectiveness of School-Based Sexual and Reproductive Health (SBSRH) interventions on prevention of pregnancy among school girls aged 15–19 years in the Hoima District, Uganda. 18 secondary schools (clusters) will be selected using cluster sampling and allocated 1:1 into control or intervention group stratified by geographical location. 1080 (60 each cluster) participants/girls aged 15–19 years will be selected using simple random sampling. The intervention group will receive tailored SRH information, in-school medical care and referral over 12 months. The control group will receive no intervention from the research team; however, they can access alternative services elsewhere if they wish. Data will be obtained at baseline, 6 months and 12 months. The outcomes are reduction in occurrence of pregnancy, utilization of SRH services and sexual behavioral change. To our knowledge, this is the first CRCT providing combined SRH interventions for prevention of adolescent pregnancy in Uganda. If effective, it could have great potential in preventing adolescent pregnancy. Trial Registration: Pan African Clinical Trial Registry (PACTR201810882140200) Registered on 16 October 2018.

Highlights

Adolescence is a transitional phase of growth and development between childhood and adulthood, mainly referring to individuals between the age of 10 and 19 years [1]
Half of the world’s population is under 25 years old and the population of young people aged between 10–25 years is estimated to be 1.8 billion with about 85% living in the developing world [2]. 49% of girls in least developed countries (LDCs) marry before they turn 18, while 10%–40% of young unmarried girls have had an unintended pregnancy, giving rise to about million children worldwide who are born every year to young married and unmarried women aged to 19 years [2]
The United Nation Population Fund estimates that every day in developing countries, 20,000 girls under age 18 give birth resulting into 7.3 million adolescent births a year [3]

Summary

Introduction

Adolescence is a transitional phase of growth and development between childhood and adulthood, mainly referring to individuals between the age of 10 and 19 years [1]. The United Nations Children’s Fund (UNICEF) defines an adolescent pregnancy as a young girl aged 13–19 years who becomes pregnant or has had a live birth [2]. The United Nation Population Fund estimates that every day in developing countries, 20,000 girls under age 18 give birth resulting into 7.3 million adolescent births a year [3]. Uganda has consistently had high rates of adolescent pregnancy at 25% for the last ten years. These rates have been coming down gradually but steadily: in 1995, it was 43%, in 2000–2001 it dropped to 31% [4] mainly because of the sexuality education program that started in schools and communities targeting young girls

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