RESUMEN
BACKGROUND: In Tanzania, adolescent pregnancy results in a denial of the girl's fundamental right to education. School expulsion of pregnant adolescents is a common practice exercised by teachers in this country for decades. This study aimed to explore the perceptions and feelings of secondary school teachers towards this practice. METHODS: The study used a qualitative approach comprising focus groups and individual semistructured interviews with a purposive sample of sixteen teachers and nine headmasters (nâ=â25) from nine secondary schools of the rural Igunga district, in Tabora region, Tanzania. Data was collected in March to June 2017 and submitted to thematic analysis. RESULTS: Though most participants were not satisfied with the practice, their role on the expulsion of pregnant students was perceived as mandatory by law and regulations. Main argument in favor was its deterrent effect, yet the review of schools' registries did not sustain that perception. Stigma and fear of contamination added a relevant contribution to its implementation. Conflicting feelings among teachers were also disclosed. CONCLUSION: This study was of most value to understand current perceptions and feelings of those who exercise the practice of banning pregnant adolescents from school in Tanzania, while having identified some of the cultural and social believes acting as influential factors in its pervasiveness. International and national human rights organizations should increase their efforts and campaigns in order to strength social awareness of the benefit of females' education to society as a whole and of adopting policies and practices in support of their equal right to education.
RESUMEN
BACKGROUND: There is wide variation among societies in profiles of adolescent health and behaviors, but they all experience sexual and reproductive health as a major challenge. However, adolescents in middle- and low-income countries are of particular concern, as it is the case in Tanzania, where limited social, educational, and health services contribute to make them victims of unwanted pregnancies, unsafe abortion, and sexually transmitted infections including HIV. Thus, we undertook a descriptive systematic scoping review of the available published information on sexual and reproductive health among Tanzanian adolescents. METHODS: We performed a scoping review to collect and analyze observational data on sexual and reproductive health behaviors among Tanzanian adolescents. Publications were identified using PubMed®, Scopus®, Web of Science™, and Cochrane Library electronic databases from 2000 to December 2017. A protocol was defined to identify relevant studies. We included original observational studies conducted in Tanzania and published in English, both quantitative and qualitative, involving adolescents (10 to 19 years old), and that considered at least one of the following items: condom use, number of sexual partners, sexual debut, contraceptive prevalence, sexually transmitted infections, unwanted pregnancies, abortion, or knowledge about reproductive health. All included articles were coded according to relevant exposures or outcomes and subsequently analyzed to assess frequencies. RESULTS: After screening for inclusion criteria, 13 publications were included in the datasheet developed to record the findings. Overall, the publications revealed that adolescents tend to be sexually active, with high rates of early sexual debut, have multiple sexual partners, and a limited use of condom and contraceptives. Sexual coercion and transactional sex were also frequent. Only one study addressed pregnancy as an outcome, and a single study looked at the relevant health services. No study was retrieved describing the frequency of unsafe abortion. CONCLUSION: Adolescents engage in high-risk sexual behaviors and experience its adverse consequences. It is essential to collect more information, but the existing evidence supports a need for improving provision of sexual and reproductive health services among Tanzanian adolescents.
