Sexual and reproductive health knowledge of secondary school adolescents in Fako, Cameroon.

Introduction: the correct sexual and reproductive health knowledge of adolescents remains important to empower them for healthy decision-making. The study aimed to assess the sexual and reproductive health knowledge of secondary school adolescents in Fako, Cameroon. Methods: a cross-sectional survey of 1180 adolescents from nine schools in Fako, was conducted using a structured interviewer - guided questionnaire. Data were analysed using SPSS version 26. Descriptive statistics and logistic regression analysis were used to outline knowledge and to identify predictors of knowledge respectively. Statistical significance was set at p<0.05. Results: more than half (54.0%) of the participants had overall good sexual and reproductive health knowledge. However, 63.1% and 55.3% of the participants had poor knowledge on reproductive system functions and sexually transmissible infections respectively. In addition, 56.0% had overall good contraceptive knowledge, with 51.6% having poor knowledge on condom. Being male (AOR=0.43, 95% CI=0.20, 0.92) and using the internet to search for sexuality related information (AOR=0.46, 95% CI= 0.22, 0.94) were associated with good knowledge. Being in lower secondary school was an independent predictor of poor knowledge (AOR= 3.83, 95% CI= 1.67, 8.81). Conclusion: although slightly above half of adolescent secondary school students had good sexual and reproductive health knowledge, there existed several gaps in such knowledge. Policymakers especially in the education sector need to evaluate the current state of school-based sexual and reproductive health education in Cameroon, in order to design comprehensive curricula, that will begin from lower secondary school. Internet-based comprehensive sexuality education is also needed.

Trends and determinants of teenage childbearing in Ethiopia: evidence from the 2000 to 2016 demographic and health surveys.

BACKGROUND: Teenage childbearing among adolescents aged 15 to 19 is a common sexual and reproductive health (SRH) issue among young people, particularly in developing countries. It is associated with higher maternal and neonatal complications. Almost half (47%) of the population in Ethiopia are young people under 15 years old. Therefore, a clear understanding of the trend and determinants of teenage childbearing is essential to design proper intervention programs. METHODS: Secondary analysis of the 2000 to 2016 Ethiopia Demographic and Health Survey (DHS) data were conducted. A total of 3710 (DHS 2000), 3266 (DHS 2005), 4009 (DHS 2011) and 3381 (DHS 2016) adolescents (aged 15 to 19 years old) were included from the four surveys. The main outcome variable of this study was teenage childbearing, and independent variables were categorized into individual- and community-level factors. The 2016 DHS was used to identify the factors associated with teenage childbearing. Multi-level logistic regression analysis technique was used to identify the factors associated with teenage childbearing. The analysis was adjusted for different individual- and community- level factors affecting teenage childbearing. Data analysis was conducted using STATA software. RESULTS: The prevalence of adolescents who started childbearing reduced from 16.3% in 2000 DHS to 12.5% in 2016 DHS, p-value = < 0.0001. From the 2016 DHS, the percentage of adolescents who have had a live birth was 10.1%, and the percentage of adolescents who were currently pregnant was 2.4%. The highest percentage of teenage childbearing was in Affar region (23.4%), and the lowest was in Addis Ababa city (3%). The odds of teenage childbearing was higher among adolescents in the age range of 18-19 years old (AOR = 2.26; 95% CI: 1.29, 3.94, p-value < 0.01), those who started sexual intercourse before their eighteenth birthday (AOR = 12.74; 95% CI: 4.83, 33.62, p-value < 0.001), who were married or living together (AOR = 8.98; 95% CI: 2.49, 32.41, p-value < 0.01), and among those who were widowed, divorced or separated (AOR = 4.89; 95% CI: 1.36, 17.61, p-value < 0.05). CONCLUSIONS: One in ten teenage girls have already started childbearing in Ethiopia. Variations were observed in the percentage of teenage childbearing across different sociodemographic- and economic variables. Factors like age, early sexual initiation before 18 years of age, ever married, and geographical region were significant factors associated with teenage childbearing. School- and community- based intervention programs aimed at prevention of early marriage and early sexual intercourse is essential to reduce teenage childbearing and its complications.

Medical students' choices of specialty in The Gambia: the need for career counseling.

BACKGROUND: Understanding preferences for specialties by medical students and the factors driving choices assists policy makers in ensuring optimal spread of personnel across disciplines. METHODS: This cross-sectional survey using self-administered structured questionnaires was conducted on consenting students of the first medical school in The Gambia, established in 1999. Data collection was in June/July 2011. Questions were on sociodemographic characteristics of students, their parents, factors related to career preferences and opinions about counseling services. Data were analysed using JMP 8.0 software. RESULTS: Respondents were 52.4% of 202 eligible students. Mean age was 24.1 ± 5.0 years. Females constituted 54.7%. Muslims were 72.7% while Gambians formed 77.0%. Commonest specialties chosen by females were Obstetrics/Gynaecology, Paediatrics and Surgery in that order, while males preferred Internal Medicine, Surgery and Obstetrics/Gynaecology. Commonest factors influencing choices by females were 'focus on urgent care' (65.5%) and 'intellectual content of specialty' (56.9%). For males, these were 'intellectual content of specialty' (60.4%) and 'focus on urgent care' / 'individual's competence' (50.0% each). More females (30.0%) than males (23.0%) had ever received career counseling, but all students desired it. CONCLUSIONS: Significant gender differences exist in specialty choices and factors influencing these choices amongst these students. All want career counseling.