Table 1 shows the demographic characteristics of survey respondents. Approximately 51% of adolescents in the survey were residing in urban areas, whereas 49% of them lived in rural areas. There were 598 (57.2%) girls and 447 (42.8%) boys in the survey. Majority (92.4%) of the surveyed respondents were in-school while only 7.6% were out of school adolescents.
Table 1
Socio-demographic characteristics of survey respondents
Variables (N = 1045) | Frequency (n) | Percent (%) |
Age in single years | | |
13 | 180 | 17.4 |
14 | 219 | 20.9 |
15 | 162 | 15.5 |
16 | 151 | 14.5 |
17 | 136 | 12.9 |
18 | 197 | 18.8 |
Gender | | |
Female | 598 | 57.2 |
Male | 447 | 42.8 |
Place of residence | | |
Urban | 551 | 50.7 |
Rural | 494 | 49.3 |
Schooling | | |
In-school | 966 | 92.4 |
Out-of-school | 79 | 7.6 |
Table 2 highlights the demographic distribution of in-depth interview respondents. There were 38 males and 39 females who were interviewed. Forty-nine of these respondents resides in urban areas while 28 respondents resides in rural areas.
Table 2
Socio-demographic distribution of IDI respondents
Variable | N = 77 |
Sex | |
Male Female | 38 39 |
Place of residence | |
Urban Rural | 49 28 |
Category of respondents | |
Policy makers/Program managers Health workers Parents of adolescents Community leaders Religious leaders | 25 18 8 20 6 |
Level of operation | |
LGA/Community State | 52 25 |
Table 3 shows the distribution of FGD respondents. In each of the community, one focus group discussion (FGD) was held with village heads. Furthermore, an FGD with adolescent boys and another with girls were held in each of the study communities
Table 3
Socio-demographic distribution of FGD respondents
FGD participants |
Number of FGD per community with village heads |
Variable (N = 6) |
Sex | |
Male Female | 6 0 |
Location | |
Urban Rural | 3 3 |
Number of FGD per community with adolescents |
Variable (N = 12) |
Location |
Rural | 6 |
Urban | 6 |
Sex | |
Females | 6 |
Males | 6 |
Findings from the quantitative survey of adolescents
Table 4 shows the current sources of SRH information to adolescents. It shows that out of 1045 adolescents that were surveyed, 635 (60.5%) mentioned teachers as the commonest source of information on signs of puberty, followed by mothers, 418 (39.8%). With respect to sources of information on relationship with opposite sex during puberty, majority of the adolescents reported that teachers were their main source 382(36.3%), followed by their friends, 313 (29.8%), and their mothers 252(24.0%). A considerable proportion of adolescents (27.9%), stated that they had not received any information or advice on relationship with opposite sex at the time of the survey.
Table 4
Sources of sexual and reproductive health information
Variables | Frequency | Percent |
+Source of information on signs of puberty | | |
¬ Teacher | 635 | 60.5 |
¬ Mother | 418 | 39.8 |
¬ Sibling | 197 | 18.6 |
¬ No one | 192 | 18.6 |
¬ Friends | 147 | 13.8 |
¬ Father | 78 | 7.4 |
¬ Guardian | 37 | 3.5 |
¬ **Other family member | 96 | 9.2 |
¬ *Other | 62 | 6.0 |
+Source of information on relationship with opposite sex | | |
¬ Mother | 252 | 24.0 |
¬ Father | 68 | 6.4 |
¬ Guardian | 25 | 2.3 |
¬ Sibling | 135 | 12.8 |
¬ **Other family member | 71 | 6.8 |
¬ Teacher | 382 | 36.3 |
¬ Friends | 313 | 29.8 |
¬ No one | 289 | 27.9 |
¬ *Other | 70 | 6.7 |
+Multiple response; *Internet, health workers, health product promoters |
Table 5 shows the relationship between adolescents’ socio-demographic characteristics and their sources of information about puberty are shown in Table 2. Significant association was observed between age category and sources of information about puberty (other family members, teachers and friends) among adolescents (p ≤ 0.003); place of residence and sources of information about puberty (parents/guardians and friends) (p ≤ 0.03); Significant association was also found between gender and parents/guardians (p < 0.001), and other family members (p < 0.001), as well as between schooling status and teachers (p = 0.001).
Table 5
Socio-demographic correlates of sources of information about puberty
Variables | N | Parents/guardians f(%) | Other family members f(%) | Teachers f(%) | Friends f(%) |
Age category | | | | | |
13–15 | 561 | 241 (42.7) | 120 (21.1) | 317 (56.3) | 54 (9.4) |
16–18 | 484 | 219 (45) | 149 (30.7) | 318 (65.3) | 93 (19) |
ꭓ2 (p-value) | | 0.51 (0.48) | 12.55 (< 0.001)* | 8.81 (0.003)* | 20.41 (< 0.001)* |
Place of residence | | | | | |
Urban | 551 | 285 (51.9) | 156 (28.1) | 352 (63.6) | 90 (16.1) |
Rural | 494 | 175 (35.4) | 113 (22.9) | 283 (57.3) | 57 (11.5) |
ꭓ2 (p-value) | | 28.58 (< 0.001)* | 3.73 (0.05) | 4.38 (0.04) | 4.50 (0.03)* |
Gender | | | | | |
Female | 598 | 344 (67.3) | 188 (31.2) | 373 (62) | 85 (14) |
Male | 447 | 116 (25.8) | 81 (17.9) | 262 (58.4) | 62 (13.6) |
ꭓ2 (p-value) | | 102.6 (< 0.001)* | 23.96 (< 0.001)* | 1.38 (0.24) | 0.03 (0.87) |
Schooling status | | | | | |
In-school | 966 | 424 (43.7) | 244 (25) | 601 (62) | 133 (13.5) |
Out-of-school | 79 | 36 (44.9) | 25 (31.8) | 34 (42.6) | 14 (17.5) |
ꭓ2 (p-value) | | 0.04 (0.84) | 1.77 (0.18) | 11.45 (0.001)* | 0.99 (0.32) |
* Statistically significant |
Table 6 shows the relationship between adolescents’ socio-demographic characteristics and their sources of information about puberty are shown in Table 3. Significant associations were found between age category, gender and sources of information about relationship with opposite sex (parents/guardians, other family members and friends) (p ≤ 0.02); place of residence and sources of information about relationship with opposite sex (parents/guardians, other family members and teachers) (p ≤ 0.03). Schooling status was significantly associated with teachers.
Table 6
Socio-demographic correlates of sources of information about relationships with opposite sex
Variables | N | Parents/guardians f(%) | Other family Members f(%) | Teachers f(%) | Friends f(%) |
Age category | | | | | |
13–15 | 561 | 138 (24.3) | 92 (16.2) | 192 (33.9) | 143 (25.4) |
16–18 | 484 | 152 (31.3) | 105 (21.6) | 190 (39) | 170 (34.8) |
ꭓ2 (p-value) | | 6.43 (0.01)* | 5.01 (0.02)* | 2.85 (0.09) | 10.93 (0.001)* |
Place of residence | | | | | |
Urban | 551 | 179 (32.5) | 118 (21.3) | 223 (40.2) | 178 (32.2) |
Rural | 494 | 111 (22.5) | 79(16) | 159 (32.2) | 135 (27.3) |
ꭓ2 (p-value) | | 13.10 (< 0.001)* | 4.88 (0.03)* | 7.23 (0.01)* | 2.93 (0.09) |
Gender | | | | | |
Female | 598 | 202 (33.6) | 145 (24.2) | 213 (35.4) | 160 (26.6) |
Male | 447 | 88 (19.5) | 52 (11.4) | 169 (37.4) | 153 (34.1) |
ꭓ2 (p-value) | | 25.22 (< 0.001)* | 27.56 (< 0.001)* | 0.44 (0.50) | 6.97 (0.01)* |
Schooling status | | | | | |
In-school | 966 | 264 (27.1) | 180 (18.4) | 363 (37.3) | 286 (29.5) |
Out-of-school | 79 | 26 (33) | 17 (21.9) | 19 (23.8) | 27 (33.4) |
ꭓ2 (p-value) | | 1.24 (0.26) | 0.56 (0.45) | 5.72 (0.02)* | 0.55 (0.46) |
Findings from in-depth interviews and FGDs
Participants highlighted that adolescents receive SRH information from various sources namely, teachers, peers/friends, family members and trusted adults, health workers, mainstream and social media, internet, and the church.
Teachers
They were frequently mentioned as a source of SRH information for adolescents, particularly for those who had attended or were attending school. They were said to provide information on topics such as puberty, sexuality transmitted diseases and relationship with the opposite sex. Some of the participants expressed their opinions thus,
“"Well as much as I know those in school get their sexual information from those teachers I talked about,” (Male, Policy maker).
"Some school have added it in their curriculum that sexual education should be part of the studies in the schools, … like myself, I teach them sex education, prevention of diseases like STDs" (HIZ01). (Health worker, Female)
Friends/Peers
Friends and peers were also frequently mentioned as a source of SRH information, particularly for out-of-school adolescents but also as well for those in school. Adolescents were perceived to rely on one another and on their boy/girl friends for SRH information
"Majority of them get their information from their peer groups, including their boyfriends or girlfriends" (Policy maker, Male)
"We get the information through friends. For example, in my school if you don’t have boyfriend, they will tell you that you have not started" (Adolescent, Female)
"Most adolescents receive information from their friends, in-school adolescents receive information from their classmates" (Policy maker, Female)
Parents and family members
Varied opinions were expressed by respondents about parents and family members being a source of SRH information for adolescents. It was noted that parents are a source of SRH information for adolescents who can confide in them. Trusted adults were also identified as a source of SRH information for adolescents
“Some adolescents get sexual and reproductive information from their mothers, for those who can confide in their mothers” (Policy maker, Male)
“Those [adolescents] out of school get SRH information from their trusted adult friends” (Policy maker, Male)
One participant categorically stated that family is the number one source of SRH information for a child, particularly information related to puberty and development of the reproductive system.
"... Family is the number one, please. A child born into a family will definitely pass through the tutelage of the mother, the father and other immediate family who will definitely give such child information expected of him and especially the one relating to his growth into adolescent stage, the sexual reproductive health system" (School Principal, Male)
Contrary views were expressed by some respondents who lamented the fact that some parents do not provide SRH information to their children due to lack of awareness or knowledge, poor communication between parents and their children, and cultural inhibitions.
"Although most of the parents teach them (adolescents) other basic things, they do not educate their children on sex-related things" (School Principal, Female)
"Some parents are not even aware of the state of their child’s health. Some of the adolescents do not even open up to their parents” (School Principal, Male)
Health workers
Although reported as an unpopular source, health workers were identified as a source of SRH information for some adolescents. It was stated that some adolescents preferred to visit informal health service providers such as patent medicine vendors (PMVs) for SRH information, rather than formal health service providers in the primary health centers. Typical responses were
“… Others get from the hospital, for those who visit the hospital” (Policy maker, Male)
“What they do is if they have problems that are related to that (SRH), they rather go to patent medicine dealers that will protect them so to speak...”(source?)(Policy maker, Male)
“… because of their tender age some of them are very shy to approach people [in the health center] to advise them or tell them this is what they should do or this is what they should not do” (source?) (Health worker, Female)
Internet, mainstream and social media
Internet and social media recurred among respondents as sources of SRH information for adolescents. Frequently mentioned social media sources were WhatsApp and Facebook which were described as providing information on what adolescents can do with respect to sexual relationships. Other mass media such as television and radio were also mentioned as sources of SRH information for adolescents
"In this era of explosive social media, most of them (adolescents) get information from social media; others get from television, radio" (Policy maker, Male)
"… So many discussions in WhatsApp and Facebook give people the insight of what adolescents can do and their sexual relationship" (Health worker, Female)
"...internet determines the fate of our younger ones these days. They always browse and do so many things there" (Health worker, Male)
"We also get (SRH) information through television and radio …" (Adolescent, Female)
Church
Some respondents mentioned the church as a source of SRH information, highlighting that the main focus of the church for adolescent SRH is abstinence from sex. One participant also correctly noted that some churches consider SRH as a topic which is not to be discussed with adolescents at all.
"In addition to other sources, they also get information from the church" (Parent, Male)
"…they can get from the church especially when the church has a programme. Two weeks ago, we had a programme here and we had to explain certain things to them (Religious Leader)
"…it depends, for some churches, during youth week, some churches invite some people to come and talk to them on that aspect (SRH) but for some other churches, it's a no go area" [laughs]. (Policy maker, Male)
1. Preferred sources of SRH information and value placed on them by adolescents
Adolescents repeatedly described friends, peers and social media as their most preferred sources of SRH information. A reason given for preferring their friends is that they feel comfortable and at ease to express their opinions to their friends. Conversing with friends about SRH was considered more interesting because there are no restrictions to topics discussed. Some adolescents also expressed that they trust their friends and can rely on them to keep discussions confidential. Some of their views are expressed in the following quotes:
“I prefer my friend because she will tell me her opinion, and I will tell her mine. When you are discussing with your friend and he/she is telling about those things [sex related matters], you can also tell him or her what you know about it and sometimes he/she will not know about an issue and, you will feel free to put her through." (Adolescent, Female)
"...friends are preferable, because speaking with friends is very interesting" (Adolescent, Male)
"...friends will tell us how to enjoy the real life unlike parents who will tell you that sex is not good" (Adolescent, Male)
In addition to the adolescents, many other respondents iterated that peers and friends are valued by adolescents, over other sources, as an important source of SRH information. This is because they trust their friends and can confide in them with very sensitive information. Friends were considered to be the first contact adolescents make for SRH information when a need arises because of a failure by parents and the school system to provide comprehensive information to adolescents. Overall, peers were considered a very strong influence and valued source of SRH information for adolescents.
"There is no other place that they get this (SRH) information that will be more powerful than peer group" (Policy maker, Female)
"So for the reason that parents and teachers fail to teach them (adolescents) – and even when teachers are pushed by the adolescents, they don’t open up to them – the only chance left for the adolescent is their peers" (Policy maker, Female)
"….. we discovered that they (adolescents) have more confidence in their peers" (School principle female)
"Adolescents value that (SRH information) from peer groups because peer group will work on their brain to make sure they convince them" (School principle Male)
Concerning social media, adolescents preferred it because there are numerous platforms which are easy to join and from which they can connect with friends (make new friends from all over the world) and chat with them. Internet was also preferred because it is easy to access and there are no limits to information that can be sourced. In the words of an adolescent:
"Internet is more important because it is a network that contains all information and can be easily accessed. On Facebook you can use it to connect and chat with your friends all over the world” (Adolescent, Male)
A few adolescents mentioned parents and school teachers as a preferred source because they are most likely to provide the right information and direction for their adolescent.
"I prefer my parents because they provide the right information and they do not deceive their children. Most times, internet provides information that may provide opportunities to make wrong choice of information" (Adolescent, Male)
2. Perceived adequacy and appropriateness of sources of SRH Information for adolescents
Table 7 summarizes respondents’ perceptions of adequacy and appropriateness of various sources of SRH information for adolescents which were previously mentioned. Parents, health workers and trained counselors were considered as adequate sources of SRH information for adolescents, whereas opinions were varied as to the adequacy and appropriateness of peers and social media as sources of SRH information.
Some respondents considered, information from primary health centers as adequate because there are trained health personnel as well as reading materials on SRH. They also reasoned that teachers could provide adequate SRH information if this becomes part of the school curriculum.
“Information from health centers (youth-friendly centers) is adequate, appropriate and tailored to the needs of the adolescents....that is why I talked about establishing adolescents’ center” (Policy maker, Female)
“In the health facility you can get that balanced information. Take for instance, if an adolescent is choosing any contraceptive method now, you give the person the pre-information on that particular method ... and at the end you counsel. So that makes it adequate” (Health worker, Female)
“Schools and parents maybe appropriate and adequate sources of information but social media and friends are not adequate and appropriate sources because they provide wrong information sometimes” (Health worker, Female)
Some participants attempted to compare various sources of information when considering the adequacy of SRH information provided. For instance, a community leader stated that health facilities are better positioned to provide SRH information, and on a more regular basis than schools.
"...What I am sure of is that the health facilities are trained institutions and are well organized for the provision of that kind of information (SRH information). In schools, trainings are done once in a while, not as regular as obtains in the health sector" (Community leader, Male)
One participant highlighted the value in combining various sources of information to achieve adequacy of SRH information to adolescents. Schools, churches and parents were considered by him as good but inadequate sources of information on their own. In his words,
“Schools, churches parents are good sources of information but independently the information they pass are inadequate, no source is enough in itself. A combination of sources may be adequate” (Policymaker, Male)
There was the tendency for some categories of respondents to consider themselves as an adequate source of SRH information for adolescents. For instance, parents more frequently identified parents as an adequate source of SRH information for adolescents, while health workers frequently mentioned themselves as an adequate source of information.
Table 7
Respondents’ perceptions of adequacy and appropriateness of sources of SRH information
Source of SRH information | Perceived adequacy | Perceived appropriateness |
Parents | Adequate. Usually targets the specific needs of an adolescent | Appropriate Are in good position to give correct information |
Health workers (primary health centers and youth-friendly health centers) | Adequate. Because information is balanced and delivered by trained health workers. Also there is the availability of training materials in health facilities | Appropriate They are well informed on SRH issues |
Trained counselors | Adequate | |
Teachers (in school) | Adequate | Appropriate Are trained to provide the right information |
Social media | Inadequate. Provides inaccurate information | Inappropriate |
Peers | Inadequate. Provides inaccurate information | Inappropriate Don’t have appropriate information |
Friends/peer group, social media, teachers and church are inadequate
Most of the participants were of the view that information from friends/peer group, social media and the church are inadequate. A state level policymaker described information from boy/girlfriend, peers, chemists and social media to be deficient. Similarly, information gotten from school (teachers) and churches may be inadequate because these sources tend to mince words providing SRH information, hence don’t give adequate and balanced information. According to some participants, the teachers and priests themselves may not have adequate information. For instance, SRH education may not be part of the school curriculum. Moreover, it was also observed by some of the participants that the church only focused on abstinence. One in her statement said that,
“Really what they get from their friends is not adequate…,You cannot give what you do not have. If their peers have the information they will give, but unfortunately they don’t have it. (Policy maker, Female
“The ones I assume not to be adequate are information they crave for on the internet and the videos, face book and so on and so forth. For example, when you talk about the video the actors and the actresses always act in the film hall not along the street but when these people are watching it they will assume that is being done along the street not knowing that they have a place where they do it”. (Parent, Male
I think the information they get from peer group is not adequate. Also, the ones they get from internet is not adequate because of varieties of views (Health worker, Female).
Appropriateness of Sources of Information
Health facilities/youth friendly centers, parents and teachers are appropriate
Most parents that took part in the study noted that the information from the parents are more appropriate than the ones they receive from the social media and peers. Youth friendly centers, and teachers in addition to parents were regarded as appropriate sources of SRH information by most state level policymakers and health workers. They believed that parents are in a good position to give correct information, while teachers and staff of youth friendly centers are well informed to guide the adolescents sexually.
“Schools and parents maybe appropriate and adequate sources of information but social media and friends are not adequate and appropriate sources.”(Health worker, Male)
The health workers and school teachers give appropriate information because they are trained and qualified. Moreover, they do not also seem to get appropriate information from the social media because they do not understand the basis of what they read, watch and hear. The important thing to do is to provide them with the right information so that they can distinguish between what is detrimental and beneficial.
Friends/Peer groups and social/mass media are inappropriate
All participants were unanimous that Peer groups and social media are inappropriate as sources of SRH information to adolescent. Given as reason is that these sources can provide information that are distorted, based on misconception and could be misleading. They argued that their peers lack appropriate knowledge, but only provide information based on their individual experiences. They believed that the internet, for example, exposes adolescents to all manner of information, including, good and bad ones. Some of the quotes are:
“A girl with painful menstrual flow then she gets information from her peers that when she sleeps with a boy the menstrual pain will reduce. That type of information is it correct? No, but that is the information she has. Had it been her mother explained everything for her she will not listen to what her friends say. This kind of misinformation is based on past experiences which are misleading because of their wrong source of information” (School principal, Female)
"What they will get from the internet might be misleading because internet is a very broad place where you can get every information positive and negative and if the person is not guided, they are not that mature to be able to know the right or the wrong."(Religious leader, Male)
"In terms of appropriateness friends and peers are not because all they do is to share their personal experiences which can either be negative or positive in nature" (Village head. Male).