Developing Adolescent Boys Toward Adaptation of Male Sexual and Reproductive Health in Communities With Embedded Cultural Manhood Values

Manhood values are highly prioritized among most culturally orientated South African Black communities with an ideology that revolves around the concept of masculinity. The notion of manhood values is deeply rooted in male dominance, sexual drive, and traditional male circumcision. The goals of this study were to (a) explore the experiences of school health nurses in the provision of sexual and reproductive health among adolescent boys; and (b) recommend suggested action to develop adolescent boys to adapt a healthy behavioral lifestyle through a health-promoting school program. This study employed a qualitative approach utilizing a descriptive and exploratory research design. The Ottawa Charter for Health Promotion was used to guide the study. Purposive sampling was used to select participants for individual interviews to collect data. A total of 21 school health nurses were selected to participate in face-to-face interviews. A thematic analysis was conducted using ATLAS ti (version 8) software. Five overarching themes were yielded and categorized as facilitators, barriers, and suggested action to improve sexual and reproductive health services as follows: (a) legislative frameworks and policies; (b) male medical circumcision, and prevention of HIV/AIDS and STIs; (c) lack of support from teachers and school-governing bodies; (d) risky sexual behaviors among the learners; and (e) empowerment and personal skills development. The study concludes with a discussion and recommendations that a comprehensive health-promoting school program should be developed for adolescent boys with guaranteed ownership and sustainability of male sexual and reproductive health.