Advancing sexual and reproductive health outcomes in rural schools with the use of a sexuality education enhancement model: learners’ perspectives

Despite evidence-based proof that sexuality education enhances school-going adolescents’ sexual and reproductive health, the high number of teenage pregnancies and sexually transmitted infections, including HIV, among young people in the rural areas of South Africa suggests that the school-based sexuality education programme in the rural areas might have less influence on learners due to various contextual factors in these settings. This phenomenological study used nine focus group interviews to explore the experiences of 84 school-going adolescents regarding sexuality education offered in their schools, located in the rural areas of the King Cetshwayo District, in Kwazulu-Natal, South Africa. The participants were purposively sampled and the transcribed data from the interviews were thematically analysed. The study revealed that the sexuality information provided to learners did not improve their motivation or encourage behaviour to act on the information provided. Additionally, the results highlighted environmental factors in the research setting that influenced the effectiveness of the sexuality education programme. To enhance its effectiveness, a sexuality education enhancement model was developed using elements of the systems theory and modified information-motivation-behavioural skills model. The model identifies the input resources needed to address issues of information, motivation and skills as well as the influencing environmental factors.