Assessing Comprehensive Sexuality Education Programs in the Democratic Republic of the Congo: Adolescents’ and Teachers’ Knowledge, Attitudes and Practices towards Contraception

Introduction: Improving teenagers’ knowledge on sexual and reproductive health (SRH) is important to prevent unintended pregnancies. We aimed to assess comprehensive sexuality education (CSE) programs and knowledge, attitudes and practices of adolescents and teachers towards contraception. Methods: Based on the reasoned action theory and CSE guidelines, a qualitative study was conducted with seven teachers and 62 adolescents aged 15 - 19. The data were collected through six focus groups (FG) of adolescents and seven semi-structured interviews of teachers. The program of the family life education course (FLEC) was assessed. The Atlas Ti software helped to analyze the data, using a deductive approach. Results: The periodic abstinence, male condoms and pills were the most known contraceptive methods. Adolescents and teachers were reluctant to use artificial contraceptive methods, apart from the male condom which they used irregularly. Girls especially preferred natural contraceptive methods, fearing side effects, such as the risk of infertility. Almost all adolescents wanted to be informed on SRH and family planning in school. However, they estimated that the content of the FLEC was insufficient and criticized the teachers’ lack of openness. Their main sources of information were peers, siblings and the internet. Mothers were an important source of information for girls, unlike fathers considered to be indifferent or even frightening. Conclusion: Adolescents’ and teachers’ knowledge are weak;and their attitudes unfavorable towards contraception. Misconceptions about contraception lead to the use of ineffective practices to prevent unwanted pregnancies. To improve knowledge, a teacher training program should be developed and the content of the FLEC improved, formalized and regulated.

Perceptions of Health Warning Signs in Seriously Ill Woman of Childbearing Age in Kinshasa

Introduction: For seriously ill women of childbearing age, perceived health warning signs may influence decision of whether or not to seek care. Inaccurate perceptions of patients and those around them may lead to attitudes that delay seeking care. This study analyzes perceptions of danger and related delays to seek care in Kinshasa. Methods: Sixty deceased women who died between March and April 2004 were taken away from two Kinshasa mortuaries. History of disease and deaths were reconstructed through medical records and semi-structured interviews of family members and leaders. The Qualitative Software Research was used to conduct a qualitative analysis. Results: Perceived health warning signs had five manifestations: Specific clinical health warning signs, aggravation of non-specific signs, persistence of signs, indirect danger signs and superstitious signs. The incorrect perception of the signs was an important cause of late awareness of the danger and delayed decision to seek care. Conclusion: Misunderstandings of signs often delayed awareness of danger as well as decisions to seek appropriate care. Educational programs teaching health warning signs should be designed to promote the timely use of facilities.