Evaluating a sexual and reproductive health education program in Mozambique: A mixed method study

Background: Early and inappropriate messages regarding sexuality and marriage taught during adolescent initiation rituals teachings in Mozambique are considered a determinant of high rates of early marriage, adolescent pregnancy, and maternal mortality. The Alert Community for a Prepared Hospital implementation research project in Natikiri, Nampula, Mozambique (2016-2020) identified adolescent initiation rituals counsellors and traditional authorities as pertinent agents to provide sexual and reproductive health education to adolescents during the initiation rituals. Objective: Develop, apply, evaluate, and disseminate a modern, transformative education tool, about sexual and reproductive health and rights, for counselors to use with adolescents during initiation rituals in Northern Mozambique. Methods: This is an exploratory descriptive and intervention study, using mixed method approaches. Findings: Results suggest, the education tool was well accepted by rituals counsellors, community leaders and the adolescents who attended the initiation rituals. It was shown to improve adolescent’s knowledge and lead to a positive behaviour change in sexual and reproductive health and rights. Conclusions: This intervention may be replicated at a national level with a low cost and significantly contribute to reducing adolescent pregnancy and early marriages and improving maternal and child health.