Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 30, 2021
Date Accepted: Jan 5, 2022
Impact Oriented Dialogue for Culturally Safe Adolescent Sexual and Reproductive Health in Bauchi State, Nigeria: Protocol for a Co-Designed Pragmatic Cluster Randomised Controlled Trial
ABSTRACT
Background:
Adolescents (10-19 years) are a big segment of the Nigerian population, and they face serious risks to their health and well-being. Maternal mortality is very high in Nigeria, and rates of pregnancy and maternal deaths are high among female adolescents. Rates of HIV infection are rising among adolescents, gender violence and sexual abuse is common, and knowledge about sexual and reproductive health risks is low. Adolescent sexual and reproductive health (ASRH) indicators are worse in the north of the country.
Objective:
In Bauchi State, northern Nigeria, the project will document the nature and extent of ASRH outcomes and risks, discuss the findings and co-design solutions with local stakeholders, and measure the short-term impact of the discussions and proposed solutions.
Methods:
The participatory research project is a sequential mixed-methods co-design of a pragmatic cluster randomised controlled trial. Focus groups of local stakeholders (female and male adolescents, parents, traditional and religious leaders, service providers, and planners) will identify local priority ASRH concerns. The same stakeholder groups will map their knowledge of factors causing these concerns, using the fuzzy cognitive mapping technique. Findings from the maps and a scoping review will inform contextualisation of survey instruments to collect information about ASRH from female and male adolescents and parents in households, and from local service providers. The survey will take place in 60 Bauchi communities. Adolescents will co-create materials to share the findings from the maps and survey. In 30 communities, randomly allocated, the project will engage adolescents and other stakeholders in households, communities, and services to discuss the evidence and to design and implement culturally acceptable actions to improve ASRH. A follow-up survey in communities with and without the intervention will measure the short-term impact of these discussions and actions. We will also evaluate the intervention process and use narrative techniques to assess its impact qualitatively.
Results:
Focus groups to explore ASRH concerns of stakeholders began in October 2021. Baseline data collection in the household survey is expected to take place in mid-2022. The study was approved by the Bauchi State Health Research Ethics Committee, approval number NREC/03/11/19B/2021/03 (1 March 2021) and by the Faculty of Medicine and Health Sciences IRB, McGill University (13 September 2021).
Conclusions:
Evidence about factors related to ASRH outcomes in Nigeria, and implementation and testing of a dialogic intervention to improve these outcomes will fill a gap in the literature. The project will document and test the effectiveness of a participatory approach to ASRH intervention research. Clinical Trial: ISRCTN Registry. ISRCTN18295275; https://www.isrctn.com/ISRCTN18295275
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.