{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:33:16Z","timestamp":1791667996549,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T00:00:00Z","timestamp":1579132800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T00:00:00Z","timestamp":1579132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The youths in Zambia have limited access to information concerning Sexual Reproductive Health (SRH) and this puts them at risk of unwanted pregnancies. Talking about other methods of preventing pregnancy or sexually transmitted infections than abstinence is regarded as culturally unacceptable. The Research Initiative to Support the Empowerment of Girls (RISE) is a cluster randomised controlled trial testing the effectiveness of different support packages on teenage pregnancies, early marriages and school drop-out rates. One of the support packages included youth clubs focusing on Comprehensive Sexual and Reproductive Health Education (CSRHE).<\/jats:p>\n<jats:p>Although similar interventions have been implemented in other settings, their integration process has been complex and comprehensive assessments of factors shaping acceptability of CSRHE are lacking. This article qualitatively aimed at identifying factors that shaped the acceptability of CSRHE youth clubs in rural schools in Central Province.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Method<\/jats:title>\n<jats:p>A qualitative case study was conducted after the youth clubs had been running for a year. Data were gathered through eight focus group discussions with grade eight pupils and eight individual interviews with teachers. Data were analysed using thematic analysis.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The perceived advantage and simplicity of the clubs related to the use of participatory learning methods, films and role plays to communicate sensitive reproductive health information made the learners like the youth clubs. Further, the perceived compatibility of the content of the sessions with the science curriculum increased the learners\u2019 interest in the youth clubs as the meetings also helped them to prepare for the school examinations. However, cultural and religious beliefs among teachers and parents regarding the use of contraceptives complicated the delivery of reproductive health messages and the acceptability of youth clubs\u2019 information among the learners.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The study indicated that CSRHE youth clubs may be acceptable in rural schools if participatory learning methods are used and head-teachers, teachers as well as parents appreciate and support the clubs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12913-020-4889-0","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T17:03:13Z","timestamp":1579194193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Acceptability of youth clubs focusing on comprehensive sexual and reproductive health education in rural Zambian schools: a case of Central Province"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-1531","authenticated-orcid":false,"given":"Eunice","family":"Chirwa-Kambole","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joar","family":"Svanemyr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingvild","family":"Sand\u00f8y","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hangoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Mumba","family":"Zulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,16]]},"reference":[{"key":"4889_CR1","first-page":"2","volume-title":"Ending child marriage: progress and prospects","author":"UNICEF","year":"2013","unstructured":"UNICEF. Ending child marriage: progress and prospects; 2013. p. 2\u20133."},{"key":"4889_CR2","volume-title":"Office of the High Commissioner for Human Rights report on child, early and forced marriage","author":"Save the Children","year":"2013","unstructured":"Save the Children: Office of the High Commissioner for Human Rights report on child, early and forced marriage, 2013."},{"key":"4889_CR3","volume-title":"The prevalence of risky sexual behaviours among youth centre reproductive health clinics users and non-users in Addis Ababa, Ethiopia: a comparative cross-sectional study","author":"N Fetene","year":"2015","unstructured":"Fetene N. The prevalence of risky sexual behaviours among youth centre reproductive health clinics users and non-users in Addis Ababa, Ethiopia: a comparative cross-sectional study; 2015."},{"key":"4889_CR4","volume-title":"Youth and comprehensive sexuality education","author":"United Nations","year":"2013","unstructured":"United Nations: Youth and comprehensive sexuality education, 2013."},{"key":"4889_CR5","first-page":"2","volume-title":"Ending child marriage in Zambia: gaps and opportunities in legal and regulatory frameworks","author":"Plan International, Policy Brief","year":"2014","unstructured":"Plan International, Policy Brief. Ending child marriage in Zambia: gaps and opportunities in legal and regulatory frameworks; 2014. p. 2."},{"key":"4889_CR6","volume-title":"Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia","author":"JM Zulu","year":"2014","unstructured":"Zulu JM, Hartig A, Kinsman J, Michelo C. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia; 2014."},{"issue":"1","key":"4889_CR7","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12978-018-0590-8","volume":"15","author":"J Zulu","year":"2018","unstructured":"Zulu J, et al. Community based interventions for strengthening adolescent sexual reproductive health and rights: how can they be integrated and sustained? A realist evaluation protocol from Zambia. Reprod Health. 2018;15(1):145.","journal-title":"Reprod Health"},{"issue":"1","key":"4889_CR8","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1186\/s13063-016-1682-9","volume":"17","author":"IF Sand\u00f8y","year":"2016","unstructured":"Sand\u00f8y IF, Mudenda M, Zulu J, et al. Effectiveness of a girls\u2019 empowerment programme on early child-bearing, marriage and school dropout among adolescent girls in rural Zambia: study protocol for a cluster randomised trial. Trials. 2016;17(1):588.","journal-title":"Trials"},{"key":"4889_CR9","volume-title":"2010 census of population and housing, central province analysis","author":"CSO","year":"2014","unstructured":"CSO 2010 census of population and housing, central province analysis, 2014."},{"key":"4889_CR10","doi-asserted-by":"publisher","DOI":"10.31899\/rh7.1003","volume-title":"Adolescent pregnancy in Zambia","author":"Population Council","year":"2017","unstructured":"Population Council, Adolescent pregnancy in Zambia, 2017."},{"key":"4889_CR11","first-page":"10","volume-title":"Educational statistical bulletin","author":"Ministry of Education","year":"2013","unstructured":"Ministry of Education. Educational statistical bulletin; 2013. p. 10."},{"key":"4889_CR12","unstructured":"Zhang Y, Wildermuth BM. Qualitative Analysis of Content. 2009. p. 1\u201312."},{"key":"4889_CR13","doi-asserted-by":"publisher","DOI":"10.21839\/jaar.2018.v3iS1.166","volume-title":"Interactive teaching strategies","author":"S Senthamar","year":"2018","unstructured":"Senthamar S. Interactive teaching strategies; 2018."},{"key":"4889_CR14","volume-title":"An African teacher\u2019s journey to self-knowledge through teaching sexuality education: making connections. Self study and social action","author":"L Masinga","year":"2009","unstructured":"Masinga L. An African teacher\u2019s journey to self-knowledge through teaching sexuality education: making connections. Self study and social action. New York: Peter Lang; 2009."},{"key":"4889_CR15","volume-title":"Protected or unprotected sex: the conceptions and attitudes of the youth in Bolgatanga Municipality","author":"Jolien","year":"2017","unstructured":"Jolien et al., Protected or unprotected sex: the conceptions and attitudes of the youth in Bolgatanga Municipality, 2017."},{"key":"4889_CR16","unstructured":"Menon J, et al. Gaining Insight into the magnitude of and factors influencing child marriage and teenage pregnancy in Zambia. Med J Zambia. 2018;41(3):145\u20139."},{"key":"4889_CR17","volume-title":"What makes a successful youth center","author":"S Luken","year":"2005","unstructured":"Luken S, Warner A. What makes a successful youth center. Heartwood: Halifax; 2005."},{"key":"4889_CR18","volume-title":"Three approaches to qualitative content analysis","author":"H Shanon","year":"2005","unstructured":"Shanon H. Three approaches to qualitative content analysis; 2005."},{"issue":"5 Pt 2","key":"4889_CR19","first-page":"1189","volume":"34","author":"MQ Patton","year":"1999","unstructured":"Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res. 1999;34(5 Pt 2):1189.","journal-title":"Health Serv Res"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-020-4889-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12913-020-4889-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-020-4889-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:25:25Z","timestamp":1610670325000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-020-4889-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,16]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["4889"],"URL":"https:\/\/doi.org\/10.1186\/s12913-020-4889-0","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,16]]},"assertion":[{"value":"3 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Clearance was sought from the Biomedical Reseach Ethics Committee of the University of Zambia Ethics Committee (UNZABREC IRB00001131 of IORG0000774, reference number 061-06-17). Verbal consent was sought from all participants and their parents\/guardians before conducting interviews and the ethics committee approved the verbal consent process. The rationale for seeking verbal consent was that the parents and children provided written consent and assent, respectively, at the time of recruitment in the trial and this included participation in the process evaluation, and this study was part of that evaluation. The processing charge for publishing the article was waivered because the main author is from a low income country according to World Bank definitions.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42"}}