School-Based Clubs Promote Health and Education among Adolescents in Ethiopia

August 4, 2021

Last week, PSTC sociologist David Lindstrom participated in a live webinar in Ethiopia sponsored by Pathfinder International and the David and Lucile Packard Foundation. Representatives from Ethiopia’s Ministry of Health and Ministry of Women, Children and Youth, as well as the country’s National Academy of Sciences were present on a panel that commented on the significance of the work. This work is part of a longstanding partnership between Brown and the Program in Public Health at Jimma University in Ethiopia.

The webinar was timed to coincide with an evaluation of the Ministry of Health’s national adolescent and youth health strategy 2016-2020.

The focus of Lindstrom’s presentation, entitled “Life Expectations in Early Adolescence and The Impact of Clubs on Reproductive Health Knowledge: Lessons from The Jimma Longitudinal Family Survey of Youth (JLFSY)” was on how school clubs can affect reproductive health knowledge (including HIV prevention) and life expectations among younger adolescents in the Jimma region.

School clubs in the Jimma area include both standard afterschool clubs focused on sports or shared academic interests, and reproductive health clubs that use creative approaches such as theatre to instruct students in HIV prevention, contraceptive methods, and health-seeking behavior, among other topics.

Raising the median age at first sex and marriage (for girls) is a policy goal for the Ethiopian government, as youth who have high expectations and aspirations for their education and occupation tend to stay in school longer and have a lower risk of early pregnancy and early marriage.

The data are drawn from the Jimma Longitudinal Family Survey of Youth (JLFSY), which followed a random sample of 3,700 households and 2,100 adolescents age 13-17 at baseline in 2005-06 over 3 survey rounds.

The main findings of this study were that the life plans that youth form in early adolescence have a significant impact on the age at which they become sexually active; young men and women who have high educational and occupational aspirations delay first sex; being in school is associated with older ages at sexual initiation and delayed marriage; and females who think their parents want them to delay marriage tend to marry at older ages. Furthermore, school engagement is a strong predictor of sexual and reproductive health knowledge at older ages.

Lindstrom commented that school-based interventions work, and that “more traditional public health approaches tend to overlook the role of parents and other adult caregivers, especially fathers.” He says the data show that adolescents want parents to be involved. He also noted that the RH clubs provide opportunities for boys and girls to be together and emphasize peer to peer interaction and the value of education. He also commented on the importance of aspirations, remarking that kids recognize the importance of education in occupational attainment, and know that early sex and marriage are a barrier to high achievement, adding that the modern labor market rewards education.

Finally, Lindstrom added that in a time in Ethiopia when it seems like everything is falling apart, given the ongoing armed conflict in the Tigray region, these findings are good news and suggest that investments in school-based interventions can help to improve health.  

Full papers from this research are forthcoming.