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Presented by: David Dudok Olga Wrezel Principal Investigator: Dr. Michael John Co-investigator: Jessica Wylie The Ethics o...
Out of Africa… <ul><li>MedOutreach 2006 members </li></ul><ul><ul><li>Student-run organization </li></ul></ul><ul><ul><li>...
Health education <ul><li>Topics </li></ul><ul><ul><li>Reproductive health </li></ul></ul><ul><ul><ul><li>HIV/AIDS, STIs, p...
Is our teaching effective, furthermore ethical?
To ethics and beyond… <ul><li>Target age group </li></ul><ul><li>Ability to apply information (e.g., access) </li></ul><ul...
Methods Draft survey,  ethics submission  June 2006 Ethics approval, Swahili translation in TZ July 2006 Teaching sessions...
Survey sample <ul><li>SURVEY OF EDUCATIONAL EFFECTIVENESS </li></ul><ul><li>REPRODUCTIV E HEALTH </li></ul><ul><li>Form/ k...
Results <ul><li>N=479 (M 217,  F 221, 41 blank) </li></ul><ul><ul><li>Mean age = 16.2  ± 1.2 </li></ul></ul><ul><ul><li>11...
Q1: How much did you know about the subject before the presentation? Q3: How comfortable did you feel talking about the to...
Knowledge Improvement On knowledge of reproductive health before and after the presentations, 307 ( 70.6% ) reported impro...
 
 
 
Self-rated Accessibility of Condoms Accessibility in sexually-active individuals =  73.1% Accessibility in abstinent indiv...
 
To ethics and beyond…(again) <ul><li>Target age group </li></ul><ul><li>Ability to apply information (e.g., access) </li><...
Conclusions <ul><li>●  The presentations were effective as measured by subjective knowledge improvement </li></ul><ul><li>...
<ul><li>From an ethical perspective, short-term presentations appear to be an appropriate vehicle of reproductive health e...
Questions? Thank you
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Ethical Challenges in GH Education: David Dudok

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The Ethics of Short-term Reproductive Health Education: A perspective
from Arusha, Tanzania

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Ethical Challenges in GH Education: David Dudok

  1. 1. Presented by: David Dudok Olga Wrezel Principal Investigator: Dr. Michael John Co-investigator: Jessica Wylie The Ethics of Short-term Reproductive Health Education – A Perspective from Arusha, Tanzania
  2. 2. Out of Africa… <ul><li>MedOutreach 2006 members </li></ul><ul><ul><li>Student-run organization </li></ul></ul><ul><ul><li>Medical, dental, nursing students </li></ul></ul><ul><ul><li>Based in Arusha, Tanzania </li></ul></ul><ul><ul><li>Summer volunteer project </li></ul></ul><ul><li>Project component = health education in secondary schools </li></ul>
  3. 3. Health education <ul><li>Topics </li></ul><ul><ul><li>Reproductive health </li></ul></ul><ul><ul><ul><li>HIV/AIDS, STIs, puberty </li></ul></ul></ul><ul><ul><li>Substance abuse </li></ul></ul><ul><ul><li>Nutrition </li></ul></ul><ul><ul><li>Oral hygiene </li></ul></ul><ul><li>Three urban secondary schools </li></ul><ul><li>Two 90 minute sessions </li></ul><ul><li>Sessions taught in English </li></ul><ul><li>Over 590 students </li></ul><ul><ul><li>age range 13-20 </li></ul></ul><ul><ul><li>Form II-IV </li></ul></ul>
  4. 4. Is our teaching effective, furthermore ethical?
  5. 5. To ethics and beyond… <ul><li>Target age group </li></ul><ul><li>Ability to apply information (e.g., access) </li></ul><ul><li>Length of teaching term </li></ul><ul><li>Language barrier </li></ul><ul><li>Cultural differences </li></ul><ul><li>Teaching methods </li></ul><ul><li>School teaching restrictions </li></ul><ul><li>Redundancy </li></ul><ul><li>Teaching from the curriculum </li></ul>
  6. 6. Methods Draft survey, ethics submission June 2006 Ethics approval, Swahili translation in TZ July 2006 Teaching sessions + survey admin August 2006 Data analysis Manuscript preparation ongoing
  7. 7. Survey sample <ul><li>SURVEY OF EDUCATIONAL EFFECTIVENESS </li></ul><ul><li>REPRODUCTIV E HEALTH </li></ul><ul><li>Form/ kidato ________ </li></ul><ul><li>Age / umri _________ </li></ul><ul><li> Male/ mwanamume  Female/ mwanamke </li></ul><ul><li> dogo/hata moja a kadiri ingi </li></ul><ul><li>Little/none Some A Lot </li></ul><ul><li> 1 2 3 4 5 </li></ul><ul><li>1. How much did you know about the subject before the presentation? ( Ulikuwa unajua kwa kiasi gain kabla ya kufundishwa somo hili?) 1 2 3 4 5 </li></ul><ul><li>2. Who told you about the subject? ( Nani aliyekufundisha?) </li></ul><ul><li>__ Family/ jamaa __ Teacher/ mwalimu __ Friend/ rafiki __ Doctor/ daktari __ TV __ Other/ ingine </li></ul><ul><li>3. How comfortable did you feel talking about the subject before? ( Ulifurahiaje kuzungumzia somo hili kabla?) </li></ul><ul><li>1 2 3 4 5 </li></ul><ul><li>4. Before the presentation, to whom did you feel comfortable talking about the subject? ( Kabla ya mjadala huu, ni nani ambaye ulizunguma naye kwa uhuru juu ya somo hili?) (Check all that apply/ Teua zaidi ya moja iwapo a kuhusu ) </li></ul><ul><li>__ Family/ jamaa __ Teacher/ mwalimu __ Friend/ rafiki __ Doctor/ daktari __ Other/ ingine __ No one/ hapana mtu </li></ul><ul><li>5. How much did you understand about the subject before the presentation? ( Ulifahamu kwa kiasi gain kabla ya somo hili?) </li></ul><ul><li>1 2 3 4 5 </li></ul><ul><li>6. How comfortable would you feel asking the presenters questions? ( Unadhari unajisikiaje kuwauliza maswali wafundishaji?) </li></ul><ul><li>1 2 3 4 5 </li></ul><ul><li>7. If any demonstrations were used, how much did they help you understand the subject? ( Iwapo vingetumika vielelezo au mifano, inge kusaidiaje kuelewa vizuri zaidi somo hili?) 1 2 3 4 5 </li></ul><ul><li>8. Do you feel you need more information on the subject? ( Unahitaji ufafanuzi zaidi kuhusu somo?) Yes Ndiyo No Hapana </li></ul><ul><li>If yes, what more would you like to know about this topic? ( Kama ndiyo, ungependa kufahamu nini zaidi kuhusa mada hii?) </li></ul><ul><li>________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ </li></ul><ul><li>9. How much do you feel you know about the subject now (Umeelewa kwa kiasi gani baada ya somo hili)? 1 2 3 4 5 </li></ul><ul><li>10. If you have had sex ( Iwapo umewahi kufanya mapenzi): </li></ul><ul><li>a. how old were you the first time (vaginal or anal sex) ( Ulikuwa na umri gain)? _______________ </li></ul><ul><li>b. how many sexual partners have you had ( Umekuwa na wapenzi wangapi) ? _______________ </li></ul><ul><li>c. every time, have you used a condom ( Kila wakati ultumia condom) ? Yes Ndiyo No Hapana </li></ul><ul><li>d. if you have not used a condom, why not ( Kama hukutumia condom, kwa nini) ? ____________________________________________________________________________________________________________________________________________________________­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­____________________________________ </li></ul><ul><li>11. If you needed a condom ( Iwapo unahitaji condom) : </li></ul><ul><li>a. where could you get one ( unaweza kuipata wapi) ? _____________________________________________________ </li></ul><ul><li>b. are they difficult to get ( je, ni vigumu kuzipata) ? Yes Ndiyo No Hapana </li></ul><ul><li>c. if yes, why ( kama ndiyo, kwa nini) ? ________________________________________________________________________________________________ </li></ul><ul><li>________________________________________________________________________________________________ </li></ul>
  8. 8. Results <ul><li>N=479 (M 217, F 221, 41 blank) </li></ul><ul><ul><li>Mean age = 16.2 ± 1.2 </li></ul></ul><ul><ul><li>117 Form II , 289 Form III, 73 Form IV </li></ul></ul><ul><li>78 reported having had sexual intercourse; </li></ul><ul><ul><li>mean first age = 13.29 ± 4.32 </li></ul></ul><ul><ul><li>mean number sexual partners = 2.45 ± 2.60 </li></ul></ul>
  9. 9. Q1: How much did you know about the subject before the presentation? Q3: How comfortable did you feel talking about the topic before the presentation? Q5: How much did you understand about the topic before the presentation? Q6: How comfortable did you feel asking the presenters questions? Q7: How useful were the demonstrations used? Q9: How much do you know about the subject after the presentation?
  10. 10. Knowledge Improvement On knowledge of reproductive health before and after the presentations, 307 ( 70.6% ) reported improvement.
  11. 14. Self-rated Accessibility of Condoms Accessibility in sexually-active individuals = 73.1% Accessibility in abstinent individuals = 60.6%   all individuals sexually active individuals sexually active - always use condom sexually active - don't always use condom difficult 40 15 7 8 not difficult 300 57 23 34 no answer 139 6 3 2 Total 479 78 33 44
  12. 16. To ethics and beyond…(again) <ul><li>Target age group </li></ul><ul><li>Ability to apply information (e.g., access) </li></ul><ul><li>Length of teaching term </li></ul><ul><li>Language barrier </li></ul><ul><li>Cultural differences </li></ul><ul><li>Teaching methods </li></ul><ul><li>School teaching restrictions </li></ul><ul><li>Redundancy </li></ul><ul><li>Teaching from the curriculum </li></ul>
  13. 17. Conclusions <ul><li>● The presentations were effective as measured by subjective knowledge improvement </li></ul><ul><li>● Teachers are a major source of reproductive health information </li></ul><ul><li>● A significant majority reported abstinence </li></ul><ul><li>● Most sexually-active students rated condoms accessible </li></ul>
  14. 18. <ul><li>From an ethical perspective, short-term presentations appear to be an appropriate vehicle of reproductive health education in this student population. </li></ul>
  15. 19. Questions? Thank you

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