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SU leads new gender-transformative sexual and reproductive health intervention study

First published in Stellenbosch University News

Prof Sarah Skeen from Stellenbosch University's Faculty of Medicine and Health Sciences recently received a research grant to the value of £638 050 (R12,5 million) from the United Kingdom's Medical Research Council. Skeen, the Co-Director of the Institute for Life Course Health Research at the Department of Global Health, will conduct an optimisation and feasibility trial titled 'If I Were Thabo'.

'If I Were Thabo' is a gender-transformative sexual and reproductive health intervention project aimed at young adolescents in Khayelitsha, South Africa, and Maseru, Lesotho. It is a joint venture between Stellenbosch University and Queens University Belfast and will be led by Skeen and Dr Aine Aventin respectively.

“The project is an adaptation and feasibility study of the 'If I Were Jack' programme which was developed in the UK," Skeen explains. “The original programme includes a culturally sensitive interactive film about an adolescent who discovers that his girlfriend is unexpectedly pregnant, and a guided discussion about how participants would feel and react in his position."

What makes this a novel programme is that it shifts the focus of adolescent sexual and reproductive health to boys and young men and uses a gender-transformative approach. According to the World Health Organisation, gender-transformative sexual and reproductive health interventions address the root causes of gender-based health inequities through interventions that redress harmful and unequal gender norms that privilege men over women. “Gender transformative approaches have also been identified as one way to disrupt underlying factors that can lead to poor health outcomes and drive HIV infection and adolescent pregnancy," Skeen says.

Globally, there are some interventions that engage men and boys to promote gender equality but the numbers are small. A recent review published in the British Medical Journal showed that only 8,4% of sexual and reproductive health interventions that target adolescent boys are gender transformative. Yet there is enough evidence that indicates these approaches improve sexual and reproductive health-related behaviours.

In South Africa, gender inequality is a pressing human rights and development issue. According to Skeen, unequal gender norms has a negative impact on sexual and reproductive health such as by increasing intimate partner violence or limiting women's control over health-related decision-making. Pursuing the development and roll out of programmes such as 'If I were Thabo' can hopefully catalyse more equality in this regard.

The formative work to inform the current project has already been completed by getting the opinions of adolescents and others on the intervention content and the changes that need to be made to it. For Skeen and her team, the next step is to adapt the programme materials for use in South Africa and Lesotho. Working with adolescents, teachers and caregivers among others, the research team will develop new films in each site and modify other intervention materials. “Once this process is complete, we will run a pilot trial of the programme to assess if the intervention implementation and evaluation design is feasible in both countries," Skeen explains.

A standout feature of this trial is the number of project partners involved which include Stellenbosch University; Queens University Belfast; the National University of Lesotho; the governments of South Africa and Lesotho; and Promundo and Sonke Gender Justice, two global organisations focused on engaging men to promote gender equality. Skeen says that it is very rewarding to be involved in a project that engages so closely with adolescents and is driven by their priorities and preferences. It is also exciting to work in two sites simultaneously. “We have previously worked on another highly successful intervention project in Lesotho and I very much look forward to working alongside the very dedicated and skilled colleagues we have there."

For more information on “If I were Thabo" visit our project pages.

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