Evaluation of an Afrocentric Sexual Health Education Curriculum for Medical, Nursing and Midwifery Students in Tanzania

Abstract

Background: Africa has the world’s highest rates of sexual health concerns, yet training programs to teach clinicians how to address sexual health concerns are rare. To address this gap, we developed a comprehensive sexual health curriculum tailored to Tanzania’s most common sexual health concerns. We use the curriculum to train sexual health education (SHE) to Tanzanian medical, nursing, and midwifery students. Aim: To evaluate training in sexual health in terms of structure, content, delivery, and cultural acceptability for medical, nursing, and midwifery professionals. Methods: First, we conducted a two-year formative research phase involving 18 Focused Group Discussions (FGD) with healthcare providers and students and 12 In-depth Interviews (IDIs) with sexual health stakeholders. The FGDs were stratified by discipline and working experience in years. The formative research phase was used to inform curriculum content and to tailor the SHE curriculum to the Tanzanian clinical context. Next, we developed a comprehensive sexual health curriculum tailored to Tanzania’s most common sexual health concerns. Given the lack of sex education that most students reported, we dedicated a day to normal sexual development and one to understanding the common sexual concerns of patients in Tanzania. We also had a strong emphasis on skills development by devoting one day for participants to practice skills. In addition, we ensured content to address cultural myths and taboos surrounding sexual health. We then trained a total of 206 students: the training was conducted in 2021. Immediately following the training evaluation was conducted as an online survey and qualitative responses were saved automatically in the Qualtrics database upon participants' completion. Results: Most participants (76.6%), evaluated the curriculum as culturally appropriate for Africa, personally valuable (96.1%) and would recommend it to a fellow student (98.5%). Furthermore, the curriculum was perceived as feasible, personally and culturally acceptable with endorsement of the training techniques employed, and suggestions on how to further improve the curriculum. Conclusion: Training the SHE curriculum is crucial to impact the core competencies of health professionals for addressing the sexual health concerns of their future clients. This study provides evidence that a sexual health curriculum tailored to the African context is highly needed, acceptable, and feasible.