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首页> 外文期刊>The Journal of adolescent health: official publication of the Society for Adolescent Medicine >Scaling up adolescent sexual and reproductive health interventions through existing government systems? A detailed process evaluation of a school-based intervention in Mwanza region in the northwest of Tanzania.
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Scaling up adolescent sexual and reproductive health interventions through existing government systems? A detailed process evaluation of a school-based intervention in Mwanza region in the northwest of Tanzania.

机译：通过现有政府系统扩大青少年的性健康和生殖健康干预措施？对坦桑尼亚西北部姆万扎地区以学校为基础的干预进行的详细过程评估。

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PURPOSE: There is little evidence from the developing world of the effect of scale-up on model adolescent sexual and reproductive health (ASRH) programmes. In this article, we document the effect of scaling up a school-based intervention (MEMA kwa Vijana) from 62 to 649 schools on the coverage and quality of implementation. METHODS: Observations of 1,111 students' exercise books, 11 ASRH sessions, and 19 peer-assistant role plays were supplemented with interviews with 47 ASRH-trained teachers, to assess the coverage and quality of ASRH sessions in schools. RESULTS: Despite various modifications, the 10-fold scale-up achieved high coverage. A total of 89% (989) of exercise books contained some MEMA kwa Vijana 2 notes. Teachers were enthusiastic and interacted well with students. Students enjoyed the sessions and scripted role plays strengthened participation. Coverage of the biological topics was higher than the psycho-social sessions. The scale-up was facilitated by the structured nature of the intervention and the examined status of some topics. However, delays in the training, teacher turnover, and a lack of incentive for teaching additional activities were barriers to implementation. CONCLUSIONS: High coverage of participatory school-based reproductive health interventions can be maintained during scale-up. However, this is likely to be associated with significant changes in programme content and delivery. A greater emphasis should be placed on improving teachers' capacity to teach more complex-skills-related activities. Future intervention scale-up should also include an increased level of supervision and may be strengthened by underpinning from national level directives and inclusion of behavioral topics in national examinations.
机译：目的：几乎没有来自发展中国家的证据表明，扩大推广对青少年性健康和生殖健康（ASRH）计划的影响。在本文中，我们记录了将学校干预（MEMA kwa Vijana）从62所学校扩大到649所学校对覆盖范围和实施质量的影响。方法：通过对47名接受ASRH培训的教师进行访谈，补充了对1,111名学生练习簿，11项ASRH课程和19项同伴角色扮演的观察，以评估学校ASRH课程的覆盖面和质量。结果：尽管进行了各种修改，但放大10倍仍可实现较高的覆盖率。共有89％（989）的练习簿包含一些MEMA kwa Vijana 2笔记。老师很热情，与学生互动很好。学生们喜欢这些课程，脚本式的角色扮演也加强了参与。生物主题的报道要高于社会心理专题。干预的结构性和某些主题的审查状态有助于扩大规模。但是，培训的延迟，教师的更替以及缺乏开展额外活动的动机，这阻碍了实施。结论：在扩大规模期间，可以保持参与学校为基础的生殖健康干预措施的高覆盖率。但是，这很可能与程序内容和交付的重大变化有关。应更加重视提高教师教学与复杂技能有关的活动的能力。未来干预措施的扩大还应包括加强监督水平，并可以通过以国家级指令为基础并在国家考试中纳入行为主题而得到加强。

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