Audience Research Study on Sexual and Reproductive Health in Maputo, Manica and Nampula Provinces

This 55-page audience research report was produced by N'weti in Mozambique to inform an interactive mass media project using a radio and television magazine linked to a social media (SMS) platform to disseminate information on sexual reproductive health and rights (SRHR), improve uptake of SRH services, and to monitor SRH services through a web-based survey. According to a report, published by the Ministry of Health of Mozambique (MISAU), sexually transmitted infections (STIs) and HIV rates are higher among young and educated people living in urban areas and lower among young and uneducated people living in rural areas in Mozambique. N'weti conducted an audience research to get a clear picture of the characteristics of young people in the provinces where the intervention will be held as well as to understand the context and groups influencing these young adults' sexual and reproductive behaviour.

The report defines three main audience groups, each with its own specific sexual and reproductive patterns and characteristics and needs. Young adults compose the first group and the their parents, guardians, and other community institutions in charge of sexual and reproductive health, such as traditional birth attendants, traditional healers, masters of initiation rites, comprise the second group. The last group includes formal sexual and reproductive health service providers, such as health providers and volunteers.

In terms of linguistics, young adults speak and read Portuguese as well as local languages. Many use local languages mainly to communicate with parents, guardians, and other relatives and community members who are not able to communicate in Portuguese. Portuguese is used to communicate with public officers, including health providers and at times with peers. Finally English is used to communicate with foreigners, normally clients. In a digital era, the majority of young adults have access to cell phones and watch national television programmes, and some also listen to national and community radio programmes. Most watch TV and listen to radio at night, and soaps are the programmes that get the most attention from young people of both sexes.

In terms of sexual health, levels of knowledge are high regarding HIV transmission and prevention, with emphasis on penile-vaginal penetration. In general, oral sex and anal sex are not known as means through which STI’s and HIV might be transmissible. Moreover young adults do not know much about STI's, little is known about existing STI's, its symptoms nor about what to do in the event of emerging symptoms. In general, reproductive matters as well as reproductive health issues are women's territory. From their childhood onward, girls are taught about reproductive matters and health. They are taught about their bodies, its reproductive functions, how to go about sex and how to manage menstrual periods. While in some places the teachings take place in secluded places during the rites of initiation to womanhood or with parents and other relatives at home, in other places girls learn about reproductive matters and health at school.

The report states that the majority of health providers dealing with sexual and reproductive health matters are female. They are overloaded and although trained to deal with sexual and reproductive health issues they are not trained to respond to sexual and reproductive health matters using the rights approach. As a consequence they are unaware of the sexual and reproductive rights for young people, and as a result many are too judgmental rather than understanding and addressing young people’s needs, including the needs of men who have sex with men. In terms of providing information, formal providers focus on transmission and prevention of HIV and STI’s. The need to tackle stigma and discrimination against People Living with HIV and AIDS (PLWHA) are also addressed by formal institutions. The need and importance of testing for HIV is also highlighted and at times the need and relevance of diagnosing and treating STI’s are also mentioned.

School programmes disseminate information regarding STI’s and HIV transmission for young people in addition to information about pregnancy prevention. The main methods promoted to prevent pregnancies at school are postpone sexual activity, sexual abstinence, and use of male condoms. At school as part of their curriculum young people learn about the human body, its parts and functions, including sexual and reproductive organs; they also learn about sexual and reproductive rights and contraception. However, while contraception is well explored by health providers at health facilities and by volunteers, the problem is that in most cases information about contraception is only available to adult women or to women who already have children. Formal providers make information available through means such as television and radio spots and programmes, posters, leaflets, manuals, and magazines that are mostly distributed at schools and health facilities or exhibited in public spaces, in the case of posters.

In general, the contribution of high mobility groups into the sexual and reproductive landscape varies with the context. For instance, in places like Namaacha, Magude, Nacala-Porto, and Nampula study participants indicate that the presence of groups of high mobility contributes to the increase of STIs, unintended pregnancies, and abortions among girls and women. This scenario might be due to the lack of adequate and accessible sexual and reproductive health information and services as well as due to unavailability of services addressing specific needs of high mobility groups.

The report concludes that the results of this study again point out the need to adopt an integrated approach to sexual and reproductive rights based on mutual respect. In terms of content, it is important to broaden the type of information available for SRH for young people. Thus, in the area of sexual health, in addition to information about transmission and HIV prevention for penis-vagina penetration, it is necessary to inform people about risks and prevention related to oral and anal sex. As well, it is important to include information about STI types, signs, and symptoms, and the double protection provided by condoms.

Click here to download the Executive Summary in English.