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. 2025 Aug 11;22(1):145.
doi: 10.1186/s12978-025-02098-8.

"Sexuality education is a double edge-sword…": a qualitative study on perceptions of school teachers on sexual and reproductive health of adolescent girls in Eastern India

G Alekhya  1 , Aravinda Chinnadurai  2 , Susmita Dora  3 , Sithun Kumar Patro  4 , Dinesh Prasad Sahu  5 , Mohanasundaram Mourougan  6
Affiliations

"Sexuality education is a double edge-sword…": a qualitative study on perceptions of school teachers on sexual and reproductive health of adolescent girls in Eastern India

G Alekhya et al. Reprod Health. .

Abstract

Background: India has the world's largest adolescent population, and adolescent girls, in particular, face distinct and pressing challenges related to sexual and reproductive health (SRH). Given that the majority of adolescent girls attend school, with teachers closely monitoring and interacting with them, the present study aimed to explore the current landscape of adolescent girls' SRH through the perception of schoolteachers in Eastern India.

Methods: The study adopted a descriptive qualitative approach by conducting twelve in-depth interviews among principals and teachers of eight secondary girls' high schools in Odisha state, India. School teachers were interviewed about SRH awareness and issues faced by adolescent girls, the existing SRH curriculum, and various service provisions on SRH. The in-depth interviews were audio-recorded, transcribed, translated to English, and independently coded by two researchers. Thematic analysis of the transcripts was done by using MAXQDA software to identify and interpret emergent themes.

Results: Four thematic areas and fourteen sub-themes emerged from the transcript. The findings underscore a unanimous agreement among teachers on the need for comprehensive SRH education. Key insights include adolescent girls' poor SRH knowledge, particularly in menstrual health, curriculum inadequacies, inadequate parental and community involvement, existing myths and taboos such as restricting menstruating girls from attending schools during exams, poor awareness and access to SRH services, and misuse of digital media.

Conclusion: In the current Indian setting, the approach to adolescent sexual and reproductive health (ASRH) falls short. The study advocates for integrating comprehensive SRH education into the school curriculum, enhancing teacher training, generating awareness on existing ASRH services, and involving the community and parents in confronting cultural barriers. Additionally, leveraging technology and establishing monitoring frameworks are crucial for effective implementation and sustained impact on ASRH.

Keywords: Adolescent behaviour; Adolescent sexual and reproductive health; Comprehensive sexuality education; School curriculum development; School health services.

Plain language summary

Adolescent girls in India face numerous challenges related to their sexual and reproductive health (SRH), including inadequate knowledge, early marriages, teenage pregnancies, unsafe abortions and sexually transmitted infections (STI). Given that most adolescent girls attend school, and teachers interact closely with them, the current study was conducted to explore schoolteachers’ perceptions of adolescent girls’ SRH. The study revealed significant issues, such as poor knowledge and menstrual hygiene practices among schoolgirls and, curriculum gaps that exclude essential topics like puberty, menstrual hygiene, and safe sex. In the study, teachers reported parental misbeliefs like restricting girls from taking exams during menstruation. The study also reveals a lack of teacher training on adolescent SRH. Poor awareness among teachers and parents about existing adolescent health services, lack of communication between students and parents, early marriages are common, and misutilization of social media. The study recommends overhauling existing SRH education and strengthening adolescent SRH services.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and approved by the Institute Ethics Committee, All India Institute of Medical Sciences Bhubaneswar. (Reference number: IEC/AIIMS BBSR/PG Thesis/ 2020-21/51). Permission to conduct the study was sought from the district education officer, Khordha District, Odisha, India. A written informed consent was obtained from all the study participants’ school teachers at their respective places. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Word cloud generated from the transcripts
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