Community sex education among adolescents in rural Uganda: utilizing indigenous institutions

Abstract

Although adolescent girls in Uganda are particularly vulnerable to HIV infection, providing relevant sexual health education to them is problematic. The senga (father's sister), is the traditional channel for socializing adolescent girls into sex and marriage among many ethnic groups in Uganda. This paper discusses the implementation and community acceptability of ‘modern’ sengas who were trained to provide HIV-related counselling to adolescent girls. Fourteen sengas were trained in two villages and, in the course of the 1-year study, 247 individuals made a total of 403 visits to them. By including both traditional services (such as advice on and assistance with labial elongation) and modern health and sex education, the sengas provided a ‘middle road’ between tradition and modernity. As a result, despite initial suspicion by the community, their activities were supported by the community generally and effective as intervention.

Notes

¹The idea of investigating this institution as a potential model for a health intervention was first suggested by Dr Jane Kengeya-Kayondo. The initial pilot study and subsequent intervention were set up and carried out by local Baganda members of the MRC Programme (HM, JN) in collaboration with local community members and leaders.

²One woman completed training but her husband stopped her from continuing with the senga activities when male adolescents and men started coming to her for counselling, three dropped out because they were too busy, and one dropped out because she felt she was not getting ‘enough benefit’ from being a senga (i.e. was not being paid).

³The training was carried out by a Ugandan social scientist (HM) and a social science assistant (JN). The training cost US$ 2,500.

⁴Locally elected political bodies consisting of nine members which exist on various levels, from the village (lowest level) to the district (highest level). The committees are charged with political, social and economic responsibilities in a particular area.

⁵During the study the sengas had to deal with six unwanted pregnancies, one forced child marriage and nine cases of marital conflicts including wife beating and separation/divorce.