Setting and study sample
SECONDARY
The study was implemented in selected schools and health facilities in Solwezi and Mufumbwe Districts (North-Western Province) of Zambia from 2017 to 2020. These two districts were selected because of high background adolescent pregnancy rates [A cross-sectional baseline assessment was conducted from August to November 2017 and followed by three subsequent rounds (R) of post-intervention (PI) data collection in November and December of each year: a first round (R1-PI) in 2018; a second round (R2-PI) in 2019; and a third and final round (R3-PI) in December 2020. At baseline, reported data on pregnancies at study sites were abstracted for 2016 and 2017.The study sample was drawn from schools selected at baseline. Schools were purposively identified and matched for consistency, according to presence of teachers trained in CSE (through orientation seminars or workshops); student access to a government health facility offering SRH services, regardless of distance; comparable student populations by age: sex composition; and annual numbers of withdrawals due to pregnancy. Using these criteria, 12 schools were selected in Solwezi (six primary and six secondary) and 11 in Mufumbwe (five secondary and six primary). Each of the schools’ Parent Teacher Association gave permission for the study, prior to IRB approvals.After baseline assessment, the 23 schools (see Fig. Distribution of schools in study districtsPrior to interventions, we engaged parents from all the study schools by convening meetings with the respective Parent Teacher Associations (PTA), and following our explanation of the study rationale, design and methods, all PTAs were unanimous in providing their approvals, in writing. Our study dissemination efforts have also included sharing of the data with the respective PTAs, community and political leaderships.