GIRLS DILEMMA’S IN
SEXUALITY
Are the messages conveyed on sexuality relevant for adolescent girls realities
of daily life?
YOAH KERKVLIET (10657762)
RESEARCH MASTERS INTERNATIONAL DEVELOPMENT STUDIES Department of GSSS at the UVA
Supervisor: Jacobijn Olthoff Second Reader: Esther Miedema
Table of Content
1. Introduction ... 3
2. Theoretical Framework ... 8
2.1 Sources and Messages on sexuality ... 8
2.1.1 Sexual educational messages in school ... 9
2.1.2 Sexual educational messages by parents ... 11
2.1.3 Sexual Educational Messages in the media ... 11
2.2 Relevant messages ... 12
2.2.1 Relevancy ... 12
2.2.2 Five factors that influence whether messages are relevant ... 13
2.2.1 Factor one: Acknowledge the sexual diversity of adolescent girls ... 14
2.2.2 Factor two: Include discourse of desire and/or pleasure ... 15
2.2.3 Factor three: Acknowledge the social context in which adolescent girls live ... 15
2.2.4 Factor four: Acknowledge the agency of adolescent girls ... 17
2.2.5 Factor five: Integrate the perspectives of adolescent girls themselves ... 19
2.3 The Socio-ecological model as a framework for analysis ... 21
3. Research design ... 23
3.1 Education Plus ... 24
3.2 The adolescent girls ... 24
3.3 Research Approach ... 26
3.3.1 Building rapport ... 26
3.3.2 Research setting ... 27
3.3.3 Research methods ... 28
3.4 Reflection on the combination and order of methods ... 34
3.5 Ethical considerations ... 35
3.6 Position of the Researcher ... 35
3.7 Data Analysis ... 36
3.8 Limitations of this study ... 37
4. Contextual Background ... 38
4.1 Community Pantanal ... 39
4.2 Politics ... 40
4.3 Socio-Economic situation and Family Life ... 41
4.4 Gender ... 42
4.7.1 Education: the school ... 43
4.7.1.1 Sexuality education ... 44
4.7.2 The church ... 45
4.7.3 Health services ... 45
4.7.4 NGO’s ... 46
5. Sexuality Education in the Pantanal ... 46
5.1 Public School: Charlas ... 47
5.2 The Parents: Cuidarse y Protegerse ... 49
5.3 Health Centre Palmira ... 51
5.4 Media: Novelas ... 52
5.5 Messages combined: is there one line of thought? ... 53
6. Adolescent girls decision making on their sexual practices ... 54
6.1 Dilemma: Creating the concept of the exception to the rule, but can we maintain these boundaries? ... 55
6.2 Dilemma: Eager to secure the deal, but how far do you go for this? ... 57
6.3 Dilemma: No boys to become independent, but is independency possible? ... 58
6.4 Dilemma: Is the meaning of sex just reproduction or is sex something more, but are they given the position to see sex as something more? ... 60
6.5 Dilemma: Girls have the responsibility for arranging contraceptives, but is there room for taking responsibility?... 61
6.6 Dilemma: The desire to share and have guidance in our decisions, but can we trust anyone? . 64 6.7 So what do girls think of the messages: Are they relevant for them? ... 64
7. Conclusion ... 66
8. Bibliography ... 74
9. Appendices ... 81
9.1 List of Respondents ... 81
9.2 Photos of the barrio of the Pantanal ... 82
1. Introduction
It was January 2015. I was joining a girl Katherine to a “charla” held at her public school in the barrio of the Pantanal, a barrio situated in the city of Granada in Nicaragua. A charla is an educational workshop, in this case on sexuality. It was conducted by volunteers from a health center with the aim to improve the sexual and reproductive health of adolescents. In Nicaragua charlas are often the only time where adolescents will be provided with sexuality education. A formal sexuality educational curriculum had been officially designed and implemented in 2010 by the Ministry of Education, however in practice this curriculum is unknown to most teachers and as such not present in the classrooms. And most parents shy away from anything to do with sexuality.
I was sitting at the back of the classroom. One of the volunteers of the health center came up to me and handed me a manual, which according to her, the volunteers would use as a guideline during their charlas. I read the title: What we learn about sexual and reproductive health. Let’s prevent teenage pregnancies. The title suggests that the messages on sexuality to come will be focused towards the sole aim of pregnancy prevention. Will this be all that I will be hearing the next hour or so or will there be more to it?
Gordillo-Tobar suggests that in Nicaragua most adolescents have an adequate level of knowledge about contraception, STD’s and the complexities of relationships as they enter adulthood (Gordillo- Tobar 2014:3). Nevertheless, Nicaragua currently has the highest unintended pregnancy rate in Latin America: 28% of the girls get pregnant before the age of 18 and 15% of the adolescent feel that they do not have the opportunity to use contraception. In Gordillo’s research, adolescents expressed that that the knowledge might be there but that they experience difficulty in applying this knowledge into their realities of daily life. According to Gordillo this can be explained by two factors. First adolescents, and particularly, girls, expressed they experience gender inequalities in their decisions in relation to sexual relations and practices. Second, one out of 5 adolescent girls do not have the confidence to talk to anybody about issues related to sexuality.
I wondered about the charla to come. Would this charla provide the adequate level of information about contraception, STDS and the complexities of relationships and would this charla like Gordillo questions be adequate for adolescent girls like Katherine, is it possible for them to apply the knowledge to their daily lives?
The charla that day was very short and rushed. The focus was clearly on preventing pregnancies as the charla showed pictures of the reproductive organs labeled by their names and the woman explained the functions of the different organs in the reproductive process. Followed by two pictures of the complete body, one of a boy and one of a girl. It was explained which body parts physically change during puberty, including how wet dreams come into existence and how menstruation works. They continued by explaining that if a girl menstruates this means that she is fertile and can become pregnant. From this moment onwards she continues into depth on pregnancies for example how you become pregnant and that it is possible you become pregnant before your first
menstruation. A step plan was outlined on how your relationships should go and underline once more that if you are not ready to have babies yet you should not have sexual relations.
Looking at this charla in the Pantanal, I fear that Gordillos conclusions about adequate levels of factual knowledge may be too optimistic. I also conclude that any information that will guide adolescents to apply the knowledge to the realities of the daily lives is minimal. More concretely, I thought about Katherine, the girl who I joined to the charla, what would she think about the messages conveyed to her? Would she feel that the messages were relevant and applicable to her reality of daily life?
This study attempts to address these questions, in the context of the barrio of the Pantanal, Nicaragua. The research question central to this is: In the context of the barrio of the Pantanal in the city of Granada, Nicaragua, how relevant are the messages conveyed in sexuality education in the daily lives of adolescent girls? Herein, sexuality education does not solely comprise the messages conveyed on sexuality in school, but also the messages on sexuality in the broader society, such from the parents, the peers, the church and the media.
To be able to answer the research questions this thesis will break it down into three sub questions. First, we must understand the messages conveyed on sexuality in broader society, such as the school, the parents, the peers, the church and the media. The first question is therefore formulated as follows: what are the messages conveyed on sexuality and how do these messages relate to each other? Second, to understand whether the messages are relevant in the daily lives of adolescent girls in the Pantanal, we must understand the realities in the social context of the adolescent girls in relation to sexuality. The second sub question if therefore: what are the contextual factors that influence the decisions making of adolescent girl in relation to their sexual practices? Third question, to understand what adolescent girls would perceive as being in line with their realities the third question is, taking into account the contextual factors of sub question two, how do adolescent girls experience these messages conveyed to them? This information will enable us to understand and analyze what we can do to make sexual educational messages more relevant from the viewpoint of the adolescent girl themselves.
In the academic literature of the last fifteen years on sexual educational messages, we see that the answer to these questions may potentially be very valuable. Sexual educational messages so far can be positioned from abstinence- only programs to comprehensive sexuality education (Tokunaga 2015). The latter has been proven to be more effective in improving sexual health when sexual health is measured as delaying sexual activity and increasing safer sexuality practices such as increased contraceptive use, fewer sexual partners and reduced frequency of sex (Kirby 2007). However, some studies have shown that comprehensive sexuality education is not enough. Therefore, studies argue that the reason for this is that the messages do not align with the realities of adolescent girls (Rijsdijk 2015; Allen 2011; Leclerc-Malala 2002; Haberland 2015; Cobbett et al. 2013). By including the realities of adolescent girls the messages conveyed will be more relevant for the decision making of
adolescent girls and as a consequence adolescent are more likely to relate to the messages and implement them (Allen 2011; Cobbett et al. 2013; Sisson 2012: Adams 2011: Venkrataman et al. 2015). As such it has been suggested that programs should go beyond the current spectrum of comprehensive education (Helmich 2009, Connell 2009). In the last fifteen years, multiple studies have criticized the sexual educational messages aimed at adolescents being conveyed within the entire spectrum presented above of not being relevant for several reasons. If we combine the criticism of these studies five main points of criticism in relation to the relevance of the sexual educational messages can be distinguished: the lack of: sexual diversity, discourse of pleasure, social context, agency and adolescent perspectives.
What we see that research is slowly addressing the issues discussed above, but are that the suggestions are not on the one hand sufficiently translated into new sexuality educational discourses and on the other hand not placed within a local context to be able to make the implementations easier (Rijsdijk 2015:21; Cobett et al. 2013; Salazar et al. 2009). So far, studies on how adolescent girls experienced sexuality education from their point of view have revealed some insights on how we could make this translation (Allen 2011; O’Higgins & Gabhain 2010; Schalet 2011) . However, Cobett (2013) argues these insights are not sufficient yet to make the transition from academic knowledge to practical implementation. Addressing this knowledge gap is important because if adolescents feel that the messages conveyed are not relevant to their own life experiences they will not engage with the context of the messages (Allen 2011). As a consequence of this disengagement adolescent will probably not to implement the insights conveyed. Then no matter the quantity or quality of the messages conveyed they are not likely to have any impact on the lives and decisions of adolescent girls (Leclerc-Madlala 2002:14).
Thus, by mean of this study this thesis attempts to contribute to the academic literature that aims to address this translation from theory to practice. Hereby, contributing to both theory and practice. In relation to the theory this thesis will contribute to the existing knowledge of which contextual factors are of influence in the daily lives of adolescent girls in relation to their decisions on their sexual practices. As well as contributing to the existing knowledge of how we can make sexual educational messages more relevant. In relation to practice this thesis will contribute by proposing several suggestions on how to implement this knowledge into practice and truly make sexual educational messages reflect the realities of adolescent girls better and as such can equip adolescent girls with the skills, knowledge, values and capacities that are relevant in their decision making process on their sexual practices in their daily lives.
To do this idea justice that sexual educational messaged will be more relevant when the perspectives of adolescent girls are taken into account this study followed a theoretical and methodological approach in line with this. The theoretical approach is the socio-ecological model. This study uses this model to understand the social and sexual realities in which adolescent girls take decisions on their sexual practices. This model recognizes that sexual practices, in fact all practices,
and associated attitudes of adolescent girls may be influenced by factors in their context. As such it recognizes the complexities of sexuality and recognizes the multiple contextual influences from all sources/factors (Boone 2015:437). This framework will be as far a possible completed by what we know, according to the academic literature, are the contextual factors that influence adolescent girls sexual decision making
In order to do justice to the idea that sexual educational messages will be more relevant when the perspectives of adolescent girls are taken into account the methodological approach of this thesis is to place the experiences of the adolescent’s girls central. As research has suggested that if adolescents themselves are ‘ made the resources’ and are listened to in non-judgmental ways, this can lead to more complex understandings of the realities of adolescents girls and the contexts in which adolescents make decisions about their sexual practices (Cobett et al. 2013:S71). This will be done through the use of qualitative research methods of observations to observe the girls lives in their own environment and through the use of task based focus groups to discuss on the basis of themes as revealed through the academic literature and the observations. Herein, the tasks will provide both as a springboard for discussion as well as making the focus groups interesting and fun for adolescents and providing a wide range of communication skills. (Noble Carr 2006:29).
In order to do this, this thesis will be structured as follows. The second chapter is the theoretical framework. The theoretical framework, aims to position this study within the existing literature and provide as such a theoretical framework from where we can start to understand and analyze the data produced by this thesis. The questions central in this framework are in relation to sub question one: 1) what are, according to the academic literature, the sources of information for adolescent girls in relation to sexuality 2) what are the messages of these sources? 3) What does relevant mean? 4) What factors, according to the academic literature, influence whether messages are relevant? 5) How, can we analyze these factors by making use of a framework, in this study the socio-ecological framework? With the use of this socio-socio-ecological framework this thesis will create, from the knowledge of previous studies, a contextual framework that will help us analyze in depth whether messages are relevant and if new knowledges is revealed that could be added to this contextual framework. In doing this, the literature discussed will be predominantly be literature from the last fifteen years within the field of sexuality (educational) studies and as far as possible in relation to adolescent girls in Latin America..
The third chapter, the research design discusses the decisions taken in the research design and reflects upon these decisions, such as the way of building rapport, the choice of research setting and the choice and order of the qualitative research methods of observation, task based focus groups and pair-interviews. Especially (with a focus on) , how these particular methods facilitated the experiences of the adolescent’s girls to be central.
The fourth chapter, the first empirical chapter, will provide an overview of the context of the barrio of Pantanal as this is the place where the girls live, grow up and is the environment and where
they receive their messages and experience their realities, while simultaneously placing the barrio within the broader Nicaraguan context. This will enable us to attain a broader understanding of the context of the barrio of the Pantanal within the broader Nicaraguan context, allowing us to analyze the experiences of the adolescent girls in relation to sexuality, discussed in the second and third empirical chapters, more thoroughly.
The fifth chapter, the second empirical chapter will discuss the first sub question: What are the sources of sexuality education in the barrio of the Pantanal, what messages do they convey, and how do these messages relate to each other? Through the use of individual map making I attained insights on what adolescent girls themselves perceive as the sources of sexuality information and what kind of messages they receive. This information allowed me to analyze how the messages relate to each other.
The sixth chapter, the third empirical chapter, will discuss the second sub question: : what are the contextual factors that influence the decisions making of adolescent girl in relation to their sexual practices? Through the use of the task based focus groups I got insights on the different contextual factors that influence adolescent girls’ sexual decisions making. The analysis of these factors highlighted that the girls face six dilemmas: how do you keep the boundaries of the exception of the rule, how far do you go in securing the deal, why should we have no boys to become independent when independency is impossible, is it possible to see sex as something more then just reproduction for girls, is there room for taking responsibility in a context where girls are held responsible. The chapter will end by discussing how adolescent girls themselves experiences the messages taken into account the contextual factors that contribute to the dilemma’s they face in their decision making process.
Finally, the conclusion will relate the theoretical framework to the three empirical chapters and answer the research question by stating that dilemmas girls face and the factors that influence their considerations they take into account in their decisions are not part of the messages on sexuality in the barrio of the Pantanal. As such, the girls feel that the messages are not relevant to their realities in their daily lives and therefore the girls will probably not implement the insights conveyed by the messages. In relation to this conclusion, on the basis of my data this thesis will suggest ways in which the messages could be made more relevant and suggests ways how to implement these suggestions. This will be presented with a particular focus on the perceptions of adolescent girls themselves on what they think would make messages more relevant and what would be a good way to implements these suggestions. based from what adolescent girls themselves expressed.
2. Theoretical Framework
This second chapter, the theoretical framework, aims to position this study within the existing literature and provide as such a theoretical framework from where we can start to understand and analyze the data produced by this thesis. The questions central in this framework are in relation to sub question one: 1) what are, according to the academic literature, the sources of information for adolescent girls in relation to sexuality 2) what are the messages of these sources? 3) What does relevant mean? 4) What factors, according to the academic literature, influence whether messages are relevant? 5) How, can we analyze these factors by making use of a framework, in this study the socio-ecological framework? With the use of this socio-socio-ecological framework this thesis will create, from the knowledge of previous studies, a contextual framework that will help us analyze in depth whether messages are relevant and if new knowledges is revealed that could be added to this contextual framework. In doing this, the literature discussed will be predominantly be literature from the last fifteen years within the field of sexuality (educational) studies and as far as possible in relation to adolescent girls in Latin America..
2.1 Sources and Messages on sexuality
Messages on sexuality are conveyed directly and indirectly through the medium of diverse sources. Sources that academic literature have identified as being most important are: the parents, the school, friends, the media and the health centers (Bleakely et al. 2009; Wood et al. 2002; Biddlecom et al. 2007; Turnball et al. 2010; Somers & Surmann 2004).
Bleakely, who has done survey data of 459 youths in Philadelphia in the US, argues that the messages of the different sources may contain three different forms of information (Bleakely et al. 2009). The first form of information is sexual socialization which is the process by which adolescents acquire information on sexual norms, ideas, beliefs and meanings. The second form of information is accurate scientific knowledge. The third form of information concern the skills to use the knowledge. Apart from the different kinds of information, Bleakely et al. suggests that depending on the context where messages are conveyed one source may be more influential than others. Furthermore, each source may have a stronger focus on one of the forms of information as each source will have their own view on what to convey to adolescents girls (Bleakely et al. 2009).
Connell suggests the forms of sexuality information the different sources convey depend on three interrelated issues (Connell & Elliott 2009:83). First, what do the agents of the sources of
information think is suitable for adolescents to know. For example, do they believe that if we inform adolescents on sexuality that this will damage them as adolescents are still innocent or do they view adolescents as capable decision makers. Second, what is the aim of the messages on sexuality. For example, is it to abstain from any kind of sexual relations or to prevent teenage pregnancy or is to enable adolescents to build positive relationships. Third, what kind of messages do the agents of the sources feel will achieve the aim. For example, do they believe knowledge will enable them to make informed decisions or do they believe it is better to do not inform them on sexuality and only support abstention. Allen (2008) has argued that the outcome on these three issues is determined by the particular historical and socioeconomic discourses that are dominant within the particular context (Allen 2008:S74).
In the following paragraphs this thesis will discuss, what according to academic literature, what kind of information the messages the different sources of information (the school, the parents and the media) convey and for what reason they convey this form of information. As such this section will provide me with a framework to understand and analyze the messages the different sources of information convey in the Pantanal.
2.1.1 Sexual educational messages in school
The school as a site of providing sexuality information has in many contexts been intensively contested and debated. On the one hand the question has been raised whether the institution of the school is appropriate for providing information on sexuality. The argument to support this views it that sexuality education will always include some messages of what is seen as accepted sexual practices. It is questioned if the school is the appropriate institution to decide what sexual practices are acceptable. They argue parents should rather be the ones to decide on this. On the other hand, it has been argued that information on sexuality is part of the school’s tasks as it is conveys knowledge that is essential to all adolescents just like reading and writing (Irvine 2004, 2002; Rienzo et al. 2006).
As a result of these intense debates and opposite views on what sexuality education should convey many different kinds of sexuality educational programs within the school setting have been developed over the last 25 years. These programs can be placed within a spectrum in which abstinence only until marriage education represents the one side of the spectrum, while comprehensive sexuality education represents the other side of the spectrum (Tokunaga 2015:113). In the following paragraphs I will discuss each side of this spectrum beginning with the abstinence only until marriage programs followed by the comprehensive sexuality educational programs.
Abstinence only until marriage programs are characterized by messages that convey a fixed set of practices that are considered right or appropriate for adolescent to live by (Allen 2008:S74). The predominant practice conveyed is to abstain from any sexual relations until you are in a mutually faithful, monogamous, heterosexual marriage. Outside of this context sex is conveyed as being wrong, harmful and risky (Schalet 2011, Connell & Elliott 2009). As such messages focus on the one hand on
the dangerous and risky side of sexual intercourse outside heterosexual marriage and on the other hand messages emphasize the social, physical, emotional and mental benefits of abstaining from sexual intercourse until marriage (Boonstra 2009, Schalet 2011). They convey such messages as they feel that adolescent are innocent, vulnerable and in need of protection. Therefore, they are concerned about the damage that inadequate or inappropriate sexuality education may cause on the well-being of adolescents (Connell & Elliot 2009). Furthermore, they feel that adolescents cannot decide for themselves what is right or wrong in relation to sexuality. For that reason, abstinence only programs prefer to convey limited information about sexuality to limit the damage done and in addition prefer to convey restricted information on what is acceptable to protect them. In this way adolescents learn how to abstain from sex without learning what to do if they decide to say yes.
Comprehensive sexuality educational programs are predominantly based on the idea that adolescents should be informed as complete as possible to enable them to make informed decisions. This is based on the assumption that if adolescents have the information and knowledge they need, adolescents will make responsible decisions that will lead to healthy sexual practices (Allen 2008:S74). Themes of information differ among the different kinds of comprehensive programs, but studies have cited that topics may include: human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations and building/managing of relations, emotional and physical sexual development during puberty, reproductive rights and responsibilities of contraception, consensually, gender, abstinence and contraception (Tokunaga 2015; Fergurson 2008; Rogow 2005).
In relation to messages in school Kirby, who has done extensive research on the effectiveness of educational programs in schools, has argued that messages on the comprehensive side of the spectrum are more effective and or relevant in improving sexual health when sexual health is measured as delaying sexual activity and increasing safer sexuality practices such as increased contraceptive use, fewer sexual partners and reduced frequency of sex (Kirby 2007). Many studies agree with Kirby and argue that all programs should become more comprehensive (Perrin & DeJoy 2003; Kohler et al 2008; Pittman &Gahungu 2006; Braeken & Cardinal 2009).
However, Leclercl-Madlala, who studied the sociocultural aspects of HIV/AIDS in South Africa , argues that messages on the comprehensive side of the spectrum that convey a high level of knowledge and information do not always result into improved sexual and reproductive health (Leclerc-Madlala 2002:3). It has been argued the reason is that the messages do not align with the realities of adolescent girls (Allen 2011; Rijsdijk 2015; Leclerc-Madlala 2002; Haberland 2015; Cobett et al. 2013; Schaalma 2004).By including the realities of adolescent girls the messages conveyed will be more relevant for the decision making of adolescent girls and as a consequence adolescent are more likely to relate to the messages and implement them (Allen 2011). As such it has been suggested that programs should go beyond the current spectrum of comprehensive education (Helmich 2009, Connell & Elliott 2009).
2.1.2 Sexual educational messages by parents
Parents have been acknowledged in literature as an important source in sexuality education. Parents often convey messages with a strong focus on sexual socialization rather than on scientific knowledge or skills. As such parents can be a powerful source as they shape the attitudes and beliefs, in general and in relation of sexuality, of adolescents girls during their entire life span (Diioro et al 2003; Bastien et al. 2011; Raffaelli and Ontai 2001).
Studies on parental messages in Latino families show that the messages focus indeed on the personal beliefs and cultural values about dating, contraceptives and sexuality. More specifically, these beliefs and values are often accompanied by parental advice and cautionary messages (Romo 2002; Gilliam 2007). By means of these kind of messages parents socialize adolescent girls on what are the expected and accepted sexual practices they may engage in.
Another characteristic of the parental messages on sexuality within Latin families was the lack of open communication (Romo et al. 2002; Diioro et al 2002; Gilliam 2007; Martinez & Orpinas 2016). The study of Diioro argues that parents often have difficulty in acknowledging and accepting adolescent sexuality. Furthermore, Diioro argues that parents often do not know how to communicate on sexuality with their daughters as they feel embarrassed and they do not know in what way to communicate to make the conversation more comfortable for themselves and their daughters (Diioro et al 2002).
In relation to the messages of parents The study of Romo et al. (2002) has shown that maternal self-disclosure about personal dating and sexuality experiences was related to adolescents reporting of better relationship with their mothers and having more conservative attitudes towards premarital sex. Bastien et al. (2011) shares this view with Romo. He argues that if parents communicate about sexuality to their daughters it may have psychosocial attributes including increased knowledge, better interpersonal communication skills, including sexual negotiation skills, and self-efficacy (Bastien et al. 2011). However, other studies which have researched this link have found mixed findings. Some studies have found a link if outcomes were being mediated by different variables such as age, race, ethnic group, educational level of both child and parent, socio-economic status, household characteristics, urban or rural residence occupation and religion, while other studies found no link at all. Therefore, Bastien argues it is still hard to make conclusion whether (open) parent-child communication is beneficial in making the educational messages more relevant (Bastien et al. 2011).
2.1.3 Sexual Educational Messages in the media
According Engle et al. the media could be a powerful source of information for sexual educational messages (Engle et al 2006). As messages conveyed through the media indirectly and directly convey messages on what is accepted and normal sexual practices and what are not. Engle suggest that in this
way the media influences adolescent sexual attitudes and as such the sexual practices adolescent girls engage in (Engle et al 2006). The media can be predominantly perceived as a means of sexual socialization.
A study of Peter & Valkenburg (2007) shows for example, that women are, often not purposefully, portrayed as sex objects only. This portrait may give the impression to adolescent girls that this is normal and accepted. However, the media can also serve as a positive means to influence the messages. For example, a study on the effect of the exposure to a television show that portrayed negative consequences of sex, led to more negative attitudes towards premarital sexual relations and to more negative moral judgements of characters engaged in this behavior (Eyal & Kunkel 2008). However, Wilson et al. (2004) which researched the extent to which adolescents identify media as a source of influence on their attitudes and sexual practices. This study revealed is that especially, parents are concerned about these
Keller & Brown (2010) argue that messages on sexuality can be positive as well as. Their argument for this is that the media has the opportunity to deliver messages in adolescents own terms and language that won’t embarrass them. They state that the media in this way has the potential to change the way people think about sexuality. An example in Nicaragua is the NGO Puntos de Encuentro which develops telenovela’s with the aim of to change the social norms by building capabilities such as the ability to identify, analyze the causes & manifestations of discrimination, social exclusion and violence. They do by discussing controversial issues in their telenovela’s to provoke discussion among friends and families (Abaunza 2002).
2.2 Relevant messages
To be able to understand and analyze whether the messages conveyed are relevant for adolescent girls we need to determine what this thesis means by the concept of relevancy. The following paragraphs of this thesis will discuss whether the messages described above are experienced to form a description on what this thesis will see as being relevant. Thereafter, this thesis will discuss various factors, that according to the academic literature influence whether messages are relevant for adolescent or not.
2.2.1 Relevancy
What we see in all three sources of information (the school, the media, the parents) described above, is that all sources argue that the messages conveyed now do often not relate to the ways adolescent girls experiences their sexuality. First, for messages conveyed in the school it has been argued the reason is that the messages, at either side of the spectrum, do not align with the realities of adolescent girls (Allen 2011; Rijsdijk 2015; Leclerc-Madlala 2002; Haberland 2015; Cobett et al. 2013; Schaalma 2004). As such it has been suggested that programs should go beyond the current spectrum of comprehensive education (Helmich 2009, Connell & Elliott 2009). As only, as Allen argues, by including the realities of adolescent girls the messages conveyed will be more relevant for
the decision making of adolescent girls and as a consequence adolescent are more likely to relate to the messages and implement them (Allen 2011). As such it has been suggested that programs should go beyond the current spectrum of comprehensive education (Helmich 2009, Connell & Elliott 2009).
Second, for messages conveyed by parents, Bastien et al 2011 argues that if parents communicate about sexuality to their daughters it may have psychosocial attributes including increased knowledge, better interpersonal communication skills, including sexual negotiation skills, and self-efficacy (Bastien et al. 2011). However, other studies which have researched this link have found mixed findings. Some studies have found a link if outcomes were being mediated by different variables such as age, race, ethnic group, educational level of both child and parent, socio-economic status, household characteristics, urban or rural residence occupation and religion, while other studies found no link at all. Therefore, Bastien argues it is still hard to make conclusion whether (open) parent-child communication is beneficial in making the educational messages more relevant (Bastien et al. 2011). If it would be more relevant, then the question what within the parental messages would be like.
Third, for messages conveyed by the media it is argued that the media has the opportunity to deliver messages in adolescents own terms and language that won’t embarrass them. They state that the media in this way has the potential to change the way people think about sexuality. An example in Nicaragua is the NGO Puntos de Encuentro which develops telenovela’s with the aim of to change the social norms by building capabilities such as the ability to identify, analyze the causes & manifestations of discrimination, social exclusion and violence. They do by discussing controversial issues in their telenovela’s to provoke discussion among friends and families (Abaunza 2002).
Taken this into account in this thesis relevance will mean any educational messages that are in line with the realities of adolescent girls and the adolescent girls can use/apply in their daily lives. Preferably, delivered in an interesting manner that adolescents can relate to, and not embarrass them, by means of their own language. In this way messages will be relevant in the sense that it will facilitate adolescent girls in making their own decisions.
2.2.2 Five factors that influence whether messages are relevant
In the last fifteen years, multiple studies have criticized the sexual educational messages aimed at adolescents being conveyed within the entire spectrum presented above of not being relevant for several reasons. If we combine the criticism of these studies five main points of criticism in relation to the relevance of the sexual educational messages can be distinguished. These points of criticism suggest five factors that may
make sexual educational more relevant. These five factors are: to acknowledge the sexual
diversity of adolescents girls, include a discourse of sexual desire and sexual pleasure, acknowledge the social context in which adolescent girls live, acknowledge the agency of adolescent girls and integrate the perspectives of adolescent girls into sexual educational messages. In the following paragraphs this thesis will discuss these five main points in the order as mentioned above. The central argument in these paragraphs will be the ways, the academic literature has argued, each of these five factors will enable sexual educational messages to be more relevant for adolescent girls. This will enable me to analyse if the sexual educational messages in the Pantanal include these five factors and if my data will find similar or different factors on how sexual educational messages can be (more) relevant.
2.2.1 Factor one: Acknowledge the sexual diversity of adolescent girls
First, it is argued that sexuality educational messages do not sufficiently acknowledge the sexual diversity of adolescent girls (Bay-Cheng 2003; Schalet 2011; Adams 2011). This insufficiency is experienced in two different ways. On the one hand, the relational context in which sexual practices take place and on the other hand the diversity in the different sexual practices themselves.
On the abstinence only side of the spectrum, Bay Cheng suggest that sexual practices are often only placed within heterosexual and monogamous relation within the context of marriage. While on the comprehensive side of the spectrum, sexual practices are not necessarily placed within the context of marriage, however Bay- Cheng suggests that sexual practices are still often placed only within the context of heterosexual and monogamous relations (Bay-Cheng 2003). Bay Cheng continues to argue that on both sides of the spectrum sexual educational messages often only address the sexual practice of vaginal penetration by a man, while in reality there is a wide range of different sexual practices such as oral sex or masturbation (Bay – Cheng 2003).
As such, this thesis argues that when educational messages fail to acknowledge the sexual diversity of adolescent girls, the girls may feel that the messaged conveyed may not be relevant to them as in reality they experience sexuality differently than the way sexuality is conveyed in the sexual educational messages. As a result of this, several authors argues that some crucial aspect of sexuality such as the skills to build and manage relationships from how to get to know each other, how to handle conflict and how to build trust are not being discussed outside of heterosexual and monogamous relations (Shalet 2011:S6, Adams 2011:1883). Furthermore, as of this adolescent are only informed on a limited range of sexual practices. This may have two consequences (Bay Cheng 2003; Connell & Elliott 2009). First, adolescents will not be informed on the need for precautions in other forms of sexual practices, limiting the ability for adolescents to make decisions that will lead to positive and healthy relationships. Second, it favors certain sexual practices, such as penile- vaginal penetration, over others. This may have as a result that some sexual practices are conveyed as being “normal” and others as “deviant”.
2.2.2 Factor two: Include discourse of desire and/or pleasure
Second, it is argued that the sexuality educational messages are missing the discourse of pleasure (Allen 2004; Fine 1998; Tolman 2012; Ingham 2006). Especially, feminist studies (Fine 1998, Tolman 2012) argue that in abstinence only programs, though in many comprehensive educational programs as well the body is desensitized. This means the capacity for desire and pleasure is ignored and that sexuality is disassociated from the embodied feelings that go along with it (Allen 2004:155). These studies suggest that due to this missing discourse of desire adolescent girls are indirectly denied the position from which they might decide to be sexually active (Allen2004). As a result the messages provide limited tools to conceptualize and promote positive adolescent sexual relationships.
Furthermore, by failing to acknowledge the possible pleasurable effects of sexual practices in combination with placing it solely within heterosexual relationships, sometimes even solely within marriage and by emphasizing the practice of vaginal penetration by men, the messages may give the impression that sexual practices are only for the purpose of reproduction (Allen 2004:154; Fine 1998; Ingham 2006).
2.2.3 Factor three: Acknowledge the social context in which adolescent girls live
Third, it is argued that sexuality educational messages do not sufficiently acknowledge the wider social context that influence adolescent sexual decision making. (Fine & McCleveland 2006, Spencer et al.2014); Tokunaga 2015, Aggleton & Campbell 2000, Shoveller & Johnson 2006, Tolman et al. 2003; Connell & Elliott 2009). In the abstinence only programs the notion that adolescent girls are capable of deciding for themselves is generally absent. Therefore, they perceive no need in including many related issues that may influence adolescent girl decision making. While in the comprehensive programs the assumption that increased knowledge and information will lead to responsible decisions and as such will lead to an improved sexual health, is too linear as it suggest that adolescent girls have complete autonomy over their decisions. McAvoy (2013) argued that factors such as influence of others, the urge to adhere to entrenched norms, the position of power within the context of social and sexual relationships, make complete autonomy nearly impossible. Therefore, Spender argues that by failing to acknowledge the wider context on the sexual decision making of adolescents we perceive adolescents to lack the capability to make responsible decisions based on accurate information and knowledge (Spencer et al. 2014:768). In other words, by not linking in on the contextual factors that influence sexual decision making, any kind of information can be conveyed but will not be of any or less impact in the decision making process as they will irrelevant (Rijsdijk 2015:410).
In the last fifteen years, studies have suggested that sexuality is more complex than has been previously recognized (Madlala 2002; Rijsdijk 2015; Aggleton & Parker 2010). Leclerc-Madlala 2002, uses the following words to explain this complexity in relation to sexuality: There is a culturally embedded, context-dependent experiential nature of meaning attributed to sexuality. Therefore, sexual practices are not solely constructed through rational decision making, but rather
are a socio-cultural construction with deeply imbued meanings and complex social representations“ (Leclerc-Madlala 2002:5). As such we see in diverse studies, that adolescents may engage in diverse sexual practices that have wide-ranging meanings and values and they do not only make decisions based on rationality (Aggleton & Parker 2010, Altman 2008, Boyce et al 2007). Sexual decisions of adolescents are rather shaped and conditioned by the diverse factors in the context. In other words, the sexual decision making of adolescent girls is relational and context specific (Schalet 2011:S5).
The study of Stern (2004), in one of the poorer urban neighborhoods in Mexico similar to the Pantanal, is a good example of the complexity and contextually embeddedness of sexuality. Stern argues that teenage pregnancy is embedded within the social context of the place where it occurs. This means that if we want to say something about the high incidence of teenage pregnancy in certain areas we have to understand each of the interrelated factors that may be considered causative (Stern 2004: 130-131). In his study Stern distinguishes six factors within the context that attribute to sexual practices which could potentially lead to teenage pregnancies: 1) school dropout, 2) existence of social network around the girls and the family, 3) girl’s home situation such as interfamily problems, 4) whether girls have life projects and aspirations for the future that go beyond motherhood and marriage, 5) the extent of trust girls have, especially the quality of the girl’s relationship with the boy and the parents and, 6) poverty. By failing to acknowledge the wider context of the sexual decision making of adolescents, we perceive adolescents to lack the capability to make responsible decisions based on accurate information and knowledge (Spencer et al. 2014: 768, Marston & King 2006, Shoveller & Johnson 2006.
Studies on which factors influence the decision making of adolescent girls in particular, suggest that adolescent girls do not have the possibility to negotiate their sexual desires and assert her decisions as equal as others (Plan 2014; Sisson 2012:59; Bay Cheng 2003, Spencer et al. 2014; Connell & Elliott 2009). The context may determine the various choices available to adolescent girls and their opportunities to implement these. This inequality can, according to this literature, be explained by the fact that sexual practices are set within gender and power relations in two ways . First, by the social gender norms present in society. These norms influence the various choices available to adolescent girls and their opportunities to implement these. For example, if girls carry condoms or initiate safe sex they are sluts, if they do not they risk a STD or pregnancy (Bay Cheng 2003:69). Spencer suggest that girls wishes and desires are therefore compromised as adolescent girls attempt to enact more “acceptable” choices that align with these dominant norms present within the context (Spencer et al. 2014:759). Second, the gender norms present in society determine the social power position of adolescent girls. A subordinated social power position of girls restrict girls ability to negotiate around sexuality and have their interests respected. Therefore, Spencer argues that we need to understand gender as a relational construct which may provide a more nuanced appreciation of the complex ways in which gender comes to define and shape sexual practices and the multiple available
choices these gendered norms come to produce and validate as being acceptable social truths (Spencer et al. 2014: 769).
Even though the available choices are limited, Sisson argues that the choices available are not necessarily experienced as negative as practices have different meanings in different contexts. Motherhood for example, is in some contexts believed to provide unconditional love, a new identity, a cemented relationships with the child’s father and a sense of self-worth that comes from being indispensable to the survival of a newborn baby (Sisson 2012:64). Sisson realizes that although some of these reasons may be flawed, for many young women being a mother is the most important role they will ever have, and they therefore see little reason to delay it (Sisson 2012:64).
2.2.4 Factor four: Acknowledge the agency of adolescent girls
Fourth, sexuality educational messages do not sufficiently acknowledge the agency of adolescent girls (Spencer et al. 2014;Aggleton &Campbell 2000;Sawyer et al.2012; O’Higgins & Gabhain 2010). Agency can according to Gay y Blasco (2007) be defined as “the kinds and degrees of influence and power social actors have regarding social situations or social relations in which they are engaged” (Gay y Blasco 2007:198). Diverse studies have acknowledged the fact that girls have agency and interpret meanings and messages, create ideas, take into account different considerations and make decisions (Evers et al. 2011:238).
The discussion in literature is about to what extent adolescents still have agency and freedom of choice even when the social context can be constraining as discussed above (REF). Jackson (2005) in Evers argues that “the outcome of a dynamic relationship between circumstances over which they have little control and their capacity to live those circumstances in a variety of ways” (Evers 2011:13) proves children have agency at all times. According to Seymour in Evers argued “children are resourceful and develop necessary competencies, to deal with or adapt to, their structure” (Evers 2011:238). The development of these competencies is referred to by Punch in Evers as “coping strategies to enable them to get by within structural constraints that children face” (Evers 2011:144). Therefore, according to Klocker (2007) in Evers in some contexts agency might be a ‘tactical agency’, referring to the fact children still exert agency in their decision making and everyday actions, even though “carried out within restrictive contexts, characterized by few viable alternatives” (Evers 2011:144). This implies that children might decide to follow an adverse life path consciously as this might prove to be the best, or in other words least adverse, alternative between all limited and harsh possibilities in their structure. Consequently, Waller (2001) argues that “coping mechanisms or styles that seemed to make some children continue to progress along a positive developmental trajectory even when confronted with adversity” might be referred to as resilience (Waller 2001:29).
According to Seymour in Evers resilience “is neither static nor an individual trait but a process of adaptation over time that varies on the situation” (Evers 2011:240). Waller explains this, referring to the theory of Bronfenbrenner, by stating that resilience is constructed within the bidirectional
relationship between the child and the structure, therefore children are at all times “influence adverse life situations as well as being influenced by them” (Waller 2001:293). Therefore, according to Waller and Skovdal in Evers at different points in live children might respond differently to the same adverse life situations (Waller 2001:293).
Whether children develop coping mechanisms that lead to positive outcomes is dependent upon the protective and risk factors present within the structure of a child (Waller 2001:292; Evers 2011:240). Hereby, risk factors are referred to factors that significantly threaten positive outcomes and protective factors to factors that significantly facilitate positive development outcomes (Waller 2001:292). Children exposed to more protective than risk factors are more likely to cope with adversities within their structure and develop positive developmental outcomes than children exposed to more risk factors than protective factors (Waller 2001:293; Evers 2011:240; Ward 2007:xi). Hereby, it should be noted that the impact of risk and protective factors are cumulative; forming risk chains or protective chains. Furthermore, risk and protective factors are not “dichotomous categories” (Waller 2001:293). Children might develop new competencies over time that enable them to cope more effectively with the adverse life situations, whereby an initial risk factor might become a protective factor (Waller 2001:293). Thereby, protective and risk factors always interact with the structure of a child and are dynamic (Waller 293:294).
What may be observed is that as a result of adolescent girl’s agency we see that in some contexts adolescents will engage in sexual practices which may in some way not be positive for their sexual and reproductive health. In these cases, the meaning or outcome of the practice may outweigh the negatives (Sawyer et al. 2012:1633). For example, in some contexts adolescents engage in sexual practices that may be risky (such as unprotected sex), because the meaning of the practice may outweigh the risk of the practice, for example a STD. This means that adolescents can consciously make ‘bad’ decisions despite knowing the risks (Sawyer et al. 2012:1633).
The study of Silberschmidt & Rash (2001) is a good example of decision making by adolescent girls. In this study adolescent girls in Tanzania decided to be sexually active with some men in return for money. As a result they were able to pay their school fees and supplies and continue their education instead of having to drop out. In this sense girls consciously choose to engage in sexual relations with men to continue their education in the hopes of having a good career and a stable income in the long run.
Eriksen summarizes the tension between on the one hand being restricted by limited available choices due to diverse contextual factors, while on the other hand having the capability and power to decide their actions for themselves, with the following words: “On the one hand adolescents choose their actions deliberately and try to realize their best goals, which is a good life, while on the other hand adolescents act under pressure which varies between people, contexts and societies which limits their freedom of choice and to some extent determine the course of their agency (Eriksen 2001:86).
We see that in the messages on the abstinence only side of the spectrum the notion that adolescent girls are capable of deciding for themselves is generally absent. While in the comprehensive programs the assumption that increased knowledge and information will lead to responsible decisions and as such will lead to an improved sexual health, is too linear as it suggest that adolescent girls have complete agency over their decisions. Rather, messages should address both sides of the coin the agency adolescent girls possess and the social context which limit to some extent their course of their agency.
2.2.5 Factor five: Integrate the perspectives of adolescent girls themselves
Fifth, sexuality educational messages do not sufficiently include the perspectives of adolescent girls (Spencer et al. 2014; Allen 2004; Sawyer et al. 2012; Higgins &Gabhain 2010; Mkumbo 2010;Schalet 2011). These studies have argued that messages only can truly support adolescents sexual decision making within the realities of their context of their everyday lives when their own experience of these realities are taken into account. Furthermore, these studies continue to argue that if we include the perspectives of adolescent girls this will ensure that the messages are placed within their own experiences and framed within the language that makes sense in the context of their own lives (Shalet 2011). All in all, adolescent girls will feel that the messages are more relevant if they reflect their realities in their own language as in this way they are more applicable to their daily lives (O Higgins & Gabhain 2010:388).
In the last fifteen years, studies slowly started to acknowledge the value of including adolescent’s own perspectives in programs aimed at adolescents. As result, diverse qualitative studies, mainly conducted in developed countries such as New Zealand, England and Ireland, started to focus on how adolescent girls experience sexuality education, what they value in sexuality education, and what they feel would improve their sexual and reproductive health (Allen 2005, Harrison and Hillier 2004, Kehily 2002, O Higgins & Gabhain 2010, Hirst 2004, Maesor 2004 ). These studies have given insights in both the dissatisfaction of adolescent girls with programs and what adolescents’ interests and needs are. In the paragraphs below this thesis will discuss first the dissatisfaction of adolescent girls with sexuality educational messages and thereafter the needs and interests in relation to sexuality educational messages of adolescent girls that these studies revealed.
The dissatisfaction of adolescents can be categorized into four categories: the program content, the way it is delivery, the setting and who delivered the messages. In relation to the content adolescents feel that the information is often too narrow, too little and too late. While the delivery and setting was often described as boring and with many disruptions from other students interferes with the messages conveyed. Finally, the deliverers have been criticized to be disinterested, ill equipped or unsupportive of their needs and interests.
Furthermore, a study from Hillier and Mitchells, on how homosexuals adolescents feel about the relevancy of sexuality education in Australia, suggested that sexuality education can also serve as a
hetero-normative instrument. The missing identities of gay, lesbian and bisexual individuals in sexuality education is one way by which heterosexuality maintains the normal status (Hillier and Mitchells 2008). This is in accordance with the study of Bay Cheng (2003), mentioned earlier on, which argued that the sexual diversity in sexual educational messages are missing and therefore can portray some sexual practices as normal, in this case heterosexual relations, while others as deviant, in this case homosexual relation. Another way Hillier & Mitchells (2008) argue messages constitute gay, lesbian and bisexual identities as deviant and potentially dangerous is by equating their identities with diseases, often with HIV/AIDS. Therefore, homosexual adolescents feel this hinders them to establish a positive sense of the sexual self.
The needs and interests of adolescent girls have been mainly been shown through their expression of what they valued in relation to different and/or broader themes in relation to sexuality. The experience of Allen, in her research in New Zealand that focuses on the suggestions of adolescent’s in high school in the sexuality educational messages, revealed that adolescents want and need information which goes beyond messages of reproduction, periods and puberty and prefer messages that could help them with decision making. Themes that adolescent mentioned of being of importance for them in helping making their decisions were sexual pleasure, abortion and teenage pregnancy and the emotions involved in forming, managing and breaking up relationships and a wider variety of sexual practices and experiences (Allen 2011). In addition, adolescents in this study feel that this should take place in a non-judgmental and safe environment with someone who they can trust and who can help guide them.
The study of Rijsdijk who evaluated comprehensive sexuality educational programs in 11 low income countries in Africa and Asia with adolescent themselves shows similar requests. However, in addition to what Allen her study has revealed Rijsdijk her study stresses that information should be objective, explicit, clear and in-depth, thus enabling them to make their own decisions on sexuality and sexual behavior Rijsdijk 2015:415).
The suggestions of adolescents show that adolescents may agree with encouraging healthy sexual practices, but do not prioritize this when expressing themselves on their perspectives on sexuality education. Adolescents have other criteria for evaluating the success of programs based on the experience of receiving programs. They ask themselves: is it interesting, provide useful and relevant information, and does it embarrass me? (O Higgins & Gabhain 2010:398). As such adolescent girls ask for messages that will enable them to be able to make decisions on their own. Messages that are conform with these criteria above will be considered relevant and in line with the realities of adolescents own life experiences and as such engage with adolescents own life experiences (Allen 2011). So we could say, that by prioritizing the fact that adolescent will find it relevant for adolescent girls and as a result engage in with the messages could lead to more improved sexual health then messages prioritizing other issues such as behavioral change and have adolescent not engage with the messages.
There are some studies, not necessarily against doing this, but have criticized an qualitative adolescent centered approach in relation to the perspective of adolescent girls on their own sexual experiences (Christensen 2004; Cook-Sather 2002). First, critics argue that adolescents are not capable in expressing their perspectives and needs in relation to sexuality as they lack life experience. However, Allen, one of the main researchers on the perspectives of adolescents on sexuality education in New Zealand, counter argued that by suggesting that adolescents do not have the capability to know what their needs are, they are denied the ability to make decisions which will allow them to experience their sexual and reproductive health positively (Allen 2008:S574). Second, critics argue that by incorporating the perspectives of adolescents themselves, the existing inequalities in relation to sexuality will be reinforced. Nevertheless, the experience of Allen in her research in New Zealand, that focuses on sexuality educational messages of adolescent’s in high school, argues that if research methodology is designed to access a diversity of adolescent’s perspectives and constructed in ways that enable the emergence of subordinate meanings, then adolescents themselves may give voice to marginalized perspectives (Allen 2008:178). As such incorporating the perspectives of adolescent girls and their own experiences will not reinforce existing inequalities. Therefore, when the perspectives of adolescent girls are obtained and handled with care Allen argues he sees no reason to not include their perspectives as they are the ones for who the messages are aimed at.
2.3 The Socio-ecological model as a framework for analysis
Above we have discussed what relevance is : any educational messages that are in line with the realities of adolescent girls and the adolescent girls can use/apply in their daily lives. Preferably, delivered in an interesting manner that adolescents can relate to, and not embarrass them, by means of their own language. In this way messages will be relevant in the sense that it will facilitate adolescent girls in making their own decisions. And discussed five different aspects that could make sexuality education more relevant and in line with the realities of the adolescent girls.
Therefore, to understand whether the messages are relevant we need to analyse the social and sexual realities in which adolescent girls take decisions on their sexual practices. To this extent, a framework would be useful that resembles the different aspects as discussed above. With the use of this socio-ecological framework this thesis will create, from the knowledge of previous studies, a contextual framework that will help us analyze in depth whether messages are relevant and if new knowledges is revealed that could be added to this contextual framework.
The following paragraphs will discuss how we can analyze the contextual factors by making use of socio-ecological framework. I choose the socio-ecological model as this model has principles that are in line with the idea that sexual, practices, in fact all practices, of adolescent girls are influenced by the wider social context. It acknowledges hereby the complexities in sexual decision making of adolescent girls, as well as the interrelationships of the different factors (Boonstra 2009). These principles are: 1) there are multiple influences on health behaviors and outcomes 2) these influences interact across
these different levels. 3) requires a focus on specific health behaviors and outcomes; identifying which factors are most likely to influence the specific behavior or outcome 4 ) suggest interventions that address factors at multiple levels may be more effective than those that address only one (Svanemyr 2015:s8).
As such this model acknowledges that sexuality is a complex socio-cultural construct. Hereby, this study will acknowledge that the sexual practices that adolescents girls engage in are a product of as Eriksen states: On the one hand adolescents choose their actions deliberately and try to realize their best goals, which is a good life, while on the other hand adolescents act under pressure which varies between people, contexts and societies which limits their freedom of choice and to some extent determine the course of their agency. In this way this study acknowledges both the constraining socio-cultural factors in the context upon the decisions of adolescent girls as well as acknowledge that adolescents have agency in their sexual decision making, even though their decisions may be restricted by their contexts. In doing this this study simultaneously acknowledges the broader sexual meanings and diversity in sexual practices among adolescent girls.
There are different variations of the Socio-Ecological Model such as the original of Bronfenbrenner 1979, McLeroy Ecological Model of Health 1988 and Stokols Socio Ecological Model Health Promotion 1992/2003. Each of these use different classifications on the levels that influence the sexual decision making of adolescents. For the purpose of this study I will use the following levels: societal, community, relational and individual. In relation to health at the individual level is the knowledge, attitudes, self-concept, skills, and personal history of an individual. At the relationship level is the relationships with peers, intimate partners, family and the support of their network. The community level is the close social environment of an individual including their relationship with the school, the workplace and the neighborhood. The societal level encompasses the larger macro level factors which influence sexual decision making of adolescents, such as gender inequality, religious or cultural belief systems, societal norms and policies that could create gaps in services, national wealth and income inequalities, employment opportunities, educational opportunities (Sawyer et al. 2012:1634, Kotchick et al. 2001)
With academic literature discussed above we can make this socio-ecological framework more specific in relation to
the research question. In this model the contextual factors that are of importance in the social context in relation to the sexual
decisions making of adolescents girls are presented. This model will allow us to analyze whether this thesis will find similar contextual factors that impact their sexual decisions in their lives or whether we can add to this theoretical framework on the basis of my data.
Furthermore, this study acknowledges the importance of the perspectives of adolescent girls themselves. To be able to do this the perceptions of adolescents will be central in this study. This will ensure that the realities of the context in which adolescent girls make their sexual decision making is being analysed. By doing this this study aims to understand, in a non-judgmental way, the complex understandings of the realities of adolescent girls and the contexts in which adolescents make decisions about their sexual practices in their own language. In the next chapter we will discuss in detail why I chose certain methods.
3. Research design
This third chapter will discuss the research design used to analyze the research question: In the context of the barrio of the Pantanal in the city of Granada, Nicaragua, how relevant/meaningful are the messages conveyed in sexuality education in improving the sexual and reproductive health of adolescent girls? In doing this this chapter will discuss the decisions taken in the research design and reflects upon these decisions, such as the way of building rapport, the choice of research setting and the choice and order of the qualitative research methods of observation, task based focus groups and pair-interviews. All the issues discussed in this decision making process were conducted during a fieldwork period of three months from December 2014 to February 2015.
Central in relation to the decisions taken was to focus on the inclusion of the perspective of adolescent girls themselves. As this has been argued in the theoretical chapter will ensure that we understand the realities of adolescent girls in their own language. Only in this manner has been argued messages on sexuality can become more relevant. Therefore, in all the decisions taken this concept of including the perspectives of adolescent girls was central.
In doing this, the paragraphs below will discuss the research design in three sections. The first section will describe the organization of Education Plus, the organization through which I gained access to the adolescent girls, to be followed by the description of the girls within the project of Education Plus who participated. The second section, will discuss the decisions taken in relation to the research approach and its related qualitative research methods of observation, task based focus groups and pair interviews and reflect upon these decisions. The last section will be a reflection of how I handled ethics, my own position during the fieldwork process and how I handled my data and my limitations in relation to what I could do in this thesis.
