"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.

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.