COMMUNITY PARTICIPATION IN ADOLESCENT SEXUAL REPRODUCTIVE HEALTH

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CHAPTER 2 LITERATURE REVIEW

INTRODUCTION

This chapter reviews literature related to the present study. Literature review is undertaken to assist researchers to comprehend and extend their knowledge of the phenomenon under study (Polit & Beck 2008:105). According to Babbie and Mouton (2001:565), the purpose of a literature review is “to determine the extent to which the topic under study is covered in the existing body of knowledge”.
In the current study, both theoretical and empirical sources were reviewed. The theoretical sources looked at stages of child development. Taking into consideration adolescence; which is a stage in human development as a child grows and transits to become an adult; an understanding of these transitional stages provides a deeper understanding on what risk factors pre-dispose adolescents to the risk of sexual reproductive health outcomes. Empirical literature provided a critical analysis of issues affecting adolescents’ sexual reproductive health with the view of identifying gaps for the current study to address.

THEORETICAL PERSPECTIVES ON CHILD DEVELOPMENT STAGES

Theories involve constructing abstract interpretations that can be used to explain a variety of situations in the social world. The theories are used in the current study to explain child growth and development in terms of physiological, cognitive and social emotional development. This is in a bid to comprehend the process, stages and characteristics of child development with a special focus on the adolescent stage.
In terms of physical growth, the development is seen on the body, and the changes occur in a relatively stable, predictable sequence. Some key characteristics under physical development include: changes in bone thickness, size, weight, height and movement (The Goodheart [Sa]:70). While, cognitive growth, (sometimes known as intellectual development), is the process that people use to gain knowledge and language through reasoning and imagination. Language and thoughts are a result of cogitative development. It forms part of the essential requirement for planning, remembering and problem solving. As children grow, mature and gain experience with their world, cognitive skills also grow (The Goodheart [Sa]:71).
Cognitive development and social-emotional development are interlinked. Learning to relate to others is an aspect of social development, and on the other hand, emotional development involves feelings and their expression. Trust, fear, confidence, friendship, humor, timidity, interest and pleasure are some of the key social-emotional traits (The Goodheart [Sa]:72). Children develop social-emotional skills as they relate with others. It should be noted that all the three stages of physical, cognitive and social-emotional development are linked to one another. Development in one area can strongly influence another area (The Goodheart [Sa]:73).

Theories of child growth and development

The works of the following theorists, Erik Erikson (1902-1994) the theory of psychosocial development (Patel 2016:2) and Lev Vygotsky (1896-1934) the theory of socio-cultural and ecological theory (State of New South Wales (NSW) 2006:3) are discussed.

Theory of psychosocial development (Erik Erikson 1902-1994)

Patel (2016:2) has noted that Erik Erikson believed that development occurs throughout one’s lifespan and his theory emphasises the social and emotional aspects of child growth and development. Children’s personalities develop in response to their social environment and this at the same time helps children in developing their skills for social interactions. In his eight stages, he believed that social crisis or conflict occurs and they require solution that is satisfying personally and socially. Maturity and social forces help in resolution of these forces and therefore parents, teachers and peers play important roles during the transitional stages by providing social opportunity and support to help children (adolescents) overcome each social conflict and crisis. Erikson theory highlights the common characteristics during these stages of social crisis as: trust versus mistrust, autonomy versus shame and doubt, initiative versus guilt, industry versus inferiority (The Goodheart [Sa]:76-77).
The psychosocial conflicts and crisis during the adolescent stage if not well supported may have long-term effects on the child (adolescent) as the child grows. Parents, peers and teachers play vital roles in supporting children transit through these stages. The negative forces such as mistrust, shame, guilt and inferiority may be of particular concerns since these negatively impacts on the child.

Socio-cultural and ecological theory of development (Lev Vygotsky 1896-1934)

Lev Vygotsky believed that children learn through social and cultural experiences. Interactions with peers and adults help children in this process. While interacting with others, children learn the customs, values, beliefs, and language of their culture. Language is an important tool for learning (The Goodheart [Sa]:81).
Lev Vygotsky presents learning as a process and this process is in a scale referred to as zone of proximal development and within the zones, on the extremes, there are tasks that a child can perform without support and on the other extreme, it is very difficult for the child to accomplish certain tasks even though the child is supported. In the middle, the child needs help in order to accomplish a task. The middle level is known as scaffolding which is ‘guided learning’. Through social interaction, scaffolding helps children to learn and therefore parents, peers and teachers provide opportunity for social interaction for children (The Goodheart [Sa]:82) through the process of scaffolding.
Based on these two theorists, an understanding of the social conflicts (the eight stages) and how these forces are supported (scaffolding) helped the researcher to explore, examine and establish the role of community in support of ASRH.

Socio-ecological model

Social ecological model (SEM) describes the interactive characteristics of individuals and their environment that underlie health outcomes. The model recognises individuals as embedded within the larger social systems that include the family, peers and friends (basically these are relationships), institutions and the broader society at large. These systems interact and their interactions influence health outcome.
(The Social-Ecological model, a framework for prevention adopted from Centres for Disease Control and Prevention (CDC), National Centre for Injury Prevention and Control 2013)
From the SEM, the individual level, there are some health risks predisposing factors including gender, age, education status, skills, beliefs and attitudes (Brown 2011:1). Interventions for prevention and or promoting health at this level should focus on improving knowledge, building skills and changing attitudes and beliefs among individuals (for the case of the current study, the support by the community stakeholders in regard to individual adolescents characteristics (table 1.1) to enhance ASRH. The current study explored and established the role of community stakeholders in supporting ASRH during and after the war period in Acholi sub-region.
The relationships level consists of the immediate family members, relatives, peers and friends whose interactions either positively or negatively influence individual response (Brown 2011:2). This is dependent on the kind of social capital/wealth that was built among the networks of relationship. The current study evaluated the effects of the role played by the community on adolescents’ reproductive health experience during and after the war era and critically assessed the kind of social capital that adolescents had with the community stakeholders.

CHAPTER 1  ORIENTATION TO THE STUDY
1.1 INTRODUCTION
1.2 BACKGROUND TO THE STUDY
1.3 STATEMENT OF THE RESEARCH PROBLEM
1.4 AIMS OF THE STUDY
1.5 OBJECTIVES OF THE STUDY
1.6 SIGNIFICANCE OF THE STUDY
1.7 RESEARCH DESIGN AND METHODOLOGY
1.8 RESEARCH SETTING
1.9 ETHICAL CONSIDERATIONS
1.10 SCOPE AND LIMITATIONS OF THE STUDY
1.11 DEFINITION OF KEY CONCEPTS
1.12 OUTLINE OF THE STUDY
1.13 CONCLUSION
CHAPTER 2 LITERATURE REVIEW
2.1 INTRODUCTION
2.2 THEORETICAL PERSPECTIVES ON CHILD DEVELOPMENT STAGES
2.3 CHARACTERISTICS OF THE ADOLESCENT STAGE
2.4 ADOLESCENTS’ SEXUAL REPRODUCTIVE HEALTH OUTCOMES
2.5 COMMUNITY PARTICIPATION IN ADOLESCENT SEXUAL REPRODUCTIVE HEALTH
2.6 INTERNATIONAL STANDARDS AND ADOLESCENTS’ RIGHTS TO SEXUAL AND REPRODUCTIVE HEALTH INFORMATION
2.7 GAPS IN THE LITERATURE REVIEWED
2.8 CONCLUSION
CHAPTER 3 RESEARCH DESIGN AND METHODOLOGY 
3.1 INTRODUCTION
3.2 RESEARCH DESIGN
3.3 RESEARCH METHODOLOGY
3.4 PHILOSOPHICAL PARADIGMS
3.5 ORGANISATION OF THE STUDY
3.6 STUDY PHASES
3.7 PHASE II, SUB-STUDY III: QUANTITATIVE STUDY
3.8 ETHICAL CONSIDERATIONS IN ALL THREE PHASES
3.9 FIELD EXPERIENCES AND CHALLENGES
3.10 CONCLUSION
CHAPTER 4 PRESENTATION OF FINDINGS 
4.1 INTRODUCTION
4.2 QUALITATIVE FINDINGS
4.3 EXPERIENCES OF TEEN MOTHERS
4.4 SUPPORT BY COMMUNITY STAKEHOLDERS ON ASRH OF THE TEEN MOTHERS
4.5 FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUP DISCUSSIONS
4.6 THE IMPACT OF THE LORD’S RESISTANCE ARMY (LRA) WAR
4.7 THE INFLUENCE OF MASS MEDIA ON THE SOCIO-CULTURAL NORMS OF THE ACHOLI IN SOCIALISING YOUNG PEOPLE.
4.8 THE INFLUENCE OF EDUCATION SYSTEM ON THE ACHOLI SOCIO-CULTURAL NORMS
4.9 PHASE III STUDY RESULTS
4.10 SUMMARIES OF KEY THEMES FROM THE QUALITATIVE STUDIES
4.11 QUANTITATIVE RESULTS
4.12 KEY FINDINGS FROM THE QUANTITATIVE STUDY
4.13 CONCLUSION
CHAPTER 5 INTERGRATION OF FINDINGS AND DISCUSSION 
5.1 INTRODUCTION
5.2 CONCLUSION
CHAPTER 6  STRATEGIES FOR ENHANCING COMMUNITY RESPONSE AND PARTICIPATION IN ADOLESCENTS’ SEXUAL REPRODUCTIVE HEALTH (ASRH) 
6.1 INTRODUCTION
6.2 COMMUNITY STRATEGY TO ENHANCE COMMUNITY RESPONSIVENESS TO ADOLESCENT SEXUAL REPRODUCTIVE HEALTH
6.3 AN INTEGRATED ADOLESCENT LIFE SKILLS AND HEALTH PROMOTION (ALSHP)
6.4 CONCLUSION
CHAPTER 7 CONCLUSION, LIMITATIONS AND RECOMMENDATIONS
7.1 INTRODUCTION
7.2 AIM AND OBJECTIVES OF THE STUDY
7.3 RESEARCH DESIGN AND METHODOLOGY
7.4 SUMMARY OF THE FINDINGS
7.5 LIMITATIONS OF THE STUDY
7.6 RECOMMENDATIONS
7.7 CONCLUSION
LIST OF REFERENCES
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