DOI: 10.1108/he-06-2025-0082 ISSN: 0965-4283

The protective role of decision-making life skills in enhancing awareness of sexual health risks and knowledge of condoms among primary school adolescents in Tanzania

Amina Yusuf Kanyama, Suitbert Emil Lyakurwa

Purpose

This study aimed to examine the protective role of decision-making (DM) life skills (DMLS) in enhancing awareness of sexual health risks and knowledge of condoms among primary school adolescents in Tanzania.

Design/methodology/approach

A cross-sectional survey was conducted among 400 primary school adolescents (classes V–VII) selected through stratified and simple random sampling, with sample size determined using Yamane's formula. Instrument validity was ensured through exploratory factor analysis (EFA) and reliability using Cronbach's alpha. Data were analysed using both descriptive statistics to determine levels of DMLS, sexual health risk awareness and condom knowledge and inferential statistics to examine their predictive relationships.

Findings

The results showed that 56% of adolescents exhibited unfavourable DMLS with female and older adolescents dominating the group. On the other hand, 44% had favourable DMLS with younger and male adolescents displaying slightly higher favourable DMLS. Awareness of sexual health risks was relatively low (78%) while 72% demonstrated high knowledge of condoms. Logistic regression results revealed that DMLS significantly predicted both awareness of sexual health risks and knowledge of condoms (p < 0.05). Gender and age were also significant predictors of knowledge of condoms (p < 0.01).

Research limitations/implications

The study shows that DMLS significantly predict adolescents' awareness of sexual health risks and knowledge of condoms. Adolescents with favourable DMLS are better able to assess risks, anticipate consequences, and make informed choices regarding protective behaviours. Strengthening DMLS at an early age may therefore enhance adolescents' ability to access, interpret and apply sexual health information. These findings have important implications for schools, teachers, curriculum developers and policymakers in strengthening life skills and comprehensive sexuality education (CSE) programmes. They also support Social Cognitive Theory and the Health Belief Model in promoting self-efficacy, risk perception and informed decision-making.

Practical implications

The findings suggest that school-based programmes should prioritise the development of decision-making skills alongside factual sexual health education. Strengthening self-efficacy and decision-making abilities can enhance adolescents' capacity to translate knowledge into preventive behaviours. Teachers and curriculum developers should incorporate interactive, participatory methods to reinforce decision-making, gender-sensitive guidance and risk perception. Tailored interventions addressing the specific needs of both genders and different age groups can improve adolescents' preparedness to navigate sexual health challenges effectively.

Social implications

Strengthening adolescents' DMLS may improve their awareness of sexual health risks and enhance their knowledge and understanding of condom use, thereby supporting more informed and protective sexual health choices. Improved awareness of sexual health risks and knowledge of condoms among adolescents may contribute to safer behaviours, reduced vulnerability to sexually transmitted infections and unintended pregnancies and healthier transitions into adolescence and adulthood. Furthermore, promoting DMLS within school settings can encourage open communication about sexual health among peers, families and communities, ultimately contributing to improved adolescent well-being and broader public health outcomes.

Originality/value

The study underscores the importance of strengthening DMLS in primary schools as a strategic intervention to enhance awareness of sexual health risks and knowledge of condoms to promote safer sexual behaviours. Tailored, age and gender-responsive life skills programmes are recommended to foster DMLS during early adolescence.

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