Developing sex education for young people in sub-Saharan Africa is essential if the battle against HIV is to be won. Information about sex and marriage has traditionally been passed on to young girls by the 'senga', their father’s sister, in rural Uganda.  The UK's Medical Research Council carried out a pilot study which adapted this traditional institution in an attempt to combat AIDS. The study was conducted in two villages in rural Masaka over a period of 12 months.

Because of social change the old form of senga is dying out.  Girls in particular have nowhere to turn for information about sexual matters. HIV in Ugandan girls aged 13 to 24 was running at over five per cent in 1997, four times as high as in boys of the same age. Some community members oppose the idea of ‘sex education’ as they think it is about learning how to perform the sexual act.  However, they are happier to accept senga, an institution which is familiar to them.

Following discussion groups in the villages, local people identified that they needed to take action to prevent the spread of HIV. 11 adult women and three teenage girls were chosen by the villagers and trained to provide sex education and counselling within the community.  The adult sengas saw an average of 21 patients each while the teenagers saw five patients over the course of the year.  Another village without the benefit of the senga project was included in the study to act as a control.  The study found that:

• girls who had visited a senga had better knowledge about HIV/AIDS; were using condoms in their sexual encounters; felt more able to discuss sexual matters; and made more use of family planning clinics
• the number of girls with sexually transmitted diseases (STDs) decreased
• members of both sexes and all ages attended for a variety of reasons, including domestic conflict and labial elongation, a local cultural practice
• only 49 per cent of the visits were made for information about HIV/AIDS, other STDs, family planning and condoms.

The report recommends:

• training male ‘kojjas' (uncles) to deal with male sexual problems
• using a formal training syllabus for the sengas and kojjas
• providing sengas and koijas with regular support
• monitoring their activities to make sure they are achieving their objectives.

The senga institution is not unique to Uganda.  The senga, or her equivalent, has an important role in initiating young girls into womanhood in several parts of East and Southern Africa.  In some of these countries a ‘kojja’ has also played an important role in sex education for boys.  The senga model could be used in many other countries in the region where AIDS is endemic.  Given the encouraging results of the pilot study, this modified form of the senga institution should be tested further in a larger study and in different communities to discover if it is effective in a variety of situations.

Source(s):
‘Harnessing the senga institution of adolescent sex education for the control of HIV and STDs in rural Uganda’, AIDS Care 15(2): 159-167, by H. Muyinda et al, 2003

Funded by: UK Medical Research Council

id21 Research Highlight: 28 August 2003

Further Information:
James Whitworth
Medical Research Council Programme on AIDS
c/o Uganda Virus Research Institute
PO Box 49
Entebbe
Uganda

Fax: +256 41 321137
Contact the contributor: Jimmy.Whitworth@lshtm.ac.uk

Medical Research Council, UK

Other related links:
'Learning from experience - sex education for young women' >

'Deadly silence: barriers to communicating HIV/AIDS in schools'

'Fighting HIV/AIDS with awareness: the case of rural Uganda'

'Shock to the system – HIV and education in Kenya and Tanzania'

'Film, book or play? Community-based HIV prevention in rural Uganda'

See id21's collection of links relevant to HIV/AIDS.

See id21's collection of links relevant to sexual and reproductive health.