Knowledge and attitudes of elementary students about reproductive health (preliminary study on elementary school in Brebes district, Central Java, Indonesia)

Sri A. Nugraheni, Sri E. Wahyuningsih, Ike J. Prihatini, Etik Sulistyowati


Background: Knowledge of elementary students about reproductive health in Indonesia still lack. There are so many students who did not know how to maintain good reproductive health. Efforts to give lessons reproductive health or sex education to elementary school age children today is still considering taboo, but this problem should be anticipated as soon as possible. To decrease maternal mortality rate and unmet-need needs innovation to educate students. Education about reproductive health is one of strategic ways to increase elementary students’ knowledge and attitudes about reproductive health. This study conducted to evaluate effect of reproductive health education and provision of media on elementary students in Brebes.

Methods: This study utilized quasi experimental pre and post-test one group design. Population of these study 70 elementary students (3 Government ES) in Brebes.

Results: Based on the results of different test with Wilcoxon Match paired Test obtained were significant differences between the respondents' knowledge and attitudes before and after reproductive health education and provision of media (p=0.001).

Conclusions: That means there were significant interventions in the form of education and provision of media to increase knowledge and attitudes of respondent about reproductive health. The results demonstrate that interventions can significantly improve knowledge and attitudes of respondents (p<0.005; Delta: 19.82). Recommendation to improve risk of maternal mortality rate is a reproductive health education with early intervention in young elementary school age children as one of strategic actions to improving knowledge and minimize incidence of teenage pregnancy.


Knowledge, Attitudes, Education, Elementary students, Reproductive health

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World Health Organization. World health statistics; 2014: 38-40.

Raj A, Saggurti N, Balaiah D, Silverman JG. Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study. Lancet. 2009;373:1883–9.

Kementerian Kesehatan RI Direktorat Jenderal Bina Kesehatan Masyarakat Direktorat Bina Kesehatan Ibu. Pedoman Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA). Jakarta. 2010.

Ferguson S, Davis D, Browne J. Does antenatal education affect labour and birth? A structured review of the literature. J Elsevier Women Birth. Australia. 2013;26(1):e5-8.

Slater C, Robinson AJ. FRCP. Sexual health in adolescents. Clin Dermatol. 2014;32(2):189–95.

Vázquez-Nava F, Vázquez-Rodriguez CF, Saldívar-González AH, Vázquez-Rodríguez EM, Córdova-Fernández JA, Felizardo-Ávalos J, Sánchez-Márquez W. Unplanned Pregnancy in Adolescents: Association with Family Structure, Employed Mother, and Female Friends with Health-Risk Habits and Behaviors. J Urban Health: Bulletin of the New York Acad Med. 2014;91(1):176-85.

Hindin MH, Fatusi AO. Adolescent Sexual and Reproductive Health in Developing Countries: An Overview of Trends and Interventions. J Int Perspect Sexual Reprod Health. USA. 2015;35(2):58-62.

Madeni F, Horiuchi S, Iida M. Evaluation of a reproductive health awareness program for adolescence in urban Tanzania-A quasi-experimental pre-test post-test research. Biomed Central J Reprod Health. 2011;8:21.

Salam RA, Faqqah A, Sajjad N, Lassi ZS, Das JK, Kaufman M, Bhutta ZA. Improving Adolescent Sexual and Reproductive Health: A Systematic Review of Potential Interventions. J Adolescent Health. 2016;59(4):11-28.

World Health Organization. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. Geneva. 2011.

United Nations Fund for Population Activities. Adding it up: The cost and benefit of investing in sexual and reproductive health. UNFPA. Accessed November 16, 2015.

Whitworth M, Cockerill R. Antenatal management of teenage pregnancy. J Elsevier Obstetr Gynecol Reprod Med. 2010;20(11):323-8.

Zheng AX, Anderson FWJ. Obstetric fistula in low-income countries. Int J Gynecol Obstetr. 2009;104(2):85–9.

Dixon-Mueller R. How young is “too young”? comparative perspectives on adolescent sexual, marital, and reproductive transitions, Studies in Family Planning. 2008;39(4):247–62.

Lalitha B, Nair S, Stone H, Isac S, Hiremath T, Raghavendra T, et al. The barriers and enablers to education among scheduled caste and scheduled tribe adolescent girls in northern Karnataka, South India: A qualitative study. Int J Educational Development. 2013;49:262–70.

Banks N. Sexually harmful behaviour in adolescents in a context of gender and intellectual disability: Implications for child psychologists. Br Psychological Society Educational Child Psychol. 2014;31:3.

Hanson L, VandeVusse L, Roberts J, Forristal A. A Critical Appraisal of Guidelines for Antenatal Care: Components of Care and Priorities in Prenatal Education. J Elsevier Midwifery Women's Health. 2009;54(6):458-68.

Villarruel AM, YZ, Gallegos EC, Ronis DL. Examining long-term effects of Cuídate-a sexual risk reduction program in Mexican youth. Rev Panam Salud Publica. 2010;27(5):345–51.

Soleimanpour S, Geierstanger SP, Kaller S, McCarter V, Brindis CD. The Role and Value of School-Based Health Care. Am J Public Health. 2010;100:9.

Andrade HHSM, de Mello MB, Sousa MH, Makuch MY, Bertoni NB, Faúndes A. Changes in sexual behavior following a sex education program in Brazilian public schools. Cad Saúde Pública. 2009;25(5):1168–76.

Che, Mazlina, Khaidzir Ismail, Moh Suhaimi Mohamad, Fauziah Ibrahim. Knowledge on Sexuality and Reproductive Health of Malaysian Adolescents– A Short Review. Procedia - Social Behavioral Sci Sci Direct. 2015;211:221-5.

Bleakley A, Hennessy M, Fishbein M, Jordan A. How sources of sexual information relate to adolescents' beliefs about sex. Am J Health Behav. 2009;33(1):37-48.

Cherie A, Berhane Y. Oral and anal sex practices among high school youth in Addis Ababa. Ethiopia BMC Public Health. 2012;12(5):1471-2458.

Svensson J, Barclay L, Cooke M. Randomised-controlled trial of two antenatal education programs. Journal of Elsevier. 2006;25(2):114-25.

Rusmilawaty. Communication, of parents, sexual content intake and teenage sexual behavior at senior high school in Banjarmasin City, Jurnal Kesehatan Masyarakat Nasional. 2016;10:3.

Rosida, Luluk, Evi Marisha, Besral. Residential density, parents sexual activity and teenage sexual behavior in Yogyakarta. J Kesehatan Masyarakat National. 2016;10(3).

Sanders J, Hunter B, Warren L. A wall of information? Exploring the public health component of maternity care in England. Midwifery J. 2016;34:253-26.