Health facilitators are key in improving sexual health knowledge and understating of school children in Nepal

Background: Many Nepalese adolescents are engaged in unsafe sexual practice due to the lack of proper information about sexual health and poor accessibility to sexual health services. Student-learning sexual health teaching materials are also ineffective in promoting sexual health at school level. This study aimed to explore the effectiveness of teaching sex education programme to the secondary school children in Nepal.Methods: The study included four schools which were randomised into two groups; control and experimental schools. The teachers in the control schools delivered sex education curriculum in a conventional way whereas the trained health facilitator in the experimental schools used a participatory teaching approach. One of the main outcomes of this study was to assess the knowledge and attitude gained about preventive measures against HIV and AIDS, STIs and teenage pregnancy. This knowledge was based on ABC: Abstinence means to avoid sex (A); Be faithful to your sex partner (B) and; Correct and consistent condom use for safer sex (C). Results: A total of 421 pupils responded in the pre-test and 366 responded in the post-test. The cross tabulation and z-score analysis shows that there were significant differences between male and female responses in the questionnaire variables in both categories of schools. A significant number of school children from experimental schools have reported the increment of sexual health knowledge about preventive measures.Conclusion: In comparison with the conventional teacher-led sex education, properly developed sex education led by a health facilitator had a significant impact on the improvement of quality knowledge and understanding of sexual health for the adolescent. The findings could be interpreted as evidence of the success of the school-based sex education intervention programme