Health promotion on sexual and reproductive health services through different platforms is essential for young people to gain knowledge and make informed decisions in their lives. In Zambia, there has been significant improvements in the provision of Sexual and Reproductive Health (SRH) services among young people in higher learning institutions. However, there exists wide differences in the strategies that are used to promote health seeking behaviours among students. One of the strategies which has proved effective in promoting SRH services is the door-to-door health promotion strategy. This innovative strategy seeks to improve sexual and reproductive health coverage by linking the services to the student.
The O3 PLUS project is using door-to-door health sensitisation within the twelve higher and tertiary education institutions that are part of the project. Door-to-door sensitisation can be viewed as health promotion delivered by a peer educator to the doorstep of a student to assist them navigate their sexual and reproductive health decisions. This strategy involves peer educators receiving specific information on a subject, that is subsequently shared with their peers in the residences. This methodology has been adopted because evidence shows that only about 18% of women and 27% of men aged 15-49 had heard of a family planning message on the radio in Zambia . Other SRH awareness approaches used in the past included infotainment and sports.
This deliberate approach of taking the information to the students through door-to-door sensitization by peer educators will not only make students get health information in the comfort of their rooms but contribute to the Sustainable Development Goal number three "good health and well-being" and the UNESCO O3 PLUS project visibility. A study conducted in Zambia established that the use of peer led door-to-door mobilisation of young people to access SRHR services showed positive impact with more than 80% of the intervention community having knowledge of their HIV status compared to ~30% in control communities . This study points to the likelihood that young people when approached in their safe spaces might respond positively to health promotion information. The door-to-door health sensitisations are hoped to upsurge the number of students with knowledge on SRH, intimate partner violence, and gender-based violence (GBV).
Door to door campaigns in the learning institutions are conducted by student peer educators with support from trained health care providers. The campaigns are conducted once per quarter using specifically designed information and education materials. Topics of discussion vary from campaign to campaign to avoid monotony. Before the day of the campaign, students are notified, and time scheduled for the visits.
The door-to-door campaign has resulted in improved access to SRH services among students in learning institutions. At the Northern Technical College (NORTEC) all the rooms on campus accommodating 1416 students (1092 males and 324 females) were visited and students engaged.
In a focus group discussion two months after the NORTEC door-to-door health promotion activity a female student beneficiary said:
“I got to talk to a fellow student on different issues that affect us as young people while preparing my super, though the interaction was not enough, being informed about health services available on campus was very good to me. Next time you should tell them to bring magazines on health services so that I can read in my own time”.
A male student said:
“The information shared was important especially on STIs, abstinence and condom use. I need to get tested for HIV and STIs”.
The interactions with the students after the door-to-door health talks show great potential and opportunity to engage with students on a one-on-one level with different sexual and reproductive health information packages including mental health.