“Such Conversations Are Not Done in the Families”: A Qualitative Study of the Determinants of Early Adolescents’ Access to Sexual and Reproductive Health and Rights Information in Rwanda.

Abstract Background Acces to sexual and reproductive health and rights information during adolescence is a basic human right. This study investigated the key informants’ perspectives on the benefits, sources of information, and the determinants (enablers and hindrances) of sexual and reproductive health and rights information among early adolescents in Rwanda. Methods a qualitative study using semi-structured interviews with purposively selected public and private key informants in Rwanda was conducted. Interview transcripts were imported in Nvivo 11 for thematic analysis. Results In total, sixteen interviews involving an equal number of male and female participants were conducted. Despite it being perceived as a taboo topic, participants acknowledged sexuality education as beneficial for early adolescents and confirmed that there are various channels for accessing gender and sexuality information. The school comprehensive sexuality education was depicted as a common source of information, while parents were not. Participants highlighted disparities in information access between rural and urban settings. Faith-based organizations and public institutions did not share the same perspective on the topics that should be covered in gender and sexuality education. Faith-Based Organizations focused on moral values of abstinence and virginity, while public institutions emphasized ways of having safe sex including the use of modern contraceptive methods. Participants noted the need to address the confusion about the concept of gender. Participants’ reflections on gender dynamics revealed that compared to girls, boys culturally override sexual health. Participants thought that access to gender and sexuality information by early adolescents depended on multiple factors at the individual (curiosity, age, behaviours), relationships (discussions with parents, peer sexual norms), community (the content of the curriculum, culture, religious beliefs), and societal (economic challenges, policy, and laws) levels. Conclusion Participants from various backgrounds acknowledged the benefits of sexuality education, as well as the various channels available to younger adolescents for accessing SRHR information, even though their perspectives on the content differed. The study’s multi-layered analysis revealed potential areas for improving early adolescents’ access to gender and SRHR information.