Telling Them Their Own Stories: Legitimizing sexual and reproductive health education in rural Bangladesh

Abstract

Most people in Bangladesh are rural, poor and underprivileged. The incidence of sexual disease has increased, but little has been done to educate rural people about sexual and reproductive health. In 1997, a sexual and reproductive health project was initiated within a collaborative research agreement between the International Centre for Diarrhoeal Disease Research (ICDDR,B) and the Bangladesh Rural Advancement Committee (BRAC), an indigenous non-governmental organization which pursues integrated rural development strategies. Qualitative in-depth interviews with 65 different women, men, boys and girls revealed significant sexual health problems and a lack of knowledge of sexual and reproductive health. The interviews were transformed into composite problem-solving picture stories and information about sexual and reproductive health. Stories mirrored respondents' interpretations of sexual behavior. Those who had achieved or ascribed legitimacy to talk about sex, e.g. traditional health providers, were trained to utilize the methods and materials. Qualitative evaluations revealed important changes in health providers' self-confidence, business and personal interactions as well as changes in clients' behavior. This project found that sexual and reproductive health education can be integrated into indigenous health activities if the sociocultural context in which sex, relationships, risks, diseases and communication occur is reflected in a program's content and methods. Unquestionably, there is a great need for sex education in rural Bangladesh.