Effectiveness of a Peer-Led School-Based Sexual and Reproductive Health Intervention among Adolescents in Kaduna State, Nigeria: A Mixed-Methods Operational Research Study

Abstract

Background

Adolescents in northern Nigeria face substantial sexual and reproductive health challenges. This study evaluated the effectiveness, acceptability, and implementation experiences of a peer-led school-based SRHR intervention in Kaduna State.  

Methods

A mixed-methods operational research study was conducted between May and June 2025 across 36 secondary schools in eight LGAs. 1,441 adolescents completed pre-test and 1,245 completed post-test structured questionnaires. Quantitative data were analysed using independent t-tests, chi-square, and multivariable linear regression. Qualitative data from implementation reports were analysed thematically.  

Results

Mean SRHR knowledge scores increased significantly from 16.31 ± 4.52 to 20.38 ± 4.11 (p < 0.001; Cohen’s d = 0.94). The proportion with good knowledge rose from 36.3% to 72.9%, while poor knowledge reduced from 42.1% to 5.6% (p < 0.001). Post-intervention exposure was independently associated with higher knowledge scores (β = 4.55; 95% CI: 4.14–4.96; p < 0.001). Willingness to undergo HIV testing increased from 63.1% to 92.4%. Qualitative themes included high acceptability of peer-led approaches, improved participation through gender-sensitive facilitation, and correction of key misconceptions.  

Conclusion

This peer-led school-based SRHR intervention was feasible and effective in improving knowledge and behavioural intentions among adolescents in northern Nigeria.