From Barriers to Engagement: A Qualitative Study of Adolescent and Reproductive Health Education in Rural Bangladeshi Schools

Abstract

Adolescent and reproductive health (ARH) education remains essential for equipping young people with accurate knowledge and life skills, yet in Bangladesh it continues to be constrained by cultural taboos, limited teacher preparedness, and curricular gaps, particularly in rural schools. The study followed the Health Belief Model (HBM) and Social Cognitive Theory (SCT) to examine teacher readiness, student comfort, and classroom strategies for addressing sensitive ARH topics. Data were collected through 18 in-depth interviews with the school teachers and nine focus group discussions with 54 students across three rural districts in Bangladesh. Thematic analysis was conducted, with coding guided by constructs from the Health Belief Model (HBM) and Social Cognitive Theory (SCT). The study found that teachers with structured training demonstrated higher self-efficacy, employed interactive methods, and encouraged greater student participation, while teachers without training often fell back on simply reading from the textbook, without providing additional context or explanation. Additionally, gender norms strongly shaped engagement, as female students preferred private discussions with female teachers in school, whereas male students were more vocal in class, sometimes reinforcing peer discomfort. Trust in teachers was a critical facilitator of dialogue, whereas stigma, incomplete curricular coverage, and inconsistent institutional support emerged as persistent barriers. The study highlights the need for scaling teacher training, strengthening curriculum design, and fostering community acceptance to create inclusive and stigma-free ARH learning environments in Bangladesh.