Knowledge, attitudes and safeguarding practices of school counsellors in Batticaloa District, Sri Lanka regarding adolescent sexual and reproductive health

Abstract

Background: Adolescents in Batticaloa District face challenges like substance abuse, sexual abuse, and teenage pregnancy. Student counselling service providers (SCSPs) play a key role in adolescent sexual and reproductive health (ASRH) education. This study aimed to assess SCSPs' knowledge, attitudes, and practices (KAP) on ASRH. Method: A cross-sectional study using total population sampling was conducted with a self-administered questionnaire assessing KAP on sexuality, contraception, STIs, safeguarding policies, and current practices. Descriptive statistics were used to analyze sociodemographic data. Results: Of 194 SCSPs, 183 (94.3%) participated. Males (51%), females (27%), those <35 years (55%), Hindus (43%), Islam (57%), Christians (40%), and SCSPs with a university degree (46%) scored above the median knowledge score (62.5%). Most answered correctly on cyber-safety (82%), domestic violence (75%), adolescent mental health (73%), and abuse survivor care (77%), but only 38% answered correctly on adolescent contraception. Among those who scored above the median attitude score (64%) were, >35 years (52%), Hindus (45%), Islam (30%), and Christians (55%). Negative attitudes included disagreement with non-heterosexual acceptance (38%), reluctance to discuss contraception (83%), and viewing forced marriage as a cultural issue (70%). SCSPs frequently educated students on substance abuse risks (90%) and consent (69%), but only 30% and 37% discussed contraception and STIs annually. Only 25% reported school sexual harassment policies, and 31% faced community barriers in protection services. Conclusion: Cultural factors and policy gaps impact safeguarding practices. Targeted trainings on sexuality, contraception, and sexual health protection are needed, alongside a review of school protection services and referral pathways.