1. Introduction

Adolescent health represents a significant global public health challenge, with unsafe sexual practices being a critical area of concern. These practices, including unprotected intercourse and multiple sexual partners, elevate the risk of sexually transmitted infections (STIs), HIV/AIDS, and unintended pregnancies, with profound implications for adolescents' well-being and development [1]. In Nigeria, these challenges are exacerbated by pervasive poverty, inadequate access to healthcare, and cultural norms that hinder open discussions about sexual health [2].

School health programs have emerged as pivotal interventions to address these multifaceted challenges by integrating comprehensive health education into the school curriculum [3]. The Nigerian government has implemented policies advocating for comprehensive sexual health education promotion among young people [4]. However, despite these efforts, risky sexual behaviour persists, and there is a critical need to assess the implementation and effectiveness of these programs at the local level, particularly in contexts like Uyo, Akwa Ibom State.

This study, therefore, aimed to assess the implementation of the school-health program on the prevention of unsafe sexual practices among students of West Itam Secondary School, Uyo. The specific objectives were to assess the availability of the program, determine students' level of knowledge and attitudes, evaluate the program's outcomes, and identify socio-cultural factors influencing its implementation.

2. Methods

2.1 Research Design and Area

A descriptive research design was adopted for this study. The study was conducted at West Itam Secondary School, Uyo, Akwa Ibom State.

2.2 Population and Sampling

The target population consisted of 521 adolescents in SS1 to SS3. The sample size was determined using Taro Yamane's formula, yielding a minimum of 226 students. A stratified random sampling technique was used to select participants proportionally from each class.

2.3 Data Collection

Data were collected over four days using a structured questionnaire. The instrument was validated for content and face validity and tested for reliability. A total of 226 questionnaires were distributed and retrieved, giving a 100% response rate.

2.4 Data Analysis

Data were analyzed using descriptive statistics (frequencies and percentages) and inferential statistics (Chi-square test) to test hypotheses at a 0.05 level of significance. Analysis was performed using the Statistical Package for the Social Sciences (SPSS).

2.5 Ethical Consideration

Ethical approval was obtained from the institution's ethical committee. Informed consent was secured from the school, parents, and students. Confidentiality and anonymity of the respondents were maintained.

3. Results

3.1 Demographic Characteristics of Respondents

Table 1 shows the demographic profile of the 226 respondents. There was a near-equal gender distribution (48.7% male, 51.3% female). Most respondents (55.8%) were aged 16-18 years, and they were well-distributed across SS1 (35.4%), SS2 (34.5%), and SS3 (30.1%) classes.

Table 1: Demographic Profile of Respondents (n = 226)

3.2 Analysis of Research Objectives

Table 2: Availability of School Health Program

As shown in Table 2, 66.4% (n=150) of students confirmed the availability of a school health program, while 33.6% (n=76) reported its unavailability.

Table 3: Level of Knowledge on Sexual Health

Education

Table 3 indicates that 44.2% (n=100) of the students had a moderate level of knowledge regarding sexual health education, followed by 33.6% (n=76) with high knowledge and 22.1% (n=50) with low knowledge.

Table 4: Attitude towards School Health Program

Majority of the students (57.5%, n=130) had a positive attitude towards the SHP. Regarding outcomes, 61.9% (n=140) reported that the program had improved their understanding and practices related to unsafe sexual practices.

Table 5: Outcome of School Health Program

The program led to improvement for 61.9% of students, showing it has a positive impact. However, 38.1% reported no improvement, revealing a substantial gap in its effectiveness for a large group of students.

Table 6: Socio-Cultural Influence on Implementation

A significant 70.8% (n=160) of respondents indicated that socio-cultural factors significantly influence the implementation of the SHP.

3.3 Hypothesis Testing

The results of the chi-square tests for the hypotheses are summarized in Table 4. Significant relationships were found between the prevention of unsafe sexual practices and program availability (H1), knowledge level (H2), program outcomes (H4), and socio-cultural factors (H5). However, there was no significant relationship between students' attitudes and the prevention of unsafe sexual practices (H3).

Table 4: Chi-Square Test Results for Research Hypotheses