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UNESCO HIV and Health Education Clearinghouse

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  1. Proposing a conceptual framework to address social norms that influence adolescent sexual and reproductive health

    With 1.8 billion young people aged 10-24 years in the world today, the cohort of adolescents and youth is the largest in history. Concurrently, millions of adolescents are confronting sexual and reproductive health (SRH) challenges, including high rates of unmet need for contraception, unintended pregnancy, and clandestine and unsafe abortion. Social norms or shared understandings of how oneself and others should behave can alleviate or exacerbate these challenges. …

  2. Improving lives by accelerating progress towards the UN Sustainable Development Goals for adolescents living with HIV: a prospective cohort study

    Background: Low-income and middle-income countries (LMICs) face major challenges in achieving the UN's Sustainable Development Goals (SDGs) for vulnerable adolescents. We aimed to test the UN Development Programme's proposed approach of development accelerators—provisions that lead to progress across multiple SDGs—and synergies between accelerators on achieving SDG-aligned targets in a highly vulnerable group of adolescents in South Africa. …

  3. Adolescent schoolgirls’ experiences of menstrual cups and pads in rural western Kenya: a qualitative study

    Poor menstrual hygiene management (MHM) among schoolgirls in low income countries affects girls' dignity, self-esteem, and schooling. Hygienic, effective, and sustainable menstrual products are required. A randomized controlled feasibility study was conducted among 14-16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls' perceptions and experiences six months after product introduction. …

  4. Rethinking sexual agency: proposing a multicomponent model based on young people’s life stories

    Sexual health policies explicitly aim to encourage young people to take responsibility for their sexuality to prevent adverse outcomes such as unintended pregnancies, STIs and sexual assault. In Europe and North America, ‘choice’ has become a central concept in sexual and reproductive health policy making. However, the concept of choice is not unproblematic, not least because the cultural emphasis on individual responsibility obscures structural limitations and inequalities, and mutual responsibility between partners. …

  5. The revised international technical guidance on sexuality education - a powerful tool at an important crossroads for sexuality education

    In January 2018, UNESCO, together with UNAIDS, UNFPA, UNICEF, UN Women, and the WHO, completed the substantial technical and political process of updating the International Technical Guidance on Sexuality Education, thereby unifying a UN position on rationale, evidence, and guidance on designing and delivering comprehensive sexuality education (CSE).

  6. Zambia’s school re-entry policy for adolescent mothers: examining impacts beyond re-enrollment

    The persistently high rate of adolescent pregnancy, particularly among poor girls and in rural areas, is one of the reasons that universal secondary school completion remains elusive in Zambia. We used a mixed methods approach to explore how Zambia’s re-entry policy is related to young mothers’ outcomes beyond re-enrollment in school. We found that girls with knowledge of the policy were less likely to be forced out of school while pregnant and perceived less stigma after delivery. …

  7. Reducing pregnancy among adolescents

    Across a range of programs, interventions that successfully changed the calculus of costs and benefits of unprotected sexual activity and childbirth delayed pregnancy among adolescents. Some programs directly altered costs and benefits while others shifted perceptions of them

  8. Challenges to implementing national comprehensive sexuality education curricula in low- and middle-income countries: case studies of Ghana, Kenya, Peru and Guatemala

    School-based comprehensive sexuality education (CSE) can help adolescents achieve their full potential and realize their sexual and reproductive health and rights. This is particularly pressing in low- and middle-income countries (LMICs), where high rates of unintended pregnancy and STIs among adolescents can limit countries’ ability to capitalize on the demographic dividend. While many LMICs have developed CSE curricula, their full implementation is often hindered by challenges around program planning and roll-out at the national and local level. …

  9. Cost-effectiveness analysis: educational interventions that reduce the incidence of HIV/AIDS infection in Kenyan teenagers

    This paper demonstrates a comprehensive and thorough application of an education cost-effectiveness analysis. Two interventions implemented in Western Kenya aimed to reduce the incidence of HIV/AIDS contraction in middle school girls. The cost-effectiveness of each intervention is assessed, ex post facto, by combining the results of the two programs’ evaluations with their costs. As few education evaluations consider cost, this article highlights a sound and disciplined method to use when detailed cost information is both readily available and unavailable. …

  10. Improving young people’s health and wellbeing through a school health research network: reflections on school–researcher engagement at the national level

    The School Health Research Network is a policy–practice–research partnership established in Wales in 2013. The network aims to: provide health and well-being data for national, regional and local stakeholders, including schools; co-produce school-based health improvement research for Wales; and build capacity for evidence-informed practice in the school health community. …

  11. The effects of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior: a systematic review

    We conducted a systematic review to assess the impact of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior. We searched PubMed to identify English-language studies evaluating school-based CAPs that reported process (i.e. number of condoms distributed or used) and sexual behavior measures. We identified nine studies that met our inclusion criteria, with the majority conducted in the United States of America. We judged most studies to have medium risk of bias. …

  12. Interventions for preventing unintended, rapid repeat pregnancy among adolescents: A review of the evidence and lessons from high-quality evaluations

    In 2017, of the 22.5 million parenting adolescents (ages 15–19) in 60 countries, approximately 4.1 million gave birth to a second or higher-order child. Adolescent pregnancy in general, and rapid repeat pregnancies specifically, expose young mothers and their children to multiple health and socioeconomic risks. The purpose of this article is to review the impact of interventions designed to prevent unintended, rapid repeat pregnancies among adolescents, including those aimed at changing norms to postpone "intended" closely spaced pregnancies to promote healthy spacing.

  13. Creating an enabling environment for adolescent sexual and reproductive health: a framework and promising approaches

    This article provides a conceptual framework and points out the key elements for creating enabling environments for adolescent sexual and reproductive health (ASRH). An ecological framework is applied to organize the key elements of enabling environments for ASRH. At the individual level, strategies that are being implemented and seem promising are those that empower girls, build their individual assets, and create safe spaces. …

  14. Short-term effects of a rights-based sexuality education curriculum for high-school students: a cluster-randomized trial

    An emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. A rigorous evaluation of a rights-based intervention for a broad population of adolescents in the U.S. has not previously been published. This paper evaluates the immediate effects of the Sexuality Education Initiative (SEI) on hypothesized psychosocial determinants of sexual behavior.

  15. Parents’ and teachers’ views on sexual health education and screening for sexually transmitted infections among in-school adolescent girls in Kenya: a qualitative study

    Background: To successfully develop and implement school-based sexual health interventions for adolescent girls, such as screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, it is important to understand parents’ and teachers’ attitudes towards sexual health education and acceptability of sexually transmitted infection (STI) screening interventions. Methods: In this qualitative study, we approached parents and teachers from three high schools to participate in in-depth interviews (IDIs) and focus-group discussions (FGDs). …

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