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UNESCO HIV and Health Education Clearinghouse

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  1. 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

  2. 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. …

  3. 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. …

  4. 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. …

  5. 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.

  6. 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). …

  7. Interventions for preventing unintended pregnancies among adolescents (Review)

    Background: Unintended pregnancy among adolescents represents an important public health challenge in high-income countries, as well as middle and low-income countries. Numerous prevention strategies such as health education, skills-building and improving accessibility to contraceptives have been employed by countries across the world, in an effort to address this problem. However, there is uncertainty regarding the effects of these interventions, hence the need to review the evidence-base. …

  8. Integrating gender and rights into sexuality education: field reports on using It's All One

    International policy agreements, along with emerging evidence about factors influencing programme effectiveness, have led to calls for a shift in sexuality education toward an approach that places gender norms and human rights at its heart. Little documentation exists, however, about the degree to which this shift is actually taking place on the ground or what it entails. Field experiences in using new curriculum tools, such as It's All One, offer one lens onto these questions. To gain a sense of practitioners' experience with this tool, a two-part exercise was conducted. …

  9. Global overview of school health services: data from 102 countries

    Objective: The objective of this paper was to produce a global inventory of school health services and describe characteristics such as target group, providers, staffing level, services, settings, and organizational challenges. Methods: The literature in PubMed and other sources were reviewed using an explicit methodology. Results: School health services exist in at least 102 countries. Usually services are provided within school premises (97 countries), by dedicated school health personnel (59 countries). …

  10. Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey

    Background: Many adolescent girls in low-income and middle-income countries lack appropriate facilities and support in school to manage menstruation. Little research has been conducted on how menstruation affects school absence. This study examines the association of menstrual hygiene management knowledge, facilities and practice with absence from school during menstruation among Bangladeshi schoolgirls. Methods: We conducted a nationally representative, cross-sectional study in Bangladeshi schools from March to June 2013 among girls 11 to 17 years old who reached menarche. …

  11. Early marriage and sexual and reproductive health vulnerabilities of young women: a synthesis of recent evidence from developing countries

    Purpose of review: To review current evidence on the links between early marriage and health-related outcomes for young women and their children. Recent findings: Every third young woman in the developing countries excluding China continues to marry as a child, that is before age 18. Recent studies reiterate the adverse health consequences of early marriage among young women and their children even after a host of confounding factors are controlled. …

  12. Learners’ perspectives on the provision of condoms in South African public schools

    A stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE’s policy by exploring learners’ perspectives on the provision of condoms and SRHR-services in schools. …

  13. Experimental evaluation of school-based HIV programs in sub-Saharan Africa

    School-based adolescent health education programs represent a durable strategy in reducing the spread of HIV because they can leverage pre-existing social and organizational structures to reach large fractions of students at critical life stages. Many evaluations of school-based HIV programs draw on multilevel study designs that assign schools to treatment conditions or assign students to treatment conditions within blocks defined by school membership. …

  14. What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders’ views

    Sex and relationship education (SRE) is regarded as vital to improving young people's sexual health, but a third of schools in England lacks good SRE and government guidance is outdated. The authors aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation. […] They identified key features of effective and acceptable SRE. Their best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.

  15. Education, HIV, and early fertility: experimental evidence from Kenya

    A seven-year randomized evaluation suggests education subsidies reduce adolescent girls’ dropout, pregnancy, and marriage but not sexually transmitted infection (STI). The government’s HIV curriculum, which stresses abstinence until marriage, does not reduce pregnancy or STI. Both programs combined reduce STI more, but cut dropout and pregnancy less, than education subsidies alone. …

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