This page contains resources related to what works in education and health, with sub-topics in the following areas: peer education, life skills education, and teacher training.

PEER EDUCATION

Peer education in youth programs is popular throughout the world, with large investments made in this approach. These programs train youth in reproductive health or HIV/AIDS issues and expect these youth to convey this information to their peers. Activities vary widely in type and frequency, number and intensity of contacts, and frequency of follow-up. Settings include schools, universities, clubs, churches, street settings, workplaces, barracks, or wherever young people gather. It can be combined with other approaches such as savings groups or ‘Safe Spaces’.
 
Youth peer education is often undertaken because it is thought that young people are more receptive to information from their peers and that these programs are a convenient way to reach a large number of youth with information, often with volunteer staff. When done well, peer education requires intensive planning, coordination, supervision, and resources, meaning there are program costs inherent in each element of a peer education program — training, support, supervision, supplies, allowances — all of which require realistic budgeting and careful monitoring. Some researchers have raised questions about the cost effectiveness of such programs, their sustainability due to high turnover, and the impact that peers actually make on their counterparts. Nonetheless, this approach has shown some promise and continues to be widely used.

Peer Educators as Agents of Change; Experience of the Integrated Family Health Program (IFHP)

Peer education is a popular and versatile approach for promoting good voluntary family planning and reproductive health care among young people around the world. Well-designed and well-implemented programs can improve young people’s health-related knowledge, attitudes, and skills as well as their access to health services. Peer education is based on the idea that young people are more likely to change their behavior if peers they like and trust advocate for change. A successful peer educator motivates people to adapt and maintain positive behaviors that promote health and prevent diseases through reinforcing behavior change. This brief describes the experience of the USAID-funded Integrated Family Health Program (IFHP) in engaging peer educators in the planning, execution, monitoring and evaluation of adolescent and youth SRH programs in Ethiopia (2014). 

Peer-facilitated Community-based Interventions for Adolescent Health in Low and Middle-income Countries: A Systematic Review

In several low- and middle-income countries (LMICs), peer facilitators, defined as adolescents or young adults selected from the group or community they serve, are employed to work in communities and schools as part of national and non-governmental adolescent health programs. Training lay peer facilitators to deliver adolescent health interventions can increase capacity for scaling up and be more cost-effective than working with specialized staff. Peer facilitators may also be better able to communicate with adolescents than older adults, and perceived as a more credible source of information. Peer facilitators might have better access to marginalized groups who have limited engagement with existing health programs. Critically, empowering young people to inform and implement adolescent health programs should make these more relevant and effective. Peer-facilitated community-based interventions show promise to improve mental health and reduce violence and substance use in LMICs, though further robust studies are needed to strengthen the evidence base (2019). 

Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis 

Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. A systematic review and meta-analysis of peer education interventions in developing countries were conducted. Peer education interventions were significantly associated with increased HIV knowledge, reduced equipment sharing among injection drug users, and increased condom use. Meta-analysis indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes but show no significant impact on biological outcomes. Further research is needed to determine factors that maximize the likelihood of program success (2019).

What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices 

This article describes the evidence for the efficacy of a number of common intervention strategies for engaging adolescents in reproductive health (RH) programming, focusing particularly on calling attention to what approaches have not been shown to be successful. In particular, the evidence suggests that youth centers, peer education approaches, and one-off public meetings have largely been ineffective in facilitating access to RH services. Other approaches, such as comprehensive sexuality education and youth-friendly services, have mixed evidence and require considerable implementation requirements to be effective (2015).

Evidence-based Guidelines for Youth Peer Education 

This tool, published in 2010, provides recommendations on evidence-based youth peer education practices and a framework for quality assurance. The document features cross-cutting issues relevant to all areas of a peer education program and gives specific tips for the different phases of implementing a program, including planning, recruitment and retention of peer educators, supervision and management, and monitoring and evaluation. It also includes explanations of the available evidence on what works in peer education and real-world examples of how the guidelines are used in successful programs. The document is focused on peer education to improve reproductive health, but it can be applied more broadly to youth peer education programs generally (2010).

Improving the Lives of Married Adolescent Girls in Amhara, Ethiopia 

This report presents the evaluation results from the “Towards Economic and Sexual Reproductive Health Outcomes for Adolescent Girls” project, implemented by CARE Ethiopia in a rural area of Amhara, Ethiopia. The project sought to provide ever-married girls aged 14-19, the majority of whom are out-of-school, with effective training on reproductive health and economic empowerment using a peer-education model. The results indicate significant benefits to participants, particularly in terms of reproductive health (2014).

 

LIFE SKILLS EDUCATION

In order to make good decisions about their reproductive health, young people need reliable information, an opportunity to develop values and attitudes consistent with health goals, and the skills to behave consistently with their knowledge and values. Sexuality and family life education, including HIV education, helps prepare young people to make good choices as they transition to adulthood. Organized education about sex and HIV can take place in schools, in out-of-school and faith-based programs, in programs for parents, and through peer education activities. Comprehensive sexuality education (CSE) embraces a holistic vision of sexuality and sexual behavior that goes beyond the prevention of pregnancy and sexually transmitted infections, aiming to equip youth with the knowledge, skills, attitudes and values that encourage healthy behavior in the context of a positive view of their sexuality. CSE programming is rights based, encouraging a respect for human rights and diversity, critical thinking skills and general capacities for full citizenship, the development of norms and attitudes that promote gender equality and inclusion and that adopt a positive life-cycle approach to sexuality.

Research on programs emphasizing a more holistic approach to sexuality and skill building has confirmed the positive impact of curriculum-based sexuality education for young people.
Even so, such programs are often controversial because many believe that sexuality is a private matter for families and that talking about it in schools or other settings can lead to young people being more sexually active. Furthermore, the rights-based approach that lies at the core of true CSE often represents a challenge to existing power structures and value systems. Other challenges to implementing high-quality programs include inadequate teacher training and varying availability of funds.

In summary, CSE programs should include the following elements:

  • A basis in core values of human rights
  • An integrated focus on gender that promotes gender equality
  • Thorough and scientifically accurate information
  • A safe and healthy learning environment
  • Linkages to reproductive health services and other programs aiming to empower youth
  • A participatory approach that emphasizes strengthening communication skills, decision-making, and critical thinking
  • Strengthening the civic engagement and advocacy of youth
  • Strong local ownership of program content
  • Programmers should aim to reach youth wherever they are, including on the most vulnerable and hard-to-reach youth

Emerging Evidence, Lessons and Practice in Comprehensive Sexuality Education: A Global Review

This report provides an overview of the status of comprehensive sexuality education (CSE) implementation and coverage on a  global level. It draws on specific information about the status of CSE in 48 countries, generated through analysis of existing resources and studies. The report examines the evidence base for CSE and its positive impact on health outcomes, takes stock of political support for CSE, and examines how the various global and regional commitments have had an impact at national levels on the delivery of CSE in practice (2015). 

School-Based Sex Education and HIV Prevention in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

School-based sex education is a cornerstone of HIV prevention for adolescents who continue to bear a disproportionally high HIV burden globally. This systematic review provides existing evidence for school-based sex education interventions in low- and middle-income countries to determine the efficacy of these interventions in changing HIV-related knowledge and risk behaviors (2014).

UNFPA Operational Guidance for Comprehensive Sexuality Education: A Focus on Human Rights and Gender

In this guidance, the United Nations Population Fund (UNFPA) provides guidance to governments and programmers on how to best design, implement, and evaluate comprehensive sexuality education (CSE) programs. These guidelines are based on scientific evidence, international human rights conventions, and agreed-upon technical standards and provide a clear common definition of CSE, a description of the essential components this includes, and four key intervention areas on which to focus (2014).

Comprehensive Sexuality Education Programmes: A Focus on the Gender and Empowerment Outcomes 

This report provides an extensive review and analysis of a wide range of evaluation studies in the field of comprehensive sexuality education (CSE). By examining CSE programs at different stages of development and in diverse settings, the report provides important guidance to future evaluations of CSE programs on methodologies, data collection instruments, and age-specific approaches, particularly as these relate to gender and empowerment outcomes (2015).

The Case for Addressing Gender and Power in Sexuality and HIV Education: A Comprehensive Review of Evaluation Studies

This peer-reviewed article assesses whether curriculum-based sexuality and education programs that directly address gender and power result in better outcomes than those that do not. A review of 22 evaluated programs (10 of which addressed gender or power) found that those that did include these as a core component were five times as likely to be effective in terms of core reproductive health outcomes, including lower rates of sexually transmitted infections and unintended pregnancies (2015).

It's All One Curriculum: Guidelines and Activities for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education

It's All One Curriculum is a resource kit for developing sexuality and HIV education curricula with an emphasis on gender equality and human rights. The first volume, Guidelines, includes content units, fact sheets, "points for reflection," and a module on advocacy. The second volume, Activities, includes sample activities, a chapter on effective teaching methods, and an additional resources section.

It’s About More than Just Sex: Curricula and Other Educational Materials on Youth Sexual and Reproductive Health

Compiled by FHI 360 on behalf of the Interagency Youth Working Group, this list contains high-quality curricula and supplemental materials designed to improve youth reproductive health. Examples of adult- and peer-led (or youth-led) curricula are included to provide youth-serving organizations with user-friendly educational resources which can be used in a variety of program settings. Published by internationally recognized global health or academic organizations as well as country-based programs, all materials are available online or by mail free of charge or at minimal cost. Materials are culturally adaptable and appropriate for low-resource settings, and are specific, structured, targeted, and medically accurate (2013).

​TEACHER TRAINING

Aside from family, teachers are often the main adults with whom young people interact on a daily basis. Ideally, as trusted gatekeepers of information, people who teach about reproductive health should function as role models, advocate for healthy school environments, and provide correct and age-appropriate information to their students. In many schools, however, reproductive health education for young people consists of didactic lectures about basic anatomy and physiology. This is hardly surprising, because most training programs fail to prepare future teachers to teach the subject effectively. As a result, many teachers complete their training with critical gaps in their own knowledge of reproductive health. Some have judgmental attitudes or religious or moral objections to teaching young people about sex, voluntary contraceptive choice and use, or condom use. Others simply feel uncomfortable talking about these subjects or using the interactive teaching methods that are most effective in promoting healthy sexual behavior.
 
Those best suited to teach young people about reproductive health should have a commitment to working with youth and teaching this material, have a healthy attitude about their own sexuality, be approachable, have good communication skills, be nonjudgmental, respect others' confidential information, demonstrate competence and knowledge in the subject matter, be willing to use interactive teaching methods, and have access to training and support.

Similarly, in education, teachers have a powerful influence on students’ success in and outside of the classroom, through the content they teach as well as the expectations they set. A high-quality education supports the development of knowledge, skills, and abilities that lead to improved health outcomes, increased individual earning potential, and a more engaged citizenry. While large gains have been made in improving girls’ and boys’ access to education, multiple forms of inequality persist between girls and boys that present challenges to advancing girls’ education globally. Given the critical importance of education to individuals and communities, how do we ensure that girls and boys are succeeding at equal levels around the world?  There are three important components to fostering a truly gender-inclusive learning environment: 1) generating support within the school and community; 2) creating a supportive classroom atmosphere; and 3) ensuring gender-sensitive content and curriculum. Gender-inclusive teaching proactively addresses challenges that both girls and boys may face in receiving an excellent education. Through supporting teachers to take on reflective practice, through gender-sensitization workshops, for example, teachers can become more aware of and take action on their own biases. One of the greatest hurdles to supporting teachers to adapt and implement gender-inclusive teaching strategies is the lack of training information.   

Comprehensive Sexuality Education in Teacher Training in Eastern and Southern Africa. Situational Analysis of Twenty-One ESA Countries

This report presents the findings of comprehensive sexuality education (CSE) in the teacher education study, which aimed to produce a high quality, evidence-informed situation analysis report that will guide the scale-up and implementation of teacher training programmes in CSE in the African continent. The situational analysis used a combination of review methods, which included: 1) conducting a comprehensive desk review across the 21 countries. 2)  a mapping exercise of all teacher training institutions (TTIs) in the 21 countries; and 3) in-depth data collection and analysis across the education sectors in six countries—Lesotho, Malawi, Mozambique, Uganda, Tanzania and Zambia (2015).

Rights, Respect and Responsibility: A K-12 Sex Education Curriculum

A free, K-12 sex education curriculum that fully meets the National Sex Education Standards, includes resources for educators at every grade level, covers all topics recommended by the CDC for sexual health education, and reflects the diversity of modern classrooms. This module was developed as a resource to support pre-service training of teachers for the delivery of school-based sexuality education in East and Southern Africa. Designed for trainers who are delivering pre-service training on sexuality education in the region, this participatory training equips teachers with the basic knowledge and skills necessary to deliver effective sexuality education in the classroom. Key topic areas include adolescent voluntary family planning and reproductive health care in East and Southern Africa; an overview of sexuality education; adolescent development; experiential learning and facilitation skills; classroom management; application of skills through simulation of lesson plan delivery, and policy and ethical considerations.

Understanding Gender: A Training Module for Teachers

Understanding Gender seeks to expand the gender perspective and skills of school teachers. The methodology is participatory and based on adult learning principles. It includes role plays, discussions, brainstorming, group work and energisers to encourage the participants to relax, express themselves freely, give honest feedback and foster a climate of unity and enjoyment through the workshop. Filled with practical exercises, it is designed to convey the varied requirements of boys and girls and the need to respond with equal respect and consideration to students of both sexes (2014). 

Guidance for Developing Gender-Responsive Education Sector Plans

This guidance has been prepared under the joint leadership of the United Nations Girls’ Education Initiative (UNGEI) and the Global Partnership for Education (GPE) supported by UNICEF. These guidelines on developing gender-responsive education sector plans provide readers with the information and tools needed to take a fresh look at gender equality and why it matters in education.

Creating Supportive Learning Environments for Girls and Boys

Teachers have the opportunity to make a difference in students’ lives every day. Creating more equal educational opportunities for students begins in the classroom and with the teacher. Gender-inclusive teaching proactively addresses challenges that both girls and boys may face in receiving an excellent education. This teaching guide provides practical, hands-on activities, suitable for large classrooms with varying levels of resources, for advancing on the journey of gender-inclusive teaching. Teachers who used the tools and strategies included in this report reported increased leadership roles for girls and boys in their classrooms, increased awareness of how gender inclusiveness improves classroom planning and teaching, effective methods for countering negative stereotypes of girls and boys that impede learning, and success in implementing gender empowerment projects in their schools and communities.

International Technical Guidance on Sexuality Education Volume 1

These technical guidance documents seek to assist education, health, and other relevant authorities to develop and implement school-based sexuality education materials and programs. Based on a rigorous review of the evidence up to the date of publication, Volume 1 focuses on the rationale for comprehensive sexuality education (2010).

International Technical Guidance on Sexuality Education Volume 2

These technical guidance documents seek to assist education, health, and other relevant authorities to develop and implement school-based sexuality education materials and programs. Based on a rigorous review of the evidence up to the date of publication, Volume 2 focuses the topics and learning objectives that should be covered in a ‘basic minimum package’ on sexuality education for children and young people (2010).

It’s All One Curriculum: Guidelines and Activities for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education

This curriculum provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated with topics such as relationships, puberty, and condom use. The two-set book is user-friendly and designed to be used flexibly, so that educators in diverse settings can easily understand the content and extract the level of detail they need to meet local goals. It is available in Spanish, French, Bangla, and Chinese, and is being adapted and translated into Arabic (2009).

Tools for Educators

This series of resources, developed by Planned Parenthood, aims to provide guidance to educators in implementing and evaluating sex education. While primarily directed to the United States, the resources are relevant to educators in a wide variety of settings.

Health and Family Life Education Teacher Training Manual:  Self and Interpersonal Relationships Theme Unit and Sexuality and Sexual Health Theme Unit

The purpose of this manual is to provide trainers in the Caribbean with materials and resources to conduct in-country teacher-training on two themes in the Health and Family Life Education (HFLE) Common Curriculum: self and interpersonal relationships, and sexuality and sexual health. The lessons' content addresses many health and social challenges in the region, including HIV/AIDS, violence, and substance abuse (2009).