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.
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).
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).
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
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).
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).