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Comprehensive Sexuality Education and Services - Youth Pregnancies Down More than 50%


Strategy researched

Study participants were randomised into 3 arms: The first arm continued standard instruction of comprehensive sexuality education (CSE) (control). In the second arm, (CSE + Health Outreach), information on available sexual and reproductive health (SRH) services was provided in schools though health fairs run by health workers to complement CSE. In the third arm (CSE + Responsive Adolescent SRH Services), learners receiving CSE were encouraged or supported to access SRH services where health providers had been trained to be more receptive to adolescents’ SRH health needs. Teachers were also encouraged to introduce students to health services.

Impact achieved

Following three years of intervention exposure, findings showed a significant decline of in-school pregnancies amongst AGYW in both intervention arms, with arm two exhibiting a more significant decline, having recorded only 0.74% pregnancies at endline (p < 0.001), as well as arm 3, which recorded 1.34% pregnancies (p < 0.001). No significant decline was recorded in the CSE-only (control arm).  The decline was more than 50% in intervention arms, as compared with the control arm, and significantly lower, as a proportion of AGYW in arm 2, followed by arm 3.

Country of study


Research methodology

3-arm RCT


BMC Public Health; 2023

Journal paper title and link

Comprehensive sexuality education linked to sexual and reproductive health services reduces early and unintended pregnancies among in-school adolescent girls in Zambia

Excerpt from Abstract

"Linking provision of CSE with accessible SRH services that are receptive to needs of adolescents and young people reduces EUP [early and unintended pregnancies], which provides the opportunity for higher retention in school for adolescent girls."


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