ABSTRACT
Every young person has the right to a full and healthy life, and duty bearers have an obligation to prepare and support adolescents and young people with the right information and skills to make safe and healthy decisions about their lives and futures. If well supported, adolescence can be a time of enormous vibrancy, discovery, innovation and hope. Yet it can also present many sexual and reproductive health challenges which affect future health and curtail opportunities for young people.
Young people growing up in Eastern and Southern Africa (ESA) face significant sexual and reproductive health challenges. In 2014, the ESA region contributed nearly half of the estimated two million global new HIV infections. Comprehensive HIV knowledge levels remain low and girls are particularly at risk, not only for HIV but also early and unintended pregnancies (EUP), sexually transmitted infections (STIs), gender-based violence (GBV) and child marriage. Adolescent girls (15–19 years) in the sub-Saharan African region experience the highest rates of pregnancy in the world, often unintended, and largely because sex, marriage and pregnancy are often not voluntary or consensual for them, and many lack access to information to make informed decisions.
Evaluations of school-based life skills or HIV education programs offered over the past two decades reveal that programs have faced significant challenges to their content and delivery, with the result that programs were restricted in their capacity to move beyond knowledge and into the development of psychosocial skills, attitudes and behaviours. The result is that large numbers of young people grow into adolescence and adulthood without the basic knowledge that is needed for reproductive health and sexuality.
The endorsement of the ESA Ministerial Commitment by the region’s leadership has ushered in a strong movement in support of comprehensive sexuality education (CSE). There is clear evidence that CSE has a positive impact on sexual and reproductive health (SRH), notably in contributing to reducing STIs, HIV and unintended pregnancy. Sexuality education does not hasten sexual activity, but it does have a positive impact on safer sexual behaviours and can delay sexual debut and increase condom use. UNAIDS and the African Union have recently cited comprehensive age-appropriate sexuality education as one of five key recommendations to fast-track the HIV response and end the AIDS epidemic among young women and girls across Africa.
