Background Adolescents in low-and-middle-income countries like Zambia face a high burden of sexual, reproductive, health and rights problems including coerced sex, teenage pregnancies, and early marriages. The Zambia government through Ministry of Education has integrated comprehensive sexuality education (CSE) in the education and school system to contribute towards addressing Adolescents sexual, reproductive, health and rights (ASRHR) problems. This paper sought to explore teachers and community based health workers (CBHWs)’ experiences in addressing ASRHR problems in in rural health systems in Zambia. Methodology The study was conducted under Research Initiative to Support the Empowerment of Girls (RISE) community randomized trial that aims to measure the effectiveness of economic and community interventions in reducing early marriages, teenage pregnancies, and school dropout in Zambia. We conducted qualitative 21 in-depth interviews with teachers and CBHWs involved in the implementation of CSE in communities. Thematic analysis was used to analyse teachers and CBHWs´ roles, challenges, and opportunities in promoting ASRHR services. Results The study identified teachers and CBHWs roles, and challenges experienced in promoting ASRHR and suggested strategies to enhance delivery of the intervention. The role of teachers and CBHWs in addressing ASRHR problems included mobilizing and sensitizing the community for meetings, providing SRHR counseling services to both adolescents and guardians, and strengthening referral to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of the boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution. Conclusion This study provides significant insight on the important roles that teachers CBHWs can play in addressing adolescents SRHR related problems. Overall, the study emphasizes the need to fully engage adolescents in addressing adolescents SRHR problems.

Background: In 1994, the International Conference on Population and Development (ICPD) affirmed that Sexual and Reproductive Health and rights (SRH&R) are human rights (UN Zambia/ UNFPA, 2017). The Zambia demographic Health Survey reported that 24.5% of Adolescents especially female under age 15 have had sexual experience at an early age (ZDHS, 2013). Issues to do with coerced sex, early marriage, and sexual abuse remains high among adolescents in Zambia (CSO, 2013/2014). Alongside the mentioned commitment towards addressing SRHR problems, several other public and private organisations have also responded to provide SRHR services as strategy aforementioned SRHR challenges. Hence, the Rise intervention that was aimed at addressing SRHR problems adolescents faced in different areas of the country. However, despite the intervention some adolescents participating in community component arm of RISE still have experienced SRHR problems, thus the need to explore the roles of teachers and CBHWs in addressing these ASRHR problemsMethodology: Using a narrative inquiry study design, a total of 21 interviews were conducted with the teachers (n=12) and CHBWs (n=9) involved in the implementation and coordination of the RISE interventions from 2016 to 2018. Thematic analysis was used to explore adolescents SRHR challenges that teachers and CBHWs grappled with and how these challenges were addressed.Results: The results reviewed that challenges that were faced by teachers as they carried out their roles included late reporting of sexual abuse cases, community myths about contraceptives, stigmatization associated with traumatic circumstances, shyness among girls to participate and strong customary norms that govern their communities. The vital roles teachers and CBHWs performed were counseling and brokering of relationships for both guardians and the adolescents, creating referrals and follow-ups to affected adolescents and creating adolescents’ safe spaces. Suggested strategies stated that there is significance of engaging adolescents in solution finding and creating safe spaces to discuss adolescents SRHR problems. Conclusion: This study provides significant insight on the important roles the teachers and CBHWs played addressing adolescents SRHR related problems despite the challenges they encountered from the adolescents, parents/guardians and community. Overall, the findings highlight the fact that adolescent engagement in addressing adolescents SRHR problems is key.