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

Abstract

Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people’s access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. For adolescent SRH programs to be effective, we need substantial effort through coordinated and complementary approaches. Unproductive approaches should be abandoned, proven approaches should be implemented with adequate fidelity to those factors that ensure effectiveness, and new approaches should be explored, to include greater attention to prevention science, engagement of the private sector, and expanding access to a wider range of contraceptive methods that respond to adolescents’ needs.

Lessons learned from a decade implementing Comprehensive Sexuality Education in resource poor settings:The World Starts With Me

“…Most of our observations are not new, but they remain highly relevant. They are also consistent with findings in a recent analysis by Chandra-Mouli, lane, and Wong (2015), who argue that adolescent sexual and reproductive health sadly suffers from interventions such as CSE being delivered ineffectively. The fact that many studies still find evidence for effectiveness despite implementation challenges, provides an all the more strong argument in favour of sexuality education's potential.…”

Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster–Randomized Trial in Ghana

“…[29][30][31][32] However, poor implementation of schoolbased programs at scale, including problems of curricula lacking basic information on condoms and contraception, poor teaching, and short program durations, have often resulted in a lack of fidelity to the designed intervention, reducing program effectiveness. 33 Our study supports the idea that text-messaging programs may be effective ways to fill this gap, by providing accurate and complete information via a medium with which adolescents are comfortable. Moreover, text-messaging programs can be tailored to the audience both in terms of cultural and individual characteristics 34 , and they can inexpensively reach a large and diverse population-the marginal costs of the interactive and unidirectional programs per participant were US$1.91 and US$0.30, respectively.…”

Opinions of Health Professionals on Tailoring Reproductive Health Services to the Needs of Adolescents

“…Religion and culture form the core fabric of people's belief systems [37]. Changing the societal perspectives on issues of morality especially relating to providing sexual and reproductive health services requires high level of commitment, hard work, and proven evidence of what works [38]. Some decision-makers in the health system mentioned the need to educate the general public including religious leaders and traditional rulers on the need to make sexual and reproductive health information and services available to young people.…”