Abstract

Adolescents have special sexual and reproductive health needs (whether or not they are sexually active or married). This review assesses the impact of interventions to improve adolescent sexual and reproductive health (including the interventions to prevent female genital mutilation/cutting [FGM/C]) and to prevent intimate violence. Our review findings suggest that sexual and reproductive health education, counseling, and contraceptive provision are effective in increasing sexual knowledge, contraceptive use, and decreasing adolescent pregnancy. Among interventions to prevent FGM/C, community mobilization and female empowerment strategies have the potential to raise awareness of the adverse health consequences of FGM/C and reduce its prevalence; however, there is a need to conduct methodologically rigorous intervention evaluations. There was limited and inconclusive evidence for the effectiveness of interventions to prevent intimate partner violence. Further studies with rigorous designs, longer term follow-up, and standardized and validated measurement instruments are required to maximize comparability of results. Future efforts should be directed toward scaling-up evidence-based interventions to improve adolescent sexual and reproductive health in low- and middle-income countries, sustain the impacts over time, and ensure equitable outcomes.

Highlights

  • Adolescents have special sexual and reproductive health needs

  • We systematically reviewed all published literature up to December 2014 on interventions to improve sexual health in adolescent population focusing on sex education, preventing unintended adolescent pregnancy, intimate partner violence, and Female genital mutilation/cutting (FGM/C)

  • We found existing systematic reviews on interventions for improving adolescent sexual and reproductive health; they were limited in their scope to a particular strategy such as school-based interventions [31,32], peer-led interventions [33], mass media [34,35], and youth centers [36]; geographic settings [37,38]; or limited to trial data only [13,39]

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Summary

Introduction

Adolescents have special sexual and reproductive health needs (whether or not they are sexually active or married). This review assesses the impact of interventions to improve adolescent sexual and reproductive health (including the interventions to prevent female genital mutilation/cutting [FGM/C]) and to prevent intimate violence. Our review findings suggest that sexual and reproductive health education, counseling, and contraceptive provision are effective in increasing sexual knowledge, contraceptive use, and decreasing adolescent pregnancy. Among interventions to prevent FGM/C, community mobilization and female empowerment strategies have the potential to raise awareness of the adverse health consequences of FGM/C and reduce its prevalence; there is a need to conduct methodologically rigorous intervention evaluations. Future efforts should be directed toward scaling-up evidence-based interventions to improve adolescent sexual and reproductive health in lowand middle-income countries, sustain the impacts over time, and ensure equitable outcomes. Sexual activity of adolescents varies markedly by gender and region; more girls compared with boys are sexually

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