'Our rights, Our lives, Our future': evaluation of a 5-year multi-country programme to enhance sexuality education in sub-Saharan Africa.

BACKGROUND: School-based sexuality education is instrumental in promoting health and well-being of adolescents and young people. While countries across sub-Saharan Africa have made significant progress in improving adolescents' and young people's sexual and reproductive health and rights, school-based sexuality education policy, curriculum development and implementation need further advancement. This paper aims to contribute to enhancing the effectiveness and sustainability of sexuality education programmes, by sharing lessons learned from the mixed-methods evaluation of the 'Our rights, Our lives, Our future' programme across 33 countries in sub-Saharan Africa (2018-2022). METHODS: The evaluation employed mixed methods. It started with a review of 35 programme documents, after which ten qualitative country case studies and 15 regional and global-level interviews with key stakeholders were conducted. The case studies were conducted in Botswana, Burundi, Cameroon, Côte d'Ivoire, Eswatini, Gabon, Malawi, Nigeria, Uganda and Zambia. They included a total of 34 focus groups discussions with adolescents, teachers and parents; 76 key informant interviews; and nine stakeholder learning sessions. Data from each method were triangulated and synthesised based on an evaluation framework. RESULTS: Findings show that the programme made a substantial contribution to keeping sexuality education on the political agenda in a context of growing opposition. The programme's support to national governments also led to significant progress in the development and adoption of sexuality education curricula. In many settings, the delivery of sexuality education was hampered by limited competencies and sometimes negative attitudes of teachers, and a lack of support in the school and community environment, including a lack of support from parents. CONCLUSIONS: Continued efforts are needed for supporting sexuality education policy processes and sustainable implementation in sub-Saharan Africa. There is a need for collaborative advocacy and countering opposition. Improving the quality of sexuality education delivered in schools also requires continuous attention. Such efforts need the engagement of multiple stakeholders, including adolescents and young people themselves. Sexuality education in schools promotes the health and well-being of adolescents and young people. Countries in sub-Saharan Africa have made significant progress in improving adolescents' and young people's sexual and reproductive health and rights. However, it is known that sexuality education in schools needs to be improved. This paper aims to contribute to more effective and sustainable sexuality education programmes, by sharing lessons learned from the evaluation of the 'Our rights, Our lives, Our future' programme (2018-2022). This programme supported 33 countries in sub-Saharan Africa in the promotion of sexuality education in schools. Findings show that the programme made a substantial contribution to keeping sexuality education on the political agenda, in a context of growing opposition. The programme's support to national governments also led to significant progress in the development and implementation of sexuality education curricula. In many countries, the delivery of sexuality education was hampered by limited competencies and sometimes negative attitudes of teachers. In addition, there was often a lack of support for sexuality education from parents and other community members. Continued efforts are needed for supporting sexuality education policy processes and sustainable implementation in sub-Saharan Africa.