Background
CSE
SECONDARY, SEXUALLY TRANSMITTED INFECTIONS
School attrition attributed to early and unintended pregnancy (EUP) exposes adolescent girls and young women (AGYW) to various social and financial hardships, negatively impacting access to resources and, thus, perpetuating gender-based inequities. School dropout is associated with poorer sexual and reproductive health (SRH) knowledge and, when coupled with suboptimal access to SRH services and persistent gender inequities, can elevate risks of EUP, HIV and other sexually transmitted infections, as well as sexual and gender-based violence (SGBV) [Zambia has a youthful population, with adolescents under 18 years constituting over half (52.2%) of the population [The Ministry of General Education (MoGE) in Zambia noted a gradual increase in the number of teenage pregnancies among in-school girls. Between 2011 and 2019, a total of 120,878 pregnancies among in-school girls (109,850 in primary school and 26,752 in secondary school) were recorded [To address the overlapping challenges of school attrition and EUP, innovative strategies for enhancing self-efficacy, agency, gender empowerment, and school retention are imperative. Comprehensive sexuality education (CSE), introduced throughout sub-Saharan Africa, including Zambia [CSE implementation in Zambia, nevertheless, has confronted various operational and structural challenges. A small qualitative study in rural Nyimba District (Eastern Province) found that teachers implement the CSE curriculum with substantial discretion, which has resulted in censorship of specific elements of the curriculum deemed incompatible with local norms [Without access to quality health services, young people have limited ways to adopt or implement some of the practices or behaviours promoted by CSE curricula (e.g., condom use, strategies for pregnancy and HIV prevention). Efforts to make services more amiable and responsive to adolescents have largely failed to improve outcomes unless they are coupled with demand-generation activities [The overall primary objective was to reduce EUP and improve SRH outcomes among AGYW in Zambia through increased access and utilization of SRH information and services.