Commentary: Promoting healthy adolescent development through comprehensive sexuality education

The ICPD Programme of Action and many intergovernmental agreements since have agreed that all adolescents, in and out of school, have a right to and must have access to comprehensive sexuality education (CSE).This CSE must include not only human biology and HIV, but must also address puberty, sexuality, where and how to access sexual and reproductive health (SRH) services, including referral when needed, and skills development for relationships based on gender equality, respect for human rights and for diversity, and the use of critical thinking (United Nations Educational, Scientific and Cultural Organization [UNESCO], 2009).Promising interventions exist in a number of countries in Sub-Saharan Africa, across Latin America, in Pakistan and in some states of India.These programmes are provided to both boys and girls, either separately or together, recognising that fundamental improvements in the lives of girls and young women require changes in the attitudes and behaviours of boys and men that perpetuate gender inequality and power imbalances.Although 'gold standard' evaluations of the impacts of such programmes are few, a number of qualitative studies, including the examples below, suggest that interventions delivered according to the UNESCO standards increase awareness and change attitudes on gender equality and power structures, at least in the short run.Regardless of the paucity of impact assessments, every child and adolescent from the earliest possible age has a right to information and education (Office of the United Nations High Commissioner for Human Rights, 1990) about these key aspects of their lives.Examples of promising programmes include