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The International Conference on Population and Development and related resolutions have repeatedly called on governments to provide adolescents and young people with comprehensive sexuality education (CSE). Drawing from these documents, reviews and meta-analyses of program evaluations, and situation analyses, this article summarizes the elements, effectiveness, quality, and country-level coverage of CSE. Throughout, it highlights the matter of a gender and rights perspective in CSE. It presents the policy and evidence-based rationales for emphasizing gender, power, and rights within programs—including citing an analysis finding that such an approach has a greater likelihood of reducing rates of sexually transmitted infections and unintended pregnancy—and notes a recent shift toward this approach. It discusses the logic of an "empowerment approach to CSE" that seeks to empower young people—especially girls and other marginalized young people—to see themselves and others as equal members in their relationships, able to protect their own health, and as individuals capable of engaging as active participants in society.

Globally, gender norms and power differentials profoundly affect both girls' and boys' sexual attitudes, practices and health. One avenue for enabling young people to reflect on traditional gender arrangements that endanger their health-and to lay the groundwork for satisfying sexual lives-is sexuality and relationships education (SRE). Unfortunately, many SRE programmes address gender norms and critical thinking skills either superficially or not at all. Moreover, in some developing countries, SRE programmes do not reach the majority of girls aged 15-19, a high proportion of whom are simply not in school. This paper argues for grounding SRE within a social studies framework, emphasizing gender and social context. Such an approach can foster critical thinking skills, can provide a foundation for subsequent lessons on explicitly sexual topics, can illuminate the links between gender inequality and other social issues, can allow for a human-rights emphasis that may prove politically less controversial than technical sexuality topics, and may ultimately prove vital to achieving better sexual health outcomes. The experience of community-based programmes provides lessons for designing and evaluating such approaches in schools.

While insufficient to meet the vast needs, billions of dollars are being invested in girls' education advocacy, program, and policy solutions around the world. At the same time, hundreds of millions are invested in research about what works in education. And yet, the policies and approaches that are pursued often don't line up with what researchers find is effective. The result is that governments, international organizations, and NGOs are too often investing scarce resources in policies or interventions without knowing whether they work. In partnership with Echidna Giving, the GIRL Center at the Population Council developed the Evidence for Gender and Education Resource (EGER), an interactive online database that practitioners, researchers, donors, and decisionmakers can use to drive better results for girls, boys, and communities around the world. EGER addresses how to ensure that limited resources are invested in the most effective solutions to achieve gender equality in education. The resulting data provide valuable insights into gaps and opportunities for the global girls' education field, and this report shares those insights.

While insufficient to meet the vast needs, billions of dollars are being invested in girls' education advocacy, program, and policy solutions around the world. At the same time, hundreds of millions are invested in research about what works in education. And yet, the policies and approaches that are pursued often don't line up with what researchers find is effective. The result is that governments, international organizations, and NGOs are too often investing scarce resources in policies or interventions without knowing whether they work. As noted in this report summary, the Girls' Education Roadmap shares insights derived from data in the Evidence for Gender and Education Resource (EGER). The report reviews thousands of studies and assesses hundreds of organizations to figure out who's doing what, what's working where, and what are the biggest needs facing girls. The goals were to make sure governments, NGOs, and donors are investing in what works and to make sure researchers are focusing on answering the most urgent questions for the field.

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for improving the reporting of circumcision status, including a) a detailed verbal description of male circumcision, b) an illustration of a circumcised and an uncircumcised penis, and c) computerized self-interviewing technology.

The standard diagnostic tools to identify sexually transmitted infections are often expensive and have laboratory and infrastructure requirements that make them unavailable to family planning and primary health‐care clinics in developing countries. Therefore, inexpensive, accessible tools that rely on symptoms, signs, and/or risk factors have been developed to identify and treat reproductive tract infections without the need for laboratory diagnostics. Studies were reviewed that used standard diagnostic tests to identify gonorrhea and cervical chlamydial infection among women and that provided adequate information about the usefulness of the tools for screening. Aggregation of the studies' results suggest that risk factors, algorithms, and risk scoring for syndromic management are poor indicators of gonorrhea and chlamydial infection in samples of both low and high prevalence and, consequently, are not effective mechanisms with which to identify or manage these conditions. The development and evaluation of other approaches to identify gonorrhea and chlamydial infections, including inexpensive and simple laboratory screening tools, periodic universal treatment, and other alternatives must be given priority.

The Population Council, in partnership with Child In Need Institute in Kolkata, Deepak Charitable Trust in Vadodara, and International Institute for Population Sciences, Mumbai, initiated the First-time Parents Project in India to develop and test an integrated package of health and social interventions to improve married young women's reproductive and sexual health knowledge and practices, enhance their ability to act in their own interest, and expand their social support networks. The project was formulated on the hypothesis that the periods immediately following marriage and surrounding the first pregnancy and birth offer a unique and powerful entry point for improving the situation of married young women. Findings indicate that the intervention had a significant, positive net effect on most indicators reflecting married young women's autonomy, social support networks, partner communication, and knowledge of sexual and reproductive health. However, the net effect of exposure to the intervention was mixed with regard to indicators related to gender role attitudes and attitudes toward domestic violence, as well as reproductive health practices. The experience of the intervention demonstrates that it is feasible to improve married young women's reproductive health knowledge and practices, expand their sources of social support, and involve them in activities with peers in safe spaces outside the home, and through the process empower them in their marital and familial relationships. The report suggests that this model could also be integrated into existing NGO or government services, and could be tested for implementation on a larger scale.

This issue of Quality/Calidad/Qualité focuses on two traditional family planning programs that undertook projects to help women enlarge their zone of influence in both the private and public spheres. The first case study focuses on the Belize Family Life Association (BFLA), a nongovernmental organization in a small Caribbean country. The second case study recounts the experience of the Pakistani government, which has an enormous, but entrenched, target-oriented family planning program. Both programs began by recognizing that women's lack of social power is a major obstacle to their being able to protect their own health. Both trained village workers to regard themselves in a different light, and to help other women enlarge their zone of influence both at home and within the provider system. And both included senior managers and policymakers in the training process, together with village workers.

AbstractIntroductionExperiences of violence during youth contravene young people's rights and increase the risk of depression and poor human immunodeficiency virus (HIV) care outcomes among youth living with HIV (YLWH). Intervention targets for mitigating the negative psychosocial effects of violence are needed, particularly in areas like rural South Africa where violence remains pervasive and mental healthcare is limited. This study aims to quantify the associations between physical and sexual violence and depressive symptoms in YLWH in rural South Africa and explore the modification of these associations by key measures of psychosocial well‐being.MethodsWe conducted a cross‐sectional survey among 362 YLWH ages 12 to 24 in rural South Africa to ascertain participants' history of physical and sexual violence, current depressive symptoms (Center for Epidemiological Studies‐Depression Scale) and levels of social support (Medical Outcomes Social Support Scale), resilience (Conner‐Davidson Resilience Scale) and self‐esteem (Rosenberg Self‐Esteem Scale). Log‐binomial regression was used to estimate the association between history of physical or sexual violence and clinically meaningful depressive symptoms (scores 16). Effect measure modification by high versus low resilience, social support and self‐esteem was assessed using likelihood ratio tests (α = 0.20).ResultsA total of 334 individuals with a median age of 21 (interquartile range: 16 to 23) were included in this analysis. Most participants were female (71.3%), single (81.4%) and attending school (53.0%). Ninety‐four participants (28.1%) reported a history of physical or sexual violence and 92 individuals (27.5%) had clinically meaningful depressive symptoms. Meaningful depressive symptoms were significantly higher among participants with a history of physical or sexual violence as compared to those with no history of violence (adjusted prevalence ratio: 2.01; 95% CI: 1.43, 2.83). However, this association was significantly modified by social support (p = 0.04) and self‐esteem (p = 0.02).ConclusionsIn this setting, the prevalence of meaningful depressive symptoms was significantly higher among YLWH with a history of physical or sexual violence as compared to those without a history of violence. However, higher levels of self‐esteem or social support appeared to mitigate this association. Programmes to improve self‐esteem and social support for youth have the potential to minimize depressive symptoms in YLWH who have experienced physical or sexual violence.

The social and economic consequences of the COVID-19 pandemic in Mexico are poised to have long-lasting and significant impact on adolescents and young adults. To inform government agency strategies and public policies related to youth in Mexico, the Population Council in Mexico, as part of the COVID-19 study team, is implementing a nationwide longitudinal cohort study. The study utilizes online surveys to reach adolescents and young adults between 15 and 24 years of age. The aim of the study is to understand the impact of the COVID-19 pandemic on the experience and perception of violence among this population, as well as its impact on other social, economic, and health outcomes related to violence. Gathering information about the unintended impacts of social distancing measures on different dimensions of adolescents' and young adults' lives and including their voices in the existing body of evidence will provide descriptive data about the on-going situation for adolescents and young adults during the pandemic. Data from this study can also be used by policy makers and practitioners to design and implement policies and interventions to reduce long-term negative health, social, and economic consequences of the pandemic for this critically important population, as well as to help design recovery policies. We are committed to openly sharing the latest versions of the study description, questionnaires, datasets, and preliminary results.