“My life would not be the same”: a qualitative, retrospective evaluation of the post-programme outcomes of an in-school comprehensive sexuality education programme in Madagascar

ABSTRACT

Little is known about the outcomes of in-school comprehensive sexuality education (CSE) programmes two or more years after programme completion, particularly in low-income countries. Projet Jeune Leader, a youth-founded Malagasy organisation, conducted a retrospective, qualitative evaluation of a CSE programme in Madagascar. The objective was to explore how former participants assessed the programme’s influence on their behaviours and lives. Our team conducted in-depth interviews with 34 young people (16–24 years old) who had participated in the programme when they were in middle school. We then synthesised the data using qualitative thematic analysis. Most interviewees indicated that the CSE programme positively contributed to some aspect of their transition to adulthood. Some reported safer sex practices, refraining from drug and alcohol use, and pregnancy prevention, while others reported improved relationships, and acts of leadership. While it is not clear which elements of the programme facilitated these changes, participants made recurrent references to relatable CSE educators and engaging pedagogy in their responses. These results encourage further research on the multi-faceted, and in some cases, non-health-related, outcomes of in-school CSE programmes in low-income countries. The work also provides critical youth-driven insights into CSE programme design to guide future programme planning and evaluation efforts.

KEYWORDS:

• Sexuality education
• young adolescents
• holistic approach
• retrospective evaluation
• sexual and reproductive health
• adolescent health

Acknowledgments

We thank the participants in the evaluation. Thanks also go to six middle schools in the Fianarantsoa School District for their partnership and collaboration in implementation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data from this evaluation are available upon reasonable request from the corresponding author.

Notes

1. These households had International Wealth Index (IWI) values below 70. According to the Global Data Lab, the IWI runs from 0–100, and measures the extent to which the basic material needs of households are met: a value of 100 represents satisfaction of all basic requirements for a decent life, including the possession of durables, housing quality and public services. At the other end of the scale, an IWI value of 0 signifies a complete lack of all durables, poor quality housing, and no access to basic services.

Additional information

Funding

This work was supported by the Principauté de Monaco – Direction de la Coopération Internationale and the Segal Family Foundation.