Building Support for Adolescent Sexuality and Reproductive Health Education and Responding to Resistance in Conservative Contexts: Cases From Pakistan

Pakistan has long been a challenging setting for the promotion of adolescent sexual and reproductive health (SRH). As in many other countries worldwide, there is little acknowledgment that adolescents have sex, whether consensual or coerced, before marriage and many believe that exposure to sexuality education will incite unwanted behavior. Furthermore, despite the fact that many adolescent girls marry early, there is also little acknowledgment that adolescents need to be proactively prepared to meet their SRH needs and promote their well-being.

Two NGOs in Pakistan– Aahung and Rutgers Pakistan (the Pakistani chapter of Rutgers)– have developed effective strategies to support adolescents’ knowledge and understanding of SRH, and in some cases empowerment, in this context. Working around the social and religious barriers to sexuality education, Aahung and Rutgers Pakistan have skillfully crafted and implemented large-scale sexuality education programs in Pakistan, collectively reaching more than 500,000 students.

While there are numerous descriptions of projects and programs on sexuality education, there is a lack of research and discussion on successful strategies to create support for and overcome resistance to its implementation in schools and communities. The landmarked 1994 International Conference on Population and Development called on countries to educate young people about SRH using age-appropriate and context-specific content and strategies. However, since this call, organized resistance and misconceptions about sexuality education have challenged efforts. A 2014 report from the United Nations Educational, Scientific and Cultural Organization (UNESCO) noted that there are few examples of scaled-up and sustained programs on these issues. The growing body of evidence on the scale-up of sexuality education programs has noted resistance as a challenge, but it has not provided a detailed discussion of the nature of resistance or strategies to overcome them.