HEALTH ECONOMICS AND HIV AND AIDS RESEARCH DIVISION
Evidence for Impact in Health and HIV
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A Review of Co-curricular Sexual and Reproductive Health and HIV Programmes


The Department of Basic Education (DBE) acknowledged the need for a co-curriculum-based response for HIV prevention targeting adolescents during Life Orientation already taught in schools. HEARD was commissioned by the DBE to conduct a desktop review of Co-curricular and Peer Education Sexual Reproductive Health and HIV (SRHH) Prevention Programmes in South Africa (SA), sub-Saharan Africa (SSA). This include effective international programmes that could be used as a gold standard for SA and SSA programmes.

This was in line with strategic outcome 3 of the Department of Basic Education Integrated Strategy on HIV, STIs and TB 2012-2016 (forthcoming).

This report is currently being reviewed by the DBE. It was carried out by sourcing, categorising and synthesising desktop and systematic reviews of various co-curricular programmes informed to identify the common characteristics of effective SRHH programmes. SA and SSA programmes were compared against international best practice co-curricular SRHH programmes. It examines the number of SA and SSA programmes that were effective by these standards. The review also informed the DBE of the characteristics of SA and SSA programmes and characteristics that required improvement. 

Effective programmes shared the following characteristics: adapting the programme to the context; using peer educators and programme participants in programme development; using trained adult facilitators or educators to facilitate the programmes; basing the programme on sociological theories; having comprehensive programme objectives; and having clear behaviours the programme aimed to change.

Fourty-two programmes were included ; 26 from SA, 16 from SSA and 10 international programmes. Our results showed only a quarter of SRHH programmes were school-based, with less than 20% involving youth in programme development. Less than a third of SA programmes and about a half of SSA programmes had been evaluated. Six of the eight evaluated programmes from SA and five of the nine evaluated programmes from SSA were effective in addressing risk and protective factors and sexual behaviours. However, only two SA programmes and one SSA programme showed a positive impact on biological outcomes. There is a need for more rigorous evaluation of SRHH programmes in SA and SSA, especially regarding the use of biological outcomes. The future implementation of SA and SSA programmes needs to integrate a number of important characteristics central to effective interventions.

For more information please contact Gavin George at 

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