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Asking the Right Questions. Existing evidence and the research agenda for youth peer education in SRH programming

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Peer education is an umbrella term used to refer to a multitude of interventions, some of which are standalone and others which are integrated into wider programming, including for sexual and reproductive health (SRH). It is not a new intervention but, rather, has been utilised for decades as a way of reaching under-served groups, including young people, with information on their health and rights.

Given the prolific use of peer education globally, the dearth of peer reviewed literature on its effectiveness is surprising, as is the tendency to focus primarily on public health outcomes relating to knowledge, attitudinal and behavioural change. In these regards, the peer reviewed literature on peer education presents mixed results; some studies indicate that it can effect statistically significant changes in knowledge, attitudes and behaviour, whilst others do not (see Tolli et al 2012 and Siddiqui et al 2020). Whilst mixed results are expected across diverse contexts, there is little complementary evidence on the conditions that have either facilitated or inhibited those results. At the same time, there is recognition in the literature that myriad variables have the potential to impact on the success of peer education programming, including: recruitment, quality of training, curriculum, resources, support, feedback, and compensation provided to peer educators as well as the frequency of sessions they provide for other young people.

The absence of clear guidance from the peer reviewed literature stands in contrast to the overwhelming consensus amongst young people, non-governmental organisations (NGOs) and funders that believe wholeheartedly in the merits of the approach and continue to integrate it into rights-based SRH programming for young people across the world. Implementing organisations and individuals tend to measure the effectiveness of peer education more broadly, going beyond health outcomes to positive youth development, empowerment and, in some instances, gender outcomes. Their experiences, expertise and evaluations remain untapped.

Amongst those who seek to promote the rights and health of young people, there is a growing commitment to generating further evidence and understanding about how peer education contributes to SRH programming, including in ways hitherto unmeasured. This study, funded by the Get Up, Speak Out for Youth Rights! (GUSO) programme, attempts to balance out the current narrative by centering the voices of those who have first-hand experience designing, managing and implementing peer education – including peer educators themselves. Tapping into the expertise of those who have lived experiences, this study examines the parameters of peer education; models of integration in SRH programming; the expected and achieved outcomes of peer education; the quality of design of peer education programmatic components, including training, support and compensation; and the research needs of organisations and activists across the globe. In addition to balancing out the narrative in these respects, the study draws out the research and evaluation needs that still exist within the SRH sector.