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Estimating the Impact of Sexuality Education and Mobile Health Services on Reproductive Health and Empowerment Among Adolescents in Sierra Leone for the Family Planning Impact Lab
Sponsor: Guttmacher Institute
Summary
The goal of this randomized controlled trial is to learn if comprehensive sexuality education (CSE) and access to mobile sexual and reproductive health (SRH) services in secondary schools can improve short- and long-term health, well-being, social and economic outcomes among adolescents and young people in two districts of Sierra Leone. The main questions it aims to answer are: 1. How do CSE and mobile SRH services (individually and combined) change adolescent SRHR, well-being and socioeconomic outcomes in the short term and in the longer term (over 3 years)? 2. What are the economic costs of providing CSE and mobile SRH services? 3. How cost-effective is the provision of CSE and mobile SRH services, given its potential impact on health, socioeconomic, and well-being outcomes? 4. To what extent are CSE and mobile SRH services being implemented according to the original plan and timeline? Researchers will compare schools receiving CSE and mobile SRH services to schools not receiving these services, to see if adolescent SRHR, well-being and socioeconomic outcomes are better in those schools that received the services. The trial will compare four groups of schools, each with 60 participating schools: 1. No additional services (control schools) 2. Only CSE 3. Only mobile SRH services 4. CSE and mobile SRH services The implementation of these services will be led by Marie Stopes Sierra Leone (MSSL) in collaboration with the Ministry of Education. MSSL will ensure that participating schools: * Attend teacher training on the CSE curriculum before the study starts, followed by yearly refresher training during the study * Have sufficient time allocated to CSE in the weekly school schedule * Have adequate teaching materials \& equipment to teach CSE * Have guidance counsellors in each school who will monitor the implementation of CSE * Have a designated "safe space" which adolescents can access for menstrual products and care. * Have access to mobile SRH services (provided by MSSL staff) on the school premises 3 times per school year
Official title: REACH Study: Reproductive Empowerment for Adolescents Through CAHLS and Health Services (FPIL Sierra Leone Component)
Key Details
Gender
All
Age Range
12 Years - 17 Years
Study Type
INTERVENTIONAL
Enrollment
5300
Start Date
2026-10-05
Completion Date
2029-10
Last Updated
2026-10-06
Healthy Volunteers
Yes
Conditions
Interventions
Comprehensive Sexuality Education
For junior secondary schools in the "CSE only" and "CSE+mobile SRH services" intervention arms, at baseline at the start of the school year, MSSL will train teachers who teach subjects in which CSE topics are included, using a standard teaching training curriculum to help mitigate the risk of variability in the quality of CSE implementation across schools. Teachers will then implement the CSE curriculum in their classes throughout the duration of the study. MSSL will provide yearly refresher teacher training throughout the study. In each school, guidance counselors will be tasked with monitoring implementation of the intervention. MSSL will provide all materials and equipment needed to teach CSE. Each school will create a "safe space" where students can go for menstrual hygiene and care.
Mobile SRH services
For junior secondary schools in the "Mobile SRH services only" and "CSE+mobile SRH services" intervention arms, MSSL will utilize three mobile clinical teams to provide direct, comprehensive SRHR services on-site at schools. Each team will be composed of two service providers trained to provide youth-friendly services, one data imputer, and a transport assistant. The team will visit each school once per quarter (3 times during the school year). A comprehensive range of youth-friendly SRH services, including contraceptive counseling, provision of LARC (implants and IUDs), short-term methods (pills, injectables and emergency contraception), condom promotion, STI services, and referrals to health facilities if needed, will be available to all students through the mobile visits.
Locations (1)
240 schools in Kambia and Kenema districts (confidential, cannot be disclosed)
Freetown, Sierra Leone