Education for health and well-being in Southern Africa



A good quality education is the foundation of health and well-being. For young people to lead healthy and productive lives, they need knowledge to prevent sickness and disease. For children and adolescents to learn, they need to be well nourished and healthy. Statistics from UNESCO’s Global Education Monitoring Report show that the attainment of higher levels of education among mothers improves children’s nutrition and vaccination rates, while reducing preventable child deaths, maternal mortality and HIV.

Education is a catalyst for development and a health intervention in its own right. The 2015 Incheon Declaration confirms that education develops the skills, values and attitudes that enable citizens to lead healthy and fulfilled lives, make informed decisions, and respond to local and global challenges.

UNESCO’s goal is to support the contribution of national education sectors to ending AIDS and promoting better health and well-being for all children and young people. The Organization is committed to strengthening the links between education and health, reflecting growing international recognition that a more comprehensive approach to school health and coordinated action across sectors is needed.

The HIV epidemic is not over and Southern Africa remains the epicenter of the global HIV epidemic. As outlined in UNESCO’s 2016 Strategy on Education for Health and Well-Being, those aged 15-24 account for 16 per cent of the global population, but represent 34 per cent of people in the age group 15-49 years acquiring HIV each year. In many settings, new HIV infections among adolescent girls and young women are substantially higher than among males of the same age. Girls and women are also disproportionally affected by gender inequality, which further limits their access to education and health information and services. AIDS is also the leading cause of death in adolescents aged 10-19 years in sub-Saharan Africa and the second leading cause of death in adolescents globally. All the 9 countries under UNESCO ROSA (Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe) remain priority countries for the HIV response as per UNAIDS classification[2], and all of them have adult HIV prevalence rates of over 10 per cent[3].

Good quality comprehensive sexuality education remains a critical intervention in efforts to end AIDS as a public health threat, and promotes gender equality and healthy relationships. UNESCO plays a critical role in advising education and health sector decision-makers on comprehensive sexuality education programmes. UNESCO, in collaboration with UNAIDS, UNFPA, UNICEF, UN Women and WHO has just published the revised International Technical Guidance on Sexuality Education  (English, French, Portuguese, Portuguese). Close to 10 years after its first edition, the updated International Technical Guidance on Sexuality Education provides guidance for quality comprehensive sexuality education to promote health and well-being, respect for human rights and gender equality, and empowers children and young people to lead healthy, safe and productive lives. The Technical Guidance is designed to assist education policy makers in all countries design accurate and age-appropriate curricula for children and young people aged 5 – 18+.

Based on a review of the current status of sexuality education around the world and drawing on best practices in the various regions, the Guidance notably demonstrates that sexuality education:


  • helps young people become more responsible in their attitude and behaviour regarding sexual and reproductive health
  • is essential to combat the school dropout of girls due to early or forced marriage, teenage pregnancy and sexual and reproductive health issues
  • is necessary because in some parts of the world, two out of three girls reported having no idea of what was happening to them when they began menstruating and pregnancy and childbirth complications are the second cause of death among 15 to 19-year olds
  • does not increase sexual activity, sexual risk-taking behaviour, or STI/HIV infection rates. It also presents evidence showing that abstinence-only programmes fail to prevent early sexual initiation, or reduce the frequency of sex and number of partners among the young.

A global team of health and education specialists work in UNESCO offices across the world, including Eastern and Southern Africa, Western and Central Africa, Latin America and the Caribbean, Asia Pacific, Eastern Europe and Asia. These specialists support the scale-up and implementation of CSE, in partnership with governments, bilateral partners, civil society organizations and young people.

UNESCO’s strategy on Education for Health and Well-being, provides the overarching framework for concerted action by UNESCO and its partners at regional and country levels during 2016-2021. While the strategy reflects UNESCO’s continued commitment to HIV, it also reflects the shift towards situating HIV within the framework of Comprehensive Sexuality Education (CSE). Furthermore, UNESCO recognises that the education sector cannot achieve better health and well-being alone and thus will also support education sector collaboration with other sectors and with the health sector in particular. UNESCO will continue to engage political leaders and the Regional Economic Communities, especially Southern Africa Development Community (SADC) to sustain the response and provide a platform for collaboration and accountability.

The overarching goal of the new strategy for Education for Health and Well-being is to improve health, well-being and education outcomes for all children and young people through:


  • Ensuring that all children and young people benefit from good quality comprehensive sexuality education
  • Ensuring that all children and young people develop the knowledge attitudes and skills needed to lead healthy lives
  • Ensuring that all children and young people have access to safe, inclusive and supportive school environments

Regional Intervention


Through UNESCO, 89 092 in-service teachers and 68 042 student teachers have been trained on CSE using in –person and online CSE training programmes. Teacher training is not only aimed at increasing the knowledge and skills of teachers, but also at challenging gender and social norms. By the end of the training, teachers have increased knowledge and confidence to deliver CSE, but also walk away with transformed attitudes and values on CSE, gender, sexuality and SRHR needs and aspirations of children and young people. 



UNESCO’s support has also reached 40 410 schools with an anticipated reach of 13 724 227 learners in the region. CSE contributes to achieving sustained reductions in new HIV infections and early and unintended pregnancies, the elimination of gender-based violence, including in schools, and the elimination of child marriage. Sexuality education when effectively delivered, equips young people to make healthier decisions and better life choices and allows them to stay in school longer, develop healthier relationships with others and become responsible citizens able to contribute to the development of their countries.



Upstream, UNESCO has been supporting governments to put in place national policy and frameworks that provide an enabling environment for the implementation of CSE. To this end, all 21 countries in the ESA region have national policy commitments in place, and have been crucial in the efforts to reach learners and teachers alike. The landmark ESA Ministerial commitment has proved to be a powerful vehicle for securing and sustaining high level political commitment from governments, and its implementation at country level has succeeded in mobilising critical stakeholders working for children and young people.

In July 2016, UNESCO convened a high-level government dialogue to mark progress made since the endorsement of the landmark 2013 ESA Commitment (link is external) which saw 20 Eastern and Southern Africa (ESA) countries commit to scaling-up comprehensive sexuality education and sexual and reproductive health services for young people (additional resources here (link is external))

The event, Fulfilling Our Promise To Young People Today, was held on the sidelines of the 2016 AIDS Conference (link is external) in Durban, South Africa (18-22 July, 2016), and brought together Ministers and representatives from government, development, and civil society from across Eastern and Southern Africa. The event saw the launch of the 2013-2015 Progress Review on the ESA Commitment (English(link is external), French(link is external), Portuguese(link is external)).


Our Rights, Our lives, Our future programme

UNESCO through the generous support of the governments of Sweden and Ireland, will be implementing the Our Rights, Our Lives, Our Future (O3) Programme (2018-2020). The programme seeks to support the delivery of good quality CSE that empowers adolescents and young people, and builds agency while developing the skills, knowledge, attitudes and competencies required for preventing HIV, reducing early and unintended pregnancies and eliminating gender based violence. With a coverage of 31 countries, the O3 Programme is expected to reach 30 million people (parents, guardians, religious leaders, and young people out of school) through community engagement activities and 10 million young people through new and social media platforms. [7]


[1] UNAIDS Strategy 2016-2021 

[2] Priority countries - Angola, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Swaziland, South Africa, South Sudan, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe. 

[3] Getting to Zero: HIV in Eastern and Southern Africa. UNAIDS, 2013.  


[5] ESA Ministerial Commitment

[6] KPMG End Term Evaluation Report (2016)

[7] Our Rights, Our Lives, Our Future (O3) Programme



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