A systematic review of the provisions, successes, and limitations of comprehensive sexuality education in tackling teenage pregnancy, gender-based violence, sexual and reproductive health, and mental health

Abstract

This systematic review evaluated the effectiveness, successes, and shortcomings of Comprehensive Sexuality Education (CSE) in addressing adolescent health challenges, including Gender-Based Violence (GBV), Sexual and Reproductive Health (SRH), mental health, and teenage pregnancy. Based on andura's (1986) Social Cognitive Theory (SCT), the review covered studies published between 2000 and 2023, including peer-reviewed articles, reports, and grey literature. A comprehensive search strategy was employed across multiple academic databases, including PubMed, Scopus, and Google Scholar, with selection criteria focused on CSE interventions relevant to GBV, SRH, mental health, and teen pregnancy. A total of 48 studies were included through purposive sampling to ensure representation across diverse global contexts. Data collection involved an extensive literature search and systematic screening, followed by data extraction based on predefined inclusion criteria. Studies were assessed for relevance, quality, and methodological rigour. Data were synthesised using descriptive synthesis and thematic analysis. The findings revealed that CSE programs in high-income countries were highly successful in reducing teen pregnancy and GBV and improving SRH and mental health outcomes (Lindberg et al., 2018). In contrast, CSE in low- and middle-income countries faced considerable challenges, including cultural resistance, resource limitations, and insufficient integration of mental health. The study concluded that while CSE has demonstrated success in certain regions, its implementation requires a culturally and contextually tailored approach, particularly in low-income countries. Furthermore, integrating mental health education into CSE programs is essential for promoting holistic adolescent health. This review highlights the need for expanded global implementation of CSE, adapted to local contexts and supported by robust policy frameworks. Governments should integrate comprehensive sexuality education (CSE) into national curricula with dedicated funding, strengthen gender-based violence laws, incorporate mental health components, engage communities and, train educators. There is also need to conduct longitudinal research to ensure effective, equitable, and culturally sensitive implementation that promotes behavior change, reduces GBV, and improves adolescent mental health outcomes.