Adolescents in much of sub-Saharan Africa, including Zambia, encounter substantial sexual and reproductive health challenges, which include higher HIV infection rates and in and out of school unintended pregnancy, often with outcomes that compromise their ability to fully realize their potential and participate in national development. In Zambia, overall, 29% of girls have begun childbearing. Six percent of girls have already begun childbearing at age 15, but the proportion of having children increases rapidly with age, reaching 53% among girls aged 19 (ZDHS, 2018). Of those in school in 2019, 15,724 girls were pregnant and only 56% (8,827) were readmitted in schools (ESB, 2019). Complementing high rates of pregnancy is data showing that one third of Zambian women marry as children; 31% of women aged 20-24 reported marriage before their eighteenth birthday (ZDHS, 2018), and it is estimated that 4.8% and 4.1% of adolescent girls and boys aged 15-19, respectively, are living with HIV. This prevalence estimate is four times higher among young women aged 20-24 (8.6%) compared to men of the same age (2.1%). For many school-going young women, early marriage and pregnancy signal the end of educational pursuits, and curtailed prospects for career choices. While educational policies in place permit pregnant girls to return to school following maternity leave, approximately half of new adolescent mothers will withdraw from school permanently. Young women, especially adolescents, also bear a disproportionately higher burden of disability, illness and deaths associated with sexuality and reproduction, as compared with their male counterparts.
In response to these multiple and overlapping challenges, the Government of the Republic of Zambia (GRZ), has been working with partners, including UNESCO, UNFPA and the Population Council, to define solutions that are underpinned by a strong research evidence base, on what works. The Population Council, with support from UNESCO and UNFPA, in collaboration with Ministries of Health and General Education, convened a virtual symposium with some partners, to share progress from implementation science research to link CSE and access to SRH information and services in selected schools and health facilities.