Photo Credit: Alexandre Bonneau-Afroto/ALIMA

Reducing Teen Pregnancy through Peer Education in Botswana

Complications during childbirth are the leading cause of death among adolescent girls (ages 15-19) in Botswana. Teen mothers who survive can still face serious long-term consequences: they may experience health problems, interrupted education, limited job prospects, and social stigma. The babies of teen mothers are also at higher risk of health issues. In Botswana and much of sub-Saharan Africa, teen pregnancy rates are about twice as high as the global average, despite efforts to curb them.

Evidence from other countries shows that certain interventions (like comprehensive sex education and youth development programs) can significantly reduce teen pregnancy. However, many of these programs are expensive or difficult to scale. Botswana has a strong school system and active youth volunteer networks, but until recently, it lacked a cost-effective, scalable approach to deliver sexual health education that truly resonates with teenagers. Cultural taboos and generational gaps often make traditional teacher-led sex ed classes less effective – students might disengage or doubt the information.

“Zones” Peer Education Program: Our grant is helping to expand Zones, a peer-led sexual health education initiative run by the NGO Youth Impact. The Zones program was inspired by a successful large-scale study in neighboring countries that found having young peer educators teach a short class led to a 40% reduction in teen pregnancy among participants. The basic idea is to make sex education more relatable: instead of an older teacher or outsider, young people just a few years older than the students (called near-peer facilitators) deliver the curriculum. They use interactive methods, share personal stories, and create a safe space for questions, which increases student engagement and trust.
By making the sessions fun and peer-led, Youth Impact ensures the message sticks. Our funding allows Youth Impact to increase the number of schools reached and refine the training and mentoring of the peer facilitators to maintain quality as they scale up.

School-Based and Integrated: The program works within Botswana’s existing school system, meaning it doesn’t require setting up new clubs or facilities. Youth Impact coordinates with secondary schools to schedule the sessions, often as part of life skills classes. The government already runs national youth volunteer schemes that enlist around 15,000 young people annually. Zones taps into this pipeline by training some of these volunteers to be the peer educators. Because these volunteers are already supported by a government budget (about $15 million for youth programs), the initiative can expand without significant new hiring costs – it’s redirecting and empowering existing human resources.

Ultra-Low Cost per Student: The cost to reach one student is only about $1.50, which is remarkably low for an educational intervention. (Many other teen pregnancy programs cost 10–50 times more per participant due to salaries for professional counselors or longer program durations.) This low unit cost is achieved by using volunteer youth and existing school time/space. It means that even with modest funding, thousands of students can be educated.
Experimentation: The program’s implementer, Youth Impact, is also committed to continuous improvement and cost reduction through data. They have a track record of testing different approaches, measuring results, and scaling up what works best. This keeps the program efficient and effective.
Tangible Impact Metrics: The program can quickly show clear outcomes, like reductions in reported pregnancies among schools where Zones is implemented, or increased contraceptive use. They also track knowledge gains and attitudes. One key metric is cost per pregnancy averted, estimated to be in the range of $490–$980, which, considering the lifelong benefits to a girl who avoids an early pregnancy (and her future children), is a very strong investment. These data points will be crucial to convince stakeholders of its value.

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