Peer education has been popularly accepted as an important component of most sexual health promotion programmes for a wide range of audiences. The potential for peer health education (PHE) programmes to be carried out in different settings - such as schools, the military, prisons, informal neighbourhood groups, the workplace, professional and other associations (e.g., football clubs) and agerelated gatherings - reaffirms the principle that "health is created by people in the settings where they live." Despite its popularity in promoting sexual health, however, peer education programmes require an extra dose of critical analysis and some suspicion.

Planners and donors are well disposed towards PHE because peers in any given setting seem more convincing than outsiders, are more open to discussing sensitive issues such as sexuality, and are efficient advocates within the community at a lower cost. PHE programmes have trained thousands of people of all backgrounds, thus building up a critical mass for effective sexual health promotion. These new peer educators are demanding that planners be more creative. They are probably contributing to a new generation of social work and health professionals, at last unafraid of, and reconciled with, sexuality. "I served as a peer educator" becomes part of many curricula vitae.

Impact evaluation is also a concern, particularly the costeffectiveness component. The slow diffusion of information, awareness and new skills in a larger and larger circle of many social groups may make PHE so expensive that it becomes impractical. Rather than short-term impact results, ponderous process evaluations, which produce better funding, are preferred to prove the value of PHE. Long reports on user satisfaction and endless training cycles are produced to show good results and some return for the investment.

Stressing the peculiar strengths of a strategy rather than its similarities to other strategies is generally a better argument for including it in health promotion activities. Nevertheless, evaluation methods chosen for peer education are often taken uncritically from other types of interventions. Creative thinking is needed to develop monitoring and evaluation indicators for PHE. For example, if we assume that the beneficiaries of PHE programmes are not only members of the selected target groups, but also society at large, the number of activists with a background of peer education in civil society or in health promoting organizations may be developed into a useful indicator.

After funding, the most common requests from PHE programmes are for training and management support. Training methods tend to be rather traditional: residential courses with trainers facing a group of trainees. Given the spectacular turnover of peer educators and the resources needed for oneweek seminars, it is necessary to explore other forms of training that may be less labour intensive and more cost effective. Possible alternatives are distance training with regular oneonone sessions, field supervision, clusters of supervised peer educators and shifting roles between educators and supervisors.

Many facilitators and planners of PHE programmes have no background in health promotion. They are trained only in peer education and then promote PHE as the only, or best, or only feasible strategy. Moreover, sometimes peer programmes for similar audiences compete and/or offer contradictory messages. Funding requirements are one reason, but much has to do with the inadequate understanding that sexual health promotion should include a mix of wellcoordinated strategies. Nondiscrimination and respect for human rights, HIV/STD prevention, reproductive health education, sexual fulfilment, access to care and enhancing quality of life, e.g., through counselling, are each components of sexual health that build on one another. Keeping this in mind, complementarity must also be the watchword for peer health programmes so that they remain in constant dialogue with other parts of the "puzzle".