Since 1998, the GTZ Reproductive Health Project has been active in the Tanga and Lindi regions of Tanzania. In 1999, a combined quantitative and qualitative study was done to assess adolescents' knowledge, attitudes and behaviours regarding reproductive health and HIV/AIDS. The study showed low levels of sexual health knowledge, in an adolescent population in which 65% of all boys and 35% of girls was sexually active. For example, only a minority knew that one-time sex can lead to pregnancy; or that a healthy looking person can carry HIV. 28% of the sexually active girls indicated they were forced when they had sex for the first time. In order to fill this gap between knowledge and sexual practice and enable adolescents to make informed choices, it was decided to develop youth-friendly education materials, with basic facts about human physiology and reproduction, sexuality, prevention of unwanted pregnancies and HIV/STIs, as well as about partnership and communication between partners.

Developing sex education materials

Young people were actively involved throughout a 7-stage process of developing educational materials tailored to adolescents' needs. Based on the most frequently asked questions adolescents (12-20 years old) had on a range of sexual and reproductive health issues, a multidisciplinary team of specialists together with youth peer educators developed the first drafts of six "question-and-answer" booklets, considered more appropriate than one book. Though the booklets target literate adolescents – 12-20 years old – the short and easy-to-read materials can be used even in non-reading settings. The booklets were enlivened with a mix of scientific illustrations, photos and cartoons: a good layout is crucial to attract young people. A final draft was reviewed by a number of experts, including eight adolescent peer educators. The booklets were produced in Kiswahili and translated into English for use in East and Southern Africa. The entire production process took seven months. From the beginning, it was decided not to seek official approval for publication from the Ministries of Education or Health, because the booklets were meant for extracurricular or out-of-school use, and because it was feared this could lead to a lengthy process of years.

Distributing the booklets – lessons learned

The booklets were sent to all GTZ partner organisations in Tanzania working with youth. Instead of systematically distributing the booklets for free in schools, youth clubs and other institutions, the dissemination strategy is to widely publicise them, but make them available on request only: an active request shows genuine interest and commitment. Small numbers of copies are offered free of charge; for larger quantities (more than 10 copies) the booklets are offered at cost price (US$ 1.- per set of six booklets). The booklets will also be publicised in newspapers and a TV programme for youth will use them in group discussions.

Four months after the series was first launched, many organisations and individuals have requested copies (70,000 distributed so far) and given their comments. Educators say they feel more comfortable to answer young people's questions, while parents like to read the booklets in order to prepare themselves. Government officials of different Ministries have given very positive feedback and have requested them for their staff, and even their own families. However, no official decision has been taken so far to introduce them into schools.

This experience has shown that actively involving youth in the development of education materials is a good way to reach young people and have an impact on their attitudes and behaviour. On the other hand, one has to be strategic about government involvement in sexual education, as leading civil servants are often conservative and not keen to take a risk. Putting a product on the market and offering it to other partners for common reprints allows large-scale distribution far beyond a project's capacity and strengthens sustainability.