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The role of schools in reducing teenage pregnancy: Policies and programs that work – a narrative synthesis
Carolyne Nakhumicha Masibo
Abstract
The issue of adolescent pregnancy is still a major health and social concern, especially among the low- and middle-income population, where disparities in education, service access, and gender inequality continue to exist. Curriculum, service linkages, and institutional climate are unique opportunities in schools to impact adolescent reproductive outcomes, but often the evidence is found to be scattered across all these areas. The proposed study will utilize a structured narrative synthesis to focus on school-based policies and programs related to the decrease in teenage pregnancy or the factors that cause it, using the principles of PRISMA 2020. They were systematically searched in PubMed and ERIC on March 12, 2026, to identify English-language studies that were published in the years 2005 to 2026. They were analyzed and synthesized using thematic synthesis with thirteen studies and reviews that met the inclusion criteria. The findings fulfill a triangulation of three areas, which include comprehensive sexuality education (CSE), reproductive health service access, and school connectedness and retention. The use of skills-based CSE of high quality has been found to consistently enhance the use of contraceptives, delay sexual initiation, and reduce sexual risk behavior when compared to those in abstinence-only and information-based approaches. School-related health services promote the use of effective contraception, especially among vulnerable groups. The institutional characteristics of connectedness, attendance, and persistence of enrollment are related to decreased risk behavior and break the two-way contact between school dropout and early pregnancy. Although the direct pregnancy outcomes are less commonly measured, the proximal outcomes have shown consistent improvements, which facilitate the effectiveness of the school-based interventions. The evidence indicates that there is no one intervention that is enough. Schools are best placed to lower teen pregnancy when they have coordinated multicomponent strategies that incorporate comprehensive curricula, confidential access to services, and institutional environments that are supportive. The policy action must thus shift to being more systemic rather than focused on individual solutions, which bring together the educational, health, and retention policies.
