Acting on the school environment for the mental health and sexual health rights of young people in Uganda

The mental health and sexual and reproductive health of young people aged 10 to 14 are closely linked, and both are particularly vulnerable in disadvantaged environments. Girls in particular often accumulate several vulnerabilities at once: limited knowledge of their own health, gender norms that limit their ability to speak up, stigma, lack of school spaces where these topics can be addressed calmly.

In Uganda, according to a summary of studies, about one in four people have a mental health problem, including depression (21%) or anxiety (20%) (Kim et al., 2021), while the country only has around fifty psychiatrists for the whole population (The Lancet Psychiatry, 2022). On the reproductive health side, the National Demographic and Health Survey indicates that about one in four girls aged 15 to 19 has already been pregnant or given birth (UDHS, 2016). A national survey by the Ugandan Institute of Statistics also found that 95% of women and girls in the country had experienced physical or sexual abuse during their lives (UBOS, 2021).

Teachers, on the other hand, lack the tools and training to address these sensitive issues in the classroom. Since 2019, JMERC has been developing socio-emotional learning and gender equality programs in Uganda, in collaboration with the Ministry of Education and the University of Makerere, which more than 15,000 students and 1,000 teachers have been involved in.

Until now, adolescent girls' mental health and sexual and reproductive health have been treated separately in Ugandan schools. The project’s innovation is based on bringing both together in one program. It involves improving mental health and decision-making capacity in terms of SRHR for young people aged 10 to 14, by integrating emotional regulation training and SRHR education in marginalized rural areas.

The approach is based on previous initiatives and insights gained by JMERC: an initial educational tool, youth clubs that had shown interest in peer learning, and a parenting program where adolescents did not feel sufficiently involved. More so, the initial approach focused on education, yet the reality continued to indicate that the challenges facing adolescents required an intersectoral approach. The innovation has been supported since April 2025 by the World Health Organization’s human reproductive health research program, with which a joint research protocol has been developed and is being reviewed for publication in 2026.

In detail, the intersectoral program combines four sections that work together based on a curriculum and tools that combine emotional regulation and SRHR.

• Teacher-led classroom sessions
• School clubs run by students
• Discussion sessions with parents and the community
• Support for management teams

The theory tested is that the knowledge passed on to children is not sufficient if the environment around them (classroom, family, school) does not change at the same time.

During the preparation phase, the project team is conducting participatory research (discussion groups, interviews, visits to schools and communities) to adjust the program's content and implementation before any larger-scale testing.

At the end of this one-year phase, the project team aims to have:

• A school curriculum combining socio-emotional skills with sexual and reproductive health education, co-adapted with teachers, students, parents and community leaders, accompanied by a guide for teachers.
• A participatory research report documenting the factors that facilitate or hinder the program implementation in Ugandan public schools.
• A contextualized assessment framework and measurement tools, ready to be used during a future pilot project to provide objective assessment of the program's effects and its cost-effectiveness.
• A national intersectoral advisory group and first agreements with public schools.

Image: Zach Wear (Unsplash)