While this review provides

While this review provides important behavioural data, other kinds of evaluation focus are suggested by others. For
example, some researchers argue for more research to increase understanding of outcomes for teachers in relation
to their own knowledge, attitudes, skills and behaviour.51
Proponents of a ‘social studies’ approach to sex education argue that they would seek to infl uence a wider range
of outcome measures than those included in standard programme evaluations. For example, changes might be
measured in relation to specifi c attitudes and behaviours related to gender equality and human rights such as
gendered leadership in school activities; girls’ participation in sports; age at marriage; attitudes regarding male and
female roles in the sexual, domestic and economic spheres; and prevalence of or attitudes toward gender-based
violence, sexual harassment, homophobic bullying and harmful practices. Similarly, measuring the effectiveness of
programmes that seek to tackle vulnerability would require different focus and methods of evaluation.
Others challenge altogether the relevance of randomised controlled trials and other experimental methods for the
evaluation of sex and relationship education programmes, arguing that what are needed are well-designed longitudinal
and cross-sectional studies that shed light upon the ways in which people actively engage with sexual health
education and that capture and describe social change.52
A different kind of challenge to evaluation is posed by those53 who argue that the domination of public health
outcomes renders invisible other aspects that also warrant attention, in particular, the role of pleasure in sexual
development and relations. Acknowledging that, in most cultures, it may be unacceptable to teach young people
how to achieve sexual pleasure, nonetheless there are indications from richer and poorer countries that public
health outcomes may benefi t from greater acceptance of positive sexual experiences. Few programmes appear to
consider or take seriously issues of sexual pleasure, intimacy and reciprocity.