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This chapter explores school-based pregnancy prevention practices and programs currently in use in schools across the nation. It identifies programs and program components that have been evaluated and demonstrated to be effective in modifying adolescent sexual behavior and preventing adolescent pregnancy. It provides guidance for assessing program goodness-of-fit to the needs and values of the local school and community, and for planning and carrying out programs demonstrated effective in school settings. A bibliography of resources provides program specifics and contact information for locating programs that have been demonstrated to be effective.

Once pregnant, nearly all women enter into prenatal care, so that the course of the pregnancy can be monitored and complications managed. At the time of entry there is a baseline examination and completion of a medical history, including sociodemographic characteristics (age, race/ethnicity), a family and individual medical history and reproductive history, and measurements of height and weight. In addition to examination for pathology and tests for pre-existing conditions, prenatal examinations throughout the rest of pregnancy almost always entail additional measurement of maternal weight, as a global indicator of nutritional status. This chapter addresses a number of areas of concern in these areas, such as the impact of the timing of entry to prenatal care, weight status, gestational weight gain, and maternal obesity, and pregnancy at the extremes of maternal age, all of which have long been the subject of epidemiologic investigation and surveillance.

This chapter reviews programmes related to the sexual and reproductive health of young people,and assesses the extent to which their needs have been met. It highlights that access to quality schooling and marketable skills are restricted, especially for girls.Sexual and reproductive health is characterized by early and unsafe entry into sexual life and childbearing, unwanted pregnancy and infection, unmet need for contraception, and unwanted or coercive sexual activity.Gender gaps persist, and rural, less educated, socially excluded and poor youth are particularly disadvantaged.Challenges include, at the individual level, limited awareness of health promoting behaviours, compromised care-seeking, and limited femaleagency; at the parent and community level, lack ofparent-child communication, and lack of a supportive environment; at the programme level, insufficient investments in the young, poorly implemented programmes to build awareness, compromisedprovision of counselling and services; and generally, limitedinter-sectoral coordination.

Chapter 6 examines the power relations underlying NGOs’ uneven negotiations of the Girl Effect. For insight into the nature of these dynamics, this chapter considers the conditions that enabled one NGO to theorize and act beyond the terms of the Nike Foundation’s power/knowledge/capital regime while another NGO was constrained by them. It focuses on the material and nonmaterial resources the NGOs mobilized, including expertise and authority, education and training, and administrative and financial independence, as well as time and space, and it examines the boundaries of possibility that resulted from a curricular, pedagogical, and relational perspective.

This chapter explores issues of reproductive justice and economic security in relation to gender equality and human flourishing. More specifically, it considers abortion and adolescent pregnancy, along with the reasons behind the inadequate access to birth control information and services. The discussion begins by looking at the Supreme Court’s landmark decision in the 1973 case Roe v. Wade regarding a woman’s right to terminate her pregnancy. The chapter then looks at the rise of anti-abortion activism in America; the sanctions imposed on pregnant women for drug and alcohol use, especially low-income women of color; the issue of women’s right to contraceptives; and Social Security for women. Finally, it examines poverty and how the inadequate safety net keeps many women trapped in violent relationships.

I first heard of the concept of community schools in 1987 while attending a briefing on a community assessment of the Washington Heights/Inwood neighborhood. The survey had been conducted to help The Children’s Aid Society (CAS) determine what levels of services were needed in the community and whether it made sense for the agency to provide them. At this presentation I was immediately struck by the idea of working in a deep partnership with a public school to improve outcomes for children and their families; this concept of community schools seemed so simple, so fundamental, yet at the same time so powerful that I thought, How could anyone be against this? Armed with this belief, I arrived at Intermediate School (IS) 218 in the summer of 1992 as the community school director of CAS’s first community school. Little did I know that my first full year as director would prove to be the most difficult, overwhelming, and at times downright humbling experience in my career. Having survived those first few years, I now have the luxury of looking back and pinpointing some of the challenges—and there were many. First and foremost, CAS and the school knew that we needed somehow to put into practice the concept of collaboration and partnership, but no one understood what that involved. We all soon realized that we were defining what it meant to be a community school as we went along. Another issue I faced was my relationship with the principal. How was I supposed to interact with him? Was he my boss? Did he have a final say on matters? Who was in charge? And what would happen when we disagreed? Still another challenge was posed by the multiple constituents in the school, from the custodian to the school safety officers, from kitchen personnel to the teachers, students, and their parents. What was my role with respect to them, and what credibility and authority did I have in dealing with all these different groups? In other words, who was I, and why should any of them listen to me? While trying to cope with these questions, I also had to ensure the successful delivery of services to virtually the entire student population (approximately 1,400 students), their families, and neighborhood residents.