Navigating Challenges in Improving Sexual and Reproductive Health and Rights in Pakistan: The Story of Aahung

This chapter examines the journey of Aahung, a Pakistan-based NGO working since 1995 to improve sexual and reproductive health and rights (SRHR), particularly of adolescents and young people in the country. Among Aahung’s most successful efforts is incorporating Life Skills Based Education (LSBE)—a culturally acceptable term for Comprehensive Sexuality Education (CSE)—into private and public school curricula. Using Aahung’s internal reports and strategic and evaluation documents, as well as insights from discussions with its most experienced employees, this chapter explores the challenges faced and strategies deployed by the organization during the process of institutionalizing CSE into Pakistan’s education system. Operating in an environment of cultural and religious conservatism and narrowing civic spaces, Aahung has encountered many challenges in the process, including gatekeepers impeding youth’s access to SRHR, a siloing development sector, a gender-segregated environment, and difficulties in achieving scalable interventions to support adolescents and young people. The chapter follows the organization’s strategies to overcome these challenges, such as localizing CSE as well as extensive stakeholder mapping and engagement to secure buy-in at the state, institutional, and community levels while maintaining a rights-based approach to SRHR. Aahung has utilized a multipronged approach, sensitizing gatekeepers in the lives of young people while navigating backlash from right-wing political groups. The chapter’s concluding section highlights key learnings from the organization’s experience relevant to CSE implementation in similarly conservative country contexts, such as the need for innovative evidence generation and using setbacks as an opportunity for systems strengthening.