It is a hardy perennial of the university environment that normative consensus around large global issues such as sexual and reproductive health and rights (SRHR) is easier to secure than the programmatic requisites. Thus, in principle, tertiary education students are included in international SRHR-related declarations and domestic policies pertaining to the education and health sectors; in practice, there is often a lack of programmatic and policy attention at institutional level, as well as a marked knowledge gap over the status of student’s sexual and reproductive health (SRH) needs. This research was commissioned by the United Nations Educational, Scientific and Cultural Organization (UNESCO) to provide a situational analysis of the status of sexuality education and availability of SRH services within the tertiary sector in the Southern African Development Community (SADC) region. While there has been substantial mobilization around comprehensive sexuality education (CSE) and services in schools in this region, as yet little attention has been paid to the status of sexuality education provision within higher and tertiary education institutions (HTEIs). Further, little is known about how and what role tertiary education institutes can/or should play in mediating student SRH vulnerability and needs. SRHR encompass the right of all individuals to make decisions about their sexual activity and reproduction free from discrimination, coercion and violence, and to achieve the highest attainable standard of sexual health. Access to SRH services allows individuals to choose whether, when and with whom to engage in sexual activity; to choose whether and when to have children; and to have access to the information and means to make those choices. Protecting the SRHR of all individuals not only saves lives and empowers people, but it can also lead to significant economic gains for individuals, families, and nations. It has been shown to reduce health care costs, improve productivity, and increase rates of education which lead to greater economic growth. However, universal access to SRHR is still not fully realized in many parts of the world, despite the potential benefit to well-being and empowerment of certain communities – particularly young women and vulnerable groups. This report provides an analysis of the status of sexuality education and SRH service provision in HTEIs in two case study countries: Tanzania and Zimbabwe. The report is based on a desk review of existing literature related to student SRH and HTEIs and on in-depth country studies conducted in both countries. The country studies consisted of an analysis of in-country interviews with a broad range of key stakeholders, student perspectives obtained through an online survey, and focus group discussions (FGDs) among students enrolled in HTEIs. This report examines student SRHR needs, concerns and outcomes, as well as policy and institutional responses.