Comprehensive sexuality education is an essential part of a good quality education that improves reproductive health and contributes to gender equality, argues Facing the Facts, a new policy paper by the Global Education Monitoring (GEM) Report at UNESCO that seeks to dispel social and political resistance to sexuality education in many countries.
Globally, each year, 15 million girls marry before the age of 18, some 16 million 15-19 year olds and one million girls under 15 give birth. Young people moreover account for a third of new HIV infections among adults and across 37 low and middle-income countries, yet only approximately one third of people aged 15-24 years have comprehensive knowledge of HIV prevention and transmission.
“It’s time to face the facts,” argues Director of the GEM Report, Manos Antoninis, “More than one in ten births are among girls between 15 and 19 years old. This not only spells the end of their education, but is often fatal, with pregnancy and childbirth the leading cause of death among this age group.”
The new policy paper presents the evidence of the benefits of age-appropriate comprehensive sexuality education. Even children at the age of five need to understand basic facts about their body, think about family and social relationships and recognize inappropriate behaviour and identify abuse. Otherwise, many will grow up with inaccurate beliefs, like roughly half the girls in the Islamic Republic of Iran, who believe menstruation to be a disease and 82% of girls in Malawi, who know nothing about menstruation before experiencing it themselves.
Children and young people should receive comprehensive sexuality education before they become sexually active. This helps them protect themselves from unwanted pregnancy, HIV and other sexually transmitted infections, and promotes values of tolerance, mutual respect and non-violence in relationships.
Nevertheless, vocal resistance to comprehensive sexuality education by some groups in a number of countries has been rising. In Uganda, a public backlash led the Ministry of Education to withdraw the national sexuality education curriculum, which was subsequently revised.
Antoninis continued: “Comprehensive sexuality education is part and parcel of a good quality education, the achievement of good health outcomes and progress towards gender equality. Yet in many parts of the world, opposition to comprehensive sexuality education has not only halted progress in sexual and reproductive health and rights, but reversed it.”
Introducing comprehensive sexuality education in the curriculum is insufficient without adequate teacher training to bolster instructors’ motivation and confidence in addressing the full range of topics concerned. In Kenya, a study of 78 public and private secondary schools showed that while 75% of teachers reported teaching all topics of a comprehensive sexuality education programme, only 2% of students reported learning them all. Only 20% learned about types of contraception and even fewer learned how to use and where to get them. In some cases, incomplete and sometimes inaccurate information was taught. Almost 60% of teachers incorrectly taught that condoms alone were not effective in pregnancy prevention. Moreover, 71% of teachers emphasized abstinence as the best or only method for preventing pregnancy and sexually transmitted infections, and most depicted sex as dangerous or immoral for young people. Namibia has tackled this by creating scripted lesson plans for teachers, while Tanzania has created online resources that teachers can turn to when in doubt.
Another problem for teachers may be a lack of lesson plans or teaching materials that are gender and human rights sensitive and reflect contemporary realities. In Ghana, Guatemala and Peru, around three-quarters of teachers reported a lack of lesson plans, learning activities and other teaching materials. Indeed, curriculum content is found to be the weak point of comprehensive sexuality education in many African countries.
Data collection on comprehensive sexuality education is also a challenge. There is now one simple question on the number of schools providing life-skills based HIV and sexuality education being used in 165 countries since 2017. Ten eastern and southern African countries, for example, have integrated such questions into their annual school census questionnaire. However, progress is not consistent across the board: recent analysis from the United Republic of Tanzania suggests that school heads are not being oriented on how to collect the data and report back.
The paper has six key recommendations for countries
1. Invest in teacher education and support,
2. Make curricula relevant and evidence-based,
3. Develop monitoring and evaluation mechanisms and ensure implementation,
4. Work with other sectors to bring about real change, notably with the health sector to link schools with health services and leverage funds,
5. Engage with community and parent organizations to overcome resistance that is not based on facts.