Advancing Comprehensive Sexuality Education: Strategies for effective implementation

Last month, to mark the International Day of Education, members of the Gender Equality Working Group (GEWG) engaged in a meaningful conversation on the intersections between sexual and reproductive health and rights (SRHR) and education and the challenges of access to and implementation of Comprehensive Sexuality Education (CSE). 

The essential role of CSE in improving health outcomes and driving societal change

CSE is defined by UNESCO as “a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: realize their health, well-being, and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives.” 

All children, adolescents and young people, including trans, non-binary and gender-diverse people, have the right to access CSE without discrimination, empowering them to make informed decisions regarding their bodies and sexuality. 

CSE is essential as it increases knowledge about many aspects of sexuality, including contraception, pregnancy and sexually transmitted infections (STIs), resulting in significant positive health outcomes with lifelong impacts. In addition, by teaching students about gender relations and addressing issues like consent, CSE has the potential to challenge unequal gender norms, promote positive attitudes related to sexuality, and prevent and reduce gender-based violence and sexual exploitation and abuse. 

Challenges to implementing CSE

1. Resistance at the policy level

There can be a lot of resistance to CSE from various stakeholders, mainly as a result of underlying misconceptions about its nature, purpose and impacts. Some of these misconceptions include concerns that CSE contradicts local religious and cultural norms, promotes early sexual activity or causes ‘gender confusion’. For example, in some contexts, Ministries of Education may be uncomfortable and resistant to include CSE programs that are not abstinence-focused in their curriculum despite evidence demonstrating the ineffectiveness and potential harm of abstinence-only sex-education programs. The use of the term CSE itself can be a tension point. Legal restrictions on sharing SRHR-related information before the age of 18 can further complicate CSE integration and may contribute to early pregnancies. 

2. Gaps between intent and effective implementation 

For CSE to be successfully implemented, it is essential to secure the support of community and religious leaders, teachers, parents and other community stakeholders. Resistance from any of these groups can significantly prevent effective implementation. For example, teachers may incorporate their own personal views that diverge from the intended goals of the curriculum.

As a result, stakeholders’ misinterpretation of CSE messages can have unintended consequences that harm communities. One example shared during the discussion involved a program promoting male engagement in the Maternal, Newborn, and Child Health continuum of care. To support this initiative, religious leaders mandated that all women must be accompanied by their partners when accessing health services. While they believed they were “championing the cause of the project”, this requirement negatively impacted single women and those who preferred to not be accompanied by male partners.

3. Lack of resources and non-academic support 

Delivering high-quality CSE requires adequate funding, training and support. In some contexts, teachers may lack the skills or confidence to deliver sexual education. In others, there is a lack of funding for non-academic support services in education institutions like trained counselors in SRHR and health facilities within educational institutions. This lack of support can increase student drop-out rates as well as increase the burden on teachers who become responsible for providing some of these support services. 

In addition, organizations are grappling with the responsibility that comes with raising awareness of SRHR when there are no support services available and the impact this has on young people (e.g., increasing awareness about harmful gender norms and gender-based violence in communities where response and support services are nonexistent).

Bridging the gap between commitment and implementation of CSE

1. Working at all levels and finding the right champions

To successfully implement CSE, it’s vital to engage with key stakeholders at all levels, including ministries, local government officials, education institutions, parents, LGBTQI+ groups, community leaders and youth, fostering collaboration, coordination and co-creation. Understanding existing power dynamics is equally essential, particularly when engaging religious leaders whose approval may be needed to precede collaboration with ministries.

Identifying and involving champions in CSE design and implementation is key. Champions and influential individuals who can advocate for CSE, can, for example, work with religious leaders or participate in sessions for caregivers, fathers’ clubs, men’s clubs and other intermediaries to facilitate program support and create buy-in at the community level. 

2. Collaboration across sectors and services

Moving beyond the silos and integrating programs with cross-sectoral approaches is most effective, emphasizing the need for enhanced engagement and collaboration among experts in health, education, gender equality, and water, sanitation and hygiene (WASH), among others. For example, SRHR programs may require close collaboration across both Health and Education Ministries, and education programs will include non-academic support services and training to educators on SRHR. 

Ensuring dialogue and links between services and relevant providers is critical. For example, as young people’s knowledge of SRHR expands through CSE, they will seek information about their options and services, requiring educators to be appropriately equipped to provide guidance on how to access services. Likewise, health providers must be ready to support young people in a gender-responsive way. 

3. Engaging youth 

Nothing for youth, without youth! Young people are some of the strongest allies for implementing CSE at national and community levels, for advocating for the inclusion of CSE in schools or for encouraging policy makers to adopt policies that mandate the provision of CSE. While safeguarding issues need to be addressed, youth need to be given opportunities to lead in the design, delivery and monitoring of CSE programs. In particular, a peer education model can be a potential solution for delivering CSE.