CSE curriculum review, selection, and adaptation

Ensuring an enabling learning environment

Any CSE programme should be selected or designed to ensure an enabling environment for students, one that engenders a sense of comfort, openness, and safety. In the classroom, a facilitator can create a protective and enabling environment, also known as ‘climate setting’, by:

  • establishing ground rules, such as keeping confidentiality and avoiding making generalizations about any groups of individuals;
  • demonstrating active listening by paraphrasing questions and contributions from learners;
  • building trust, as demonstrated by a willingness to respond to all questions without shame or minimization;
  • encouraging contributions from learners in participatory ways, which communicates the value of the students and enables them to personalize and integrate the information and skills being taught.

Methods of integration of CSE

School-based CSE can be offered as a stand-alone curriculum, an integrated programme, or a subject that is infused throughout the curriculum. There are pros and cons to each approach:

  Pros Cons
  • In-depth coverage of specific topics.
  • Teacher training is focused on specialized teachers who may choose to develop career path in the same area.
  • Additional time allocated to content.
  • Easier to monitor and evaluate.
  • A designated teacher is accountable for the curriculum.
  • Assuming it is institutionalized.
  • It is easy to make it compulsory.
  • It is easy to develop and update the materials.
  • Potentially most cost effective option in terms of numbers of teachers trained and dedicated teaching and learning materials.
  • Hard to compensate for a missed content.
  • Not many tutors are specialized in this field of study (CSE).
  • Increased workload on the teacher.
  • Easily sacrificed if not examinable.
  • Extra budget implications for the school.
  • Learners will learn aspects of CSE even if it’s not compulsory.
  • All levels benefit from all topics of CSE even though they are integrated.
  • Creates opportunities for learning across the curriculum.
  • Allows for the use of the existing assessment modalities.
  • Reduces pressure to create space in the timetable for a new subject supported by dedicated staff and new training needs.
  • Methodologies used.
  • Leaves the scope and depth of the curriculum at the discretion of the teacher.
  • Selective teaching is prevalent, which focuses on content that is less ‘embarrassing’ to talk about in class.
  • May be difficult to monitor at the level of the learner as potentially more difficult to assess and examine because of the multiple carrier subjects.
  • Limits accountability and ownership in the curriculum.
  • Potentially less cost-effective as there is a need to train and monitor larger numbers of teachers, and produce more teaching and learning materials.
  • Greater opportunity for coverage of CSE.
  • Easier to institutionalise.
  • Dilution.
  • May be difficult to apply certain methodologies, like participatory, given the need to monitor larger numbers of teachers and produce more teaching and learning materials.

[Source: UNESCO. 2015. Comprehensive sexuality education in teacher training in Eastern and Southern Africa, p. 24.]

Questions to ask when implementing a CSE curriculum in a community

  • Is the programme designed for this community? If not, what adaptations will need to be made?
  • What background and training will the curriculum facilitator need? How can that support be provided, and what will it cost? (See the Toolkit section, Teacher training and support)
  • What costs are involved in obtaining, implementing, and sustaining the curriculum?
  • What costs are involved in adapting the curriculum?
  • Is it an incremental curriculum that only has a positive impact if implemented from start to finish? Or does it offer lessons that can supplement an existing programme?
  • Is it a research- or evidence-based curriculum? Is it an evidence-informed or promising programme?
  • Does it support the key values of CSE, as discussed in the Toolkit section, Getting started?

In particular, it should be established whether the curriculum addresses:

Comprehensiveness of content in: 

  1. Self-awareness, self and others/relationships (including power in relationships) 
  2. Human development; puberty, body, and reproduction 
  3. Sexuality and sexual behaviour
  4. Sexual health: STIs/HIV/AIDS (prevention, including condoms; treatment; care) 
  5. Sexual health: pregnancy, contraception, abortion 
  6. Communication, negotiation, and decision-making skills Issues that are relevant both as content areas and for general approach: 
  7. Gender-focus (both in terms of content and approach) 
  8. Rights-based (both in terms of content and approach) 
  9. Age-appropriateness Pedagogic issues/teaching methods that: 
  10. Empower young people and build agency 
  11. Are diverse, participatory, and facilitate personalizing of information 
  12. Build critical thinking skills

[Source: UNESCO; UNFPA. 2012. Sexuality education: a ten-country review of school curricula in East and Southern Africa.]

The selection of a curriculum should be informed by best practices, content standards, and guidelines. The characteristics of effective CSE programmes are discussed further in the Getting started section of this toolkit.

There are many evaluated and effective sexuality education programmes in existence worldwide. Developing an original curriculum can be costly and requires a larger investment of time and resources. Communities may look to save costs by adapting these existing programmes to their own (social and cultural) context.

[Source: Radboud University Nijmegen (Netherlands). Medical Centre. 2011. Cost and cost-effectiveness analysis of school-based sexuality education programmes in six countries: full report.]

Unless conducting comparative research across different communities, each community should be prepared to make adaptations to existing curricula based on community norms, language, needs assessment results including young people’s views, CSE policies, and the input of international and regional CSE expert consultants. These adaptations might include changing some of the language, images, or cultural references without impacting on effectiveness.

When using an evaluated curriculum, certain adaptations can reduce the programme’s effectiveness. Reducing any of the following can have a negative impact on programme outcomes:

  • the number or length of sessions;
  • reducing participant engagement;
  • eliminating key messages or skills to be learned;
  • removing topics completely;
  • changing the theoretical approach;
  • using staff or volunteers who are not adequately trained or qualified;
  • using fewer staff members than recommended.

CSE standards and available curricula

Numerous international entities offer standards for teaching CSE to help programme implementers determine whether a curriculum or set of lessons are teaching what young people need to know at various ages and stages. You can find examples of these standards in the resources section, but in particular, the UNESCO International technical guidance on sexuality education, referenced throughout this toolkit, offers a wide range of guidance on standards for CSE programming.

Most of the published CSE curricula worldwide are available in hard copy format only, and therefore entail costs to obtain. Some necessitate the additional financial impact of training to accompany the curriculum. All of these potential costs should be considered in the original budgeting for CSE implementation.

CSE teaching resources available online vary in scope and quality, and most online curricula also have fees associated with them. It is more likely that partners will find individual lesson plans that can be adapted and compiled into a usable curriculum, which may or may not need to be supplemented with new lessons. A curated list of online resources is available through the UNESCO Health and Education Resource Centre.

    Linking education to health services

    Effective school programmes often establish close links with local sexual and reproductive health services to facilitate access to contraception and STI testing. In some cases, health service providers set up a regular base inside schools; this not only ensures easy access to services but also helps normalize the concept of sexual health. It is critical that governments deliver both education and youth-friendly services to maximize the benefits for young people and to ensure cost savings to the health system. Ministries of health and education need to work in a joined-up way to finance and deliver CSE and sexual and reproductive health services for young people. These services should include prevention of adolescent pregnancy; care for pregnant adolescents; HIV prevention, testing, counselling, treatment, and care; vaccination against human papillomavirus; and safe abortion care.

    [Source: IPPF. 2016. Everyone’s right to know: delivering comprehensive sexuality education for all young people.]