Research demonstrates that curriculum-based CSE contributes to:
- delayed sexual initiation,
- decreased frequency in sexual intercourse,
- decreased number of sexual partners,
- reduced risk-taking,
- increased and more consistent condom use,
- increased and more consistent use of contraceptive methods.
[Source: UNESCO. 2017. International technical guidance on sexuality education, p. 28.]
Sexuality education has more impact when school-based programmes are complemented with community elements, including condom distribution; providing training for health providers to deliver youth-friendly services; and involving parents and teachers (Chandra-Mouli et al., 2015; Fonner et al., 2014; UNESCO, 2015a). Multi-component programmes, especially those that link school-based sexuality education with non-school-based, youth-friendly health services, are particularly important for reaching marginalized young people, including those who are not in school (UNESCO, 2016c).
[Source: UNESCO. 2017. International technical guidance on sexuality education, p. 30.]
Effective CSE programmes
- Involve experts in research on human sexuality, behaviour change and related pedagogical theory in the development of curricula.
- Assess the reproductive health needs and behaviours of young people in order to inform the development of the logic model.
- Use a logic model approach that specifies the health goals, the types of behaviour affecting those goals, the risk and protective factors affecting those types of behaviour, and activities to change those risk and protective factors.
- Design activities that are sensitive to community values and consistent with available resources (e.g. staff time, staff skills, facility space and supplies).
- Pilot test the programme and obtain on-going feedback from the learners about how the programme is meeting their needs.
- Focus on clear goals in determining the curriculum content, approach and activities. These goals should include the prevention of HIV, other STIs and/or unintended pregnancy.
- Focus narrowly on specific risky sexual and protective behaviours leading directly to these health goals.
- Address specific situations that might lead to unwanted or unprotected sexual intercourse and how to avoid these and how to get out of them.
- Give clear message about behaviours to reduce risk of STIs or pregnancy.
- Focus on specific risk and protective factors that affect particular sexual behaviours and that are amenable to change by the curriculum-based programme (e.g. knowledge, values, social norms, attitudes and skills).
- Employ participatory teaching methods that actively involve students and help them internalise and integrate information.
- Implement multiple, educationally sound activities designed to change each of the targeted risk and protective factors.
- Provide scientifically accurate information about the risks of having unprotected sexual intercourse and different methods of protection.
- Address perceptions of risk (especially susceptibility).
- Address personal values and perceptions of family and peer norms about engaging in sexual activity and/or having multiple partners.
- Address individual attitudes and peer norms toward condoms and contraception.
- Address both skills and self-efficacy to use those skills.
- Cover topics in a logical sequence.
Levers of success include:
- commitment to addressing both HIV and sexuality education reflected in a favourable policy context;
- tradition of addressing sexuality, however tentatively, within the education system;
- preparatory sensitization for head teachers, teachers and community members;
- partnerships (and formal mechanisms for these), for example, between education and health ministries and between state and civil society organizations;
- organizations and groups that represent and contribute young peoples’ perspectives;
- collaborative processes of curriculum review;
- civil society organizations willing to promote the cause of comprehensive sexuality education, even in the face of considerable opposition;
- identification and active involvement of ‘allies’ among decision-makers; support for in-service training for teachers and for the dissemination of appropriate materials;
- availability of appropriate technical support (such as from UN partners and international non- governmental bodies), for example in relation to: sensitization of decision-makers; promoting participatory learning methods by teachers; and engagement in international networks and meetings;
- involvement of young people in sensitizing parents, teachers and decision-makers;
- opportunities for decision-makers to participate in school-based sexuality education through observation and dialogue with teachers and students;
- removal of specific barriers to comprehensive sexuality education, such as the withdrawal of homophobic teaching material;
- willingness to resort to international policy and legal bodies.
[Source: UNESCO. 2010. Levers of success: case studies of national sexuality education programmes, p. 9.]