CSE implementation at regional and country levels

Regional Implementation

Different regions have shown leadership in the implementation of CSE, from demonstrating increased political will, to developing and investing in CSE programming:

  • Within Europe, the WHO Regional Office produced Standards for sexuality education in Europe, which provides a framework to support policy-makers, education and health authorities, and other stakeholders in implementing quality standards for sexuality education across the region.
  • The Ministerial Commitment on comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in Eastern and Southern Africa (ESA) has been endorsed by 21 countries in the Eastern and Southern Africa region.
  • In West and Central Africa (WCA), Ministers of Education and Health from 25 countries endorsed the WCA Commitment in April 2023. This high-level political commitment focuses on timely access to CSE, information programmes and health services adapted to the needs of adolescents and young people, equipping them with knowledge and skills to make responsible and informed choices for their health and well-being.
  • In Latin America and the Caribbean, ministers of health and education declared their commitment to sexuality education through the Preventing through Education Declaration signed in 2008. Governments committed to integrating strategies and ensuring interdepartmental coordination and agreed to implement and strengthen ‘multi-sectoral strategies of comprehensive sexuality education and promotion of sexual health, including HIV/STI prevention’. More information on CSE in Latin America and the Caribbean is described in this report [in Spanish].
  • The Montevideo Consensus, adopted in 2013 at the Regional Conference on Population and Development in Latin America and the Caribbean, calls for the effective implementation from early childhood of CSE programmes, and the implementation of comprehensive, timely, good-quality sexual health and reproductive health programmes for adolescents and young people. November 2023 saw the tenth anniversary of the adoption of the Consensus, marked by publication of the second regional report on its implementation.
  • The Asia-Pacific region has traditionally had a favourable policy environment towards implementing HIV education, with most countries integrating broader sexuality education into national HIV strategies. The commitment from the Asian and Pacific Population and Development Conference in 2013 focused on ensuring SRHR for all, particularly the poorest and most marginalized populations, and recognized the need for sufficient resources for sexuality education programmes.


Country Implementation

  • Armenia – Integrated Model of Sexuality Education: Armenia has evolved its approach to sexuality education over the past 20 years, moving from an optional subject to integrating it into mandatory subjects. Recent reforms included a large-scale teacher preparation program and the development of supplementary resources like educational videos and a dedicated website. The government’s commitment is further demonstrated by its ratification of the Lanzarote Convention in 2020, mandating the provision of information on sexual risks and abuse to children (page 38).
  • Cameroon – Holistic Sexuality Education: Cameroon is a pioneer in the WCA region with its national curriculum and teacher training program for CSE. Initial teacher training was complemented by digital tools like DVDs and radio broadcasts to reach more teachers quickly. However, challenges remain, such as the need for better integration of CSE into regular teaching and addressing local reluctance. UNESCO has been working to involve key actors in the communication sector to reduce misinformation (page 37).
  • Pakistan – Building Community Support: In Pakistan, NGOs Aahung and Rutgers Pakistan have successfully reached over 500,000 students with CSE programs by prioritizing community support. Their strategies include engaging key stakeholders, sensitizing religious groups, and using media to build positive perceptions. These efforts have helped overcome societal and cultural barriers, ensuring the sustainability of CSE programs (page 44).
  • South Africa – Scripted Lesson Plans: Since 2000, South Africa has integrated sexuality education into the Life Orientation subject. In 2015, the Department of Basic Education developed scripted lesson plans to support teachers in delivering comprehensive sexuality education. These plans provide detailed instructions for activities, materials, and key points, aiming to empower teachers and ensure consistency. The phased implementation and parent sensitization meetings have helped address misconceptions (page 36).
  • Tunisia – Major Reforms in Sexuality Education: Tunisia has made significant strides in sexuality education following the 2017 national law to combat violence against women, which includes education for health and sexuality. The Arab Institute for Human Rights, the Tunisian Association for Reproductive Health, and UNFPA have been pivotal in advocating for CSE integration. An Expert Committee developed teaching resources, and in 2019, the Ministry of Education mandated sexuality education for learners aged 5-18 (page 21).

[Source: UNESCO; UNICEF; UNAIDS; UNFPA; WHO; UN Women. 2021. The journey towards comprehensive sexuality education: global status report.]

Scotland has mainstreamed comprehensive sexuality education as part of an emphasis on health and well being. Scotland has developed a policy framework that puts health and well-being at the centre of the school curriculum and at the heart of children’s learning, alongside literacy and numeracy. The framework is supported by legislation and policies including the Children and Young People (Scotland) Act 2014, which sets out to improve the well-being of children and young people through systematic and consistent recognition of their rights, in accordance with the United Nations Convention on the Rights of the Child. Under the Curriculum for Excellence, all teachers, regardless of subject, and all non-teaching staff are expected to reflect health and well-being, literacy and numeracy in their lessons and work practices.
The health and well-being curriculum covers relationships, sexual health and parenthood. Its use is guided by eight well-being indicators: safe; healthy; achieving; nurtured; active; responsible; respected, and included. Because each child is unique, there is no set ‘level’ of well-being children should achieve. Instead, the indicators aim to be responsive to pupil needs and fully personalized, while ensuring consistency in how teachers consider the quality of each pupil’s life. This allows teachers to respond not only to the local context but also to students’ unique circumstances.
The Scottish Education Authority recognizes that there will inevitably be variation in teaching from school to school, as the Curriculum for Excellence is based on learner needs at a local level and takes local health and well-being priorities into account. While there are clear expectations about how children should progress, teachers, headteachers and education professionals are given the authority to decide what is taught and how content is delivered.
Source: O’Neill (2017).

[Source: GEM Report Team. 2019. Facing the facts: the case for comprehensive sexuality education, p.13.]

More information on the implementation of CSE at country level is available in the Profiles Enhancing Education Reviews (PEER).