School-based sexuality education: an overview.
Olufadewa II1, 2, 3, Adesina MA1, 3, Oladokun B3, Oladele RI1, 3*, Ayorinde T3, Abudu FR3
1Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.
2Department of Reproductive Health Sciences, Pan African University of Life and Earth Sciences Institute, PAULESI, Ibadan, Nigeria.
3Slum and Rural Health Initiative Research Academy, Ibadan, Nigeria.
*Correspondence: Ruth Ifeoluwa Oladele; +234 818 147 1741; firstname.lastname@example.org
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Sexuality education has been recognised as a basic human right which empowers young people with comprehensive information to have a better view about themselves, healthy relationships, and take charge of their sexuality. Even though sexuality education is crucial to the promotion of sexual health because it ensures that young learners are given the opportunities to develop a positive and factual view of sexuality and sexual health, there are limited approaches for effective sexual education. Therefore, this paper discusses school-based sexuality education as an important strategy to increase awareness about sexual health among youth and adolescents, and the importance of training teachers to deliver comprehensive sexuality education.
Keywords: Sexual health, Sex education, Youth, Reproductive health, School-based sex education, Sex.
Cite this article: Olufadewa II, Adesina MA, Oladokun B, Oladele RI, Ayorinde T, Abudu FR. School-based sexuality education: an overview. Yen Med J. 2021;3(1):8–11.
Everyone has the right to experience and fully develop their sexuality, and sexuality education has been considered a human right. According to the Sexuality Information and Education Council of the United State (SIECUS), an organisation advocating for the sexual health and rights of all people for over five decades, sexuality education “is a lifelong process of acquiring information and forming attitudes, beliefs, and values about identity, relationships, and intimacy. It encompasses sexual development, reproductive health, interpersonal relationships, affection, intimacy, body image, and gender roles”.1 This elaborate definition emphasises the fact that sexuality education is not only about learning the human physiology or HIV/AIDS prevention, it is about empowering young people with comprehensive information to have a better view about themselves, healthy relationships, and take charge of their sexuality.
Furthermore, the United Nations Economic, Scientific and Cultural Organisation, UNESCO2 defines sexuality education as ‘an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information’. This definition takes into account the cultural environment and supports the teaching of sexuality education to younger children as long as age-appropriate information is given to them. Hence, it advocates for not only comprehensiveness but also a wider age-coverage of sexuality education. It is noteworthy that sexuality education is tailored to the age and developmental stage of a child. For instance, a young 5-year-old child is taught about topics such as friendship and about different part of the body. As the child grows older and develops, advanced topics are introduced such as puberty, sexual rights and family planning. This is known as ‘age-appropriateness’.
SEXUALITY EDUCATION AND HUMAN RIGHTS
Comprehensive and evidence-based sexuality education is universally accepted as a human right.3 It has been grounded especially in the right to access health-related information.3 Several international organisations and policies confirm this right including the United Nations Committee on the Rights of the Child, the 1994 Programme of Action of the International Conference on Population and Development, the Committee on the Elimination of Discrimination against Women, the Committee on Economic, Social and Cultural Rights, and the United Nations Convention on the Rights of Persons with Disabilities.
IMPORTANCE OF SCHOOL-BASED SEXUALITY EDUCATION
Contrary to some assumptions, several studies have shown that sexuality education does not corrupt the minds of young people.4-6 Sexuality education is crucial to the promotion of sexual health because it ensures that young learners are given the opportunities to develop a positive and factual view of sexuality and sexual health.7,8 The ‘age-appropriateness’ of sexuality education allows young children to have access to empowering information about their sexuality such as learning about values and human relationships; and it makes them more likely to recognise abusive persons and less likely to stay in an abusive relationship.
Sex education’s primary goal is to give young people the opportunity to receive information, examine their values and learn relationship skills that will enable them to resist becoming sexually active before they are ready, to prevent unprotected intercourse and to help young people become responsible sexually healthy adults.8,9
According to a Tanzanian study,10 teachers viewed school-based sexuality education as an important strategy for protecting young people from STIs, HIV/AIDS and an effective strategy for promoting adolescent sexual reproductive health and ensure healthy adolescent sexual development. A recent qualitative study by Achora et al.,5 conducted in a rural community in Uganda found that sexuality education helps to keep girls in school by helping to reduce the rate of unwanted pregnancy that often led to drop-out among adolescent girls. Also, teaching on human sexuality also made girls stay in school during their menstrual period.5
In a thirty-month quasi-experimental study by Maticka-tyndale6 of a HIV Prevention education intervention programme in twenty primary schools and over three thousand students in Kenya over three consecutive school years, it was found that students from intervention schools had better knowledge, attitude, self-efficacy, and risk-reducing sexual behaviour. The study was however limited because behavioural changes were based on self-reporting of participants.6
A systematic review and meta-analysis from thirty-three studies conducted on school-based sexuality and HIV prevention education in low and middle-income countries found that there was a significantly greater self-efficacy related to refusing sex or condom use, greater HIV knowledge, fewer sexual partners and less initiation of first sex during follow-up.4
The importance of teachers for the delivery of an effective school-based sexuality education cannot be underemphasized as it has been found in several studies that students prefer teachers to teach sexuality education. Rosenthal et al.11 found that young people prefer teachers to deliver sexuality education to them because they were perceived by young people as the most credible, reliable and trustworthy source of information about sexuality.11 Also, because young people felt that they were too close to their parents, they were said to prefer to have other sources that teach them about human sexuality.12 Furthermore, the school is an institution where teachers instruct students on other subjects following the curriculum for each subject; it is therefore the best platform to teach students about a curriculum-based teaching on human sexuality because parents and guardians have little knowledge of this curriculum and they will rarely follow this curriculum in teaching their children.3
It has been found from several studies that parents shy away from the responsibility of teaching their children about human sexuality.13,14 According to a qualitative study conducted by Wanjeet al.15 in Kenya, found that parents preferred sexuality education to be taught by school teachers. Some fathers also admitted that they do not have close relationships with their daughters due to cultural and religious reasons therefore their communication on sexual health and relationships is negatively affected.15 Hashimoto et al.14 in a quantitative study conducted among over 5,000 parents in Japan found that parents preferred that the physiological aspects of human be taught in school rather than homes. However, due to the quantitative nature of the study, the reason for this was not adequately explored. In a recent qualitative study conducted in Malawi by Nash et al.,16 many parents were found to have delayed discussions on sexuality education with their children until after sexual debut due to concerns that it might lead to earlier exploration and experimentation with sex. They preferred that teachers or health experts teach sexuality education;16 a study conducted in Lesotho by Mturi and Hennink17 provided evidence that revealed that teachers preferred that young people learn about sex education in schools while parents play a supportive role. These evidences point to one obvious fact: teachers are the major stakeholders in delivering comprehensive, reliable and non-judgemental sexuality education. Hence, investigating teachers’ perception and attitude towards the sexuality and HIV/AIDS programme is therefore important.
Comprehensive sexuality education is largely influenced by culture and religious beliefs in Africa,15 therefore more studies should be carried out on sexual health and sexuality education in Africa by African researchers as they have better understanding of these factors.18 Also, the Federal Ministry of Education should include sexuality education in the academic curriculum especially for people with disabilities as it has been found out that they have poor knowledge of sexual health due to poor access to sexual health information.19 Hence, the government, non-governmental organisations and stakeholders should provide disability inclusive materials such as brailed books and audio messages for easy communication. School teachers should also be trained appropriately to deliver comprehensive sexuality education.
School-based sexuality education is an important approach in increasing the awareness of young people about sexual health. This will further help to reduce the rate of HIV/AIDS and STIs among youths and adolescents.
OII and AMA conceptualised the study. OII, AMA, OB and ORI carried out the literature search and wrote the first draft of the manuscript. AT and AFR reviewed and edited the first draft of the manuscript to produce the final draft.
- Definition of sex education 1996. Available from: www.siecus.org. Accessed September 1, 2020.
- Comprehensive Sexuality Education, 2009. Available from: https://en.unesco.org/news/why-comprehensive-sexuality-education-important. Accessed September 1, 2020.
- Adesina MA, Olufadewa II. Comprehensive Sexuality Education (CSE) Curriculum in 10 East and Southern African Countries and HIV prevalence among the Youths. European J Environ Pub Health. 2020;4(1):em0035.
- Fonner VA, Armstrong KS, Kennedy CE, O’Reilly KR, Sweat MD. School based sex education and HIV prevention in low-and middle-income countries: a systematic review and meta-analysis. PloS one. 2014 Mar 4;9(3):e89692.
- Achora S, Thupayagale-Tshweneagae G, Akpor OA, Mashalla YJ. Perceptions of adolescents and teachers on school-based sexuality education in rural primary schools in Uganda. Sexual Reprod Healthcare. 2018;1(17):12-18.
- Maticka-Tyndale E, Wildish J, Gichuru M. Thirty-month quasi-experimental evaluation follow-up of a national primary school HIV intervention in Kenya. Sex Edu. 2010;10(2):113-130.
- Wilhelm R. Definition of sex education. 2011. Available from: http://dictionary.sensagent.com/sex+education/en-en. Accessed September 1, 2020.
- Maqbool M, Khan M, Mohammad M, Adesina M, Fekadu G. Awareness about reproductive health in adolescents and youth: A review. J Applied Pharm Sci Res. 2019;2(3):1-5.
- Donovan P. School-based sexuality education: the issues and challenges. Fam Plan Perspect. 1998;30(4):188-193.
- Mkumbo KA. Students’ attitudes towards school-based sex and relationships education in Tanzania. Health Edu J. 2014;73(6):642-656.
- Rosenthal DA, Feldman SS. The importance of importance: adolescents’ perceptions of parental communication about sexuality. J Adolescence. 1999;22(6):835-851.
- Tanton C, Jones KG, Macdowall W, Clifton S, Mitchell KR, Datta J, et al. Patterns and trends in sources of information about sex among young people in Britain: evidence from three National Surveys of Sexual Attitudes and Lifestyles. BMJ open. 2015;5(3):
- Onwuezobe IA, Ekanem EE. The attitude of teachers to sexuality education in a populous local government area in Lagos, Nigeria. Pak J Med Sci. 2009;25(6):934-937.
- Hashimoto N, Shinohara H, Tashiro M, Suzuki S, Hirose H, Ikeya H, et al. Sexuality education in junior high schools in Japan. Sex Edu. 2012;12(1):25-46.
- Wanje G, Masese L, Avuvika E, Baghazal A, Omoni G, McClelland RS. Parents’ and teachers’ views on sexual health education and screening for sexually transmitted infections among in-school adolescent girls in Kenya: a qualitative study. Reprod health. 2017;14(1):95-99.
- Nash K, O’Malley G, Geoffroy E, Schell E, Bvumbwe A, Denno DM. “Our girls need to see a path to the future”- perspectives on sexual and reproductive health information among adolescent girls, guardians, and initiation counselors in Mulanje district, Malawi. Reprod health. 2019;16(1):8-11.
- Mturi AJ, Bechuke AL. Challenges of including sex education in the life orientation programme offered by schools: the case of Mahikeng, North West Province, South Africa. Afri J Reprod Health. 2019;23(3):134-148.
- Olufadewa II, Adesina MA, Ayorinde T. From Africa to the World: Reimagining Africa’s research capacity and culture in the global knowledge economy. J Glob Health. 2020;(10):010321
- Olufadewa II, Adesina MA, Ekott M, Adeyemo O, Iyiola O. Disabled persons’ knowledge about HIV infection and their access to HIV/AIDS information and services in Africa: A systematic review [conference abstract poster presentation]. AIDS 2020 Conference – International AIDS Society. 2020.