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 agreements, such as keeping confidentiality and avoiding making generalisations 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 minimisation;
-
Encouraging contributions from learners in participatory ways, which communicates the value of the students and enables them to personalise and integrate the information and skills being taught.
CSE Standards Worldwide
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. Examples of these standards include:
-
The International Technical Guidance on Sexuality Education, referenced throughout this Toolkit, which offers a wide range of guidance on supporting country and regional leaders in putting mechanisms into place to successfully implement and sustain CSE programming.
-
The National Sexuality Education Standards, Content and Skills: Grades K-12 was developed in the United States by more than 50 national CSE organisations, experts and youth to outline what is age- and developmentally-appropriate information and skills categorized within a range of content and skills.
-
The Standards for Sexuality Education in Europe, developed by the World Health Organisation and the Federal Centre for Health Education, BZgA, offers helpful background on the psychosexual development of children as they grow, as well as the standards themselves, which begin on page 37.
-
Strengthening Comprehensive Sexuality Education for Young People in School Settings in Zambia: A Review and Documentation of The Scale-Up Process offers the CSE framework they used in grades 8 and 9.
Curriculum Review, Selection and Adaptation
School-based CSE can be offered as a stand-alone curriculum, an integrated program and a subject that is infused through the curriculum. There are pros and cons to each approach:
(Source: UNESCO, 2015 -- Comprehensive Sexuality Education in Teacher Training in Eastern and Southern Africa)
There are many CSE curricula and lesson plans available worldwide. Developing an original curriculum can be costly, and requires a larger investment of time and resources. Communities should be encouraged to review existing programmes to see whether they can adapt any for use in their communities before developing new resources.
In implementing a CSE curriculum in a community, partners need to ask themselves:
-
Is the program designed for this community? If not, what adaptations will need to be made?
-
What background and training will the facilitator of the curriculum need? How can that support be provided, and what will it cost? (See the Toolkit section, Teacher Training)
-
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 program?
-
Is it a research- or evidence-based curriculum? Is it an evidence-informed or promising program?
-
Does it support the key values of CSE, as discussed in the Toolkit section, Getting Started?
In particular, does the curriculum address:
Source: (UNESCO and 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 and the Characteristics of Effective CSE Programmes, which can be found in the Getting Started section of this Toolkit.
Evaluated and effective sexuality education programmes exist in several countries around the world. UNESCO recommends that new initiatives save costs by adapting these programmes to their own (social and cultural) context. (Source: UNESCO, 2011 – School-Based Sexuality Education Programmes: A Cost and Cost-Effectiveness Analysis in Six Countries)
Unless conducting a comparative research across different communities, each community should be prepared to make adaptations to existing curricula based on community norms, language, the needs assessment results including young people’s views, CSE policies and the input of international and regional CSE consultant experts. 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; and/or
-
using fewer staff members than recommended.
Available CSE Curricula
Most of the published CSE curricula world-wide are available in hard copy format only, and therefore require financial investment for purchasing and shipping. Some require the additional financial impact of training to accompany the curriculum. All of these should be considered in the original budgeting for CSE implementation.
CSE teaching resources available online vary in scope and quality. 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.
The only full K-12 curriculum available online is “Rights, Respect, Responsibility (The 3Rs)”: A K-12 Sexuality Education Curriculum from Advocates for Youth (United States). It is fully downloadable, with all supplemental materials, for free.
Below are links to 14 topic-based lesson plans developed for implementing CSE in East and Southern Africa, created by UNESCO, UNFPA, and Advocates for Youth. They are intended for students between the ages of 9-15.
The following resources are designed for Adolescents Ages 10 – 17
“Children and Adolescents' Sexual and Reproductive Health Rights”: Activities Guide for children age 10-13 – Save the Children (Sweden)
“Children and Adolescents' Sexual and Reproductive Health Rights”: Activities Guide for adolescents age 14-17 – Save the Children (Sweden)
The following resource provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated with topics such as relationships, puberty, and condom use, for learners age 15 or older but can be adapted for learners as young as 10.
Materials for Youth
Let’s Talk! Early and Unintended Pregnancy is a resource for adolescents that:
-
describing the changes of puberty
-
explains what early and unintended pregnancy is and how it can be prevented
-
dispels myths and misconceptions about pregnancy
-
explains what STIs are and how they can be prevented
-
discusses relationships between adolescents and their families, peers, and partners, with a focus on distinguishing between healthy and unhealthy relationships
-
answers some frequently asked questions.
[Sub-page or pop-up box]
Linking Education to Health Services
Effective school programmes have often established close links with local sexual and reproductive heal
Monitoring and Evaluation of CSE Programmes
Monitoring is the process of determining whether a programme is making progress toward its goals and objectives. It is done by routinely tracking activities on an ongoing basis. Monitoring activities typically assess inputs and resulting outputs.
-
Inputs are the resources that contribute to making the work possible; for example, funding, staff, time, equipment, supplies and facilities.
-
Outputs are the products of the programme or work.
Monitoring is done throughout the course of a programme in order to allow implementers to make adjustments as needed.
Evaluation is the process of examining whether the programme’s objectives have been achieved. Evaluation is designed to measure the effects of the CSE programme on the young people receiving it. Although conducted at the conclusion of a programme (and in some cases, after a pre-determined time following implementation to examine longer-term impacts of the programme), the system for evaluation needs to be established before the curriculum is delivered in order to collect the appropriate data throughout.
(Source: The Partnership for Maternal, Newborn and Child Health and Women Deliver, 2018 -
-
Situation assessments shed light on who is actually reached by existing programmes, and who is not; when CSE is taught; and what policies and guidelines are in place.
-
Process evaluation tracks activities, inputs, outputs and progress, while operations research identifies programme delivery problems and tests new solutions.
-
Outcome evaluation assesses achievements, such as changes in knowledge, attitudes and skills among the programme participants.
-
Impact evaluation examines longer- term achievements that are linked to a particular programme. These are assessed through research methods such as randomized controlled trials or quasi-experimental designs. It should be noted, however, that such trials are expensive and few CSE programmes have the capacity to conduct rigorous impact evaluations.
(Source: UNFPA, 2015 – “The Evaluation of Comprehensive Sexuality Education Programmes: A Focus on the Gender and Empowerment Outcomes”)
Appropriate research methods for CSE evaluation include document analysis (for programme quality); qualitative methods (in-depth interviews, focus group discussions); quasi-experimental designs; epidemiological time series analyses; population-based surveys; and cross-sectional (stakeholder) surveys. Sample criteria and indicators are outlined below:
(Source: UNFPA, 2015 – “The Evaluation of Comprehensive Sexuality Education Programmes: A Focus on the Gender and Empowerment Outcomes”)
[Sub-page or pop-up box]
Documenting and Communicating Results
Documenting the results of CSE implementation is important for a number of reasons:
-
It communicates the impact community leaders’ and members’ support had on a programme, and therefore the need to maintain and strengthen this support
-
It reinforces for community leaders and stakeholders, including funders, that their investment of time and resources were well spent
-
All implementations should be considered steps in an ongoing process. Documenting results, in addition to lessons learned, sets the stage for continuing and additional implementations, as well as scale-up plans and processes.
As progress and results are documented, it is important to communicate them to members of the community. There are a few things to consider when communicating about CSE programme implementation:
-
Timing – create a plan for how often the programme plans to communicate with the community, and communicate that plan up front. This will set the expectation for how often stakeholders will hear from the programmers. This should be a flexible plan; for example, if a programmer plans to offer one update mid-way through the implementation but questions are raised from the community, the programmer should respond to the community needs and offer an additional update.
-
Level of Detail – until a programme is completed and impacts assessed or evaluated, it is best to wait to share whether a particular implementation can be considered “successful,” based on the original goals and objectives.
-
Number and Focus of Messages -- Messages about a programme can be both primary and secondary. The primary message is the most universally compelling statement to all audiences (e.g. the need to reduce HIV). When a particular audience needs reinforcement, a primary message is often supported by secondary messages. Secondary messages often explain how the objectives of the primary message will be met. There may be several secondary messages tailored to the specific needs of an audience. For example, “The learners in the CSE programme all demonstrated knowledge about and facility with using condoms.”
(Adapted from: UNICEF, 2010 – “Advocacy Toolkit: A Guide to Influencing Decisions that Improve Children’s Lives”)
Suggestions for communicating about a CSE Programme:
-
Use evidence to write a “briefing paper” on CSE to outline why it is relevant for young people in a specific country or community that includes recommendations of how CSE can be improved by future programmes. Briefing papers can be written in collaboration with local, complementary organisations working on health or youth.
-
If working with a CSO or other organization, create an official organisational position statement on CSE, and encourage other complementary organisations to do the same.
-
Organise public launches for any papers or position statements as an opportunity to bring together decision makers and young people to share expertise and support. Use the internet and social media to create hashtags, Instagram stories, live-tweet the event to open it up to an even bigger audience.
-
Engage with the media by sharing articles and press releases with local/national TV, radio and newspapers, being sure to include young people who can speak to the impact of a programme as well as the importance of CSE.
-
Engage with other CSE advocates worldwide by sharing actions and experiences on such online communities as the Global Online Hub for Advocacy in Comprehensive Sexuality Education.
(Adapted from: UNESCO, IPPF and The PACT, 2017 -- “We Demand More! A Sexuality Education Advocacy Handbook for Young People”)
The following table can be used to identify the messages that would be useful to communicate to various community groups and organisations:
(Source: UNESCO, IPPF and The PACT, 2017 -- “We Demand More! A Sexuality Education Advocacy Handbook for Young People”)
Resources
For additional information on the topics discussed in this section, please visit the following links:
Introducing a new CSE programme or reviewing an existing one
The Standards for Sexuality Education In Europe: Guidance For Implementation, supplements the above resource by outlining the process for developing a national school-based sexuality education programme and provides step-by-step guidance on how to introduce new or improve existing sexuality education programmes. Although connected to the European standards, the recommendations and guidance apply to programmes worldwide. It is available in English, French, Italian, Spanish and Russian.
Comprehensive Sexuality Education (CSE) in Asia: A Regional Brief offers examples of CSE implementation in 11 countries from South, South East, and Central Asia.
Strengthening Comprehensive Sexuality Education for Young People in School Settings in Zambia: A Review and Documentation of The Scale-Up Process provides detailed case study for schools that are either beginning a new CSE programme or scaling up an existing one.
UNFPA’s Education is Empowerment offers examples of CSE implementation in India, Mongolia, Uganda, Burkina Faso, Peru, Yemen, Latin America and the Caribbean.
The US CDC developed a workbook titled Community Needs Assessment, with guiding tools for determining CSE needs in a community.
Improving the Quality of SRHR Education Programmes for Young People is a readiness checklist developed by Stop AIDS Now and WPF for CSE programmers to use in communities.
The UNFPA Operational Guidance for Comprehensive Sexuality Education: A Focus on Human Rights and Gender provides a situation assessment tool with questions to ask and ideas on how to address gaps in teacher training.
IPPF’s From Evidence to Action: Advocating for Comprehensive Sexuality Education offers specific guidance on how to create positive, enabling environments for implementing CSE.
Goal setting and prioritisation
The US CDC’s Practical Use of Program Evaluation among Sexually Transmitted Disease (STD) Programs, Part 2 provides additional guidance on how to develop SMART goals.
UNESCO and partners’ Early and Unintended Pregnancy and The Education Sector: Evidence Review and Recommendations, discusses reducing early and unintended pregnancy, and offers recommendations on what is important to prioritise in CSE programming.
Curriculum
Promoting Gender Equality Through Textbooks: A Methodological Guide – UNESCO resource available in English, French and Arabic offering guidance on how to promote gender equality, a key goal of CSE, in all classes.
The WHO Regional Office for Europe and BZgA created a Guidance for Implementation report that outlines on pages 42-45 a foundational understanding of how lesson plans, teacher aids, and student handbooks can be developed.
General Adaptation Guidance: A Guide to Adapting Evidence-Based Sexual Health Curricula, published by ETR and the US CDC, provides general green (safe), yellow (proceed with caution) and red (unsafe) light adaptation guidance for practitioners considering making adaptations to sexual health EBIs.
Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs, written by ETR Associates, offers guidance for developing, adapting and implementing curricula.
Partnerships
The Partnering Initiative and UN DESA’s Maximising the Impact of Partnerships for the SDGs: A Practical Guide to Partnership Value Creation offers a Partnership Value Assessment Tool to determine which organisations may or may not be good fits for partnering on CSE implementation.
Monitoring and evaluation
UNFPA and IPPF’s Inside and Out: Comprehensive Sexuality Education Assessment Tool can be used by community organisations to track the quality and success of CSE implementation. It is available in English, French and Spanish.
The Evaluation of Comprehensive Sexuality Education Programmes: A Focus on the Gender and Empowerment Outcomes compiles an extensive analysis of many different CSE programs across the globe.
Scaling up
CSE Scale-Up in Practice offers step-by-step guidance on effective scaling up efforts in CSE. It also provides in-depth case studies from a number of ESA countries that have implemented and scaled up their CSE.
Strengthening Comprehensive Sexuality Education for Young People in School Settings in Zambia: A Review and Documentation of The Scale-Up Process offers a detailed description of efforts to scale up CSE in Zambia.
UNESCO’s Cost and Cost-Effectiveness Analysis of School-Based Sexuality Education Programmes in Six Countries offers additional, in-depth recommendations for cost-effective scaling up of CSE.
Comprehensive Sexuality Education: The Challenges and Opportunities of Scaling Up is a valuable foundational document to determine whether a community is ready to scale up a CSE programme, as well as what they will need to consider and put into place in order to be successful and sustainable.
WHO and ExpandNet’s Nine Steps for Developing a Scale-Up Strategy, available in English, French and Spanish, is a guiding document for scaling up CSE efforts. It also features worksheets that can be used in conjunction with the guide.
th services to facilitate access to contraception and testing for sexually transmitted infections. 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. In some cases, health service providers have set up a regular base inside schools which not only ensures easy access to services but also helps to normalize the concept of sexual health. 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.”)
[Sub-page or pop-up box]