EMERGING EVIDENCE, LESSONS AND PRACTICE IN COMPREHENSIVE SEXUALITY EDUCATION A GLOBAL REVIEWPbiiied 2015 by the Unled Nation Edicotera, Scenic and Cua Organizaton, 7, ploce de Foninoy, 75352 Panis O7 SP, Force UNESCO 2015 Tis publication s availabe in Open Access unde he AtubuionShoraa 3.0 ISD [CCANSA 3.0 160) leans fp://teaecommons.xg/ leorios/bysa/3.0/go/|. By ng th cont fis publeabo, fhe wos accapl io be bound by tho lems of usa ol ho UNESCO Open Accass Repeston ip:/ At esto org /open access /esmsaseccby eh The dasigntons emolyed ard he prmenion of mall roughest his pucakon do rot imply he eaprssion of ony opinion ahatceve on hs pat cof UNESCO conceing he lgol sibs of any coum, ay, ly Fara oF sous, oF cenoening the dla of ontas or bounds Tho ideas and opis expresso inthis publican are tase of he ous thy oe not recasarly tho of UNESCO and do not coma he Organization ISBN: 9789231001390 Photon 1]: Fike Autikan Govermen- Deparment ol Fort Aas ond rade hips: /reatvecommors oxg/iconses/04/3.0/0u/ hota by Im Himes fr DA ne 11, 203 P-17: FiksAuscan Government Depart of Frsign Afats ond Fado hps:/ /reatveconmors oxg/lesreas/0y/3.0/2u/ Photo by Conor Ashleigh for DFAT, 8 March 2012 1.23: Flickr Asion Development Bark his: /craavoconmons org/censcs/boy/2.0/ Photo by Ab Abdulah/ADB. p31: @UNESCO/ Tnsn Sibodh 1.37: @UNESCO/ Ried Poductins Designed by Aue Mazoper Prikl by UNESCO Prod in onceCONTENTS ACKNOWLEDGEMENTS 5 ACRONYMS 6 EXECUTIVE SUMMARY 7 1. INTRODUCTION a] 1.1 Defining comprehensive sexuality education 12 1.2 Evidence for the benefits of CSE 4 1.3 Young people call for CSE 15 2. SITUATING CSE WITHIN DIFFERENT CONTEXTS 17 2.1 Age-appropriate content forthe development ‘of heathy behaviours 18 2.2 Regional commitments to CSE 19 2.3 Adaptability of CSE content 20 2.4 Working with communities and parents 20 3. DELIVERING AND STRENGTHENING CSE 23 3.1 Placement in the curriculum 24 3.2 Mandatory vs. optional 25 3.3 Teacher training 25 3.4 Assessing CSE 26 3.5 Inclusive ways of delivering CSE 28 4. ANALYSIS OF COUNTRY DATA, 4.1 Key findings from the country data 4.1.1 Poi lve 4.1.2CSE poston wihin the curialom 4.1.3 Curiclom content 4.1.4 Teacher taining 5. CONCLUSION ANNEX 1: TABLE OF DATA ON ADOLESCENT HEALTH AND PROVISION OF CSE IN SELECT COUNTRIES ANNEX 2: DEFINITIONS OF CSE BIBLIOGRAPHY 40 44 46LIST OF CASE STUDIES (CASE STUDY 1: STRENGTHENING THE NATIONAL PROVISION OF CSE IN SCHOOLS IN ZAMBIA (CASE STUDY 2: REDUCING UNINTENDED PREGNANCY IN THE UNITED KINGDOM (CASE STUDY 3: A GENDER-FOCUSED APPROACH IN BANGLADESH CASE STUDY 4: COST EFFECTIVENESS IN ESTONIA CASE STUDY 5: ENGAGING PARENTS IN PAKISTAN (CASE STUDY 6: BUILDING TEACHERS’ CAPACITY TO DELIVER (QUALITY SEXUALITY EDUCATION ACROSS AFRICA (CASE STUDY 7: BUILDING THE EVIDENCE BASE WITH A STRONG. EVALUATION FRAMEWORK IN COLOMBIA CASE STUDY 8: CSE REACHES OUT-OF SCHOOL CHILDREN AND YOUNG PEOPLE CASE STUDY 9: USING MOBILE TECHNOLOGIES TO REACH VULNERABLE YOUNG PEOPLE IN NIGERIA. LIST OF BOXES BOX 1: GROUNDED IN HUMAN RIGHTS BOX 2: YOUNG PEOPLE'S SEXUAL AND REPRODUCTIVE HEALTH BOX 3: CORE GLOBAL INDICATOR FOR MONITORING AND EVALUATION OF EDUCATION SECTOR RESPONSS TO HIV AND AIDS BOX 4: REGIONAL POLICIES [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015 4 15 19 an 28 26 28 29 13 13 27 33ACKNOWLEDGEMENTS This repost on the curent stotus of sexality education was prepared for and fist presented fo the Programme Coordinating Board (ACB| of the Joint United Nations Programme on HIV/ AIDS [UNAIDS]. It was produced by the Section for Heath ‘and Education of the United Nations Educational, Scientific cond Cultural Organization {UNESCO}, in consultation with ‘he United Nations Population Fund (UNFPA) and the UNAIDS Secretariat UNESCO would like to express appreciation to everyone who contibuied to the report development: the reports authors, Helen Pamy in collaboration with Groce Wiletz (constants) members of the UNAIDS PCB, who received the sept during the board mesting of June 2015 ond provided useful feedback; Elizabeth Bonomar, Mona Kaidbey, and Matthew Cogan of UNFPA, New York, along with Morten Ussing of UNAIDS, Geneve, who all contibutad tachnical comments ord suggestions inthe review ofthe crak repon. We are groteful fr the input of the UNESCO Regional HIV and Health Advisors and thir teams: Justine Sass (Asia and the Pacific Tigran Yepoyan (Easier and Cental Europe); Poticia Machawira, with Vicioria Kisaolye ond Mwonsa Nislesoni (Eason and Southern Aical; Mary Guinn Delaney (atin ‘America and the Caribbean; and, Xavier Hospital (Wes! and Central Africa. Thanks are also due to colleagues in the Division fr Inclusion, Peace and Suslinable Development at UNESCO headquarters in Paris, headed by SooHyang Choi, Director; contibutions from Joanna Herat, Marina Tedesco, Jenelle Babb, Aviana Stahmes, Chis Castle, Christophe Com, Scheherazade Feddal, Yong Feng Liu and Scot Pulizi were invaluable in the Finalization ofthe report. This report wos made possible through the generous fnancil suppor of the Governments of Sweden and Norway.ACRONYMS AIDS CEDAW > se DHS EECA Ems ESA, vA, oy HV ICASA icpD ‘Acquited Immunodeficiency Syndrome German Federal Ofce for Heath Education Convention on the Elimination of oll Forms of Discrimination Against Women Commission on Popultion and Development Comprehensive sexuality education Demographic and Heath Survey Eastem Europe and Cental Asio Education Management Infomation Systems Fastom and Southam Aftica Education as a Vaccine Genderbased violence Human Immunodeficiency Vins Intemational Conference on AIDS and STs in Arca International Conference on Population and Development Information and communication technology Intemational Planned Parenthood Federation Intemational Technical Guidance on Sexuality Education MBE NGO. pce POA SADC SERAT RH SRHR st UN UNAIDS UNESCO. UNFPA UNICEF WA WHO. Yea, lotin America and the Caribbean Monitcring and evaluation Nongovernmental organization Programme Coordinating Board (UNAIDS) Processoriented approach Souther Afican Development Community Sexually Education Review and Assessment Tool Sexual and reproductive health Sewol and reproductive heath and rights Sewelly tansmited infection United Nations sini Urited Nations Programme on HIV/AIDS United Nations Educational, Scientific and Cukural Osganization United Notions Population Fund United Nations Children’s Fund West and Central Alice World Heath Orgonization Young Women’s Chrisian Association [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015EXECUTIVE SUMMARY This report provides on overview ofthe status of comprehensive sexuality education (CSE) implementation ond coverage on @ lobal level. t draws on specific information about the status OF CSE in 48 counities, generated through analysis of existing resources and studies. The report examines the evidence base for CSE and is positive impact on heath outcomes, takes stock of political suppor for CSE, and examines how the various global and regional commitments have had on impact ot national levels on the delivery of CSE in practice. The current review represents the fist in a series of periodic reports hat cm 1 monitor the global implementation of CSE Comprehensive sexuality education is recognized os on ‘age-appropriate, cultvrally relevant approach fo teaching ‘about sexvalily and relationships by providing scientifically ‘ccurate, realistic, non-judgmental information’. |UNESCO, 2009), Actoss the world there are many diferent names for, cond approaches fo, comprehensive sexuality education. The objective of CSE is fo ensure thot young people are receiving comprshensive, life shilsbased sexwaliy education to gain the knowledge and skis to make conscious, heathy ond respectful choices about relationships and sexvaliy. Core clements of CSE programmes share certain similares: CSE's fim grounding in human rights —incuding he Highs ofthe child, cond the empowerment of children and young people - ond a reflection of the broad concept of sexually as @ natural part of human development. Efetive sexualiy education stats exryin childhood and progresses thiough adolescence and adulthood building knowledge and skis that ore appropriate for each stage through « careily phasad process overtime, like any ther subject inthe curriculum There is clear evidence that CSE has @ positive impact on sexual ond reproductive health (SRH), netably contributing towards reducing sexvally transmitted infections (STIs), the Human Immunodeficiency Virus [HIV] and unintonded pregnaney. CSE has demonstrated impact in tens of improving inowledge and seltesteem, changing attitudes and gender cond social nots, ond building selFeficacy. This is particularly ciieal during adolescence, as young people make the ‘ranstion inlo aduthood. Inagrating content on gender and righs, and delivering CSE together wih fons to expord access to « fill onge of highqualiy, youtriondly sexual and reproductive heath services and commodities, makes sexuality education even more effective [Habedand, 2015). Evidence has confined that sewaliy education does not hasten sexual ctvity bt has 0 positive impact on safer sexual behaviouts and can delay sexvol debut and increase condom use UNESCO, 2000; Fonner et al, 2014) Global momentum around CSE has rested in increased politcal commitment wordwide. In 2008, ministers of education ‘and heath ftom Latin America ond the Caribbean signed the Preventing through Education Declaration! commiting 10 delivering sexoly education and health services. Simi, in 2013, 20 counties across Eastamn and Southom Afica (ESA) endorsed a1 Ministerial Commitment on CSE and SRH services for adolescents and young people, soting spectic targets 10 ensure access to highaualiy, comprehensive life sillsbased HIV ond somvaliy education ond appropriate youthriondly heath services forall young people. UNAIDS ond the Afican Union have teceniy cited comprehensive, ageappropriaie sexuality education as one of five key recommendations to fst track the HIV response ond end the AIDS epidemic among ‘young women ond girls across fica. Many counties in the AsioPaciic region, Wes! Ahica and Europe ore alo revising their palicies and opproaches fo scale up sexuality education. ‘Young people are increasingly demanding their right to sexuality education, as evidenced by tho 2011 Mali Call 10 Action; declarations ot the 2011 Intemational Conference on ADS ond STIs in Aiea [ICASA|; the 2072 Balt Global Youth Forum Declaration; he 2014 Colombo Declaration en Your youth delegates’ inputs othe post-2015 development ogenda through the ‘Have you soon my Rights coalition; as well as tho cedvocacy effors of he PACT coalition of you organizations The paltical momentum has led many governments to scale up eliveryof CSE ond to seek guidance on bes practice. Ministies cfeducation are working in collaboration wih minstes of heath cond deparments responsible for child protection and youth welk boeing, Porieships wih civ sociely and private instutions hove been ciical in key elements of scaleup such as leacker raining ‘and the development of reaching and learning resources. However, a gap remains between the global and regional polices in place and the actul implementation and monitoring con the ground. Across the world, saxvliy education may be delivered 5 a standalone subject ~ with the advantages of providing opportuiies for specialized teacher taining and being easier to monitor Alematvely, it may be inlegroted ceross relevant subjecss within the school curiculum, making 1 See: hip: //wovanecootg/row irra AA NTEDIA/FED/ Sareago/e/doclraton prveningedicatononglh pe acco 4 ay 2013)i les ltely fo be cut to reduce pressure on an overcrowded timetable. CSE may be mandatory or it may be delivered through optional courses. However, where sexually education is nomcompulory, extracunicular or only parially compulsory « large number of students will not reap is bonefis. CSE content_must respond oppropriaiely to the specific context and needs of young people in order to be effective. This odoptabily is ental fo culturally relevant programming, and includes understanding the messages that cultures convey corcund gender, sex ond sexvality. This may include a concerted focus on topics such os gender discrimination, sexual ond genderbosed violence, HIV and AIDS, child mariage and harmful oetonal practices. As with oll cunicula, CSE must be delivered in accordance with national laws and policies. There has been increased focus recently on sengthening curicula in numerous counties, athough this remains a critical need. Reviews of curicula show that increased attention is required to promote the development of key competencies «as well as fo examine how gender norms, religion and culture influence learners’ aides and behaviour Athough CSE content must be odapied fo reflect local contests, there ore cattain core topics that are essentol to maintaining quality fond. meeting inlorational standards. Indicators have been developed to measure whether sexaliy education programmes moet ‘essential and ‘desirable’ criaia (UNESCO, 2013} Too afin, topics are aught too late, for example, afer young people have already experienced puberty or menstuation oF inioted sex ocivity, Recent assessments show that gender cond rights should be consistently strengthened across curricula, cand address the needs of young people living with HIV and other key populations. Effective CSE has to be both inclusive and non-sigmatizing, coddressing sexual and genderbased violence and promoting gender equal, as well as ensuring the neads and rights of all young people, including those living with HIV (UNESCO and GNPs, 2012) Delivering high-quality CSE requires adequate training and capacity. Teacher trining remains limited in scope, ond, if provided at al, is usualy delivered only through inservice training. Consequently, teachers often feel uncomfortable and ovoid discussing sensive issues like sexual behaviour, sexual, and how students can access conttaception and obiain referals for SRH services. They alo do not consisinily use paricipalory methodologies to engage pupis filly in heath ond life skis education. Engaging parents and communities inthe implementation and scale-up of CSE is teal, both fo ensute that there is support forthe subject among the school communiy, and to enhance overall understanding of the issues facing adolescents and young people. Stalegies and tools for community engagement including werk wih fath communis, have been developed in all regions of the world reviewed for this sudy. Despite some report to the contrary, most parents are supportive of schook based sexually education ond many parens report feeling uncomfortable discussing sex or relationships with their childton, Wile young people often seek information about sex, sexuality cond relationships from ther pees, the inemat or cher sources, sexodly education that is delivered by fused and tained codultsis proven to be more ofective in prometing heathy soxwal behaviour This roport demonstrates that « majorly of countries are now embracing the concept of CSE, informed by evidence and international guidanee, and are engaged in strengthening its plementation at a national level. This includes specifically cengoing otfenion to curicula revision, integration of CSE into the national curiculum, investment in monitoring systoms, the engagement of communis and the scaloup of effective teacher raining. In concedt with national governments and civ socily, development peainers — including the UNAIDS Joint Programme — are supposting counties in their efforts to develop ogeappropriate, evidenceinformed curicula that reflec the country context and that will have @ dive, beneficial impact cn the HIV response and mare widely on adolescent and young people's heath [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015CASE STUDY 1: STRENGTHENING THE NATIONAL PROVISION OF CSE IN SCHOOLS IN ZAMBIA ‘The government of Zambia is spearheading a major project that aims to strengthen tho delivery of CSE to young peoplo from ages 10 to 24, including those living with HIV and with disabilities. By increasing access to high-quality, age-appropriate sexuality education and services, ‘tha project ultimately seeks to contribute to improved SRH outcomes for Zambian adolescents and youth. Sinco 2014, a revised curriculum with integrated CSE has been rolled out in Grades § to 12 in all schools across the country. CSE has also been successfully integrated into pre-service training for primary teachars. In-service teachers also receive capacity building in effective delivery of CSE, By December 2014, a total of 12,852 in-service teachers had been trained in effactive delivery of CSE at classroom level, and a further 25,017 will be trained by the end of 2015, Teaching and learning materials have also been produced by the Ministry of Education for all grades, and ‘National and Provincial Standards Officers have been trained to monitor the quality and delivery of CSE at school level. ‘A baseline survey examined knowledge levels among teachers and students, as well as their attitudes. It also provided a picture of the curront status of CSE provision in the education sector, and the degreo ‘to which it facilitates accass to SRH services for adolescents and young people. ‘The new curriculum is expected to be rolled out in all schools in the country with certain ‘champion schools’ identified for enhanced programming. In addition to the standard teacher training, curriculum and materials that are consistent across all schools, these ‘champion schools’ also offer peer-education programmes and clear links to health services. This variation will also provide opportunities for comparison and analysis of outcomes between the two types of programming, Building ownership that uses evidence, particularly the baseline survey results, has proven essential to the implementation process. Considering ‘the project's scale and level of ambition, the engagement of multiple sectors ~ including ministries of health, education, development, youth and sport, as well as non-governmental organizations (NGOs) and other partners ~ has likewise proven vital in enhancing both ownership and sustainability. Source: Presentation to World Béucetion Forum, May 2015 by the Deputy Minissr of ‘Baucation af Zambia, (Alice Soi, UNESCO Zambia, personal camemsnication, 10 Jane 2015).INTRODUCTION Comprehensive saxualiy edveation (CSE| has attacted growing interest and attention ever recent years. This is demnonsrted ond ‘elnforced by increased political commitment globally and the development of expert guidance, standards, curicula and other tools fo skenghhen the implementation of CSE in practice. Across the world, there are 0 wide range of diffrent approaches to delivering sexvaliy education; ofthis slage in the evolution of the field, it is imely o take stock ofthe evidenes, practice and lessons leamed to dale This repor provides an overview of the sions of CSE implementation and coverago on a glebal lvel, drawing on specific information about the status of CSE in 48 counties, gonorated through anchsis of exsing resources and studios. Best practice in toms of providing CSE continues to develop. The ceurtet report examines the evidence base for CSE and, through 1 series of case studies from every region, explores inatves that are sating the standard and pioneering new practices in the delvery of CSE. ft represents the first in a series of periodic reports that ims to monitor the global implementation of CSE Comprehensive life skills-based sexuality education helps young people to gain the knowledge and skills to make conscious, healthy and respectful choices about relationships and sexuality. 1.1 DEFINING COMPREHENSIVE SEXUALITY EDUCATION The Intemational Technical Guidance on Sewalty Education (GSE) ~ publshed by UNESCO wih UNAIDS, UNFPA, the Unied Nations Chidken’s Fund (UNICEF) and the Werkd Heath (Organization (WHO) — provides @ comprehensive review of ‘he gods, cbjecives, outcomes, content ond implementation approaches fr planing and delivering CSE prograrnmes s part cof on HIV response. The ITGSE is woluniary ond defines CSE as on ‘ogeoppropriae, cuturaly relevant approach fo teaching about sexnliy ond relationships by proving scentficaly cccurai, reais, onjudgmental infomation’ (UNESCO, 2000), This definition bulds onthe rigiel wosding provided by he niernational (Conference on Population and Development CPD) that references sewually education as on approach fo premoting the wellbeing cf cdolescens hat should be ‘oge appropri, begin as ecaly «5 possible, foster mature decison making and specifically aim to tamsiorato gender inequaliy’ (UNFPA, 20a). Both defntions ray on WHO's werking definton of hun sexual as a broad cconceptthat is «natural part of huncan davelopment through every phase of life ond inches physical, psychological, spiral and social components (WHO Europe, 1999/2001 | As part che growing movement and support for CSE globally, and «the fidld evohes and develops, the inlerational communi ~ incding UNFPA |2014), WHO Europe and the Geman Federal Office for Heath Education (BZga) {2010} ond Iniemational Planned Parenthood Federation [FFF] (2010}—have al bulton this wih complementary working dfitions, wih varying emphases hat reflec thir own cxganizatonol mondofes ond prot see Annex 2 for fuer details). What is consent throughout thir approaches is CSES fir grounding in human rights?’ and the empowerment of chen, adolescents ond young people, promoting the fundamental principles of young parsons ight 10 education bout their bodies, relationships and sexuality 2 en Commoncn free nd Deepen, cr 2007) Ig: / mun rg/0n/dovcopmen’ des popstaten/conmscion/ pA/42/CHDA2 Ras2009 pl (accoued 14 May 2015) 3 See Commision cn Population ae Developer. Reslson 2012/1 ip //me nt rg /250/pepscon/ep)cpl0012/ Agence 20 om208/ Decisions 02 2Orlaer/Eecurt.202012_|_ Aéelecents2200na.20¥ou pal occood 14 May 2013] [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015BOX 1: GROUNDED IN HUMAN RIGHTS Young people's access to CSE is grounded in internationally recognized human nights, which require ‘governments to guarantee the overall protection of health, ‘well-being and dignity as per the Universal Declaration on ‘Human Rights, and specifically to guarantoo the provision of unbiased, scienificaly accurate sexuality education ‘These rights are protected by intemationally ratified ‘weaties, and lack of acosas to SRH education remains a barrier to complying with the obligations to ensure the rights to life, health, non-digcrimination and information, view that has been supported by the Statements of the ‘Commutoe on the Rights of the Child, the Convention on (One of the main challenges in defining sexually education, fond particularly the elements that comprise comprehensive programming, may stom from the diferent temminologies used 105s national policies and curicula. Many different names core used, rellecing an emphasis on various aspects of CSE by diffrent counts. These include: prevention education, relationships and sexvalty education, family Ife education, HIV education, life sills education, heathy fesiyles and the basics life salty. However, cor elements ofthese programmes beor sinilartiss, and incorporaie some or many aspects of CSE BOX 2: YOUNG PEOPLE'S SEXUAL AND REPRODUCTIVE HEALTH > More than 40 per cent of the world’s population 1¢ ‘under the age of 25, wihich represents the latgest ‘generation of young people the wotld has ever seen, > Young people account for almost 5D per cent of new HIV infections, > In sub-Saharan Africa, young women from 15 to 24 ‘years old are twice as likely as young man to be living ‘with HIV. > Giobaly, only 24 per cont of young people can Gemonstiate accurate Imowledge about HIV ‘prevention and transmission, > Worldwide, more than 15 milion gitis fom 15 to 19 years old give burth every year, with 19 per cant of young women in developing countries becoming ‘prognant before thay turn 18, the Elimination of all Forms of Discrimination Against Women (CEDAW) Committee, and the Commitise on Eoonomic, Social and Cultural Rights The commitment of individual states to realizing these rights has been realfiimed by the international ‘community, in particular the Commission on Population land Development (CPD), which — in its resolutions 2008/12 and 2012/13 — called on govemments to provide young people with comprehensive education on human soxuality, SRH and gendor equality. Sours: Universal Dedaration of Human Rights; Commission on Population and Development (CPD). Throughout this document, the term CSE is used to describe all of these programmes, understanding that CSE encompasses more than just sex education, HIV education and general lifo skills aed heath education, where each is taken in isolation CSE that is scientifically occurale, nonjudgemenial, oge ‘appropriate and gendersensve in a carefly phased process from the beginning of formal schooling fs something that cll children ond young people can benefit from. Comprehensive life shilsbosed sexuality education helps young people to xin the knowledge and skills to make conscious, heathy and respectul choices about relationships and sexually > Adolescent gus and young women make up 40 per cent of all unsafe abortions worldwide, and 2.5 milion, ‘unsafe abortions occur every yoar among this age rowp. > A significant proportion of adolescent. pregnancies result from rape, and most births take place in the ‘context of early marriage > Anoumated one in three woman and gue worldwide report surviving physical and/or sexual abuse, most often at the hands of an mtimate parmer, malang ondor-basod violence one of the most widespread, hhuman rights violations > Pregnancy and childbirth are the leading cause of death among adolescent gitls between the ages of 15, and 19 in low-mcome counties. {INTRODUCTION a1.2 EVIDENCE FOR THE BENEFITS OF CSE There is clear evidence that CSE has © posive impact on sewal ond reproductive health (SRH), notably in contributing 'o reducing Sl, HIV and unintended pregnancy. Sexuality education does not hasten seswol activity but has @ positive impact on safer sewal behaviows and con delay sexual debut (UNESCO, 2000]. A 2014 review of schoobbased senuolty education programmes. has demonstrated increased HIV knowledge, increased saltefficacy relaled to condom uso nd refusing sex, increased conttaception and condom use, @ reduced number of sexual porinrs and lar intron of fist sevval intercourse [Fonner et al, 2014). A Cochrane review of 41 randomized contolled trials in Europe, the United States, Nigoria and Mexico also confimed that CSE prevents unintonded adolescent pregnancies (Oringanie et al, 2009). A study in Kenya, invoking more than 6,000 students who had received sexvaly education led fo delayed sexual ination, tnd incteased condom use among those who ware sexually ctv once these students reached secondary school compared to more than 6,000 students who did not receive sexually education [Matick Tyndole, 2010 Sexuality education does not hasten sexual activity but has a positive impact on safer sexual behaviours and can delay sexual debut (UNESCO, 2009). CASE STUDY 2: REDUCING UNINTENDED PREGNANCY IN THE UNITED KINGDOM ‘In most Western European countries, the rate of unintended pregnancias among adolescents has steadily declined in recent years. However, the adolescent pregnancy rate in the United Kingdom was the highest in ‘the region, and the UK Government resolved to address this. England and Wales experienced a 66 per cent reduction in the under-18 birth rate between 1998 and 2013 (Office for National Statistics, 2015). This success is attributed to the National Teenage Pregnancy ‘Suatogy, which aimed to promote more widespread contraceptive uso ‘by expanding the provision of high-quality sexuality education, easier ‘access to services and Improved training for health-care providers to ‘mest young people's needs. Source: UX Teenage Pregnancy Independent Advisory Group nal epor, 2010 and personal ‘communication (Roger Ingham, University of Southampton, 11 June 2015) UNAIDS ond the Afican Union have recognized CSE’s impact on increasing condom use, voluntary HIV testing ord reducing pregnancy among adolescent gis ond have inclued comprehensive, ageoppropriale sexually education as one of fve key recommendations to fast tack tho HIV responso and end the AIDS epidemic among young women and gts in Arca (UNAIDS and the African Urion, 2015) A the fold of senvaliy education develops, here is increasing focus on addressing gender, power relations and human rights in order to improve the impact on SRH outcomes. Inegratng content on gender and rights makes sexwaliy education even more affecive (UNFPA, 2014a). A review of 22 curicalum based sexaliy education programmes found thot 80 per cent of programmes that addressed gender or power relations wore associated with « significant decrease in pregnancy, childbearing or STls. These programmes were five times as fective os those programmes that did not adkess gender oF power [Haberland, 2015). CSE empowers young people to tele ciically on thot envkcnment and behaviours, ond promotes gender equaliy and equitable social norms, which Cte important contbting factors for improving healh outcomes including HIV infcton rates. Tho impact of CSE als increasoe when delivered logather with effors to expand access to a fil range of high- qualiy, youbiendly sarvices and commedtios ppriculaly in relation to coriraceptive choice (UNESCO, 201 10), A global review of evidence in the education sector aso found that leaching sexvaliy education builds confidence (Uniethale ot al, 2014), « necessary skill for delaying the oge thot young people fist engage in soxicl inlercouse, and for using contraception, incliding condoms. CSE has « domonskated impact on improving knowledge, selesteem, changing ofitudes, gender and social norms, and building selfeticacy. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015(CASE STUDY 3: A GENDER-FOCUSED APPROACH IN BANGLADESH BALIKA, a recent Population Council initiative, sought to evaluate the impact of the It's All One Curriculum on adolescent girls in Bangladesh. In a context where a significant proportion of girls are married before the age of 18, the evaluation aimed to generate specific data about what is offoctivo in dolaying the practices of carly, child and forced marriage. ‘The BALIKA study explored values and attitudes reqarding gender and rights awareness among rural adolescent girls from 12 to 19 years old. It asked questions about gender equality, literacy, necessity of education, ‘a woman's role in the family, masculinity, marriage and violence. ‘The findings revealed the need for education on gender rights for all adolescents irrespective of age, marital status or level of schooling. In particular, adolescent girls who were married, not in school, and ‘who had lower oducational attainment appeared to be loss aware of ‘their gender rights, including autonomy and freadom from violence. ‘Awareness of these rights is Instrumental in changing attitudes and empowering adolescents to deal with and transform harmful cultural ‘norms and practices Indicators demonstrated the demand for comprehensive and effective programmes to address the needs of particularly marginalized girls in ‘terms of optimizing their health and well-being. Key findings enabled the programmes to improve teacher training and support, involve parents and roll out complementary counselling programmes for both Girls and their teachers. ‘Sowos: UNFPA. 2016. The Bvaluation of Comprehensive Sexuaity Education Programmes: ‘A tocus on the gender and empowerment outcomes ew Yor UNFPA: Population Couns. ‘204 From ovidonce to action: Raults fom tho 2019 hasclin survey for the BALICA projec pezonal communition (Saja Amin, Population Cou, 11 June 2015), 1.3 YOUNG PEOPLE CALL FOR CSE ® While there is increased recognition ata global lvel regarding young people's need for sexvaliy education, progress has boon uneven in ranslting this recognition into nationally implemented programmes. Young people are offen denied even the most basic information about hei sexual and reproductive heath and rights. Implementing and resourcing CSE programmes continues to be a challenge in mony parts of the word, However, a global movement has galvanized around ensuing access to CSE, wih youthled movements in paricular cling for stronger responses, susained commiment and the upscaling of resources. ‘As a result, sexealiy education and SRH services for young people feature prominently in the post2015 development agenda. Young people themselves are increasingly demanding their right to sexually education, as evidenced by the 2011 Mali Call to Action; declarations at the 2011 Intemational Conference on AIDS and STs in Affi (ICASAI; the 2012 Bali Global Youh Forum Declaration; and the 2014 Colombo Declaration on Youth. The UN Majar Group on Children ond Youth also continues o highlight CSE os one o is top priorities, for the Sustainable Development Goals and in related UN. Wihin the consultations on the post2015 development cegendo, young people have advocated consisonly for sexuality education, notably through the ‘Have you seen my Rights youth cooltion. The PACT, a cooltion of youth organizations working on HV, has highlighted the need for sexuality education in the consultation process on the update and extension of tho UNAIDS strategy {INTRODUCTIONNe Say WITHIN DIFFERENT fi y CONTEXTS8 SITUATING CSE WITHIN DIFFERENT CONTEXTS 2.1 AGE-APPROPRIATE CONTENT FOR THE DEVELOPMENT OF HEALTHY BEHAVIOURS Effective sexuality education responds to the needs and capaciy cof children ond adolescents through o buildingbleck opproach which develops knowledge that is appropriate to each age group ond developmental siage. Ageappropriate content is @ prerequisite for CSE that is affective in doveloping ond strengthening young people's abily io make conscious, heathy nd respectul choices about relationships and sexy Intemational siondards and guidance recommend that sexually education stars carly in chiidhood and progresses through codolescence and adulthood (WHO Regional Ofice for Europe ond BZgA, 2010; UNESCO, 2009) building knowledge cond skils through @ carehily phased process overtime, Eke any other subject inthe cuticulum. Too ofien, topics are lought too late — for example, ater young people have alteady experienced puberty or menstuation. Sexality education must begin before the onset of sexual activity, should respond to young people's evolving needs and develop their knowledge, otitudes and skis fo prepare them appropriciely forall stages oftheir development and capacties. Th Intematinal Technical Guidance on Sexually Education (UNESCO, 2009) proposes can ageappropriate set of topics and learning objectives that consivies o CSE programme for oges 5 to 18+. The Standards for Sexwaliy Education in Europe recommend stating CSE ‘education fiom bith Developing postive seltestoem and heathy behaviours and relationships during adolescence is recognized os having a lifelong impact. Sealy edvcation contibutes to laying the foundation for heathy future eltionships, as well as good SRH cond heath seeking behaviour. CSE with very young adolescents between the ages of 10 to 14 years is erica as this age marks « key transtion between childhood and older adolescence ‘and adulthood, ‘sting the stage for future SRH and gendered offitudes and behaviouts’ (gras, 2014} CSE with very young adolescents between the ages of 10 to 14 years is critical as this age marks a key transition between childhood and older adolescence and adulthood, ‘setting the stage for future SRH and gendered attitudes and behaviours’ (Igras, 2014) Primary education is now compulsory in almost every county, ‘making this an important vehicle for reacking o large number of children in a costelfacine manner (UNESCO, 2014 Staring sexuality education in primary school allows children to identify and report inappropriate behaviour (including child cbusel and develop healthy atiudes abou heir own body and relationships. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 20152.2 REGIONAL COMMITMENTS TO CSE Different regions have shown leadership inthe development and implementation of CSE, fom demonshoting increased pabtical wil, 10 developing and investing in CSE programming Western Europe pioneered the introduction of schoolbased sexuality education programmes 50 years ago. Counties such (0s Sweden, Norway and the Netherlands, with longstanding senvoly education programmes in schools, have sigriicanly lower adolescent bith res than counties in Easiemn Europe ond Cental Asa (FECA, where open discussion of issues related to sewaliy ond sexval and repreducive heath and rights SRH8) in schools remains more sensive. In Estonia, for example, several research resus demonstate the strong coreation over ‘ime between the development of sexvaliy education and the steady improvement in sexual heath indicators among young people from 2001 onwaids. These recent improvements ore atibuted othe development of mandatory sexvalty education programme in schools, in combination wih the evolution of vyouth-riendly sexual hea service delivery [UNESCO, 201 To Within Europe, the WHO Regional Office produced Standards for Sewaliy Education in Europe, which provides a framework to support policymakers, education and heath aubhortes, cond other stkeholdess, in implementing quality standards for sealily education across the region. In tia America ond the Corlbbean, ministers of heath ord education declared their commitment to sexually education through the Preventing through Education Ministerial Declaration CASE STUDY 4: COST EFFECTIVENESS IN ESTONIA ‘A study of the cost effectiveness of CSE highlights the potential cost savings of rolling out @ national, mandatory sexuality education signed in 2008. Governments commited to integrating strategies and ensuring infetdeperimental coordination and greed 10 implement and strengjhen ‘multisectoral stotegles oF comprehensive sepuality education and promotion of heath, including HIV/STI prevention’ (UNAIDS, 2009). Counties inching Argentina, Uuguay, Colombia, the Dominicon Republic, Cuba, Peru and Mexico hove ako developed national logislative frameworks, making the delivery oF CSE compukory. Similarly, in Easiem and Souther Afica, the political will 1o ensure access 0 CSE has beon affimed at he decisionmaking level, 05 evidenced by the Ministerial Commiment on CSE and SRH services for adolescenis and young people. This key culcome explcily prizes, ‘ensuing access Yo good qual, comprehensive, life skilsbased HIV and sexuality educetion (CSE| and youth Fendly sexwol and repreductive heath services for all adolescents and young people’, and adopts @ culturally relevant approach (UNESCO, 201 3c) The AsiePaclic region has raditionally hod «highly fovourable palicy envionment towards implomonting HIV education, with most counties inlegrating broader sexualiy education into national HIV strategies (UNESCO, 20126]. The commiment from the Asion and Pacific Population and Development Conferonce in 2013 focused on ensuing SRHR for all pariculatly the poorest and mest marginalized populations. © al programme. In Estonia, a mandatory programme was rolled out for 7-16 year olds, alongside youth-friendly sexual and reproductive health services. The cost of rolling out the programme was $5.6 million. Between 2001 and 200 an estimated 13,490 negative health outcomes. ‘were prevented, including 4,280 unintended pregnancies, 7,240 incidences of STI transmission and 1,970 HIV infections. Ina cost-benefit analysis, based on HIV infections prevented and on HIV treatment costs alone, sexuality education would only have to be responsible for 4 por ‘cont of all HIV infections averted to be considered as not only a cost- effective intervention but a cost-saving one too. ‘Sou: UNESCO. 2011 Schoo! based sarualy education: A cost and cost atectvencs study In sr countries Pais, UNESCO. 2 STUATING CSE WITH DIFFERENT CONTE2 2.3 ADAPTABILITY OF CSE CONTENT CSE conlont must respond appropriatsly to the specific conlext and needs of young people in order io be effecive. This odaptabily is central 1o culturally relevant programming, cond includes understanding the messages [sometimes postive, sometimes negative) thal cultures convey around gender, sex cond sexvoliy, This may inclede «a concerted focus on topics such 1s gender discrimination, sexual and genderbased violence, HIV and AIDS, child mariage and harmful tadtional practices. As wif all curicula, CSE must be delvered in accordance with national laws and polices. While some adaptability of content is clearly important, tho fundamental principle of © young persons ight fo accurate tnd timely education about thot bodies, elaionships, sexual beheviour and heath is pararnourt. There ore therefore certain 010 opis that are essntal 19 mainaining quality and meeting intematonal sandards UNESCO, 20130; UNESCO, 2011. The indicator hamework in Box 3 in Section 3.4, developed by UNESCO in consultation with the UNAIDS IniorAgency Task Team on Education, is one tool hat can be used to help adapt conlent fo suit specific national and local contexts. Although this tool focuses spectically on HIV ond AIDS, the majocty of the ceria ~ pariculaly those categorized as ‘desirable ate highly relevant for adehessing broader SRH and gender ‘outcomes, including unintended pregnancy. While CSE should reflect national legal framewexs, there is still «need for national efforts to review ond reform harmful lows ond policies thot might have @ negative impact on adolescent health and wellbeing, such as those that sanction discrimination = including criminalization in some instances ~ based on gender, age, healh status, pregnancy or other grounds. Equally, iris important to addess the lagal and policy bears that prevent adolescents and young people fom accessing services, information ond education. South Afica’s Children’s Ac, for insance, passed in 2005, lowered the age of consent fox HIV testing and contraceptives fo 12 years, thereby expanding ‘2ccess 10 soxval and reproductive heath care for adolescents in a country where an estimated 11 per cent oF young men tnd 6 per cent of young women become sexually active belore the age of 15 UNICEF, 2011). This decision by tho South Avian Law Commission was informed by the need to both recognize the relies of he HIV epidemic and io acknowledge the evolving capaciy of adolescents. A reported result ofthe change was increased access fo HV tesing (UNAIDS, 201 3b 2.4 WORKING WITH COMMUNITIES AND PARENTS Parents and families play a key role in shaping attitudes, norms and values related to gender roles, sexuality and the status of adolescents and young people in the community (Svanemyr et al, 2015) Parents can play an important role in communicating wih heir children about soxvaliy,releionships and wellbeing, porrculaty ‘among younger age groups. Studies have repeatedly shown ‘hat favourable perenal atitudes influence childrens atitudes, whether this is elated fo acceptance of sexually education, uptake of HIV testing or coniaceptives. Parents and families play a key oe in shaping ctitudes, norms and values elated to gender roles, sexually and the satus of adolescents and young people in the community [Svanemyr eta, 2015) Values teloted to the centrality of the family, lifeaffiming copproaches and solidarity ae also central tenets in fathbased sources of learning for young people. Fathbased approaches in the response to the HIV epidemic have demonskoted considerable power, innovation and value. Similarly, fit based suppor! for senvaliy education as a way of promoting and protecting human dignity has been expressed throughout the evolution of sexvality education. For example, in 2003, the Warld Young Women's Chrisian Association [YWCA] Council cedopied a resolution on Reproductive Heath and Sexvaiy, that calls on the YWCA movement o promote and work towards the provision of extensive accesso quality education, resources, information, discussion and counselling for women and gis regarding heir reproductive right. However, young people indicate that they generally lam about relationships and sexualiy from souces oher than their pparenis, Many porenis may fel uncomfortable and insuficienity [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015prepared fo provide sowvalty education, and therefore support schools faking on this role as a supplement to any discussions within the family [WHO Regional Office for Europe and BZA, 2010), Parental and community support or resisiance has bon widely recognized as an important factor that enables or constrains the implementation of CSE for young people beth in and out of schools Despite existing opposition to sexvoliy education by some politica or figious groups who may have cerain influence over public atiudes towards CSE, parent in many pars ofthe world suppotschoolbased sexvoly education. A recent online poll of patents in Chine indicated that 90 per cent of those quesioned were in favour of incorporating sexvaliy education into school curicula, including information about family planning and how fo cope with inappropsiote sexual advances UNESCO, 2014), Similly, 88 per cent of Russian women aged 15-44 support sexuoliy education in schools to provide knowledge about pregnancy, Sl, contaception ond ther SRH issues (Federal State Stalsic Service (ROSSTAT|/Minisry of Heath of tho Russian Federation, 2012). Suveys in the Unied States CASE STUDY 5: ENGAGING PARENTS IN PAKISTAN ‘The Pakistani NGO Aahung develops culturally relevant strategies to respond to the community's SRH needs. Aahung succeeded in integrating its life skills-based education programme into public and show that parenis want thei children to be taught both about dolaying soxwal debut, and having safer sex when the time comes (Advocates for Youth, 2008), Demographic and Heath Sorvey [DHS dota from counties in Easter and Souther Africa show that, in a laige mojoriy of counties, over 60 per cent of chil ogre that chldran oged from 12 t0 14 years old should be taught about condoms (UNESCO, 201 3e) NGOs ond UN agencies have pilsted effective programmes to equip parents with the information and sis to communicate effectively on these topics. In. several counties in Latin America ~ including Argantina, Uruguay and Peru ~ ministies of education have produced motarials oimed ot porents to suppot their chitken’s activites ot school. In eight counts in Alica, NGOs and UN agencies have developed specific tools to support community engagemert in sexualiy education, Parenis'imwolement in school heath education commitees ~ as members of school boards, o as advacotes during community controversy ~is vital to making sure that young people receive ccccarate information and tha answers fo their questions are not consored private schools in Sindh province. As part of the organization's work {to engage a broad range of stakeholders, it explored ways of engaging ‘with parents and community leaders. Aahung works closely with the school administration and community members to ensure local support for the project. The organization invites parents to a meeting where ‘they can ask questions about the curriculum and raise any concerns ‘thoy may have. They discuss where young poople will access soxuality information in the absence of CSE programmes. Parents recognize the benefits of Aahung’s programme, which is evidence-based, accountable and delivered by tained professionals, particularly when compared to the altematives, such as young people receiving information from thelr peers or the media. Aahung has found ‘that involving parents in this way increases support for the programme and results in fewer barriers for the project’s implementation. Source: Website ofthe NGO Aahung: www aahung ot and personal communication (Sheena ‘Ha Aahung, 10 May 2015) 2 STUATING CSE WITH DIFFERENT CONTE 2¥" ~~ DELIVERING AND Tt STRENGTHENING CSE24 DELIVERING AND STRENGTHENING CSE 3.1 PLACEMENT IN THE CURRICULUM ‘As CSE gains momentum and intrest at inlerational, regional and national levels, governments are increasingly puting in place measures fo scaleup their delivary of some form of ife skilsbased sexually education, as well as seeking guidance con best practice, parculary regarding placement within the school curiclum. Sexually education may be delivered as a stand-alone subject or iniegrated across relevant subjects within ‘he school curicla. These options hove direct impications for implementation, including teacher taining, the ease of evoking ond revising curicula, the likelihood of curicula being delivered, and the methods though which i's delivered. Within counties, choices obout implementing integrated or stondolone sewaliy education ore Nypcaly linked to national policies and overall organization of the curicula. The county summary table in Annex. T reveals. fait even division in terms of ‘opproach. The evidence base on the effectiveness of standalone 1. integrated sexwaliy education programming is sil limited However, thore aro discernible diffoences for policymakors to consider when deciding he positon of CSE witin he curiculum The pedagogical approaches promoted through sexuality education [...] are increasingly being recognized as transformative approaches that impact on learning and education more widely ‘sa standalone subject, sexoliy education is set apart from the rest ofthe curiculum, wheher on its own ox within a broader standalone heath and life skis curiculm. This makes more ‘wlnerable ro potently being sacrificed due o time and budget constraints, since school curicula ore typically overcrowded. However, @ standalone curriculum also presents opporiniies for specialized teacher raining pathways, and the use of non- formal teaching methodologies tha im to build eames citical thinking skils. The pedagogical approaches promoted through sexually education — such as leamercented methodologies, development of sills and volves, group leaming and peer engagement ~ are increasingly being recognized as transformative approaches hatimpact on leaning and education more widely. As a standalone subject, it i also significantly easier to monitor, which is crucial in terms of evaluating the effectiveness of programming, and revising curicula where it is not delivering the desired leaming oulcomes When sexuality education is integroted or infused, it is Imainstoamed across @ number of subject areas, such as biology, social studies, home economics or iligious studies While his model may reduce pressure on an overcrowded couriculm, itis dificuk t monitor or evalvaie, and may limit teaching methodologies to toditonal approaches. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 20153.2. MANDATORY VS. OPTIONAL In order to maximize the effectiveness of sexvalty education, i must be comprehensive inthe information and skis ® impos, ond # must ao have bioad coverage. Where sexually eduction is nor- compulsory, extxcuricular or only partially compulsory, o large number of sents will nt reap is benelis (UNESCO, 20126}. ‘A costelfoctveness study of CSE concluded tha, in oxdor to reach © aca mass of young people ond vse resources effectively, CSE programas should be mandatory ond scaledp though stato schoo’ (Kiel eto, 2014, p!-13; UNESCO, 20141 3.3 TEACHER TRAINING The question of whether CSE shoul be compulsory or optional also impacts on the number of teachers available who are equipped to deliver it, since delivering CSE requires adequate polsory subject within teacher tiring programmes, or compulsory uoias for CSE teachers in schools, effecve delivery cannot be guaranieed. raining and capaciy. Inthe absence of CSE as a NGOs have been critical in developing and pilosing curicla ond innovative delivery methods, but they generally lack the capacity to deliver programming on @ rational scale. National govemments, particulary ministies of education and heath ate best placed to coordinate the implementation of sexuahly education in a way that maximizes available resources, and stives lowards universal access. The oxcilabitly of taining ond support to teachers is crucial to guaranteeing that CSE is delivered in « safe endironment Research from ten counties in ESA found that most curcula did not mention access to guidance, supervision of teporing requirements for teachers who encountered disclosure of sexwal abuse during dalvery of sexuality education programmes [UNESCO/UNFPA, 2012), pointing to acre lock of supervision and support CASE STUDY 6: BUILDING TEACHERS’ CAPACITY TO DELIVER QUALITY SEXUALITY EDUCATION ACROSS AFRICA ‘Save the Children in South Africa led the implementation of Pan-African Comprohensive Sexuality Education and Information project across 15 ‘countries in Southern, Easter and Western Africa, The programme piloted the process-oriented approach (POA), a unique teacher-training ‘methodology recognizing that anyone who delivers sexuality education ‘will be influenced by their own personal attitudes, beliefs and values. ‘Teachers ware encouraged to examine thelr own attitudes and values ‘to issues relating to sex, sexuality, gender and relationships to consider how these might influence their delivery of CSE and to reflect on their responsibility to deliver information that is technically accurate ‘and unbiased, This included participating in activities that explored personal values and attitudes from the perspective of both leamers ‘and teachers, Teachers were also given the opportunity to practice delivering sexuality education sessions ~ particularly those parts of the ‘curriculum that they found most challenging ~ and to receive feedback +o build their confidence and skills, Source: Save the Chdren training manual end personal communication (Yarnah Hats, ‘Seve the Chulten, 10 June 2018). {3 DELVERING ANDSTRENGTHENING CSE 252% 3.4 ASSESSING CSE ‘Monitoring he impact of sexuality education canbe challenging Monitoring knowledge levels ~ for example, HIV knowledge rough DHS indicators ~ does not necessarily reflec the impact fon attitudes oF translate into behaviour change. Evalvcting sewalty education according to heath indicators such as adolescent pregnancy or HIV incidence may confound the impact of education with access to services and cther important cconfexual factors UNESCO, 2014) ‘A vay of monitoring ond evaluation tools have been developed in recent years. Toos such as he Sexuality Education Review and Assessment Tool |SERAT) [UNESCO, 201 1b) ond PF’ Inside and Out, give a hamewor for ossessng the scope, content and delivery of sexaliy education both, ond out of school As part ofits supporto national minsties of education to scale up sexvalty education, UNESCO and the IniocAgency Tsk Team on Education developed the following indicator to examine the quali, comprehensiveness and coverage of life skilsbased HIV ond soxuliy education. As patt of o larger monitoring framework for education sector responses to HV cond AIDS, this has been fied tesed in several Afican ond Caribbean counities. UNESCO and pariness are supporting its rollout for the education sector through existing educotion management information systems [EMIS Tho indicator measures the extent io which certain ‘essential or ‘desrabl’ criteria have been included in schookbased sexually educotion. The essential lopics are those that have the grees! dltect impact on HV prevention and include: life skills such as ommuication and negation; sexual and reproductive heath information; and, HNVspecific information. ‘Desitable’ topics cre those that have on indiect impact on HIV prevention but that ore importan! as part of an overall sexually edvcation programme. Although this focuses primarily on HIV outcomes, it does nevertheless copiure many broader concepts of CSE such 1s pregnancy, gender equally and human development This indicator isin the process of being integrated inthe EMIS cf approximately 18 counties in the ESA region. By 2016, all Southern African Development Community (SADC] counties «te expected lo integrate the global monitoring and evaluation framework indicaios inlo EMIS. A similar process is expected in West ond Central Africa (WCAJ, where UNESCO has provided training 1 11 counitas on the integration oF indicators into heir onnval school census. Further indicators and evaluation tools have been used in indvidval counties, or for spectic programmes [such as those managed by civil society organizations. In recent yeas, tools have been refined to specifically take note of gender and rights within CSE (UNFPA, 2015]. While collectively ogreed sets of indicotoss could offer CSE providers and supporters the means io calle skalegic information to inform programme and planning, CASE STUDY 7: BUILDING THE EVIDENCE BASE WITH A STRONG EVALUATION FRAMEWORK IN. COLOMBIA ‘The Ministry of Education of Colombia has led the implementation of 42 national sexuality education programme that bullds on the pillars of gender equality, citizenship and human rights, as well as community participation, Priortoscaling up the programme, the Minister of Education insisted on building in an intensive monitoring and evaluation plan, which incorporated a rigorously tested self-administered questionnaire for students, as well as an evaluation of the school environment. Evaluation has revealed thet, in addition to improving students’ Jmowledge of SRHR topics, the wider school and community environment also had a significant impact on young people's learning. Students with the highest levels of knowledge reported feeling that their classrooms ‘wore safe spaces where they could count on being treated fairly and with respect, particularly in communities where there was an absence of armed conflict. Teacher training was also found to be important, as those students whose teachers had been trained in citizenship and ‘human rights demonstrated higher levels of knowledge. Source: UNFPA. 2016. The Bvaluation of Comprehensive Sexuality Bdueation Programmes: [A focus on the Gender and Empowerment Outcomes New York, UNFPA, personal ‘Communication (Marta Carclin Ira, Universidad Loe Andee, 8 June 2015) iQ [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015indicators must also be focused on the planned outcomes of that paricular CSE programme, which should reflect the needs and context of young peopl in that seting (Keting ot «al, 2015], For example, in many Southern Akican countries, measuring improvements in HIV knowledge and related skis remains critical. In ther setings, such os Europe, for example, measuring atiudes towards sexval divetsiy, or competencies with regards to accessing heath services, may be priostized. Essential topies are those that have the greatest direct impact on HIV prevention and include: life skills such as communication and negotiation; sexual and reproductive health information; and, HIV-specific information. BOX 3: CORE GLOBAL INDICATOR FOR MONITORING AND EVALUATION OF EDUCATION SECTOR RESPONSE TO HIV AND AIDS Indicator 3: Life skills-based HIV and sexuality education ocontial topics _Docision-making/assortivenoss Communication/negotistion refusal Human rights empowerment Destrable topics Other gender life skills Acceptance, tolerance, empathy and non-discrimination Essential topics Human growth and development Sexual anatomy and physiclogy ‘Famly lif, marriage, long-term commitment and interpersonal elationshipe Society, culture and sexuality: values, attitudes, social norms and the media in relation to ‘sexually Reproduction Gonder oquality and gendor roles Sexual abuse/tesisting unwanted or coerced sx Condoms ‘Sexual behaviour (sexual practices, pleasure and feelings) ‘Transmission and prevention of sexually transmitted infections (STIs) Desirable topics Pregnancy and childbirth Contraception other than condoms Gonder-based violonco and hamnful practicos/tojecting violence Sexual diversity Sources for SRH services/secking services Other content relatad to SRH/SE ocontial pics Transmission of HIV ‘Prevention of HIV: practising safer sex, including condom use ‘Treatment of HIV Destrable topics HIV-related stigma and discrimination Sources of counselling and testing services/seeking counselling, treatment, care and support Other HIV and AIDS-related specific content 3 DELVERING ANDSTRENGTHENING CSE 272% 3.5 INCLUSIVE WAYS OF DELIVERING CSE Achieving universal access fo good quality CSE requires specific strategies fr reaching marginalized young people who are out of school. Young people who face discrimination and abuse oftheir human rights — including the righ 10 education — are ot greatest risk of poor SRH outcomes. Young people who face particular challenges in accessing education may also be at increased risk of HV elifection and sexual and genderbased violence. This includes young people wih disabiliis, young people without parenial care, young migranls, young workers, pregnant ond matted gils, and those from key populations such as young people who sell sex, young people living with HIV, young kansgender people, young people using drugs and young men who have sex wih men. CASE STUDY 8: CSE REACHES OUT-OF-SCHOOL CHILDREN AND YOUNG PEOPLE In many countries, the stato and civil socioty have found innovative solutions to ensuring that children who are out of school can still benefit from sexuality education. Failing to prewide marginalized adolescents and young people wih CSE will deepen he socal exclusion that many experience, liming their potentiol and puting thelr heath, futures ond hives ot greater risk. NGOs have played an important role in developing innowalive salagies for reaching vulnerable and hardHoreach young people through intemet and mobile technologies, new modi, community and youth cenkes, as well as sport. Many of the most success interventions have been developed in Parinership wih young people (VilsTones and Sranemy, 2015). These complemeriary deliveyy methods capitalize on existing CSE mechanisms by accurately assessing what young people want, use and can curtenily access. CSE that includes Communitybased components — including invoking young people, parents and teachers in the design of interventions — results inthe mest sigiicant change. ean woe In tho Arab states, ¥-PEER ~ a poor-to-peor youth network ~ reached ‘more than 1.4 million young people with SRH messages and training using a theatre-hased peer education approach. Ia Egypt, a network of local NGOs provides reproductive health education to boys and girls aged 15-17 backed by the National Council for Childhood and ‘Motherhood, with support from UNFPA and UNICEF. In Guatemala, the Population Council and UNFPA are scaling up ‘Abriendo Oportunidades’ (Opening Opportunities), a programme for vulnerable girls who are either in school, out of school, married, unmarried or teenage mothers, that offers a comprehensive curriculum of health, sexuality and lifo skills. ‘Source UNFPA. 2014. Operational Gucance fr Oompretnsire Senay Education: A Focus (op Homan Rights snd Gonder Nev Yor, UNFPA [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE SEAUALIY EDUCATION A GLOBAL REVIEW 2015,CASE STUDY 9: USING MOBILE TECHNOLOGIES TO REACH VULNERABLE YOUNG PEOPLE IN NIGERIA Education as a Vaccine (EVA) ~ an NGO based in Abuja, Nigeria = hamesses the technologies that adolescents and young people already access to develop innovative ways of communicating about SRH information, and linking young people to youth-friendly services. Ina context challenged by religious polarization, advancing sexuality education at a policy level and in schools has beon limited in Nigeria, ‘making this type of out-of-school provision vital Working in partnership with one state govemment, EVA is using Information and Communication Technology (ICT) and cyber cafes to deliver CSE through e-learning, with content developed by young people themselves. EVA also piloted a 24-hour phone, email and text ‘messaging service that allows young people to reach out to trained professionals anonymously with urgent SRH-related questions. The response to this service has been overwhelming with more than 10,000 ‘texts received each month, EVA also bridges the gap between education and services by ‘mapping youth-friendly $RH services, including HIV and STI testing and treatment, contraception, pregnancy testing and gender-based violence (GBV), and by inviting young people to rank the relative ‘youth friendliness’ of different services Source: Personal comamuniction(Fadskmi Alinfadsrin, Edusstion 19May 2010), 8 Vaccine, Nigeria, {3 DELVERING ANDSTRENGTHENING CSE 2»ANALYSIS OF COUNTRY DATA2 4. ANALYSIS OF COUNTRY DATA Tho counity tables in Annax | provide on overview of the situation regarding CSE across 48 counties. They summarize information on national euriculs, policy and implementation of CSE in choos. Data was generated through o ropid sivtional analysis using existing resources and studies. In some countios detailed information was available following the application of the SERAT tool a a national level. Other regions have conducted con indepth review of policies and stalegies required, for example, to implement and scaleup sexuality education Asia Pocitic region} (UNESCO, 20126) and prevention educotion| (Easiam Europe and Cental Asia) (UNESCO, 20136) oF detailed review of somvaly education curicula across dlferont counties (East and Souther Aca) (UNESCO/UNFPA, 20121 For other countries, the available dota was relatively limite. This combination of approaches allowed fora rapid sitvaional assessment in he counties selected, while having the significant limitation of fling t provide a flly comparative sty. The counity summaries include information that ilusates the conlexval sitation ~ for example, regarding young poople's 4.) 4.1.1 Policy level Increased intentional and regional syppost for CSE, as well 63 invesiment in programming ond technical supp, is evident atthe policy level. Almost 80 por cont of the counties in this cossessment have policies or staiegies that support CSE. Despite this increased political wil there remains significant gap beiweon the numerous global ond regional policies in place and the actual implementation on the ground. Fve yours fon from the LAC Declaration, jst over hal of he countries had implemented the recommendations IPPF and Democtacio.y Sexvatidad, 2012). Despite all counties in ESA naw reporting having a policy oF strategy to promote life skilsbased HY education for young people, many face ongoing challenges in their implementation. Few srotegias oF policies are fully knowledge levels regarding HN, gender noms and the cxolescent national fry rate ~ and data on the statis of CCSE implementation. The table presents information on CSE's pasion within te notional curicalum fwheher ii soncelone © iniegrated), whether itis mandatory or optional, the age groups covered, whether teacher taining is provided (noting that, even where taining is delivered, coverage may be pachy| cond whether a national policy exis to provide a mandate for CSE in schools. Additionally, all the couriry curicula were assessed against three standardized benchmarks, in line with cn oggeed set of indicators (UNESCO, 2013a} outining infomational standards for CSE. These include in the curiculs: * Teoching on generic life skis lo.g., decision moking, communication, negotiation sil, gender equaliy © Teaching on sexual and reproductive heath and sexuchy education le.g., human growh and development, roltionships, reproductive hea, sexual abuse, ansmission of STs) + Teaching on HIV transmission and prevention KEY FINDINGS FROM THE COUNTRY DATA, operationalized and there remains a need to srengthen nation wide coordination ond monitoring mechanisms fo support mult secioral implementation, Almost 80 per cent of the countries in this assessment have policies or strategies that support CSE. Despite this increased political will, there remains a significant gap between the numerous global and regional policies in place and the actual implementation on the ground. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015BOX 4: REGIONAL POLICIES Asia-Pacific: 21 out of 25 countries’ national HIV strategies/plans referenced the role of education; ‘most targeted in-school young people, mentioned. capacity development of toachers and promoted HIV and life skills education. Cambodia and Papua ‘New Guinea have established HIV policies for the education sector. Eastern Europe and Central Asia: All countries ‘covered in the assessment had national policies supporting CSE - with the exception of Uzbekistan, Kazakhstan and the Russian Federation ~ providing a comerstone for the delivery of life skills-based health education, with HIV and SRH education being central. West and Central Africa: Most countries in the assessinent have an education sector policy on HIV and AIDS, completed by a strategy that creates an enabling environment for the delivery of life skills- based HIV and sexuality education. SERAT studies 1.2 CSE position within the curriculum The majority of counties report providing ite skilsbased sexvolty ond HIV education inthe cucu at secondary level Counties across ESA hove inegrated (or re in he process of integrating) CSE across both primary and secondary schools, «swell as during teacker raining. In Asia and the Pact, lass than hol (43 per cent) of counties have inlegiated sexuatiy education ot primary level, whila 22 out oF 28 countries reporied doing 50 at secondary level UNESCO, 20120), The analysis differentiates between ‘ilegtaied’ approaches, where issues of senoliy and HIV prevention were incorporated and discussed in mainsteam mandatory subjects actoss the curiculum — most commonly Biology, People and the Word/ People and Health, Basics of life Softy ~and those where CSE was dalivored as a ‘standalone’ subject, either focusing sololy oon CSE or whore tis was « key focus of hfe skilsbased heath education, such as Healthy lifes or if Skil. The number of counties delivering standalone vs. integrated approaches was faily evenly split. Some counties —pariclarly those in the Asia Poxitic and EECA regions - offered addtional, optional courses ‘hat addressed HIV prevention, in paticulr, in more dephh. In the EECA region, educational programmes that address sewolty ond HIV prevention ore usually taught at secondary lovel and ate iniegiaied into a mandatory, life skilsbosed subject. Aleatively, they are integrated inlo of least one ‘mainstream’ mandatory subject, such as Biology, People and Heath or Basics of ile Safely. The majority aso offer optional ccouses, usually at secondary Level. However, the limited duration of courses ord piocameal approach in many counties show that, 12 out of 13 countries have a plan that supports the implementation of a sexuality education programme. Latin America and the Caribbean: In 2008 health and education ministers signed a declaration affirming a mandate for national school-based sexuality and HIV education, as well as endorsing the incteased availability of adolescent friendly reproductive health services, Eastern and Southern Africa: Ministers of health and education from 20 countries affirmed and endorsed the Ministerial Commitment on CSE and SRH services for adolescents and young people in December 2013, setting specific targets to ensure access to high-quality, comprehensive, life skills- based HIV and sexuality education and appropriate youth-friendly health services for all young people, moans thatthe potenial of CSE 10 translate knowledge into asserive atitudes and behaviour change among young people snot yet being fly realized. The ennual progress review following the ESA Commiment demonstrates the very significant progress made in translating this spect of the commitment into action. The majorly of the 21 counties (14 at primary level, 13 at secondary) have heady incorporated life silsbased sexuality education into the cuicolum though @ combination of integrated and stanc clone approaches (UNESCO with UNAIDS, UNFPA, UNICEF WHO, 2014). A number ofthese counties have either aleody ‘made this exominable or have plans to do so, at both primary cond secondary levels. Several counties ~ including Angel, Burundi, Kenya, Rwanda, South Sudan and Zimbabwe — are sill n the process of updating their if skilsbased sexuality and HIV education curiclum within the scope of ongoing national cericulym reform processes -3 Curriculum content Thoro hes boon increasod recon focus on sronghening cumcula in some countries ~ particularly those across ESA and counties suchs Thailand, China andindi in Asia athough his remains « citical need. In toms of curiculum design, insfcient focus s placed on developing key competencies, incuding cstical thinking, and on examining how gender norms, tligion and culur influence ramets’ attitudes and behaviour (ntenatonal AIDS Society, AIDS 20141 In 2012, jst over haf he counties in UAC reported teaching ifrmation on RH, HWY prevention, genderisies, human ight, A ANALYSIS OF COUNTRY DATA 8u including sexual rights, GBV, prevention and relationships. Only four counties had undertaken a formal review of curticula (FPF cond Democracia y Seruolidad, 2012). A review of curicula ‘across en counties in EECA found tha, in many instances, sexual beohoviour, sexvolty and contraception wore either touched on very brefy or completely excluded from classroom discussion (UNESCO, 20138). Eight counties in ESA now have curricula ‘hat meet inlemational criteria, @ notable improvement since a review in 2011 highlighted gops in over 70 per cont of the topics (UNESCO/UNFPA, 2012). The review hos served as @ catalyst to improve content around sexualy, sexual behaviour, sofor sex and sexual and gendorbased violence. Issues of gender and righls are almost consisenily absent or inadequately covered thiowgh curent curicula across all regions. In WCA, where the SERAT tool was used to assess 10 ut of 13 national sexually education programmes, fewer than hal ofthe curricula met globol standards for required contont ‘cross all age groups, wih gender and social noxms identified (0 the wookest oreas. The issue of child mariage was oko cither omited or pootly addressed fiom curicula in Kenya, lesctho ond Molawi where this remains a perinent issue Sexal abuse/explitation/rape were also missing oF were poorly addressed in these counties and in South Africa, which has one of the highest rales of sexval violence in the world ‘A teviow of curicula actoss ton counties in FECA reveled © failure to address the issue of school safety, despite the acknowledged vulnerabiliy, of ils in particular, to abuse by boys, teachers and cther adults in school setings UNESCO, 2013b) Around the world, gils and young women face particular challenges with regards 1 accessing and completing education, including risks of sexual harassment and assaut, lack of bathrooms, and the offen unsafe journey to and from school UNESCO, 20126). Factors outside of school ako have on impact, including family and social pressure for gis to perform caregiving and domestic roles, and fo ener into early mariage, wich resut from the discriminatory gender nous ‘hat CSE seeks to address. The lack of appropriate attention to gender in CSE curicula represents a stark disconnect fom the really for most adolescent gits ond young women. I presents {an important eny pointe begin to acdeess heir vulnerability by inducing topics at primary school on appropriate touching, chikd protection and sexwal exploitation ond abuse, and to build the skils and knowledge of boys and gitl to address gender inequaliy ond power dynamics. Wik resources such as fs All One Curriculum (IPFF, 2009) and UNFPA Operational Guidance for CSE, the tools are now available to deliver lective genderfocused CSE in all contexts Russia and Uliaine have intoduced taining and sensitization pregrammes for teachers to address he needs of young people living wih HIV and 10 halp provent sigma and discrimination Blows, Ukraine, Kyrgyzstan and Tajikistan — and counties such os Jomaica, Australia and Canada — have national pelcis to suppot staff and pupils who are living wit or ffeced by HIV tnd protect thom from discrimination, Hawover, mas! curicula rarely acknowledge the specific SRH needs and rights of young peopl living wih HIV, young people with disabilities (+ young gay, lesbian and transgender people, especially as they reach pubery. Efectve CSE has to be both incisive and nonstigmatizing. It should addkess sewal and genderbased violence and promote gender equaliy, as well as ensure the reeds and rights to education, privacy, fling vlationships ond SRHR} ofall young people, including those living with HIV [UNESCO and the Global Network of People Living with HIV (GPs, 20121 The lack of appropriate attention to gender in CSE curicula represents a stark disconnect from the reality for most adolescent girls and young women, 4.1.4 Teacher training Improving cuniculi line with international standards is clearly koy, but the quality of CSE delivered to young people depands ulimately upon teachers’ krowledge, confidence and skill to daliver the subject. Teachers must be adequately trained in tho subject mater and in patticipatory approaches (Over the last decade, there has been an increased focus on training teachers in life skill, including for the prevention of HIV. Through the Prevention through Education Declaration of 2008, LAC countries commited to including CSE curcula in oll teacher raining programmes by 201.5 (UNICEF Barbados and Eastem Caribbean, 2011], However, five years later only eight counties had achieved national coverage of teacher training (PF ond Democracia y Sexualidad, 2012) and ‘the evidence relating tothe quality ond scale of HIV and Ife sklls delivery in the classroom would sugges! that here are sill igificant gaps between training and delivery’ (UNAIDS IATT, 2013). While cover half the counties in the table reporied including sexually education elements in teacher taining, is ofen unclear how many teachers are reached and whether tis includes pre-and inservice training. Similarly, challenges remain in ensuring that teachers actually teach the more sensiive aspects of the cuticulm. In WCA, only 6 out of 19. counties that implemented the ‘SERAT too} achieved ‘song’ ratings for mexe than 40 por cont of the elements of heir teacher training programmes. None of the remaining seven counties explicly prepated teachers 10 face embarassment when talking about sexually, to avoid bias caused by personal nous and beliss, oto avoid pressuring learners to talk about serstive topics. Teacher training remoins 12 weck point in most schootbased sewally education programmes. Developing and updating taining curicula and suppering teachers to examine theit own voles and biases remains @ proty. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015Despite most ESA coxntties reporting trining teachers on sexvalty education, the review of HIV education in ESA countios (Tiendrebeogo et al, 2003} found that teachers frequently focured on knowledge rather than skills and used didactic methods rather than engaging pupils through participatory copproaches. A recent sidy in Tanzania (Matungwa et ol 2012) demonskoted leachers’ inability to discus issues relating ‘o sowvaly, sex, condom use and family planning and their belle that discussing isues relating to masturbation, condoms, seval pleosure and homosemvally was counter to community noes, culure and religion. Increcsingly, teacher training programmes in the region are now focusing on examining personal otitudes ond values in order to improve comfort ond confidence as well as the content and teaching skis required (Seve the Children, unpublished workshop manual and taining marwol - see Bibliography) Brazil offers @ postive example. In the state of Sao Paulo, an inclusive ond transformative approach to teacher training on sexuality education has been developed that allows teachers io explore thet own personal attitudes to various issues, including eval divers, belore then supporting them to develop the skills to teach these complex subjects (UNICEF, 2010). n Namibia, the Rainbow Project runs workshops for teachers exploring social inclusion/exclusion bosed on eachers’ own experiences, including issues affecting gay, lesbian, bisenvol and transgender people (UNESCO, 201 2c) In EECA, a number of counties reported insufficient teacher preparation to deliver highquoliy prevention education. Teacher training for CSE is often limited in scope. Wis usually delivered only through inservice taining, with the result that teachers ofen feel uncomfortable discussing sensitive issves ond do not consisionty use paticipatory methodologies io engage pups flyin heath and life sis education, Without adequate "raining and sensitization to the issues, teachers may potently reenforce harmful messages to young people ~ sometimes backed by harmful and punitive national laws. This perpetuates sfigna and discrimination in the community and may be particularly damaging 10 winerable young people who may be living wih HV or coming fo tems with ther own sexually A ANALYSIS OF COUNTRY DATA aCONCLUSION38 CONCLUSION Evidence demonstaes cleatly that CSE contibuies to HV prevention, as well as broader SRH and gender equaliy outcomes. AAs such, CSE is a catical enabler within the HIV response ond should therefore fom port of any national HIV response, while education more brocdy remains on important dovslopment synergy. UNAIDS has recently cited comprehensive ageappropriae sexuality education as one of five key recommendations fo fas rack the HIV response and tend the AIDS epidemic among young women and gis across Aiea (UNAIDS and Afican Union, 2015) Young people themsslves are increasingly demanding their ‘ight 10 sexudliy edhication, as winessed over the last five yours through @ number of calls to action. The development of Intemational Technical Guidance on Semaliy Education (2009), the European Standards for Sexuality Educotion (2010) and the UNFPA Operational Guidance for Sexvaliy Education (2014) hove all represented key milestones. in defining CSE ond providing support for counties to identify CCSE key components based on the best available evidence. These technical guides, along with programme support ond engagement rom a wide range of stakeholders, have facilioted tho process of implementing, measuring and assessing national CSE pregrommes fo ensure tha hey meet agreed international standards Tho data generated though this siuational analy reflects the increased poliical commitment and attention given to CSE at glebal lool. Tho vast mojarty of counties aro naw cctvely embracing the concept and engaging in he process of supporting ~ or skengthening — is implementation at a national level. This has resuled specficaly in ongoing atenton to ceurcula revision ia many counties, intagation of CSE ito the national curiculm and the development and rllout of efoctvo teacher traning. Continued advocacy and suppott are required to ensure that these goins are sustained and fo inlegrate evidence and lessons ~ including specticaly the need to address gonder and rights within CSE to srengihen the delivery oF CSE in practic. Young people around the world need comprehensive, ageapproprite sexuality education to develop their seltesteam and gain the knowledge ond sls to make conscious, heathy and respect choices about relationships and sexualiy [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015ANNEXES40 ANNEX 1: TABLE OF DATA ON ADOLESCENT HEALTH AND PROVISION OF CSE IN SELECT COUNTRIES eo Young Adolescent Reflects: young peoples rolatod: CSE ploce in Age groups {Teacher | National coy |HOV) POE | lige | he | fir” | See | moraine) “Eas |Mesr ig| ne Sie | Sve | tere Car ‘ewe [24] riz | 1e7[rpeggsene| Uaomw | Payad | Mendany | ve | We fd ime] ace | oom momma [oa] oz | 9 | 2 | a | goheama | wm | Pamnand | nendaoy | ve | ve on reac ‘emo mons [ore] or | m |e | a | sedobm | ve | Rammed | neniany | me | mo) vont eam [ooprcor| 3 | @ |» | amido | | rey | monoy | we | we wi outta oat =e, tame [ow] cas Pes fa |) mgmt | mt | ree mga) se | moa a costa |n odecier| "She Tea | onlay a econ vomow fais] re | <6 | wmyond | Uns oan | man [imgucie| ve | we ads moot gen | te fh Soles | Seis | "Shes sed fos] soz | 7 | amide | 6 | manent | mony | ve | Sey moa verona ~ sesso iw sans [1 | por | | 7 | & | mpegs | tetsu | Pamyant | trom | ve | Xe fd sa” | aon ssh Gmoie [ore frogm| a | «| 4 | Sonido | ve [PmyGnie] Oped we | we 0 "EuCS™ ccolday [Sends a Coron fas] rie [av [wm | 13 | mmpad | wm | Pan | mdony | ne | We wai exe | m2 ootots Coeaaien] 38 [prs | me |e || mgmt [| Amd | tay | |e Republic: Moo secondary | mplemenk ame ae fas] ron [ve | @ | tw Ppt [te | Pepe Peay | ae | mob iy [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015deat tetas + | “aed x plain Peer sete Reet Rete Hivx| Yer eri f international) om " Contry , Dene | iy | Soe [tne] ARE | Seer | rang | toe fhe | Savi) | Sire or ceo [<0 | hedoo | 99 © [rovneooed| n> | moved | ony | teed | wr Secondary inc | by policy, ee ea — carbo | 05 [02 | 241 koe co | tohasoe | vm | temo | me | om | “ct ce ay me ceuatem| 27] 1 | ve | | ta | thm | ve | Raped | thimm | vo | ve maz 5 Bowe [1 | cos | 7 | 7 | 138 | twat | ne | fimryed | wendy | re | ve ca moe oniay | od a tone [12] os |e | o | 7% | wound Tanya | Mendy * Mee aa com fia] soa | m | a | o | wmpomd Paya | Mey * Mes 5 Gaunat | 06 | oa | a we | sudaoe | ne | tomanand | Oped | ve | vm mee aa von [2 | roo | a | wv | a | vee | wa | nem | wa | wa | ro Me eee wis [oo] ai | © | «© | 2 | mpm | no | seamiey | onoa | vm | ro 32 ce” | a | “ee em teste vows fos] fos | = | a | = | wmont | roma | soantey | open | ve | vo ia fro |v] ros | | s | | sundobw | we | himoyod | mndaoy | ve | we hes =e Tawa [02 | mode | 22 | 12 | 2 | wmpoed | no | fimoned | waayand | ne | Ne ES vor | | gaa | | s | 10 | pagent |ttrmmen| frenyedt | Meany | Um | ve m7 SMESivcak | iomect | secmtiny | We a cg.” | sade voor fore] cor | a | a | a | sunfobm | we | Soamtry | mndioy | com | wo nies pee een tate fre] nos} | a |e | mpd | vo | tomy | mnkiny | tnlemm | vo Mee (pina ae ee a eae — wow [r03] a6 | «2 | 19 | 140 | Somiobe | vx | fmm | monday | vm | vo wi Eales come rami | 108 { pet [95 [20 | 198 | tmpomd [nkescn | Pamayand | Menigoy | Gao | Me Set Z Sak a tyme [oe | roa | a TY | thine | tiww | imnyerst | Uo | Ute | nom mee aa went [vas] rae | = | as | a2 | sudo | ve | Rinayond | manny | ve | ne aoe |e y [oaf rar] a] = | 7 [impondigoie] romal | scnday | mendaoy | no | ve we moo Cb} Sandon my | Noe eure ora raparew | oo | Foa | 22 a | Sanden | Rom | Peep | etary [Yn pal] Ye Bins on a 41adesct telat | ‘aed st plein pgzgeips |Nendoy /| eacer | Noel Hivx| Yer eri f international) om " Cony 2 Coie | fey | Seb | nemsesh| “Sea | "Seca | cing | yoy: eke | Save | sos or mice | oo | roa | a | sndcone | we | seamiey | endian | om | Ye tse ABs Sth tem [oa [ream] a7 | | | meet | te | Reed [taganino] Yous | ro redaon | = cscoiny | "nc fer st | atx qe woe [20] ca | ar [5 [a | mpm Utemam| Ogmpmny | Mey | Ute | moe Tomed | ond seconlay | NA | eoge os chai [or] ria | a | Soveoe | | tea | Monday | tino | os ie rt | ad et ee whsdm [22 | fi | mean |» | 72 | mea | ue | wa | wa ] re | w Ab opm Sieh Send [27a] tiza] se | | | amide | vo [Pept] Mndawy | vo | Mri Tooa on om bey || cial vata [os [tar] | @ | a) smddbe | meeps | semtsy | omma | oar | we wel ea, vw | | paz] a | mo | a) moms | we | rend | mendaoy | vm | we we ee |S ears toms fur fros | | | | tga || Sentey | Mndy | ne | hot a win cooey [owe] wwe | emg Gepicom | nao | rosgme | Monon | sont | ne cos, Eta | patasig | “ST |e! | cap | Shy ease ‘ite vows [7a] raz | am | o» | iz? | emmoat |yeinpean| Gym | Mendig | we | wo setae pe eay met M24 ca " ‘rom 2017) teow [ow] roa] [a | 2 | Sere | vw | fone | nowdony | romd | ve ae mot Vaswm [ore] ror] |» | @ | Sedde | Ne | Semtry | Onma | ter | te mh wenn [oa] ror] a | s | 2% | tmgunt | Amt | Saandsy | Mndooy | tom | vo ea) aa cael “y wave [rasp ras | | @ | 2 | pont | we | Gpwpmay| may | om | vo any | a mad ts metab | | roo] ss | © | s | mage |Unirwac| rmanand | mendaoy | vm | we mma an |= * Nol thal se courte ragdaly tock HIV prowolonce dota, with counties in Ean and Souhern Aca pactering o faux an HIV ncianca ‘among yng people he number ard deh cf rew actors asa beer mai er asmsing he dmames of HW narsmision, parcally Incoutmes wih amore generalized epidemic ‘Adee heh and soil do | Pacontage cf youna omen and man ce 15-24 yous ed who bath conecty dot way of poventng the soxal tannin of HV and who je! major ‘econo clad HV fenton 1 Thsclunm shans dot onthe gay ead wd elope adc ~'Pacentage of women aged SHAS who beewo a bores jk 42. EERCING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE SEXUALTY EDUCATION + A GLOBAL REVIEW 2015biting ox beating is we ae aay fe long fiero: ngs wi ime a eve eta the fad ors wit ting i; ‘hon she nlc he clon Suc: hip/ fv cea uncle cpr aia Hel Ip: /ww devin /wpconen/wplonde/2013/07/201 3 Afea Scorecard hstirclsedVeence Ago Wonen Gast. 1a, Adokcon! tty oe mnber brs por 1,000 women ages 15-19 Compretenie tau eduction det: grate CSE grated in mamnsteam mandetry tbe cross the circ sich 9s Bclogy. Sondalone: CSE taught os par fale sb hth edvearenprogiomme ich as Heatly fessor Se Sl Dass he curd mest sandarzed benchmars to eraxe qual, ncng leaching on 1) genre le ils, decon making, communication, eget sil), 2|sowal and epeductve hoo (8H) ord vou edvcatan(.g, burn gowh ard dowcpnan, tcaeciss, ependictvo heath {Sood abuse, hormone 3} HV toramaon and potion Which age gious era taught CSE? I some cuts, secondary enone is aw 20 pratay CSE the only oppemuy io each young pope ough fama chenon vit ined inf cure, & CSE eahingcorpuibo®? Nee hal even whee comply, may ache onl el cmorible aching expec of a CSE ‘imc, £0 coverage maybe pach, i Are ches tina oda CSE® Whats charting eis bts oan mato acho ach, is has ban noted nob cose, es may re days man cope coverage bu th! sme ocho tang dows ke poe, a national ply pce ha proas2 nda for © CSE cum fo bo ough schol 4a ANNEX 2: DEFINITIONS OF CSE Internationcl Conference en Population and, Development. 1994. Programme of Action, paragraphs 4.29, 7.37, 7.41, and 7.47 Sewaliy education to promote the wellbeing of adolescents t specifies key features of such edvcation. ‘© Education should take place both in schools ond af the commurily level, be age-appropriate, begin as early as possible, fosor mature decision making, and specifically ‘im fo improve gender inequaly * Such programmes should addiess specfc lopics, inching _gonder relations and equality, violence ogainst adolscont, responsible sewal behaviou, contraception, family life ‘ond semvolly tansmited infections (STIs, HV and AIDS provention UNESCO, UNAIDS, UNFPA, UNICEF, WHO. 2009. International Technical Guidance on Sexuality Education CSE is an ogeappropriate, cull relevant approach to teaching obout sewaliy and relationships by providing scientifically cccutte, realistic, non-dgemental information WHO & BzGA. 2010. Standards for Sexuality Education in Europe: A framework for policy makers, education cand health authorities and specialists Sexually education means learning about the cognitive, emotional, socio, interactive and physical aspects of sexuatiy. Sexually education strts eatly in childhood and progresses through adolescence and aduthcod. For children and young people it aims fo suppor and protect sex development I gradually equips and empowers children and young people with information, skils and postive valves to understand ond enjoy their soxvaiy, have safe and fuliling relationships and ‘ake responsibil for eir own ond other people's sexual heath nd wellbeing it enables hem to make choices that enhance the quality of heir lives and conkibuie fo « compassionate ond jst socioly. All children and young people have the right to have access io ogeapproprate sexually education In this definition, the primary focus is on sewvalty as a positive human potential and @ source of satstaction and pleasure. Tho clearly recognized neod for knowkdge ond skis roqured to prevent sexual itheath comes second 10 this overall postive ‘approach. Furthermore, sexualiy education should be based on intemationally accepied human rights, in particular the right to know, which precedes prevention of il heath IPPF. 2010. IPPF Framework for Comprehensive Sexuality Education (CSE) A rightsbased approach fo comprehensive sexuality education s20ks to equip young people with he knowledge, sil, attudes tnd volves they need to determine and enjoy thei sexually ~ physically and emotional, individually ond in relationships. Views ‘soxvaliy’holsically and within the context of emotional {and social development. I recognizes that information alone is not enough. Young people need io be given the opportunity fo ccequire essential Ife skils and develop postive atindes and voles, Comprehensive sexuality education must help young people to: ‘Acquire accurate information: on sexvol ond reproductive righis; information to dispel myths; references to resources ond services Develop life skis: such as erica thinking, communication cond negotiation skis, sedevelopment skis, decisionmaking skills; sense of sl; confidence; assertiveness; abiliy 10 take responsibly; abiliy to osk questions and seek help; empathy. Nuriure postive attiudes and volves: openmindedness; respect for self and others: positive selfworh/esioem; comfor!; nom iudgemeniol ottude; sense of responsibilty; postive otitude towards theit sexual and reproductive heath Comprehensive sexuality education covers « broad range of issues relating to both the physical and biological aspects of sexvoliy, ond the emotional and social aspects. recognizes cond accepts all people os sexual beings and is conceened wih more than jus the prevention of disease or pregnancy. CSE programmes should be adapted to the age and stage of development ofthe target group. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015UNFPA. 2014. Operational Guidance for Comprehensive ‘Sexvalty Education: A Focus on Human Rights and Gender CSE is ageappropri, curiculumbosed education, which enables inand outotschool children and young. people, ‘according to their evolving capasiy, to: © Acquire accurate information about human sexuality, sexual cond reproductive health, giowh and development, anatomy ‘ond physiology: + Bxplore and nurture postive values and atitudes concerning senual and social relationships; and, * Develop if sks that encourage critical thinking, gender sensiive communication and negotiation ond decision making, as wel os fostering a sense responsibilty fr their ‘own behaviour and respec forthe rights of ohers 4546 BIBLIOGRAPHY ‘Advecatos for Youth, 2008, Paranis os advecatos for comprohonsive sox ed in schools. hip:/ /wwmadvecateslonyouth.og/ ‘componeni/contni/article/ 158-parens (accessed 16 June 2015). Aliidevinfo.2015. 2015. Afica scorecard on violence agains! women and gis: Highlighting male and female aides to gender boxed violence — including adolescents hitp:/ /weewalt-dax info/wp-conient/uploads/201 5/07 /2015-Ahica Scorecarconstisionalsed Violence Against WomenitsF...pat Bole T. 2008. The Sourd of Silence: Diffcules in communicating on HIV/AIDS in schools. Experiences fom indi and Kenye. london, ActionAid. htp:/ /www ibe. unesco.org/AIDS /dac/HIV20AIDS%20187 pa BZgA and UNFPA. 2015. Policy Brief No. I: What is Sexsliy Education? hitp:/ /eeca.unfpa.org/sies/cefauk/tles/ pub pal/ GAKC Policy Brief No_1_ pa De Groaf, H., Krujor,H., van Acker, J. and Meir $. 2011. Sex under the age of 25: A population study of Dutch adolescont serval heath, Unechi, Rlgers WPF. Federal State Statisic Service (ROSSTAT)/Minisry of Heath of he Russian Federation. 2012. Reproductive Heath Survey, Russia 2011, Executive Summany. hip://wer.cde.gov/teproductveheath / global/publications/surveys/ wssio/nssicsuvey- 201 1 execsum pat Fonner et al. 2014. School based sex education and HIV prevention in low and middle-income counties: A systematic view ‘ond metsanchpis. PloS ONE 13]: 289692. Doi: htp:/ /jourak, plos.org/ plosone/artce?id=10.1371 /jouinal pone.0089602 Habedand, N.A. 2015. The case for addressing gondor and power in soxaliy and HIV education: A comprehensive roviow of ‘evalvtion sudies. Inerational Perspectives on Sexual and Reproductive Health, Vol. 41, No. 1, pp. 31-42. htps:// ‘evrw gutmacherorg/ pubs joumols/4 103 1 5.himl Haldre, K., Part, K. and Keng, E. 2012. Youth sexual heath improvement in Estonia, 1990-2009: The role oF sexuality ‘education and youhriendly services. European Journal of Conkaception and Reproductive Healh Care, Vol. 17, No. 5, pp. 351-362 Hun, Fond Mentetosas Castején, . 2012. Evalvacién de fa implementacién de fa dectaracién ministerial ‘Prevent con Educacién’ 2012 del acvordo a la acc; avances en latinoameéica y el caibe. hip:/ /wwe cealicionmesoamericana.org/sites/default/les/ EvaluacionDecloracionMinisierial2012.pf Igias, S.M., Macieira, M., Murphy, E. and Lundgren, R. 2014 Investing in very young adolescents’ sexual and reproductive health, Global Public Heath: An International Joumal for Research, Policy and Practice, Vol. 9, No. 5, pp. 555-569. DOK: 10.1080/17441692.2014.908230 hip://dx.doi.org/ 10.1080/17441892.2014.908230 Intemational AIDS Socialy. 201.4. Poster Exhibition, Missing the lnget using standordisad assessment ools to identify gaps and strengths in sexvaliy education jn Wes! ond Central fica, 20th Iniemational AIDS Conference Melboue Australia 20-25 Jy 2015, THFE375, UNESCO: htp://pag.aids20 14.org/abstacts spxPaid-8663 (accessed 27 August 2015) Intemational Conference on Population and Development. 1994. Programme of Acton. IPP. 2009. ffs All Ono Curriculum fwtten by Intexnaional Sexualiy and HIV Curriculum Wosking Group]. London, PPE: IPPF, 2010. Framework for Comprehensive Sexuality Educotion (CSE]. London, IPF. hip:/ /wawippf org/tesource PPE Framework Comprehensive Sexualiy Education [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015IPPE. 2013. From Evidence fo Action: Advocating for Comprehensive Sexwalty Education. London, IPP. hip:/ /wenipphorg/ resouce/ Evidence Aton Advocating comprehensive soxvaly education IPPF and Democracia y Sexudlidad. 201.2 Evaluacion de la Implementacion de la Declaracion Ministerial Prvenie con Educacion 2012; Avances en Latinoomerica y el Caribe Keting, E. et ol. 2015. Evaluation of holistic sexuality education: A European expert group consensus agreement. The European Journal of Contraception ond Reproductive Heath Care, hits: / /www.docphin.com/reseaich/ article detail/17468668/PubMedD 26024010/Evahiaonotholisic-sexvaliy education European expertgraupconsensus: cogreement Kivela, J, Holde, K., Par, K., Keng, E. and Boltussen, R. 2014. Impact and costeffectiveness analysis ofthe national chook based sexually education programme in Esonia, Sex Feucation: Sexvaliy, Sociely and leaming, 14:1, 1-13, DO! 10.1080/14681811.2013.813386 MatickaTyndale,E. 2010, A multlevel mode! of condom vse among mole and femole upper primary school student in Nyanza, Kenya. Soc Sci Med, Aug 5, Vol. 71, No. 3, pp. 616-25. Epub 2010, May 5: Matingwo, D. etal. 2012. Rethinking the Teacher’ in SchootBased, Teachersled Sexually Education Programmes jn Rural and Unban Tanzoni. 19th Inornational AIDS Conference: Abstract No. THADO306. hip://www.nebi.nm.nih.gov/ pme/ coricles/PMC3499903/ [accessed 17 October 2013) Ministerio de Sclud Piblica y Asislocia Social Programa Nacional de Prewencion y Contol de ITS/VIH/SIDA de Guatemala, 2014. tnforme Nacional sobre os Progresos Realizados en la Lucha Conta el VIM y sido. Guatemala, 2014. hip:// ‘weer ncids.org/site/ default files /county/documents/ /GIM_narative_report_20 14 pat COfce for National Stisics. 1998-2013. Conception Statistics, England and Wales. London, Ofice for Netional Statistics, hitp://werw.ons.go«uk/ons/reV/vsob | /conception tatsics-englandand-wales/index himl (Oringanie, C. ¢ ol. 2009. Interventions for preventing unintended pregnancies omong adolescenis. Cochrane Database of Systomatic Roviows.Isue 4. Population Council. 201.4. From evidence fo action: Resuls from the 2013 baseline survey forthe BALIKA project. Population Counel etal. 2009. is All One Curiculum. New York, Population Council. hip: /www popcouncl.og/teseorch/ iscllone-curicuumguidelines ond activites for eunitied approach Population Council and UNFPA. 2007. Addressing Gender and Rights in Your Sex/HIV Education Curiculum. New York, The Population Council. hip: /tivheatthclearinghouse.unesco.o1g/sites/defoult/fles/esources/7 123_ AddressingGenderRighis pdf Sonthya, K.G. 2011. Early maniage ond sexual and reproductive heath werabiliies of young women: A synthesis of recent ‘evidence from developing countries. Current Opinion in Obstorics and Gynecology, Vol. 23, No. 5, pp. 334-39, Svanemyr J, Amin, A., Robles, QJ. and Greene, M\E. 2015. Creating an enabling environment for adolescent sexual and reproductive heath: A framework and promising approaches. Journal of Adolescent Healt, Vol 56, No. 1, pp. S7-S14. Teenage Pregnancy Independent Advisory Group (United Kingdom. 2010. Final Report Teenage pregnancy: Ras! successes — fave challenges. hips:/ /wanw.gow ck/ govemmeni/ uploads/sysiem/uploads/ottachment_dota/ile/ 181078/THAG. FINALREPORT pdfUNADDS. 2008, Ministerial Declaration’ Prevention though Education. hip://Awwweunesco.o1g/new/ flecdmin/MULTIMEDIA/FIEID/Santiogo/pal/ declaration preventingeducationeenglish pa Tiendtebeogo, G., Meijer, S. and Engelberg, G. 2003. life Skils and HIV Education Curicula in Abica: Methods and Evolutions. USAID Technical Paper No. 119. Washington, DC, USAID. hitp:/ /pdt.usaid.gov/pat_docs/PNACTORS. pdf UNAIDS. 2012. Brazil Report NCPI hip: /woweunaids.og/sites/defaut/files/en/daloanalyss/knowyouresponse/ ncpi/201 2counties/Brazit820NCPN%20201 2. pdf UNAIDS. 2013. Thinythird maeting ofthe UNAIDS Programme Coordinating Board, 17-19 December 2013, Agenda tiem 19, Thematic Segment: HI, adolescents and youth, Background note, UNAIDS/PCB |33)/13.22. htp:/ /www.unaids a”48 ‘1g/sites/defoui/iles/en/ media /unaids/contentassets/documents/pcb/2013/pcb33/agendaitems/20131121_ ThomaticsogmentHIV%20youhradolescents%20.paf {accessed 27 August 2015) UNAIDS. 2013. UNAIDS Report on the Global AIDS Epidemic 2013. hip://www.unaids.o1g/sies/dolou/tles/en/medla/ naids/contentassets ‘documents /epidemiology/2013/gr201 3/UNAIDS. Global Report2013_en pf UNAIDS, 2014. The Gap Report. Geneva, UNAIDS. hip: /wiwnaids org/stes/defauk/tles/en/media/uncids/ contanlassets /dacuments/unaidspublication/20 14/UNAIDS_Gap_report_en.pd UNAIDS IAT, 2013. 2011-2012 Education Sector HIV and AIDS Global Progress Survey. Progression, Regression or Siognarion® Paris, UNESCO. UNADDS and the Afican Union. 2015. Empower Young Women and Adolescent Gis: Fast racking the end ofthe AIDS epidemic in Abica, Geneva, UNADS. UNAIDS and WHO. 2012. Technical Guidance Note for Global Fund HIV Proposals: Prevention, treatment and care and. “suppor for young people. Geneva, UNAIDS. hip:/ /wr who int/hiv/ pub /toolkis/YourgPaople Techical Guidance, GlobalFund® 10_May2010.pdF UNESCO. 2009. Iniemational Technical Guidance on Sexvalty Education: An Evidenceinformed approach for schools, teachers and health educates. Paris, UNESCO. hip:/ /unesdoc. unesco.crg//images/0018/001832/18328 le pd UNESCO, 201 1a. SchoolBased Sexvaliy Education Programmes. A cos! and costoffectivaness analysis in six counties. Paris, UNESCO. hip: //ww.unesco .org/new/fileadmin/MULTIMEDIA/HQ/ED /pd/CostingStudy pdt UNESCO. 201 1b, Sexuoliy Education Review and Assessment Tool. hip://hisheaithcleatinghouse.unesco.oxg/library/ documents /senvaliy educationreview-andassessmentiootserat0 [accessed 4 May 2015) UNESCO, 2012a. A Review of Policies and Sategies to Implement and Scale Up Sexuality Education in Asia and the Paci. Bangkok, UNESCO. hip: / /unesdoc.unesco.c1g/images/002 1 /002150/21500 le.pdf UNESCO. 2012b. World Atlas of Gender Equaly in Education. Paris, UNESCO. htp:/ /www.is.unesco.o1g/Education/ Documents/unescoworldalas gender education 2012. pdf UNESCO. 2012c. Good Policy and Practice in HIV and Health Education: Education Sector Responses to Homophobie Bullying. Booklet 8. Pers, UNESCO. UNESCO. 2013a. Measuring the edcation sector response fo HV and AIDS: Guidelines forthe constuction and use of core indicators. Pars, UNESCO. UNESCO, 2013b. Prevention Education in Eastem Evrope and Cental Asia: a review of policies and practices. Moscow, UNESCO. hip:/ /unesdoc.unesco.org/images/0022/002264/226426E.pat UNESCO. 2013c. Young People Taday. Time to Act Now. Why Adolescents and Young People Need Comprehensive Sexuality Educesion and Reproduciive Health Services in Eastem and Southern Atica. Paris, UNESCO. hip: //unesdloe.unesco. ‘rg/imagos/0022/002234/223447e.pdt UNESCO, 2014. Charing the Couse of Edveation and HIV. Pais, UNESCO. hip://unesdec:unesco.01g/ images/0022/002261/226125e. pdf UNESCO and the Gicbol Network of People living with HIV (GNP+). 2012 Posfve leaming: Meng the needs of young ‘people living with HIV (YPIHIV in the education seco Pais, UNESCO. UNESCO/UNADDS. 2011. Educaids county snapshot: Brazil hip:/ /unesdoc unesco.org/ images/0019/001928/192896E pdf UNESCO with UNAIDS, UNFPA, UNICEF, WHO. 2014. Young People Today, Time fo Act Now. East and Southern Afica ‘Commitment: One Yoar in Review 2013-14 UNESCO/UNFPA. 2012, Sexualy Education: A lencounty review of school curicua in East and Souther Afica, Pari, UNESCO. hip: //unesdoc.uneseo.o1g/images/0022/002211/221121e.pdF [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015UNFPA. 2013, State of World Population 20133: Mesherhood in Childhood ~ Facing the chollenge of adolescent pregnancy. hip: /wws:nfpa.ctq/shes/delout/fles/pubpdt/ENSWOP201 3fnal pat UNFPA. 20140. Operational Guldance for Comprehansive Sexually Education: A focus on human rights and gender. Now York, UNFPA. hip:/ /wawwcunfpa.c1g/stes/defauh/tles/pub-pdl/ UNFPA%200perationais20Guidance®20F0i%20 (CSE%20 Fina L2OWEBY20Version pd UNFPA, 20146, The Power of 1.8 Bion: Adolescents, youh and the transformation of tho fre. New York, UNFPA. UNFPA, 2015. The Evaluation of Comprehensive Sexuality Education Programmes: A focus on the gender and empowerment cuicomes. New York, UNFPA. UNFPA/Loaiza, E. and lang, M. 2013. Adolescent Pregnancy: review of he evidence. UNFPA, New York UNICEF. UNICEF Data: Monitoring the Sitotion of Chichen and Women. hp://data.uniceforg/ chi protection/atitudes him! UNICEF. 2010. Blame and Bonishment. The Undorground HIV Epidemic Affecting Children in Easton Europe and Cantal Asa. Geneva, UNICEF. hip:/ /swwwxanicel.org/ceecis/UNICEF_BlomeBanishmeni_WEB.final pdt UNICEF 2011. Opportunity in Ciss: Preventing HIV fiom early adolescence to young adetthond. New York, UNICEF United Notions, General Assembly. Report ofthe United Notions Special Rapporteur on the right to eduction, A/65/162. 23 July 2010. Available from undocs.org/A/05/162 Unter E, Noth, A.,Amot, M., lly, C., Moletsane, L, MurphyGraham, E., Paks, |. ond Saito, M. 2014. interventions tb ankance gtk’ education and gorder equaliy. Education Rigorous literature Review. London, Deparment for International Development. htp:/ /+4d. did gov.uk/pd/outpuls/HumanDev_evidence/Gitk.Edvection_lierahe_ Review 2014 Uniethalior pa Viet Nam. 2014. Vietnam AIDS Response Progress Report 2014. Ha. Noi. hip:/ /wwwrwunaids.ong/sites/defout/files/en/ clatacnalyss/nowycuresponse/countyprogressieports/20|4counities/VNM narative report_2014. pdt VillsTones, Lond Svanomys, J. 2015. Ensuring youl’ right participation and promotion of youth kadosship in the development of sewal and reproductive heath policies and programs, Journal of Adolescent Healt, Vol. 56, No. 1, pp. S51-S97. WHO Regional Office for Europe. 199/200. Definitions and indicators in family planning, materal and child heath and reproductive health used in he WHO Regional Ofice for Fup WHO Regional Offic for Ewope and BZgA. 2010. Stands for Sexuality Education in Europe: A amework for policy ‘mokes, education ard hoalth authorities and specials. Cologne, BZgA and WHO. hitp://mww.begawhoce. do/#vid~20c7 lacbd 19f260cbakd 1066847 6858id-home WHO, 2006. Preventing HIV/AIDS in Young People: A systematic review of the evidence from developing counties. Geneva, WHO. htp://whalibdoc who ini/ts/WHO_TRS_938_eng.paf WHO. 2013. Global and Regional Estimates of Violance against Women: Prevalence and health effects of inimate pare violence and nor-pariner sexval violence. Geneva, WHO. bip:/ /apps.who.in/iris/ bitsteam/ 10665/85239/1/978924 1564625_eng.pdfua= ‘Women’s Refugee Commission ef al. 2012, Adolescen! Seal and Reproductive Heath Programmes in Humanitarian Settings: ‘An in depth lack at family planning services. Women's Refugee Commission, Save the Children, UNHCR, UNFPA. hitp:/ /werw.unfpa.crg/stes/defoul/Hes/ resource pdl/ AAASRH_good_practice.documentation_Englsh_FINAL pdt ‘Wold Bank. World Bank Databank, hitp://da¥a,worldbank.org/indicator/SPADO.TFRT 201. Eastern and Sourhem Ahica Ministerial Commitment: Young People Today. Time to Act Now. hitp://wwow unesco.o1g//new /fleadmin/MUILTIMEDIA/HG/HIV-AIDS /pdi/ESACommiimeniFINALAFimedon7ihDecomber pdf 0so Unpublished Dlamini, N.R. 2014. Global Consutation on Education Sector Roeponsos to Early and Unintended Pregnancy. 5 November 2014, Presentation by the Depariment of Heath, Republic of South ica. Swe the Children. Making it Personal: Workshop Manual — A personal, processoriented approach fo raining in soxvaiy, gender, sel and repreduetive health and righs and HIV and AIDS. Save the Children. Training Manual: Intodtion tothe Processovientedl Approach in Comprehensive Sewolly Educotin (CSE} UNAIDS. 2015. Background Paper on ite Indicator on Sexually Education in UNAIDS Unified Budget, Resuts and ‘Accouniabilly Fromework [UBRAF] forthe MERG Indicator Working Group. UNESCO. Forthcoming, Positioning CSE inthe Cuniculum: Modaltis for Delivering Elective Comprehensive Sexvoty Education. UNESCO and UNFPA. 201.5. Comprehensive Sexualy Education in Teacker Tiaining in Eastem and Southern Afica. Sitational “Anais of TweryOne ESA Counties UNICEF Barbados and the Eastom Caribboan. 201. Final gional Roport: Situation Analysis of Sewwalty Education in tho Coribbean. Personal communication between the report authors and representatives of the following organizations allowed for the development of case studies provided in this report ‘Aahung, Pakistan (Sheena Hadi, 19 May 2015] Education as @ Vaccino, Nigeria Fadckomi Akinfaderin, 19 May 2015) Population Council, Bangladesh (Sojeda Amin, 11 June 2015] Save the Childron, South Aion [Yurnah Hattas, 10 June 2015) UNESCO, Zambia [Alice Sal, 10 june 2015) Universidad los Andes, Colombia [Marta Carclna Iboma, 8 June 2015) Univesity of Southampion, UK Roger Ingham, 11 une 2015) Note: uns sated otherwise, all web links ware accessed by the cuthors between 27 April and 15 May 2015. [EMERGING EMDENCE, IESSONS AND FEACICE IN COMPREHENSIVE EXUALIY EDUCATION » A GLOBAL REVIEW 2015This publication provides a global review of the current status of comprehensive sexuality education (CSE] implementation and coverage. It draws on specific information about the status of CSE in 48 countries, generated through analysis of existing resources and studies. The report examines the evidence base for CSE and its positive impact on health outcomes, takes stock of political support for CSE, and examines how the various global and regional commitments have had an impact at national levels on the delivery of CSE in practice. The current review represents the first in a series of periodic reports that aims to monitor the global implementation of CSE. For more information on UNESCO’s work on comprehensive sexuality education, visit www unesco.org/alds or contact cids@unesco.org This report was made possible through the support of the Governments of Sweden and Norway ® ’ @UNAIDS Soursioponconon © olvag231 |