The purposes of this paper are: to assess how comprehensive sexuality education (CSE) is implemented in schools in the World Health Organisation's European Region; and to investigate the evidence supporting its effectiveness. Data were collected in 2016-2017, using a validated questionnaire sent to representatives of governmental and nongovernmental institutions in 25 countries of the WHO European Region. Theresults demonstrated that, in nine countries, sexuality education can be classified as comprehensive; in ten countries it is non-comprehensive; in four countries there is no programme in place; and two countries were excluded from theanalysis. In contrast to non-comprehensive sexuality educationprogrammes, CSE programmes address a wider range of topics, including the social, emotional and interpersonal aspects of sexuality. Furthermore, teachers are more often trained to deliver sexuality education and participatory teachingmethods are widely used. CSE programmes are more valued by pupils as a source of information on sexuality, based on national survey results. The availability of CSE programmes coincides with more effective contraceptive use andlower teenage fertility rates. However, more rigorous research is needed to establish a causal relationship between CSE and adolescent sexual and reproductive health indicators.
ZusammenfassungJeder Mensch hat das Recht auf den Zugang zu evidenzbasierten Informationen zur Sexualaufklärung, Verhütung und Familienplanung. Im Sinne eines ganzheitlichen Verständnisses von sexueller und reproduktiver Gesundheit fördert die Bundeszentrale für gesundheitliche Aufklärung (BZgA) mit ihren Maßnahmen das Recht auf eine selbstbestimmte Sexualität von Menschen mit Beeinträchtigungen. Der vorliegende Praxisbeitrag stellt diese Aktivitäten und Materialien zusammenfassend dar.
Background
Comprehensive sexuality education is a crucial factor for protecting the health and well-being of children and young people. A recent assessment, conducted by the Federal Centre for Health Education and the International Planned Parenthood Federation European Network (IPPF EN), gives an up-to-date overview of the current status of sexuality education (SE) in schools in 25 European and Central Asian countries. It further provides information on challenges and good practice in this field.
Methods
Pre-tested questionnaires were sent to representatives of governmental (Ministries of Health or Education) and nongovernmental organisations (IPPF member associations) in 25 countries in Europe and Central Asia. All representatives of the nongovernmental (25) and two-thirds of those in governmental organisations (16) responded. The questions were grouped under five themes related to SE: legal framework, status of implementation, barriers and opposition, youth-friendly sexual and reproductive health (SRH) services, and national data on adolescent SRH.
Results
In 15 of the 25 countries surveyed, a legal framework exists (law/ policy/ strategy) which supports SE in schools. In 11 countries, SE is mandatory in schools, and in 10 countries SE clearly has a comprehensive character. In most countries, SE is integrated into broader teaching subjects, e.g. biology or life skills education. A lack of teacher training and of monitoring and evaluation of SE programmes has been identified in the majority of countries.
Conclusions
In the past two decades, remarkable progress has been made in developing and implementing SE in the region. Nevertheless, further improvements are urgently needed, as differences between and within countries persist. These include the quality and the comprehensiveness of SE programmes, the monitoring and evaluation of these programmes and the development and implementation of teacher training.
Key messages
Remarkable progress has been made in implementing sexuality education in Europe and Central Asia. Nevertheless, further action is needed to reduce differences in implementation and quality between and within countries.
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