Investigating the ‘C’ in CSE: implementation and effectiveness of comprehensive sexuality education in the WHO European region

Abstract

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.

Barriers to sexuality education for children and young people with disabilities in the WHO European region: a scoping review

“…We included studies from the 53 European and Central Asian member states of the WHO European Region since the scoping review was conducted within the framework of engagement of the German Federal Centre for Health Education (BZgA), which is the WHO Collaborating Centre for Sexual and Reproductive Health for the WHO European Region. Our systematic review was designed to build on the WHO European Region's vision on sexuality education 1 which The Centre it has been promoting for the past decade (Ketting, Brockschmidt, and Ivanova 2020;Ketting 2018; WHO Regional Office for Europe and Federal Centre for Health Education 2010). It forms the basis of a guidance document for policymakers and programmers of sexuality education for children and young people with disabilities that will be published by WHO for the European Region.…”

“…This aligns with findings from Ketting, Brockschmidt, and Ivanova's (2020) recent study of implementation of CSE implementation in the WHO European Region, which only identified two CSE programmes outside of northwestern Europe (in the Czech Republic and Estonia). The authors concluded that 'in southern and southeastern Europe and in Central Asia, CSE programmes are yet to be seen' (Ketting, Brockschmidt, and Ivanova 2020); hence it is unsurprising that no programmes specifically targeting children and young people with disabilities could be identified. This is an important research gap, particularly given the important influence of culture on sexuality and disability, as well as culturally diversity in the WHO European Region.…”

“…The additional intersection with age group and the general taboo in many societies regarding young people's sexuality makes this a highly sensitive topic, which is reflected in the limited literature available. The observation that many studies on sexuality, disability and young people originated from northern and western European countries that have a longer history of sexuality education and more inclusive policies than other countries in the WHO European Region, is, therefore, unsurprising (Ketting 2018;Ketting, Brockschmidt, and Ivanova 2020;Tossebro 2016;Kabatova 2018). All other barriers seem to be linked to this fundamental societal barrier: if people's sexuality, and, in particular, that of children and young people with disabilities, is not recognised or is stigmatised, the way educators address this topic and redirect responsibility to each other will be affected (McCann, Marsh, and Brown 2019).…”

Sex Education in the Spotlight: What Is Working? Systematic Review

“…Pleasure and desire are largely absent within sex and relationship education [ 71 ] and, when they are included, they are often proposed as part of a discourse on safe practice, where pleasure continues to be equated with danger [ 72 ]. The persistent absence of a “discourse of desire” in sex education [ 73 , 74 ] is especially problematic for women, for whom desire is still mediated by (positive) male attention, and for whom pleasure is derived from being found desirable and not from sexual self-expression or from their own desires [ 75 ].…”

Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study

“…Currently, there are gaps: according to the Guttmacher Institute [29], only 2% of students indicate having received CSE; teachers claim 75% of schools provide it. Successfully implementing CSE does require teacher training and development of material lesson planning, suggested a comparison of European countries which had implemented CSE to those that have not [56]. In Kenya, this means that a nationwide commitment to CSE-roll-out would need to include culturally PLOS ONE appropriate education and sensitization for teachers and other stakeholders such as parents to ensure their alignment and improve their commitment to providing learners with CSE.…”