Abstract
Comprehensive sexuality education (CSE) was implemented in South African schools in the year 2000 as part of the subject Life Orientation, with the aim of contributing positively to adolescent sexual health in a holistic manner. Continued high rate of teenage pregnancy and HIV infection is an indication; however, that the programme is not entirely successful. To establish why the aims of the programme and the consequences of learners’ sexual behaviour do not correspond, this systematic review aimed to determine how the programme contributes to the sexual health of adolescents and to make recommendations for its improvement. Nine databases were searched, after which two reviewers independently evaluated the methodological quality of the identified studies using an appraisal tool. The 22 articles that met the criteria for final inclusion were qualitative in nature and included cross-sectional and cohort studies. Results indicate that the contribution of the CSE programme is reflected in teachers, learners and the curriculum. Teachers are in need of expert training and learners are neither actively involved in the learning process nor the development of the programme as they need and would like to be. Recommendations include the development of context-specific training curricula for pre- and in-service teachers as developed collaboratively by various experts and stakeholders. Learners’ voices, active involvement, cultural context and needs are fundamental to the development and delivery of CSE. The teaching method and content of sexuality education should meet the contemporary needs of the 21st century adolescent to ensure optimal sexual health.
Highlights
Introduction and backgroundAccording to the United Nations Educational, Scientific and Cultural Organisation (UNESCO),[1] comprehensive sexuality education (CSE) is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality: It provides opportunities to acquire comprehensive, accurate, evidence-informed, and age-appropriate information on sexuality
The sample consisted of two main groups of participants: that is, the deliverers and/or managers of CSE: 255 Life Orientation (LO) teachers, Heads of Department (HOD), Lesbian, gay, bisexual, transgender, intersex, queer (LGBBTIQ) seven principals, two deputy principals and 20 student teachers enrolled for an honours degree in education; and the recipients of CSE: 589 learners ranging between Grades 6 and 12 of which 167 were boys, 194 were girls, and the gender of the rest was not
What is needed for improvement of the comprehensive sexuality education programme This review provides the opportunity to consolidate reported recommendations for the CSE programme’s improvement
Summary
According to the United Nations Educational, Scientific and Cultural Organisation (UNESCO),[1] comprehensive sexuality education (CSE) is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality: It provides opportunities to acquire comprehensive, accurate, evidence-informed, and age-appropriate information on sexuality It addresses sexual and reproductive health issues, including, but not limited to: sexual and reproductive anatomy and physiology; puberty and menstruation; reproduction, modern contraception, pregnancy and childbirth; and sexually transmitted infections, including human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS).1(p. South African (SA) schools since 2000.2 The Minister of Basic Education in SA reported that despite this, pregnancy and HIV infection amongst learners remain high and claims that there has been ‘no change’ in the behaviour of learners.[2] These claims can be confirmed by current statistics of the sexual health of adolescents in SA. Human immunodeficiency virus prevalence in SA (existing infections in the population) is higher amongst adolescent girls and young women (15.6%), who account for three-quarters of 20–24-year olds living with
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