Centering Diverse Stakeholder Perspectives to Inform Inclusive University-Level Sexual and Reproductive Health Education

A Call for Comprehensive, Disability- and LGBTQ-Inclusive Sexual and Reproductive Health Education

Adolescents’ knowledge on sexual ity and reproductive health is still limited, although there have been initiatives to provide sexual and reproductive health education as indicated by previous studies. This paper examines reproductive health and sexuality education for adolescents that has been conducted by government and non-government at the high school level. This paper is based on a research using mixed methods of quantitative methods that are supported by qualitative. Quantitative methods are surveys conducted to 918 students and 128 high school teachers and supported by focus group discussions and in-depth interviews in eight cities in Indonesia. Focus group discussions conducted to civil society organizations, teacher forums, and youth groups, while in-depth interviews conducted to local government, parents, school committees, and religious/community leaders. The results show that the reproductive and sexual health education does not match the reality of sexual behavior and sexual risk faced by teenagers because: (1) reproductive health and sexuality education that is given to the high school level is more focused on the biological aspects alone, (2) There is still a notion that sexuality is a taboo to be given at school, (3) the sexuality education tends to emphasize the dangers of premarital sex from the moral and religious point of view, (4) the sexuality education has not looked at the importance of aspects of gender relations and rights of adolescents in adolescent reproductive and sexual health. The construction of adolescent sexuality and the discourse on sexuality education contribute to the content and methods of sexual ity and reproductive health education for adolescents. Normal 0 false false false EN-US X-NONE X-NONE

Background: Comprehensive sexuality education (CSE) aims to equip youth to make informed decisions about their bodies and sexuality to lead healthier lives. The nature of sexual and reproductive health (SRH) education in Canada is determined locally by provincial and territorial governments, resulting in inconsistent coverage, delivery, and quality of curricula. This study assessed the strengths and gaps of Canadian SRH curricula using the United Nations’ International Technical Guidance on Sexuality Education and offers evidence-based policy recommendations. Methods: Provincial and territorial SRH curricula for Grades 6–12 for Canadian public schools were extracted from publicly available governmental websites and examined using the 94 learning objectives across 8 Key Concept Areas (KCA) and 27 Topics obtained from the UNESCO Guidance. Each curriculum was reviewed by two researchers and given a Comprehensiveness Score (CS). The number of Guidance learning objectives addressed within a Topic was calculated as the Topic score, and the sum of the Topic scores within a KCA was reported as the KCA score. Results: The mean CS across Canada was 58.35%, with the highest score being 81.91% (ON) and the lowest being 37.23% (NWT). KCA 5 (Skills for Health and Wellbeing) (65.93%) and KCA 2 (Values, Rights, Culture and Sexuality) (63.46%) had the highest coverage across Canada, while key gaps included KCA 8 (Sexual and Reproductive Health) (51.44)%. The lowest-scoring topics were Topic 8.2 (11.54%) and Topic 1.4 (21.79%), with learning objectives on long-term parenting and relationships, and HIV and AIDS stigma and care widely missing. Conclusions: SRH curricula across Canada vary in comprehensiveness. Increasing alignment and comprehensiveness of SRH curricula across the country, while allowing for context-specific additions in each province or territory, could improve the quality and consistency of SRH education. In addition, SRH curricula should be regularly evaluated and updated as needed, ensuring they reflect societal changes and are evidence-informed.

South Carolina ranks 16th in the USA for highest rates of teenage pregnancy. The South Carolina Comprehensive Health Education Act (CHEA) does not require medically accurate, unbiased, culturally appropriate materials, and varies greatly in compliance and implementation. This study aimed to better understand parents’ perspectives in one county in South Carolina regarding reproductive and sexual health education. A total of 484 parents responded to a qualitative questionnaire, collectively representing 798 students. Researchers conducted a thematic analysis to organise the data. Main themes identified include comprehensive reproductive and sexual health education as a duty; dispelling the myth of abstinence-only education; and the value of comprehensive reproductive and sexual health education. Parents described teaching reproductive sexual health education in public schools as a ‘duty.’ Furthermore, parents rejected the idea that abstinence-only education is effective and believed reproductive and sexual health education should be taught without the influence of religion. Parents valued inclusive reproductive and sexual health education, covering a robust set of topics. Findings from the study provide evidence for the need to update current reproductive and sexual health education materials and legislation to meet parental demands and reduce youth sexual and reproductive health disparities.

Indigenous adolescents and young people in Panama are at high-risk for sexually transmitted infections, due in part to limited access to condoms and comprehensive sexual and reproductive health (SRH) education. There is a paucity of evidence on how to develop sexual and reproductive health education programmes that incorporate different sources of learning. We used Bronfenbrenner’s Ecological Theory to understand two key sources of learning: noncaregivers (school or healthcare personnel) and caregivers (parents/grandparents/stepparents). Better understanding about sexual and reproductive health learning sources could provide a foundation for the development of targeted, culturally congruent interventions. This study included ethnographic observation in two Indigenous communities in Panama, followed by semi-structured interviews with young people and caregivers. Findings suggest non-caregiver sexual and reproductive health education was commonly provided by teachers, and increasingly through the Internet. Caregivers focused on topics of abstinence/delaying sexual debut, pregnancy, and STIs/HIV; condoms pregnancy, and STIs/HIV. Condoms and condom use were not mentioned. Traditional sexual and reproductive health teaching by same-gender caregivers took place through the rituals of mokän (girls at menarche) and grön (boys 13–14 years). To develop culturally congruent interventions, wesuggest programmes to improve sexual and reproductive health knowledge and access to condoms, which respect and build on social and traditional learning spaces.

Sexual and reproductive health education for adolescents remains crucial for Indonesia as it is home for more than 44 million teenagers as of 2022, in its way to anticipate demographic bonus in 2030. Government Regulation no. 61 of 2014 concerning Reproductive Health mandates sexual and reproductive health education in formal and informal education settings. By using a systematic literature review (SLR) method, this study assesses the current state of school-based sexual and reproductive health education in Indonesia. Findings reveal that the delivery of sexual and reproductive health education in Indonesian schools is fragmented, spread across various subjects such as Biology, Sports, Religious, Civic and Moral education classes, as well as extracurricular activities. Key stakeholders, including families, teachers, peers, and school principals, play crucial roles in shaping adolescents' understanding of reproductive health. However, challenges such as cultural taboos, easy access to potentially misleading online information, and inadequate teacher training hinder effective education. In addition, Comprehensive Sexual Education (CSE) has been suggested by WHO to be implemented and integrated in the core curriculum, with programs like SETARA pilot project showing promise in improving adolescent knowledge and attitudes towards reproductive health. However, the success of such programs requires cooperation from various stakeholders and a shift in societal norms regarding adolescent sexuality.

The need for science-based knowledge about sexual life is natural for children and youth all over the world. Official statistics on the incidence of sexually transmitted infections, gender-based violence, and early pregnancies emphasize the urgency of the problem of developing sexual competence for Ukrainian children and youth. The purpose of the article is to study the foreign and Ukrainian experience of sexual education at school, to understand the essence of the concept of comprehensive sexuality education, its actors, and the requirements for their training. The main research method was document analysis. The results of a review of approaches to developing the researched problem in foreign and national scientific publications and a comparative analysis of Ukrainian, some foreign and international standards (guidelines, recommendations) regarding sexual education are highlighted. It was found that today there is no unity in terminology, interpretation, and criteria for defining sexual education. There are national differences in approaches to understanding its goals and content. Sexual education is interpreted in a narrow and broad sense, but in this matter, scientists are gradually more and more inclined to use a complex approach. A broad interpretation of sexuality education shifts the traditional emphasis from the physiological and biological features of the sexes, the problems of sexual life, including the prevention of accidental pregnancy, sexually transmitted diseases, and the achievement of safe sexual satisfaction (sex education, sexual health education) to the issues of forming a culture of sexuality and related feelings, understanding and protection of one's rights, including sexual, throughout life, humane treatment and responsible behavior in relationships, clear and respectful communication, preparation for marriage and family life (comprehensive sexual health education, comprehensive sexuality education). Comprehensive sexuality education has strong support in the international discourse and is supported by a relatively robust evidence base. A comprehensive approach enables educators and policymakers to address not only the individual determinants of young people's sexual and reproductive health but also the social determinants of their health and well-being. Comprehensive sexuality education is not reduced to the activity or responsibility of an individual teacher. However, it is the result of the collective actions of all teachers in conditions of mutual support and exchange of experience in implementing sexual education programs. Health, biology, and physical education teachers considered critical in sexual education at school. At the same time, it is necessary to strengthen teachers' ability in sexuality education by improving the qualifications of teachers and providing constant support. The document analysis proved the inadequacy of the development and practical solution of the introduction of comprehensive sexuality education in Ukrainian schools. At the same time, the European and American experience of a number of foreign and international standards, guidelines, and technical documents, which relate to the content and results of sexuality education for students, the quality of the application of education standards, and professional training of teachers, shows a reasonably stable conviction that comprehensive sexuality education contributes to children and society as a whole.

BackgroundAlthough comprehensive sexuality education (CSE) is widely recognised as a key strategy for improving adolescent sexual and reproductive health and rights, significant gaps remain in its implementation, especially among out-of-school migrant adolescents affected by seasonal internal migration. This study sought to explore the experiences of this subgroup in accessing timely and comprehensive sexual and reproductive health education within the context of seasonal migration in the urban slums of the Greater Accra Region.MethodsThe study adopted a qualitative exploratory design, guided by the socioecological model of health behavior. Urban slum communities relevant to the study were identified via criterion purposive sampling. The study was then publicised, and participants were recruited through formal and informal social networks, including youth groups. A total of 15 (fifteen) migrant adolescents were selected via convenience sampling, with the final sample size reached by data saturation. To gain a broader perspective, the study also included migrant peers and gatekeepers. Data collection involved 10 (ten) in-depth interviews (IDIs) with migrant adolescents, two (2) focus group discussions (FGDs), two (2) key informant interviews (KIIs) with peer network leaders, and one interview with a migrant gatekeeper.ResultsMigrant adolescents face limited access to SRH education because of their absence in communities, resulting in a lack of confidence in SRH decision-making, leading to low confidence in SRH decision-making. Peer networks influence SRH choices, often reinforcing reliance on informal health providers for sexual information and addressing cultural barriers. Community outreach programs primarily target young mothers attending child welfare clinics rather than targeting wider community migrant adolescents.ConclusionsThe paper concludes that migrants’ mobility hinders access to SRH education, resulting in poor SRH knowledge and decision-making. This study underscores the need to address individual-, interpersonal-, and community-level factors. Seasonal migration should be acknowledged as a key social determinant of health and incorporated into national sexual and reproductive health (SRH) policies.

Advancing Sexual and Reproductive Health Education—Pursuing the Long Arc of Justice

Adolescence is a crucial period that affects cognitive, emotional and social development. With accurate information, adolescents can make informed health decisions, easing their transition to adulthood and enhancing their understanding of sexual and reproductive health issues. This study examined the perceptions and experiences of teachers and students regarding sexual and reproductive health education in five selected secondary schools in the Sagnarigu Municipality of Ghana. Ten focus group discussions and 16 in-depth interviews were conducted. The findings showed that some form of sexual and reproductive health education was being implemented in all the sampled schools, with respondents acknowledging its importance for informed decision-making. However, challenges remain, including cultural and religious barriers, lack of good quality standardised materials, inadequate teacher training, and limited resources for effectively delivering the curriculum. These results underscore the need for a comprehensive sexual and reproductive health education programme that addresses existing gaps in the current approach. We recommend the use of a culturally sensitive education that aligns with prevailing social norms regarding sexual and reproductive health. Adequate resources and training are needed to foster the development of a supportive environment for delivering good quality sexual and reproductive health education in Ghana.

Sexual Health Education- Using Animated Videos to Teach Teenagers and Young Adults

Sexual and reproductive health (SRH) is a fundamental health problem that is recognized globally. One of the reproductive and sexual health problems is the lack of sensitivity to reproductive health education for the future bridegroom. It can be the cause of the high Maternal and Child Mortality Rate (MMR and IMR). Sexual and reproductive health education for the future bridegroom is an effort to enhance knowledge with the aim of preventing dissatisfaction and failure in married life. Various challenges in providing sexual and reproductive health education (SRH) such as internal and external factors must be resolved immediately with the support of the relevant policymakers. The purpose of this research was to identify evidence related to sexual and reproductive health education for future bridegrooms. The method in this research was scoping review. The literature search in this study used 3 health journal databases, namely Ebsco, ProQuest, Willey online library, and 1 search engine; Google Scholar. Articles were selected using inclusion criteria, namely original research, in English and Indonesian, published in the last 5 years (2016–2021). The total search results were 2,743 articles, and ten articles were found that met the inclusion criteria in the author's review. The instruments used to assess the quality of articles were the Joana Brigs tool from Joana Brigs Institute (JBI) and the Mixed Methods Appraisal Tool. The results of the review found data related to the need for sexual and reproductive health education for future bridegrooms, barriers, and efforts/evidence-based made both nationally and internationally. From the review of the ten articles that the need for sexual and reproductive health education is not only due to medical problems, but also from the perspective of social problems, the provision of SHR services and government policies is considered a priority.

Comprehensive sex and reproductive health education is crucial for promoting overall health and wellbeing, as it plays a vital role in dispelling misinformation, fostering positive attitudes toward reproductive health, and empowering informed decision-making among young people. Despite its recognised importance by global entities such as the World Health Organisation (WHO) and the United Nations Educational, Scientific and Cultural Organisation (UNESCO), comprehensive sex and reproductive health education remains insufficient worldwide. This inadequacy is a multifaceted issue, stemming from various factors, including governmental policies, social norms, cultural beliefs, inadequate curriculum, and insufficient teacher training. Schools, as primary providers of reproductive health education, often prioritise pregnancy prevention over other important reproductive health topics, leading to significant gaps in students' knowledge, further prompting young individuals to seek supplementary knowledge from external sources, like the internet or social media. To address this disparity and to promote reproductive health awareness, the International Reproductive Health Education Collaboration (IRHEC) was established in 2019 and aims to provide educational resources for the public, teachers and health professionals. The IRHEC have created a teaching guide specifically for teachers to cover all aspects of reproductive health, to be used in schools globally. To develop this resource, it has been essential to determine what is taught in schools and the attitudes of teenagers to reproductive health education and family building. In the UK, we examined the curriculum in the four nations and huge gaps were identified in reproductive health education. Subsequently, a survey was conducted with 931, 16–18-year-olds in England and pupils were asked their views on their education, if they had been taught about a list of reproductive health topics in school and their attitudes to these topics. They reported that topics around pregnancy prevention were taught, such as contraception (90%), and sexually transmitted infections (90%) but key subjects such as fertility (30%) endometriosis (3%) and PCOS (2%) were not taught. This survey has been repeated in Belgium, Greece and Japan and similar patterns observed. Teenagers in the UK (21%) and Belgium (18%) rated their school sex and reproductive health education to be either poor or very poor compared to teenagers in Japan (3%). In the UK, Belgium, and Japan, young people have similar future parenthood intentions. Most young people in the UK (64%), Japan (60%), and Belgium (60%) want to have children in the future. A higher percentage of young people in Japan (70%) expressed a desire for two children compared to those in Belgium (60%), Greece (53%) and the UK (49%). To ensure comprehensive sex and reproductive health education, efforts must be tailored to the needs of each community and demographic. Collaboration among policymakers, educators, healthcare professionals, and communities is essential to enhance school curricula to include a broader spectrum of reproductive health topics and promote culturally sensitive educational approaches. By doing this, we can empower young people with the knowledge and skills necessary to navigate their reproductive health journey with confidence. There is an urgent need for a concerted action to bridge knowledge gaps and ensure that young people receive comprehensive sex and reproductive health education.

Teenage pregnancy and child marriage continue to rise in Malawi despite the introduction of compulsory Life Skills education in primary schools in 2002. A qualitative approach, employing focus group discussions with participants was used to explore the barriers faced by teachers in delivering sexual and reproductive health education in primary schools in southern districts of Malawi. Pupils, teachers and parents from a total of 10 primary schools, seven in Mangochi and three in Zomba, were invited to participate in focus group discussions on barriers to sexual and reproductive health education. The teaching experience of teachers ranged from one to six years. Pupils were aged between 10 to 19 years while parents had to have a child learning sexual and reproductive health at school to participate. Thematic analysis revealed several barriers to delivering sexual and reproductive health education: over-emphasis on abstinence, an unconducive learning environment, existence of sexual practices linked to becoming of age rites, peer pressure, lack of sexual and reproductive health reinforcement by parents, and inadequate training for teachers. Policymakers and curriculum developers/implementers should create an approach which is inclusive of all stakeholders and able to provide young people with comprehensive sexuality education that is rights based and effective.

Objectives Sexual health remain a significant challenge in rural Indonesia, driven by limited access to education, health, logistics, communication, and the lack of public policies in prioritizing sexual health. To see the multifaceted challenges, a holistic approach to sexual and reproductive health is a key strategy for improving sexual health and well-being. This systematic review aims to explore all research on sexual health and sexual well-being in rural Indonesia so that it can provide a comprehensive picture of the conditions and challenges faced by rural communities related to these aspects. Method The study retrieved relevant literature from the Scopus database following the PRISMA guidelines with Watase Uake Tools. A total of 124 studies were identified, with 28 studies meeting the inclusion and exclusion criteria. The review spans a decade of research from 2015 to 2025, incorporating multidisciplinary perspectives across psychology, health, public policy, and sociology. Results This systematic literature review groups several sexual health problems that occur in rural Indonesia, such as early marriage, multiple marriages, sexual harassment, premarital sex, risky sexual behavior, sexual violence, sexually transmitted infections (STIs), HIV/AIDS, sexual dysfunction, gender inequality, reproductive health, sexual well-being, pornography use, and sexual health education with policy about sexual health in indonesia such as HPV vaccine in Indonesia, sexual and reproductive health education, early marriage in Indonesia, sexual violence in Indonesia. Conclusion With the information obtained, researchers, scientists, and practitioners working on sexual health issues can better understand the specific dynamics that affect rural communities. This includes understanding the cultural, social, and economic factors that influence sexual health and assessing the effectiveness of various interventions that have been implemented.