Abstract
Abstract We used SERAT to assess the implementation of CSE in four countries. The data collection took place between December 2021 and July 2022. All four countries teach sexuality education, which is supported by adequate legal and policy frameworks, and integrate it into their school curricula. The comprehensiveness of the curriculum, teacher training and learning methods differ across the four countries. The integration of the sexuality education concepts varies across countries. Relationships and values topics are generally more present in the curricula across all age groups. Topics with lesser attention are gender, sexual behavior and sexuality. The content is more comprehensive for the age group 12-15, followed by 15-18 in all countries. All countries integrate learner-centred learning techniques and employ different teaching strategies for sexuality education, including participatory methods. Overall, there is a lack of school-based SRH services and commodities, including contraception. In countries where school-based health services exist, nurses often do not have guidelines or a mandate to provide relevant information. Monitoring and evaluation is one of the weakest components of all programmes in three of the four countries. To conclude, there is a need to enhance the content in all age groups, improve teacher training and provide materials to teachers and students, strengthen links with health services, involve relevant stakeholders in curricula development and introduce measurable monitoring and impact indicators.
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