Comprehensive

Sexuality Education
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Education for a healthy future

What is comprehensive sexuality education?
Comprehensive sexuality education (CSE) is a curriculum-based process of teaching and learning about the cognitive, emotional,
physical, and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes, and values that
will empower them to realize their health, well-being and dignity; develop respectful social and sexual relationships; consider how
their choices affect their own well-being and that of others; and understand and ensure the protection of their rights throughout their lives.

CSE should be culturally relevant and adapted to the national context, scientifically accurate, non-judgmental, age- and
developmentally-appropriate, and complete, and should be provided in a carefully phased process from the beginning of formal
schooling. In addition, research has shown that CSE is most effective when it is based on gender equality and a human rights
approach; and if it is able to develop skills for healthy living.1

“Young people are receiving

confusing and conflicting messages
about relationships, about sex,
and about gender. It’s critical
that schools deliver scientifically
accurate education that develops
the skills, knowledge, attitudes, and
competencies needed to navigate
a healthy transition to adulthood.
Government and the education
sector in sub-Saharan Africa have
both an opportunity and an urgent
responsibility to scale up sexuality
education programmes.”

(Former) Minister of General

Education, Dr Dennis Wanchinga
– Zambia, January 2018

What does
‘comprehensive’
mean?
“Comprehensive” refers to the
breadth and depth of topics
related to sexuality, including sexual
and reproductive anatomy and
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physiology, puberty and menstruation,

reproduction, modern contraception,
pregnancy and childbirth, and HIV and
other sexually transmitted infections
(STIs). This content is consistently
delivered to learners over time,
throughout their education, rather
than a one-off lesson or intervention.
What CSE content is recommended?
CSE provides children and young people with an age-appropriate and phased education on eight key concepts and essential topics.2 It
emphasizes values such as respect, inclusion, non-discrimination, equality, empathy, responsibility and reciprocity.

Key concept 1: Key concept 2: Key concept 3: Key concept 4:

Relationships Values, rights, culture and Understanding gender Violence and staying safe
sexuality
Topics: Topics: Topics: Topics:
1.1 Families 2.1 Values and sexuality 3.1 The social construction of 4.1 Violence
1.2 Friendship, love and romantic 2.2 Human rights and sexuality gender and gender norms 4.2 Consent, privacy and bodily
relationships 2.3 Culture, society and sexuality 3.2 Gender equality, stereotypes and integrity
1.3 Tolerance, inclusion and respect bias 4.3 Safe use of information and
1.4 Long-term commitments, and 3.3 Gender-based violence communication technologies
parenting (ICT’s)

Key concept 5: Key concept 6: Key concept 7: Key concept 8:

Skills for health and well- The human body and Sex, sexuality and the sexual Sexual and reproductive
being development life cycle health
Topics: Topics: Topics: Topics:
5.1 Norms and peer influence on 6.1 Sexual and reproductive 7.1 Sex, sexuality and the sexual life 8.1 Pregnancy and pregnancy
sexual behaviour anatomy and physiology cycle prevention
5.2 Decision-making 6.2 Reproduction 7.2 Sexual behaviour and sexual 8.2 HIV and AIDS stigma, care,
5.3 Communication, refusal and 6.3 Puberty response treatment and support
negotiation skills 6.4 Body image 8.3 Understanding, recognizing
5.4 Media literacy and sexuality and reducing the risk of STIs,
5.5 Finding help and support including HIV

“I saw the need to get more involved in teaching comprehensive sexuality education because of the way our society hides information on sexuality. I
remember growing up and being told that if you sit next to a boy at school you would conceive. I don’t want the current generation to go through what
we went through.”

- Agather Shindende, a teacher at Kabulonga Primary School

What is CSE called in the different African countries?

While research has identified CSE’s essential content, it is up to each country to adapt it to the local context, in line with national laws and
policies. Different components of CSE have been taught in nearly all sub-Saharan countries for decades through various programmes often
referred to as Life Skills Education (LSE) or prevention education. CSE builds on these existing programmes, increasing their effectiveness and relevance.
While CSE is now a globally recognized term used for ease of reference, the terminology or name used by each country varies for example:

Guidance and Counselling LSE Curriculum Life Skills, Sexuality, HIV and AIDS Education
Swaziland Zimbabwe

Educação Sexual Compreensiva Comprehensive sexuality education

Mozambique Zambia “It used to hurt me whenever a girl passed
better than me in any subject. Now, after
L’éducation à la vie familiale Education sexuelle complète learning some topics in CSE on gender, I have
Democratic Republic of the Congo Ivory Coast/Togo come to appreciate that we are actually the
same and now I do get help from girls in
Family Life and HIV Education Education sexuelle intégrée
Nigeria Cameroon some subjects and they too get help from me
and it doesn’t hurt me anymore.”
Education à la santé de la reproduction
Senegal - Remmy Kasangili Grade 9,
Jacaranda Primary School
Myths and misconceptions

CSE hastens sexual behaviour CSE teaches that traditional masculine and
CSE increases sexual behaviour feminine natures are harmful
CSE increases sexual risk-taking behaviour
CSE increases STI/HIV infection rates
NO
CSE does not state that traditional masculine and feminine
NO natures are harmful. CSE does promote reflection and
International research has shown CSE: understanding of gender norms and stereotypes and
• delays initiation of sexual activity critical thinking skills on how these shape our attitudes and
• increases use of condoms and other contraceptives behaviours, some of which are harmful to ourselves and
• increases knowledge others.
• decreases number of sexual partners
• decreases frequency of sexual intercourse
CSE teaches how to masturbate or other sexual
• decreases risk taking
practices
• decreases frequency of unprotected sex

CSE teaches homosexuality NO

CSE does not teach how to masturbate or other sexual
practices. CSE does help young people to understand and
NO manage their risk in relation to sex, including non-penetrative
sex.
CSE does not promote homosexuality or endorse or
campaign for any particular lifestyle, other than promoting
quality education, health, and well-being for all. CSE is in CSE promotes abortion
line with agreements signed by UN member states which
reiterate that all people, regardless of age, sexual orientation,
or gender identity, should have equal access to the NO
highest attainable standard of health, including education, Technical guidance on CSE only notes that young people
health services, and accurate SRH information – without should have access to full information about comprehensive
discrimination. SRH services. In countries where abortion is legal this should
include information on abortion and post-abortion care. The
CSE covers content that is not age-appropriate inclusion of information on abortion is therefore dependent
on national contexts.

NO SRH and rights (SRHR) give children the right to

CSE content is always adapted to the age and developmental do as they please with regard to sex
stage of the learner.

CSE goes against a countries’ laws and policies NO

SRHR cover the rights to health, education, to be protected
from violence and abuse, to access information, to bodily
NO integrity, and the need for consent.
CSE is adapted to national contexts by curriculum developers
and national stakeholders, in line with national laws and Abstinence-only programmes are sufficient
policies.

CSE destroys family values

NO
Research has shown that abstinence-only programmes are
insufficient. However, abstinence is a key element of CSE
NO which needs to be combined with a focus on delaying sexual
activity, and with content about condoms and other forms of
CSE does not destroy family values, it develops values such
contraception.
as respect, responsibility, and reciprocity, and emphasizes the
importance of healthy relationships and family.
What are the effects of CSE?3

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INCREASES REDUCES
Age of first sex Unprotected sex
Use of condoms & other contraceptives Number of sexual partners
Knowledge and self-esteem Frequency of sexual intercourse
Risk taking

Changes negative attitudes and norms

CSE also contributes to changes beyond health outcomes, including:
preventing and reducing gender-based and intimate partner violence; reducing discrimination;
increasing gender equitable norms; increasing self-efficacy and confidence; building stronger and
healthier relationships; and improving educational outcomes.

“It is the responsibility of religious institutions to educate adolescents and young children on issues of comprehensive sexuality education, now we have
UNESCO and other partners supporting us in advancing our work, and we are grateful”

– Bishop Michael Akpami, Secretary of CAN

Why do young people need CSE?

158 million young people

aged 15-24 in sub-Saharan
Africa (expected to rise to 281
million by 20504)

New HIV infections5 among young people in 2016

Eastern and Southern Africa: 210,000 female and 94,000 male

West and Central Africa: 80,000 female and 47,000 male

Comprehensive knowledge of HIV

Eastern and Southern Africa: 35% female and 36% male

West and Central Africa: 20% female and 26% male6

The African region 5-25% of adolescent girls have sexual

will only reap the intercourse before the age of 15.7
benefits from the
demographic 12% of adolescent girls aged 15-19
dividend if have given birth (global average 5%).8
young people are
educated, healthy Maternal mortality is the leading cause of
and employed. death among girls aged 15-19 globally.

Too many young people receive confusing and conflicting information about relationships and sex as they
make the transition from childhood to adulthood. This has led to an increasing demand from young people for
reliable information which prepares them for a safe, productive, and fulfilling life.

CSE responds to this demand, empowering young people to make informed decisions about relationships and
sexuality and navigate a world where gender-based violence, gender inequality, harmful norms, negative notions
of masculinities, early and unintended pregnancies, and HIV and other STIs still pose serious risks to their health
and well-being.
I want to think that CSE/Life Skills-based Sexuality Education (LSBSE) is a single stride in the right direction in preventing early and unintended pregnancy.

- High school life skills teacher, Lesotho

Are African governments supportive of CSE?
As a result of the high rates of new HIV infections, early marriage, early initiation of sexual activity, and early and unintended pregnancies, many
African governments are highly supportive of CSE. CSE and access to, and usage of, adolescent- and youth-friendly SRH services are recognized as key
interventions to improve the health and well-being of young people and enable countries to reap the benefits of a demographic dividend. To show
their commitment, governments have signed up to a number of regional commitments and standards that directly advocate for, or require CSE and
adolescent- and youth-friendly SRH services to be implemented.

Title Content
SADC Minimum Standards for Child and Adolescent HIV, TB The provision of CSE is identified as a minimum standard.
and Malaria Continuum of Care and Support (2010)

Eastern and Southern African Ministerial Commitment on “Initiate and scale up age-appropriate CSE during primary
comprehensive sexuality education and sexual and reproductive school education to reach most adolescents before puberty, before
health services for adolescents and young people (2013) most become sexually active, and before the risk of HIV transmission
or unintended pregnancy increases. Using agreed international
standards, ensure that CSE is age-, gender- and culturally-
appropriate, rights-based, and includes core elements of knowledge,
skills and values as preparation for adulthood: decisions about
sexuality, relationships, gender equality, SRH, and citizenship.”

Pan-African High-Level Conference on Education “We commit to achieving gender equality through:
Nairobi Declaration and Call for Action on Education - Bridging • Rendering all aspects of the education system gender-sensitive,
continental and global education frameworks for the Africa We Want responsive, and transformative.
(2018) • Providing sexuality education in schools and tertiary
institutions and ensuring access for adolescents and
young people.”

African Union Roadmap on “Harnessing the Demographic “Scale up age-appropriate and culturally sensitive
Dividend through Investments in Youth” (2016) comprehensive education on SRH in order to avert many
complications and challenges associated with unintended
pregnancies and STIs, and their consequent impact on the
development and well-being of young people, for in- and out-
of-school youth, and implement innovative behavioural change
programmes using new media and technology.”

Addis Ababa Declaration on Population and Development in “Adopt and implement relevant CSE programmes, both in
Africa Beyond 2014 (2013) and out of school, that are linked to SRH services, with the active
involvement of parents, community, traditional, religious, and
opinion leaders; and young people themselves.”

The African Union’s revised Maputo Plan of Action 2016-2030 for Target “adolescents and youth (both in and out of school) with
the Operationalization of the Continental Policy Framework for age-appropriate and culturally sensitive comprehensive
Sexual and Reproductive Health and Rights (draft) education on SRH that involves parents and communities”.

African Common Position on the African Union’s Campaign to Provide (inter alia) “education (including life skills and health
End Child Marriage in Africa education, including comprehensive education for sexual
health)”

International Conference on Population and Development (ICPD) Calls upon governments “… to give full attention to meeting the
Resolution 2012/1 Adolescents and youth. The Commission on reproductive health-service, information and education needs of
Population and Development (2012) young people… and to provide them with evidence-based
comprehensive education on human sexuality, SRH, human
rights, and gender equality to enable them to deal in a positive
and responsible way with their sexuality.”
About UNESCO
UNESCO is the United Nations’ specialized agency for education. It provides global and regional leadership
in education, strengthens national education systems, and responds to contemporary global challenges
through education, with a special focus on gender equality and Africa.

UNESCO’s mission on the area of health education

• Promoting healthy lifestyles among girls, boys, young women, and men through skills-based education in formal educational settings,
non-formal educational activities, and informal education.
• Ensuring that all children benefit from good quality comprehensive sexuality education that includes information on HIV prevention.
• Ensuring that all children and young people have access to safe, inclusive, health-promoting learning environments.

UNESCO Regional Office for Southern Africa

8, Kenilworth Road, Newlands
PO Box HG 435 Highlands, Harare, Zimbabwe
+263 (0)776775 - 9
www.unesco.org/new/en/harare

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1
UNESCO. 2018. Revised Edition. International technical guidance on sexuality education. An Evidence-informed approach.
2
CSE, its effects, and promising implementation practices are well researched subjects. Two main evidence reviews exist: The 2008 review was based on 87 studies; the 2016 review on 22
rigorous systematic reviews, 77 randomized controlled trials (RCT), of which more than half where situated in low or middle income countries, and information from non-RCT publications and
online resources (40 studies were conducted in African countries). For further details see UNESCO. 2018. Revised Edition. International technical guidance on sexuality education. An Evidence-
informed approach.
3
UNFPA. 2012. Status Report: Adolescents and young people in sub-Saharan Africa.
4
http://aidsinfo.unaids.org/. 2016 data for young people aged 15-24 years.
5
UNICEF. State of the World Children. 2017 Statistical Tables.
6
statcompiler.com, statistic applies to most countries in the region.
7
UNICEF. State of the World’s Children. 2017 statistical tables.
8
UNESCO. 2018. Revised Edition. International technical guidance on sexuality education. An Evidence-informed approach.