Based on a rigorous and current review of evidence on sexuality education programmes, this International Technical Guidance on Sexuality Education is aimed at education and health sector decision-makers and professionals. It has been produced to assist education, health and other relevant authorities in the development and implementation of school-based sexuality education programmes and materials. Volume I focuses on the rationale for sexuality education and provides sound technical advice on characteristics of effective programmes. A companion document, (Volume II) focuses on the topics and learning objectives to be covered in a ‘basic minimum package’ on sexuality education for children and young people from 5 to 18+ years of age and includes a bibliography of useful resources. The International Technical Guidance is relevant not only to those countries most affected by HIV and AIDS, but also to those facing low prevalence and concentrated epidemics.
The designations employed and the presentation of materials throughout this document do not imply the expression of any opinion whatsoever on the part of UNESCO concerning the legal status of any county, territory city or area or its authorities, or concerning its frontiers and boundaries.
Published by UNESCO © UNESCO 2009 Section on HIV and AIDS
Table of Contents
This International Technical Guidance on Sexuality Education was commissioned by the United Nations Educational, Scientific and Cultural Organization (UNESCO). Its preparation, under the overall guidance of Mark Richmond, UNESCO Global Coordinator for HIV and AIDS, was organized by Chris Castle, Dhianaraj Chetty and Ekua Yankah in the Section on HIV and AIDS, Division for the Coordination of UN Priorities in Education at UNESCO.
Nanette Ecker, former Director of International Education and Training at the Sexuality Information and Education Council of the United States (SIECUS) and Douglas Kirby, Senior Scientist at ETR (Education, Training, Research) Associates, were contributing authors of this document. Peter Gordon, independent consultant, edited various drafts.
UNESCO would like to thank the William and Flora Hewlett Foundation for hosting the global technical consultation that contributed to the development of the guidance. The organizers would also like to express their gratitude to all of those who participated in the consultation, which took place from 18-19 February 2009 in Menlo Park, USA (in alphabetical order):
Prateek Awasthi, UNFPA; Arvin Bhana, Human Sciences Research Council (South Africa); Chris Castle, UNESCO; Dhianaraj Chetty, formerly ActionAid; Esther Corona, Mexican Association for Sex Education and World Association for Sexual Health; Mary Guinn Delaney, UNESCO; Nanette Ecker, SIECUS; Nike Esiet, Action Health, Inc. (AHI); Peter Gordon, independent consultant; Christopher Graham, Ministry of Education, Jamaica; Nicole Haberland, Population Council/USA; Sam Kalibala, Population Council/Kenya; Douglas Kirby, ETR Associates; Wenli Liu, Beijing Normal University; Elliot Marseille, Health Strategies International; Helen Omondi Mondoh, Egerton University; Prabha Nagaraja, Talking about Reproductive and Sexual Health Issues (TARSHI); Hans Olsson, The Swedish Association for Sexuality Education; Grace Osakue, Girls' Power Initiative (GPI) Nigeria; Jo Reinders, World Population Foundation (WPF); Sara Seims, the William and Flora Hewlett Foundation; and Ekua Yankah, UNESCO.
Written comments and contributions were also gratefully received from (in alphabetical order):
Peter Aggleton, Institute of Education at the University of London; Vicky Anning, independent consultant; Andrew Ball, World Health Organization (WHO); Prateek Awasthi, UNFPA; Tanya Baker, Youth Coalition for Sexual and Reproductive Rights; Michael Bartos, UNAIDS; Tania Boler, Marie Stopes International and formerly with UNESCO; Jeffrey Buchanan, formerly with UNESCO; Chris Castle, UNESCO; Katie Chau, Youth Coalition for Sexual and Reproductive Rights; Judith Cornell, UNESCO; Anton De Grauwe, UNESCO International Institute for Educational Planning (IIEP); Jan De Lind Van Wijngaarden, UNESCO; Marta Encinas-Martin, UNESCO; Jane Ferguson, WHO; Claudia Garcia-Moreno, WHO; Dakmara Georgescu, UNESCO International Bureau of Education (IBE); Cynthia Guttman, UNESCO; Anna Maria Hoffmann, United Nations Children's Fund (UNICEF); Roger Ingham, University of Southampton; Sarah Karmin, UNICEF; Eszter Kismodi, WHO; Els Klinkert, UNAIDS; Jimmy Kolker, UNICEF; Steve Kraus, UNFPA; Changu Mannathoko, UNICEF; Rafael Mazin, Pan American Health Organization (PAHO); Maria Eugenia Miranda, Youth Coalition for Sexual and Reproductive Rights; Jean O'Sullivan, UNESCO; Mary Otieno, UNFPA; Jenny Renju, Liverpool School of Tropical Medicine & National Institute for Medical Research; Mark Richmond, UNESCO; Pierre Robert, UNICEF, Justine Sass, UNESCO; Iqbal H. Shah, WHO, Shyam Thapa, WHO; Barbara Tournier, UNESCO IIEP; Friedl Van den Bossche, formerly UNESCO; Diane Widdus, UNICEF; Arne Willems, UNESCO; Ekua Yankah, UNESCO; and Barbara de Zalduondo, UNAIDS.
UNESCO would like to acknowledge Masimba Biriwasha, UNESCO; Sandrine Bonnet, UNESCO IBE; Claire Cazeneuve, UNESCO IBE; Claire Greslé-Favier, WHO; Magali Moreira, UNESCO IBE; and Lynne Sergeant, UNESCO IIEP for their contributions to the bibliography of resources. Finally, thanks are offered to Vicky Anning who provided editorial support, Aurélia Mazoyer and Myriam Bouarour who undertook the design and layout, and Schéhérazade Feddal who provided liaison support for the production of this document.
Few young people receive adequate preparation for their sexual lives. This leaves them potentially vulnerable to coercion, abuse and exploitation, unintended pregnancy and sexually transmitted infections (STIs), including HIV. Many young people approach adulthood faced with conflicting and confusing messages about sexuality and gender. This is often exacerbated by embarrassment, silence and disapproval of open discussion of sexual matters by adults, including parents and teachers, at the very time when it is most needed. There are many settings globally where young people are becoming sexually mature and active at an earlier age. They are also marrying later, thereby extending the period of time from sexual maturity until marriage.
Countries are increasingly signalling the importance of equipping young people with knowledge and skills to make responsible choices in their lives, particularly in a context where they have greater exposure to sexually explicit material through the Internet and other media. There is an urgent need to address the gap in knowledge about HIV among young people aged 15-24, with 60 per cent in this age range not able to correctly identify the ways of preventing HIV transmission (UNAIDS, 2008). A growing number of countries have implemented or are scaling up sexuality education1 programmes, including China, Kenya, Lebanon, Nigeria and Viet Nam, a trend confirmed by the ministers of education and health from countries in Latin America and the Caribbean at a summit held in July 2008. These efforts recognise that all young people need sexuality education, and that some are living with HIV or are more vulnerable to HIV infection than others, particularly adolescent girls married as children, those who are already sexually active, and those with disabilities.
Effective sexuality education can provide young people with age-appropriate, culturally relevant and scientifically accurate information. It includes structured opportunities for young people to explore their attitudes and values, and to practise the decision-making and other life skills they will need to be able to make informed choices about their sexual lives.
Effective sexuality education is a vital part of HIV prevention and is also critical to achieving Universal Access targets for reproductive health and HIV prevention, treatment, care and support (UNAIDS, 2006). While it is not realistic to expect that an education programme alone can eliminate the risk of HIV and other STIs, unintended pregnancy, coercive or abusive sexual activity and exploitation, properly designed and implemented programmes can reduce some of these risks and underlying vulnerabilities.
Effective sexuality education is important because of the impact of cultural values and religious beliefs on all individuals, and especially on young people, in their understanding of this issue and in managing relationships with their parents, teachers, other adults and their communities.
School settings provide an important opportunity to reach large numbers of young people with sexuality education before they become sexually active, as well as offering an appropriate structure (i.e. the formal curriculum) within which to do so.
The International Technical Guidance on Sexuality Education comprises two parts. Volume I focuses on the rationale for sexuality education and provides sound technical advice on characteristics of effective programmes. This companion document (Volume II) presents a ‘basic minimum package' of topics and learning objectives for a sexuality education programme for children and young people from 5 to 18+ years of age and includes a bibliography of useful resources. The intention is to provide concrete guidance for the development of locally adapted curricula.
The development of the topics and learning objectives was informed by a specially commissioned review of existing curricula from 12 countries2, guidelines and standards as identified by key informants, and through searches of relevant databases, websites and electronic mailing lists3 (see References). The Guidance was further developed through key informant interviews with recognised experts (see list in Appendix III), and through a global technical consultation meeting held in February 2009 with experts from 13 countries (see list in Appendix IV). Colleagues from UNAIDS, UNESCO, UNFPA, UNICEF and WHO have also provided input into this document. Thus, while by no means exhaustive, some of the topics and learning objectives are solidly embedded in evidence and all are grounded upon practical experience.
In addition, the topics covered in those evaluated programmes that effectively changed behaviour, reviewed in the companion document (Volume I) on the rationale for sexuality education (http://www.unesco.org/aids), informed some of the learning objectives. Additional programmes referred to in the rationale for sexuality education covered some but not all of the learning objectives described in this volume.
Future versions of the International Technical Guidance will be produced and will incorporate feedback from users around the world, and will continue to be based on the best available evidence.
The goals of the topics and learning objectives are to:
• provide accurate information about topics that children and young people are curious about and about which they have a need to know;
• provide children and young people with opportunities to explore values, attitudes and norms concerning sexual and social relationships;
• promote the acquisition of skills; and
• encourage children and young people to assume responsibility for their own behaviour and to respect the rights of others.
As a comprehensive package, all learning objectives address children’s and young people’s need for information and right to education. However, while only some of these learning objectives are specifically designed to reduce risky sexual behaviour, others will attempt to change social norms, facilitate communication of sexual issues, remove social and attitudinal barriers to sexuality education and increase knowledge.
The topics and learning objectives in this volume are intended for young people at primary and secondary school levels. However, many people have not received any sexuality education at those levels and so learners in tertiary institutions may also benefit from the learning objectives in the International Technical Guidance. Indeed, the need for sexuality education at tertiary level may be especially critical, given that many students will be living away from home for the first time, may develop relationships, and may become sexually active. In addition, the topics and learning objectives may prove useful for teacher training and curriculum development or simply as a checklist to review existing curricula and programmes.
It is equally important to provide sexuality education to children and young people out of school, especially for those who may be marginalised for a variety of reasons, and particularly vulnerable to an early, unprepared sexual debut and sexual exploitation and abuse.
The topics and learning objectives address four age groups and corresponding levels:
1. ages 5 to 8 (Level I)
2. ages 9 to 12 (Level II)
3. ages 12 to 15 (Level III)
4. ages 15 to 18+ (Level IV)
The learning objectives are logically staged, with concepts for younger students typically including more basic information, less advanced cognitive tasks, and less complex activities. There is a deliberate overlap between levels 3 and 4 in order to accommodate the broad age range of learners who might be in the same class. Level 4 addresses learners from ages 15 to 18+ to acknowledge that some learners in the secondary level may be older than 18 and that the topics and learning objectives can also be used with more mature learners in tertiary institutions. All information discussed with the above-mentioned age groups should be in line with learners' cognitive abilities and pay attention to children and young people with intellectual/learning disabilities.
The sexual and reproductive health needs and concerns of children and young people, as well as the age of sexual debut, vary considerably within and across regions, as well as within and across countries and communities. This, in turn, is likely to affect the perceived appropriateness of particular learning objectives when developing curricula, materials and programmes. Learning objectives should therefore be adjusted to their context. However, this should be done in response to the available data and evidence rather than because of personal discomfort or perceived opposition.
The topics and learning objectives cover four components of the learning process:
1. Information: sexuality education provides accurate information about human sexuality, including: growth and development; sexual anatomy and physiology; reproduction; contraception; pregnancy and childbirth; HIV and AIDS; STIs; family life and interpersonal relationships; culture and sexuality; human rights empowerment; non-discrimination, equality and gender roles; sexual behaviour; sexual diversity; sexual abuse; gender-based violence; and harmful practices.
2. Values, attitudes and social norms: sexuality education offers students opportunities to explore values, attitudes and norms (personal, family, peer and community) in relation to sexual behaviour, health, risk-taking and decision-making and in consideration of the principles of tolerance, respect, gender equality, human rights, and equality.
3. Interpersonal and relationship skills: sexuality education promotes the acquisition of skills in relation to: decision-making; assertiveness; communication; negotiation; and refusal. Such skills can contribute to better and more productive relationships with family members, peers, friends and romantic or sexual partners.
4. Responsibility: sexuality education encourages students to assume responsibility for their own behaviour as well as their behaviour towards other people through respect; acceptance; tolerance and empathy for all people regardless of their health status or sexual orientation. Sexuality education also insists on gender equality; resisting early, unwanted or coerced sex and rejecting violence in relationships; and the practice of safer sex, including the correct and consistent use of condoms and contraceptives.
Decisions need to be made about whether sexuality education should be: taught as a stand-alone subject (as it is in Malawi and Jamaica); integrated within an existing mainstream subject, such as health or biology (as it is in Viet Nam); delivered across several other subjects, such as civics, health and biology (as in Mexico); or included in guidance and counselling (as it has been in Kenya until recently).
Decisions will be influenced by general educational policies, the availability of resources (including the availability of supportive school administration, trained teachers and materials), competing priorities in the school curriculum, the needs of learners, community support for sexuality education programmes and timetabling issues. A pragmatic response might acknowledge that, while it would be ideal to introduce sexuality education as a separate subject, it may be more practical to build upon and improve what teachers are already teaching, and look to integrate it within existing subjects such as social science, biology or guidance and counselling.
In Malawi, sexuality education is taught as a stand-alone and examinable subject at the secondary school level and is integrated into carrier subjects and not yet examinable at the primary school level. In both cases, sexuality education is taught by trained teachers using specifically designed materials.
In Mexico, sexuality education is integrated within various parts of the curriculum such as science and civics education, in recognition of the fact that sexuality is part of many aspects of life. Sexuality education may become a separate subject for learners (aged 15-18 years) in upper secondary school.
In the United Republic of Tanzania, sexuality education is integrated within carrier subjects such as a science and civics education. The Tanzanian case proves that sexuality education does not need to be made an entirely separate subject in order to be included in curricula.
In Viet Nam, the Ministry of Education is in the process of developing a compulsory extra-curricular component, which will complement intra-curricular content. The strategy also makes use of participatory approaches and peer support reinforced by a parallel parental programme.
The overarching topics under which learning objectives have been defined are organised around six key concepts:
2. Values, attitudes and skills
3. Culture, society and human rights
4. Human development
5. Sexual behaviour
6. Sexual and reproductive health
Each topic is linked to specific learning objectives, grouped according to the four age levels. The learning objectives are the intended outcomes of working on particular topics. Learning objectives are defined at the level when they should be first introduced, but they need to be reinforced across different age levels. When a programme begins with older students, it may be necessary to cover topics and learning objectives from earlier age levels. Based on needs and country/region-specific characteristics, such as social and cultural norms and epidemiological context, the contents of the learning objectives could be adjusted to be included within earlier or later age levels. However, most experts believe that children and young people want and need sexuality and sexual health information as early and comprehensively as possible.
The tables below specify the topics and learning objectives which can provide a comprehensive ‘menu' for curriculum development. The topics and learning objectives are drawn from evidence concerning curricula that have been demonstrated to change behaviours, as well as from practical experience.
UNAIDS. 2008. 2008 Report on the global AIDS epidemic. Geneva: UNAIDS.
UNAIDS. 2006. Scaling up access to HIV prevention, treatment, care and support. The next steps. Geneva: UNAIDS.
CDC. 2008. Healthy Youth! National Health Education Standards 1-8, CDC School Health Education Resources. Atlanta: CDC.
Deutsch, C. et al. 2005. Standards for Peer Education Programmes: Youth Peer Education Network. New York: UNFPA and Family Health International.
Education International and WHO. 2001. Training and Resource Manual On School Health and HIV/AIDS Prevention. Brussels: Education International (EI) and the World Health Organization (WHO).
IPPF. 2006. IPPFFramework for Comprehensive Sexuality Education. London: International Planned Parenthood Federation.
IPPF. 1997. IPPF Charter Guidelines on Sexual and Reproductive Rights. London: International Planned Parenthood Federation.
Jamaica Ministry of Education and Youth and Caribbean Consulting Group. 2007. Health and Family Life Education Curriculum Grades 1-6. Caribbean Consulting Group. Brooklyn: Caribbean Consulting Group.
Jamaica Ministry of Education and Youth and Caribbean Consulting Group. 2007. Health and Family Life Education Curriculum Grades 7-9. Brooklyn: Caribbean Consulting Group.
Mercy Corps. November 2007. Commitment to Practice: A Playbook for Practitioners in HIV, Youth and Sport. Portland: Mercy Corps.
New York City Department of Education. 2005. HIV/AIDS Curriculum Overview. New York: New York City Department of Education.
PATH. 2006. Tuko Pamoja: A Guide for Talking with Young People about their Reproductive Health. Nairobi: Programme for Appropriate Technology in Health.
Senderowitz, J., Kirby, D. 2006. Standards for Curriculum-Based Reproductive Health and HIV Education Programmes. Washington, DC: Family Health International.
SIECUS. 2006. Establishing National Guidelines for Comprehensive Sexuality Education: Lessons and Inspiration from Nigeria. New York: SIECUS.
SIECUS. 2000. Developing Guidelines for Comprehensive Sexuality Education. New York: SIECUS.
State of New Jersey Department of Education. 2006. New Jersey Core Curriculum Content Standards for Comprehensive Health and Physical Education. Trenton: State of New Jersey Department of Education.
Svenson, G. R. 1998. European Guidelines for Youth AIDS Peer Education, Malmo. Brussels: European Commission.
UNAIDS. 2007. Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access. Geneva: UNAIDS.
UNESCO. 2005. Reducing HIV/AIDS Vulnerability Among Students in the School Setting: A Teacher Training Manual. Bangkok: UNESCO.
UNESCO IBE. 2006. Manual for Integrating HIV and AIDS Education in School Curricula. Geneva: International Bureau of Education/UNESCO.
Asian Pacific Resource and Research Centre for Women. 2005. Arrows for Change: Women's, Gender and Rights Perspectives in Health Policies and Programmes. Vol. 11 Bumper Issue. Kuala Lumpur: ARROW.
Chingandu, L. 2008. Multiple Concurrent Partnerships: The story of Zimbabwe—Are small houses a key driver? Zimbabwe: Southern Africa HIV and AIDS Information Dissemination Service. http://www.comminit.com/en/node/278405/38
Chinvarasopak, W. 2008. Teachers and Sex: Uneasy Bedfellows? The Experience of the Teenpath Project, PowerPoint presentation at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2403.ppt
Delaney, M. G. 2008. Prevention through Education, PowerPoint presentation at the 1st Meeting of Ministers of Health and Education to Stop HIV in Latin America and the Caribbean, Mexico City, August 1, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2404.ppt
Exchange Magazine. 2008. Gender Violence, HIV and AIDS. Exchange on HIV/AIDS, sexuality and gender. No. 3. Amsterdam: Royal Tropical Institute. http://www.kit.nl/smartsite.shtml?ch=FAB&id=10488&IssueID=3&Year=2008
Family Health International. 2007. New Websites Make Information About Youth More Accessible. Durham: Family Health International. http://www.fhi.org/NR/rdonlyres/e6k4h7j3p5euhcx43e55pdtsqqx2746tzd2hots7j5iyr6p v4cnbhjoqwyf6dc64ebf6yredaqhazf/YL23e.pdf
Hearst, N. 2007. AIDS Prevention in Generalized Epidemics: What Works? Senate Testimony, December 11, 2007. http://help.senate.gov/Hearings/2007_12_11/Hearst.pdf
IRIN Plus News. 2008. South Africa: SexEducation—The Ugly Stepchild in Teacher Training, IRIN Plus News, 22 May 2008. http://www.plusnews.org/Report.aspx?ReportId=78357 .
IRIN Plus News. 2008. Mind Your Language: A Short Guide to HIV/AIDS Slang, IRIN Plus News, 18 June 2008. http://www.irinnews.org/Report.aspx?ReportId=78809
IRIN Plus News. 2008. Kenya: More Education Equals Less Teen Pregnancy and HIV, IRIN Plus News, 25 July. http://www.irinnews.org/report.aspx?ReportID=79456
Kaiser Daily Health Policy Report. 2008. HIV/AIDS Hinders Children's Access to Education, UNDP Official Says. Kaiser Daily Health Policy Report, June 16 2008. http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52746
Kaiser Daily HIV/AIDS Report. 2008. HIV/AIDS Campaign Launched In Tanzania To Address Issues of Multiple Sex Partners. Global Challenges, October 27, 2008. http://www.medicalnewstoday.com/articles/127122.php
Kamugisha, N.E. 2007. An Improved School Environment Contributes to Quality Adolescent Sexual and Reproductive Health. PowerPoint presentation, Kampala, Uganda: Straight Talk Foundation. http://www.jhsph.edu/gatesinstitute/_pdf/policy_practice/adolhealth/presentations/.../3C_Namayanja_ Improved%20School%20Environment.pdf
Kirby, D. 2008. Abstinence and Comprehensive Sex/HIV Education Programmes: Their Impact on Behaviour in Developed and Developing Countries. Powerpoint presentation at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSY0301.ppt
Knerr, W., Philpott, A. 2008. Global Mapping of Pleasure: A directory of organizations, programmes, media and people who eroticize safer sex. Oxford: The Pleasure Project. http://www.thepleasureproject.org/content/File/ Global%20Mapping%20of%20Pleasure_2nd%20Ed_lo%20res(1).pdf
Maticka-Tyndale, E. 2008. Sustainability of Gains Made in a Primary School HIV Prevention Programme in Kenya into the Secondary School Years. PowerPoint presentation at the Investing in Young People's Health and Development Conference, Abuja, Nigeria, April 27-29. http://www.jhsph.edu/gatesinstitute/_pdf/policy_ practice/adolhealth/presentations/.../3C_Maticka-Tyndale_2ary%20school%20Kenya.pdf
Mulama, S. 2007. The Sexuality Education Needs of Teacher Trainees in Kenya. Lagos: Africa Regional Sexuality Resource Centre. http://www.arsrc.org/downloads/sldf/FinalReport%20Stella%20Mulama2006.pdf
Phamotse, P. 2008. HIV & AIDS and the Education Sector in Lesotho. PowerPoint presentation delivered by Chris Castle at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2402.ppt
Philemon, L. 2008. Multiple Concurrent Partnerships Make HIV/AIDS A Quagmire. Guardian/IPP Media, 24 October. http://kurayangu.com/ipp/guardian/2008/10/24/125038.html
Star Schools Project. http://starschool.brimstone.net/ (accessed June 30, 2008).
UN. 2008. New Report Says Some Cultural Factors Influencing Spread of AIDS Are Specific to Africa. Press release. New York: United Nations. http://www.thebody.com/content/world/art47245.html
UNESCO. 2005. Adolescence Education: Newsletter for policy makers, programme managers and practitioners. Vol. 8, No. 1. http://www.unescobkk.org/fileadmin/user_upload/arsh/AEN/AEN_June05.pdf.
UNICEF Children and HIV and AIDS http://www.unicef.org/aids/index_introduction.php.
United Nations Committee on the Rights of the Child. CRC/GC/2003/4, 1 July 2003. General Comment 4: Adolescent health and development in the context of the Convention on the Rights of the Child (CRC)8
“The Committee calls upon States parties to develop and implement, in a manner consistent with adolescents' evolving capacities, legislation, policies and programmes to promote the health and development of adolescents by (...) (b) providing adequate information and parental support to facilitate the development of a relationship of trust and confidence in which issues regarding, for example, sexuality and sexual behaviour and risky lifestyles can be openly discussed and acceptable solutions found that respect the adolescent's rights (art. 27 (3));” (CRC/GC/2003/4, para. 16)
“Adolescents have the right to access adequate information essential for their health and development and for their ability to participate meaningfully in society. It is the obligation of States parties to ensure that all adolescent girls and boys, both in and out of school, are provided with, and not denied, accurate and appropriate information on how to protect their health and development and practise healthy behaviours. This should include information on the use and abuse, of tobacco, alcohol and other substances, safe and respectful social and sexual behaviours, diet and physical activity.” (CRC/GC/2003/4, para 26)
United Nations Committee on Economic, Social and Cultural Rights. E/C.12/2000/4, 11 August 2000. Substantive issues arising in the implementation of the international covenant on economic, social and cultural rights. General Comment 149
“The Committee interprets the right to health, as defined in article 12.1, as an inclusive right extending not only to timely and appropriate health care but also to the underlying determinants of health, such as [...] access to health-related education and information, including on sexual and reproductive health.” (E/C.12/2000/4, para. 11)
“By virtue of article 2.2 and article 3, the Covenant proscribes any discrimination in access to health care and underlying determinants of health, as well as to means and entitlements for their procurement, on the grounds of race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, physical or mental disability, health status (including HIV/AIDS), sexual orientation and civil, political, social or other status, which has the intention or effect of nullifying or impairing the equal enjoyment or exercise of the right to health.(...)” (E/C.12/2000/4, para. 18)
“To eliminate discrimination against women, there is a need to develop and implement a comprehensive national strategy for promoting women’s right to health throughout their life span. Such a strategy should include interventions aimed at the prevention and treatment of diseases affecting women, as well as policies to provide access to a full range of high quality and affordable health care, including sexual and reproductive services. A major goal should be reducing women’s health risks, particularly lowering rates of maternal mortality and protecting women from domestic violence. The realization of women's right to health requires the removal of all barriers interfering with access to health services, education and information, including in the area of sexual and reproductive health. It is also important to undertake preventive, promotive and remedial action to shield women from the impact of harmful traditional cultural practices and norms that deny them their full reproductive rights.” (E/C.12/2000/4, para. 21)
United Nations Convention on the Rights of Persons with Disabilities. A/61/611, 6 December, 2006. Article 25 - Health10
“States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. In particular, States Parties shall:
(a) Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes... ”
International Conference on Population and Development (ICPD) Programme of Action (POA)11
“All countries should strive to make accessible through the primary health-care system, reproductive health to all individuals of appropriate ages as soon as possible and no later than the year 2015. Reproductive health care in the context of primary health care should, inter alia, include: family-planning counselling, information, education, communication and services; education and services for prenatal care, safe delivery and post-natal care, especially breast-feeding and infant and women’s health care; prevention and appropriate treatment of infertility; abortion as specified in paragraph 8.25, including prevention of abortion and the management of the consequences of abortion; treatment of reproductive tract infections; sexually transmitted diseases and other reproductive health conditions; and information, education and counselling, as appropriate, on human sexuality, reproductive health and responsible parenthood.” (ICPD POA, para. 7.6)
“Innovative programmes must be developed to make information, counselling and services for reproductive health accessible to adolescents and adult men. Such programmes must both educate and enable men to share more equally in family planning and in domestic and child-rearing responsibilities and to accept the major responsibility for the prevention of sexually transmitted diseases. Programmes must reach men in their workplaces, at home and where they gather for recreation. Boys and adolescents, with the support and guidance of their parents, and in line with the Convention on the Rights of the Child, should also be reached through schools, youth organizations and wherever they congregate. Voluntary and appropriate male methods for contraception, as well as for the prevention of sexually transmitted diseases, including AIDS, should be promoted and made accessible with adequate information and counselling.” (ICPD POA, para. 7.9)
“The objectives are: (a) To promote adequate development of responsible sexuality, permitting relations of equity and mutual respect between the genders and contributing to improving the quality of life of individuals; (b) To ensure that women and men have access to the information, education and services needed to achieve good sexual health and exercise their reproductive rights and responsibilities.” (ICPD POA, para. 7.36)
“Support should be given to integral sexual education and services for young people, with the support and guidance of their parents and in line with the Convention on the Rights of the Child, that stress responsibility of males for their own sexual health and fertility and that help them exercise those responsibilities. Educational efforts should begin within the family unit, in the community and in the schools at an appropriate age, but must also reach adults, in particular men, through non-formal education and a variety of community-based efforts. (ICPD POA, para. 7.37)
“In the light of the urgent need to prevent unwanted pregnancies, the rapid spread of AIDS and other sexually transmitted diseases, and the prevalence of sexual abuse and violence, Governments should base national policies on a better understanding of the need for responsible human sexuality and the realities of current sexual behaviour.” (ICPD POA, para. 7.38)
“Recognizing the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescent, appropriate direction and guidance in sexual and reproductive matters, countries must ensure that the programmes and attitudes of health-care providers do not restrict the access of adolescents to appropriate services and the information they need, including on sexually transmitted diseases and sexual abuse. In doing so, and in order to, inter alia, address sexual abuse, these services must safeguard the rights of adolescents to privacy, confidentiality, respect and informed consent, respecting cultural values and religious beliefs. In this context, countries should, where appropriate, remove legal, regulatory and social barriers to reproductive health information and care for adolescents.” (ICPD POA, para. 7.45)
“Countries, with the support of the international community, should protect and promote the rights of adolescents to reproductive health education, information and care and greatly reduce the number of adolescent pregnancies.” (ICPD POA, 7.46)
“Governments, in collaboration with non-governmental organizations, are urged to meet the special needs of adolescents and to establish appropriate programmes to respond to those needs. Such programmes should include support mechanisms for the education and counselling of adolescents in the areas of gender relations and equality, violence against adolescents, responsible sexual behaviour, responsible family-planning practice, family life, reproductive health, sexually transmitted diseases, HIV infection and AIDS prevention. Programmes for the prevention and treatment of sexual abuse and incest and other reproductive health services should be provided. Such programmes should provide information to adolescents and make a conscious effort to strengthen positive social and cultural values. Sexually active adolescents will require special family-planning information, counselling and services, and those who become pregnant will require special support from their families and community during pregnancy and early child care. Adolescents must be fully involved in the planning, implementation and evaluation of such information and services with proper regard for parental guidance and responsibilities.” (ICPD POA, para. 7.47)
“Programmes should involve and train all who are in a position to provide guidance to adolescents concerning responsible sexual and reproductive behaviour, particularly parents and families, and also communities, religious institutions, schools, the mass media and peer groups. Governments and non-governmental organizations should promote programmes directed to the education of parents, with the objective of improving the interaction of parents and children to enable parents to comply better with their educational duties to support the process of maturation of their children, particularly in the areas of sexual behaviour and reproductive health.” (ICPD POA, 7.48)
United Nations. A/S-21/5/Add.1, 1 July 1999. Overall review and appraisal of the implementation of the Programme of Action of the International Conference on Population and Development (ICPD + 5)12
“Governments, in collaboration with civil society, including non-governmental organizations, donors and the United Nations system, should: (a) Give high priority to reproductive and sexual health in the broader context of health-sector reform, including strengthening basic health systems, from which people living in poverty in particular can benefit; (b) Ensure that policies, strategic plans, and all aspects of the implementation of reproductive and sexual health services respect all human rights, including the right to development, and that such services meet health needs over the life cycle, including the needs of adolescents, address inequities and inequalities due to poverty, gender and other factors and ensure equity of access to information and services; (c) Engage all relevant sectors, including non-governmental organizations, especially women’s and youth organizations and professional associations, through ongoing participatory processes in the design, implementation, quality assurance, monitoring and evaluation of policies and programmes, in ensuring that sexual and reproductive health information and services meet people’s needs and respect their human rights, including their right to access to good-quality services; Develop comprehensive and accessible health services and programmes, including sexual and reproductive health, for indigenous communities with their full participation that respond to the needs and reflect the rights of indigenous people; [....]” (A/S-21/5/ Add.1, para. 52(a)-(d))
United Nations Fourth World Conference on Women (FWCW) Platform for Action (PFA)13
“The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and
reproductive health, free of coercion, discrimination and violence. Equal relationships between women and men in matters of sexual relations and reproduction, including full respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behaviour and its consequences.” (FWCW PFA, para. 96)
“Actions to be taken by Governments, international bodies including relevant United Nations organizations, bilateral and multilateral donors and non-governmental organizations [...] (k) Give full attention to the promotion of mutually respectful and equitable gender relations and, in particular, to meeting the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality;” (FWCW PFA, para. 108(k) and A/S-21/5/Add.1, para. 71®)
“Actions to be taken by Governments, in cooperation with non-governmental organizations, the mass media, the private sector and relevant international organizations, including United Nations bodies, as appropriate [...] (g) Recognize the specific needs of adolescents and implement specific appropriate programmes, such as education and information on sexual and reproductive health issues and on sexually transmitted diseases, including HIV/AIDS, taking into account the rights of the child and the responsibilities, rights and duties of parents as stated in paragraph 107 (e) above;” (FWCW PFA, para. 107(g))
United Nations. A/RES/S-26/2, 2 August 2001. General Assembly Special Session on HIV/AIDS, Declaration of Commitment on HIV/AIDS 14
“We, the Heads of State and Government and Representatives of Heads of State and Government, solemnly declare our commitment to address the HIV/ AIDS crisis by taking action as follows [...] By 2003, develop and/or strengthen strategies, policies and programmes, which recognize the importance of the family in reducing vulnerability, inter alia, in educating and guiding children and take account of cultural, religious and ethical factors, to reduce the vulnerability of children and young people by: ensuring access of both girls and boys to primary and secondary education, including on HIV/AIDS in curricula for adolescents; ensuring safe and secure environments, especially for young girls; expanding good quality youth-friendly information and sexual health education and counselling service; strengthening reproductive and sexual health programmes; and involving families and young people in planning, implementing and evaluating HIV/AIDS prevention and care programmes, to the extent possible;” (para. 63)
More general references may also include:
• The 2000 Education for All (EFA) Dakar Framework for Action15 stresses in one of its six goals that youth-friendly programmes must be made available to provide the information, skills, counselling and services needed to protect young people from the risks and threats that limit their learning opportunities and challenge education systems, such as schoolage pregnancy and HIV and AIDS.
• EDUCAIDS16, the UNAIDS initiative for a comprehensive education sector response to HIV and AIDS that is led by UNESCO, recommends that HIV and AIDS curricula in schools “begin early, before the onset of sexual activity”, “build knowledge and skills to adopt protective behaviours and reduce vulnerability”, and “address stigma and discrimination, gender inequality and other structural drivers of the epidemic”.
• The World Health Organization17 (WHO, 2004) concludes that it is critical that sexuality education be started early, particularly in developing countries, because girls in the first classes of secondary school face the greatest risk of the consequences of sexual activity, and beginning sexuality education in primary school also reaches students who are unable to attend secondary school. Guidelines from the WHO Regional Office for Europe call on Member States to ensure that education on sexuality and reproduction is included in all secondary school curricula and is comprehensive.18
• UNAIDS19 has concluded that the most effective approaches to sexuality education begin with educating young people before the onset of sexual activity.20 UNAIDS recommends that HIV prevention programmes: be comprehensive, high quality and evidence-informed; promote gender equality and address gender norms and relations; and include accurate and explicit information about safer sex, including correct and consistent male and female condom use.
The consultant interviewed key stakeholders/informants to document best practice with developing and implementing formal school-based sexuality education programmes and curricula in developing countries, particularly in sub-Saharan Africa. However, information about developing particularly innovative approaches existing in Europe and North America has also been included.
A) Key informants were initially contacted by phone and/or email, and interviews were requested.
B) Once they agreed to participate, and gave their informed consent, they were emailed a semistructured interview guide so that they could prepare in advance, or choose to type up their responses.
C) Arrangements were made to call the respondents at an agreed upon date and time.
D) Respondents were contacted, questions were asked during a semi-structured phone or face-to-face interview, and their responses were then recorded, transcribed and compiled as background information for development of the working draft of the International Technical Guidance on Sexuality Education.
A total of 11 in-depth interviews were conducted with a set of pre-determined questions using a semistructured interview guide. The tool was developed to help document best practice with developing and implementing formal school-based sexuality education programmes and curricula. Interview questions on the semi-structured questionnaire were intentionally designed to be open-ended, and interviews with key informants were loosely structured to encourage free flow of information and ideas, and to maximise focus on their area(s) of specialisation, while eliciting their feedback and response.
Eight of the interviews were completed by phone, and one by a face-to-face interview. Two of the informants preferred writing their responses instead of the phone interview, and two informants submitted written responses as supplemental information to their phone interviews. The phone interviews ranged in duration from one half hour to two and a half hours.
In addition, four more informal interviews were conducted with informants not on the key informant contact list because they were thought to have particular insight and/or experience that might be helpful. They included: Novia Condell, UNICEF Jamaica; Shirley Oliver-Miller, Independent Adolescent Reproductive and Sexual Health Consultant; Bill Finger and Karah Fazekas of Family Health International (FHI). Although helpful, information provided was more limited in scope; thus, their responses were not transcribed and compiled with the other key informant interviews.
1. What has been your experience with developing and implementing sexuality education programmes in schools or in the formal education sector?
2. What has presented challenges?
3. What has been successful; what has worked?
4. What are the most important elements of quality sexuality education programmes?
5. What is the best way for Ministries of Education to work with schools to get them to promote and implement comprehensive sexuality education approaches?
6. How can we move schools and communities towards comprehensive sexuality education verses abstinence-only-until-marriage approaches?
7. What is (are) the best school-based sexuality education programme(s) you know about?
8. How should the programme be taught (what are the entry points) in schools (e.g., as a separate subject, along with a carrier subject, or integrated throughout the curriculum)?
9. What is the best process (or most promising practises) for ministries of education to undertake when developing and implementing a sexuality education programmes in schools?
10. What is important to include in an International Technical Guidance document for ministers and policy-makers that will help them implement quality programmes?
Mary Guinn Delaney
This bibliography of teaching materials was developed to accompany the International Technical Guidance on Sexuality Education. It is composed of existing, high quality sexuality education curricula, curriculum guides and teacher training manuals from around the world. The bibliography is intended to serve as a practical reference for curriculum developers, programme planners, school principals and teachers. The resources were selected based on the following criteria established at an expert technical consultation in February 2009:
• Contributes towards comprehensive sexuality education curricula, curriculum guides or teacher training manuals
• Evaluated or recommended by experts
• Recently published (1998-2009) with accurate, up-to-date information reflecting latest “state-of-the-art” knowledge
• Targeted to learners or educators, particularly at the primary and secondary school level, but also including the tertiary level
• Available in English, French, Spanish or Portuguese
Updated versions of this resource list and their annotations can be found on the UNESCO HIV and AIDS Education Clearinghouse website http://hivaidsclearinghouse.unesco.org.
Note: The inclusion of resources in this bibliography does not represent an endorsement by UNESCO and the other UN partner organizations involved in the development of the International Technical Guidance.
Common ground: principles for working on sexuality
Produced by: Talking About Reproductive and Sexual Health Issues (TARSHI)
From evidence to action: advocating for comprehensive sexuality education
Produced by: International Planned Parenthood Federation (IPPF)
Access: Can be downloaded online from www.ippf.org/en/Resources/Guides-toolkits/From+evidence+to+actio
(Free Adobe Acrobat Reader® software required.)
Guidelines for comprehensive sexuality education in Nigeria
Produced by: Action Health Incorporated and Sexuality Information and Education Council of the United States (SIECUS)
Access: Can be downloaded online from www.siecus.org/_data/global/images/nigerian_guidelines.pdf (Free Adobe Acrobat Reader® software required.)
Guidelines for comprehensive sexuality education: kindergarten through 12th grade
Produced by: National Guidelines Task Force and Sexuality Information and Education Council of the United States (SIECUS)
Date: 2004, 3rd edition
Access: Can be downloaded online from www.siecus.org/_data/global/images/guidelines.pdf (Free Adobe Acrobat Reader® software required.)
IPPF framework for comprehensive sexuality education
Produced by: International Planned Parenthood Federation (IPPF)
Access: Can be downloaded online from
www.ippf.org/NR/rdonlyres/CE7711F7-C0F0-4AF5-A2D5-1E1876C24928/0ZSexuality.pdf (Free Adobe Acrobat Reader® software required.)
Jamaican guidelines for comprehensive sexuality education: pre-school through age 24
Produced by: Jamaican Task Force Committee for Comprehensive Sexuality Education (Jamaica Family Planning Association (FAMPLAN Jamaica) and Sexuality Information and Education Council of the United States (SIECUS)
Access: Can be downloaded online from www.siecus.org/_data/global/images/Jamaica%20Guidelines.pdf (Free Adobe Acrobat Reader® software required.)
Manual for integrating HIV and AIDS education in school curricula
Produced by: United Nations Educational, Scientific and Cultural Organization (UNESCO) International Bureau of Education (IBE)
Access: Can be ordered (in hard copy or on CD-ROM) free of charge from firstname.lastname@example.org or downloaded online in five different languages.
English: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/IBE_CurrManual_3v_en.pdf French: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/IBE_CurrManual_3v_fr.pdf Spanish: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/Manual_SP.pdf Russian: www.ibe.unesco.org/fileadmin/user_upload/_temp_/Manual_complete_RUreduced.pdf
Arabic: www.ibe.unesco.org/fileadmin/user_upload/_temp_/Manuel_complet_ARbis.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: Joint Committee on National Health Education Standards and American Cancer Society Date: 2007, 2nd edition
Access: To order a printed book (at the cost of US$29.95), a CD-ROM ($19.95) or a downloadable PDF ($9.95) visit: https://www.cancer.org/docroot/PUB/PUB_0.asp?productCode=F2027.27 or www.cdc.gov/HealthyYouth/ SHER/standards/index.htm
Produced by: Early Childhood Sexuality Education Task Force and Sexuality Information and Education Council of the United States (SIECUS)
Access: Can be downloaded online from www.siecus.org/_data/global/images/RightFromTheStart.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: Austrian Ministry of Education and Cultural Affairs Date: 1994
Access: The document is only available online in German. It can be downloaded from www.bmukk.gv.at/ schulen/unterricht/prinz/Unterrichtsprinzipien_Se1597.xml (Free Adobe Acrobat Reader® software required.)
Produced by: Family Health International (FHI)
Access: Can be ordered free of charge from email@example.com or downloaded online from www.fhi.org/NR/rdonlyres/ea6ev5ygicx2nukyntbvjui35yk55wi5lwnnwkgko3to uyp3a33aiczutoyb6zhxcnwiyoc37uxyxgZsexedstandards.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: Save the Children, Sweden and Swedish Association for Sexuality Education (RFSU)
Access: The English version can be downloaded online from www.savethechildren.net/alliance/resources/hiv_ aids/2007_SCSweden_TellMeMore.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: Federal Centre for Health Education (Die Bundeszentrale für gesundheitliche Aufklärung, BZgA) Date: 1999
Access: This publication can be downloaded from www.bzga.de/?uid=0cdce7ce03172b7fba028de802bec1fd& id=medien&sid=72&ab=20.
(Free Adobe Acrobat Reader® software required.)
It can also be obtained free of charge from the following address: BZgA, D-51101 Cologne, Germany or by email: firstname.lastname@example.org. Order number: 13006070.
Produced by: Helen O. Mondoh, Lois W. Chiuri, Johnson M. Changeiywo and Nancy O. Omar Date: 2006
Access: Can be obtained from the following address: QUESTAFRICA, c/o FORMAT, POB 79, Village Market, 00621 Nairobi, Kenya. Phone: + 254 (20) 675 2866 or by email: email@example.com or firstname.lastname@example.org.
Growing up and sexual maturation among the Luo of Kenya: removing barriers to quality education
Produced by: Helen Mondoh, Lois W. Chiuri, Nancy O. Omar, Johnson M. Changeiywo Date: 2006
Produced by: World Population Foundation (WPF) and Maastricht University Date: 2008
Access: Can be downloaded online from www.wpf.org/documenten/20080729_IMToolkit_July2008.pdf (Free Adobe Acrobat Reader® software required.)
More information and hard copies of the document can be obtained from: World Population Foundation (WPF), Vinkenburgstraat 2A, 3512 AB Utrecht, The Netherlands. Tel: +31 (30) 23 93 888; Email: email@example.com
Produced by: Youth Incentives Programme, Rutgers Nisso Groep Date: 2007
Access: The tool can be downloaded online from www.youthincentives.org/Downloads (Free Adobe Acrobat Reader® software required.)
Produced by: Healthy Teen Network and ETR Associates Douglas Kirby, Lori A. Rolleri and Mary Martha Wilson Date: 2007
Access: The tool can be downloaded online from: www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78-4784-BA7C-5D0436F6040C%7D/uploads/%7BAC34F932-ACF3-4AF7-AAC3-4C12A676B6E7%7D.PDF (Free Adobe Acrobat Reader® software required.)
A hard copy of this tool can also be ordered for US$10 at: www.healthyteennetwork.org/index.asp?Type=B_ PR&SEC=%7B2AE1D600-4FC6-4B4D-8822-F1D5F072ED7B%7D&DE=%7BB3E92693-FE7D-4248-965F-6AC3471B1E28%7D
A Sexatlas for schools. Sexuality and personal relationships: a guide for the planning and implementation of teaching programmes in this area for primary, junior secondary and senior secondary schools
Produced by: Swedish Association for Sexuality Education (RFSU)
Access: The guide can be downloaded online from:
English: www.rfsu.se/upload/PDF-Material/sexatlas%20engelska.pdf French: www.rfsu.se/upload/PDF-Material/atlas_sexuel_des_ecoles.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: Swedish Association for Sexuality Education (RFSU)
Access: To order the book, please contact: RFSU, Box 4331, 102 67 Stockholm, Sweden.
Phone: + 46 (0)8 692 07 00; Fax: + 46 (0)8 653 08 23; Email: firstname.lastname@example.org
Basics and beyond: integrating sexuality, sexual and reproductive health and rights.
A manual for trainers
Produced by: Talking About Reproductive and Sexual Health Issues (TARSHI)
Produced by: Action Health Incorporated Date: 2003
Access: The document can be ordered for free from Action Health Incorporated publications by sending an email to: email@example.com
Produced by: One World UK; Butterfly Works; Action Health Incorporated and the Nigerian Educational Research and Development Council (NERDC)
Produced by: Nigerian Educational Research and Development Council (NERDC) with the support of UNICEF Date: 2006
Access: To order a copy, contact: NERDC Headquarters, Lokoja - Kaduna Road, Sheda,
P.M.B. 91 Federal Capital Territory, Abuja, Nigeria. Or visit www.nerdcnigeria.org
Produced by: Health Communication Partnership (HCP), Ethiopia Date: 2005
Access: Can be downloaded online from the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs:
English www.jhuccp.org/legacy/countries/ethiopia/PLETH178.pdf Amharic www.jhuccp.org/legacy/countries/ethiopia/PLETH179.pdf Oromifa www.jhuccp.org/legacy/countries/ethiopia/PLETH180.pdf (Free Adobe Acrobat Reader® software required.)
Produced by: ETR Associates and Janet S. St. Lawrence Date: 2005, revised edition
Access: The manual can be ordered for US$54.95 from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: +1 (800) 321-4407;
Fax: +1 (800) 435-8433. Two optional videos Seriously Fresh and Are You With Me? can be ordered for $65 each from Select Media Publishing online at www.selectmedia.org or by mail: Select Media, Inc.,
POB 1084, Harriman, NY 10926, USA.
Produced by: Phoenix Publishers Ltd., Helen O. Mondoh, Owen McOnyango, Lucas A. Othuon, Violet Sikenyi and Johnson M. Changeiywo
Access: To order the books, visit www.phoenixpublishers.co.ke/order.php or write to Phoenix Publishers Ltd., Kijabe Street, Nairobi, POB 18650-00500, Kenya.
Choose a future! Issues and options for adolescent boys and girls in India
Produced by: The Centre for Development and Population Activities (CEDPA)
Date: 2004 and 2003, updated edition
Access: More information on the programme can be obtained from the Centre for Development and Population Activities (CEDPA), 1133 21st Street NW, Suite 800, Washington DC 20036, USA.
Draw the line/respect the line: setting limits to prevent HIV, STD and pregnancy
Produced by: Center for AIDS Prevention Studies/University of California and ETR Associates Date: 2003
Access: The manuals can be ordered for US$21 each from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407;
Fax: + 1 (800) 435-8433.
Facilitating school-based co-curricular activities on HIV and AIDS. Students and teachers learning for an HIV free generation
Produced by: Federal Ministry of Education, Nigeria and Action Health Incorporated Date: 2007
Access: For enquiries please contact: firstname.lastname@example.org Family life and HIV education for junior secondary schools
Produced by: Action Health Incorporated (in partnership with the Lagos State Ministry of Education, Nigeria). Published by Spectrum Books Limited.
Access: The documents can be ordered free of charge from Action Health Incorporated publications by sending an email to: email@example.com
Focus on youth: an HIV prevention program for African-American youth
Produced by: ETR Associates Date: 2009
Access: Can be ordered for US$59.95 from ETR Associates online at http://pub.etr.org/
or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: +1 (800) 321-4407;
Fax: +1 (800) 435-8433.
Good things for young people: reproductive health education for primary schools
Produced by: MEMA kwa Vijana (Tanzanian Ministries of Health and Education, the Tanzania National Institute for Medical Research (NIMR), the African Medical and Research Foundation (AMREF) and the London School of Hygiene and Tropical Medicine (LSHTM))
Access: Can be downloaded online as follows:
Teacher's Guide for Standard 5: www.memakwavijana.org/pdfs/Teachers-Guide-Std-5-English.pdf Teacher's Guide for Standard 6: www.memakwavijana.org/pdfs/Teachers-Guide-Std-6-English.pdf Teacher's Guide for Standard 7: www.memakwavijana.org/pdfs/Teachers-Guide-Std-7-English.pdf Teacher's Resource Book: www.memakwavijana.org/pdfs/Teachers-Resource-Book.pdf (Free Adobe Acrobat Reader® software required.)
For details of how to obtain the Swahili language version, contact Annabelle.South@lshtm.ac.uk
Let us protect our future. A comprehensive sexuality education approach to HIV/STDS and pregnancy
Produced by: Select Media
Access: Forthcoming in autumn 2009
Produced by: Select Media, Loretta Sweet Jemmott; John B. Jemmott, and Konstance A. McCaffree Date: 2006, 3rd edition
Access: The basic package of the document can be ordered for US$145.00 (the complete package including the four optional videos costs $535.00) from Select Media Publishing online at http://selectmedia.org/customer-service/evidence-based-curricula/making-proud-choices/ or by mail: Select Media, Inc., POB 1084, Harriman, NY 10926, USA.
Produced by: The Youth Health and Development Programme, UNICEF, Government of Namibia, University of Maryland School of Medicine Date: 1999 and 2001
Access: The documents can be downloaded online from www.unicef.org/lifeskills/index_14926.html (Free Adobe Acrobat Reader® software required.)
Produced by: Nigerian Educational Research and Development Council (NERDC), Federal Ministry of Education of Nigeria, Universal Basic Education (UBE) and Action Health Incorporated Date: 2003
Access: The document can be downloaded online from www.actionhealthinc.org/publications/downloads/ jnrcurriculum.pdf (Free Adobe Acrobat Reader® software required.)
Our future: sexuality and life skills education for young people Produced by: International HIV/AIDS Alliance Date: 2007
Access: The three books can be ordered free of charge from firstname.lastname@example.org or downloaded online from:
(Free Adobe Acrobat Reader® software required.)
Produced by: Unitarian Universalist Association of Congregations (UUA)
Dates: 1999 and 2000
Access: The manuals can be ordered at a cost of between US$40 and $75 each from UUA bookstore online at www.uua.org/religiouseducation/curricula/ourwhole/ or by mail: Unitarian Universalist Association of Congregations, 25 Beacon Street, Boston, MA 02108, USA. Phone: +1 (617) 742-2100;
Fax: +1 (617) 723-4805.
Produced by: Instituto Promundo, Pan American Health Organization (PAHO) and World Health Organization (WHO)
Access: The manuals can be ordered free of charge from email@example.com
or downloaded online from
(Free Adobe Acrobat Reader® software required.)
Program M. Working with young women: empowerment, rights and health
Produced by: Instituto Promundo, Salud y Género, ECOS (Comunicagao em Sexualidade), Instituto PAPAI and World Education Date: 2008
Access: A hard copy of the manual can be ordered free of charge from: firstname.lastname@example.org It can also be downloaded online from:
(Free Adobe Acrobat Reader® software required.)
The Blue Book. What you want to know about yourself (15+ years)
Produced by: Talking about Reproductive and Sexual Health Issues (TARSHI)
Date: 2005 and 1999
Access: The booklets can be downloaded online from www.tarshi.net/publications/publications_sexuality_ education.asp (Free Adobe Acrobat Reader® software required.)
Produced by: ETR Associates and Richard P. Barth Date: 2004, 4th edition
Access: The Trainer’s Manual (US$42.95), the Student Workbook, in English or Spanish (set of five, $18.95) and the Activity Kit ($39) can be ordered from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407; Fax: +1 (800) 4358433.
Produced by: Karin K. Coyle, Joyce V. Fetro, Richard P. Barth, ETR Associates and Center for Health Promotion Research and Development, University of Texas-Houston, Health Science Center Date: 2007, revised edition
Access: The complete set of Safer Choices manuals, student workbooks and an activity kit can be ordered for US$189.95 through ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407; Fax: + 1 (800) 435-8433. A video/DVD, “Blood Lines”, recommended for use with Level 2, can be purchased for $149. Teacher training for this programme is available in the US through ETR Associates (email@example.com).
Produced by: ActionAid International and Alice Welbourne Date: 1999
Access: The manual can be previewed on www.steppingstonesfeedback.org/?page_id=965 or www. stratshope.org/t-training.htm. It can be ordered at low cost from Teaching Aids at Low Cost (TALC) on www. talcuk.org/books/bs-stepping-stones.htm
Produced by: Stellenbosch University, Department of Education South Africa and World Population Foundation (WPF)
Access: The programme is available online at http://arhp.co.za/todays_choices/. It may be copied (downloaded) and printed free of charge.
UDAAN: towards a better future. Training manual for nodal teachers.
Produced by: The Centre for Development and Population Activities (CEDPA), India; Jharkhand State AIDS Control Society and Department of Education, Government of Jharkhand, India Date: 2006
Access: More information on the programme can be obtained from the Center for Development and Population Activities (CEDPA), 1133 21st Street NW, Suite 800, Washington DC 20036, USA. Phone: + 1 (202) 939-2612;
Produced by: World Population Foundation (WPF), Butterfly Works and SchoolNet Uganda Date: 2003
Access: A part of the curriculum is available online for free at: www.theworldstarts.org/start/begin.html For more information regarding the curriculum, see: www.wpf.org/documenten/20060809_WSWM_handout. doc or contact World Population Foundation, Vinkenburgstraat 2A, 3512 AB Utrecht, The Netherlands. Tel: +31 (30) 239 38 88. Email: firstname.lastname@example.org.
- DAKU! For secondary schools in Indonesia, developed by the World Population Foundation (WPF),
- MAJU! For special education schools for deaf youth in Indonesia, developed by the World Population Foundation (WPF), Indonesia and the Directorate of Special Needs Education (DSE) of the Indonesian Ministry of Education and Culture, 2008.
- Langhka Pastiku! For special education schools for blind youth in Indonesia, developed by the World Population Foundation (WPF), Indonesia, the Ministry of Special Education in Indonesia and Yayasan Pelita Ilmu (YPI), 2008.
- SERU! For juvenile correction institutes in Indonesia, developed by the World Population Foundation (WPF), Indonesia.
- You and me. For kindergarten in Indonesia, developed by the World Population Foundation (WFP), Indonesia and Bernard van Leer Foundation, 2007.
- The world starts with me! For secondary schools and disadvantaged youth in Kenya, developed by the World Population Foundation (WFP), Centre for Study of Adolescence (CSA) and NairoBits Digital Design School, Nairobi, 2006.
- The world turns by my hands! For secondary schools in Bangkok, developed by the World Population Foundation (WFP) and the Association for the Promotion of the Status of Women (APSW), 2007.
- Journey to adulthood. For the Teacher Training University Students of Danang University of Education in Viet Nam, developed by the World Population Foundation (WFP) Viet Nam, Danang University of Education, Department of Education and Training Danang and National Institute of Educational Sciences, 2009. (An adaptation for secondary schools is under development.)
Produced by: YMEP-project (a collaboration between Kenyan, Tanzanian, Ugandan, Zambian and Swedish Member Associations of the International Planned Parenthood Federation (IPPF))
Date: 2008, revised edition
Access: The book can be downloaded online from
(Free Adobe Acrobat Reader® software required.)
p.5 © 2004 Ian Oliver/SFL/Grassroot Soccer, Courtesy of Photoshare p.17 © 2006 Rose Reis, Courtesy of Photoshare
1 Sexuality Education is defined as an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information. Sexuality Education provides opportunities to explore one’s own values and attitudes and to build decision-making, communication and risk reduction skills about many aspects of sexuality. The evidence review in Volume I section 4 of this document refers to this definition as the criterion for the inclusion of studies for the evidence review.
2 Botswana, Ethiopia, Indonesia, Jamaica, Kenya, Namibia, Nigeria, South Africa, Tanzania, Thailand, USA and Zambia.
3 These included but were not limited to the following sites: SIECUS; Johns Hopkins Bloomberg School of Public Health Center for Communications Program’s The Info Project; International HIV/AIDS Alliance; Family Health International; Institute of Education, University of London; United Nations Educational, Scientific and Cultural Organization (UNESCO); UNESCO International Bureau of Education (IBE); United Nations Population Fund (UNFPA); and International Planned Parenthood Federation (IPPF).
4 “In no case should abortion be promoted as a method of family planning.In circumstances in which abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion. Post-abortion counselling, education and family-planning services should be offered promptly, which will also help to avoid repeat abortions." ICPD POA, para. 8.25 “In circumstances where abortion is not against the law, health systems should train and equip health-service providers and should take other measures to ensure that such abortion is safe and accessible." Key actions ICPD+5, para. 63iii
5 “In order to promote the health and development of adolescents, States parties are also encouraged to respect strictly their right to privacy and confidentiality, including with respect to advice and counselling on health matters (art. 16). Health-care providers have an obligation to keep confidential medical information concerning adolescents, bearing in mind the basic principles of the Convention. Such information may only be disclosed with the consent of the adolescent, or in the same situations applying to the violation of an adult’s confidentiality. Adolescents deemed mature enough to receive counselling without the presence of a parent or other person are entitled to privacy and may request confidential services, including treatment." CRC Gen Com 4(2003) para. 11. “The realization of the right to health of adolescents is dependent on the development of youth-sensitive health care, which respects confidentiality and privacy and includes appropriate sexual and reproductive health services." CRC Gen Com 4(2003) para. 40b.
6 McCary J.L. 1978. McCary's Human Sexuality. Third Edition. New York: D. Van Nostrand and Company, pp. 150 & 262. Strong, B., DeVault, C. 1988. Understanding Our Sexuality. Second Edition. Eagan MN: West Publishing Company, pp. 179-80. Haas, A., and Haas, K. 1990. Understanding Sexuality. Times Mirror/Mosby College Publishing: St. Louis. p. 207. Francoeur, R.T., Noonan, R.J. (Editors). 2004. The International Encyclopaedia of Sexuality. Volume 5. New York: Continuum Intl Pub Group.
7 “In order to promote the health and development of adolescents, States parties are also encouraged to respect strictly their right to privacy and confidentiality, including with respect to advice and counselling on health matters (art. 16). Health-care providers have an obligation to keep confidential medical information concerning adolescents, bearing in mind the basic principles of the Convention. Such information may only be disclosed with the consent of the adolescent, or in the same situations applying to the violation of an adult's confidentiality. Adolescents deemed mature enough to receive counselling without the presence of a parent or other person are entitled to privacy and may request confidential services, including treatment." CRC Gen Com 4(2003) para. 11. “The realization of the right to health of adolescents is dependent on the development of youth-sensitive health care, which respects confidentiality and privacy and includes appropriate sexual and reproductive health services." CRC Gen Com 4(2003) para. 40b.
8 UN. 2003. United Nations Committee on the Rights of the Child. General Comment 4: Adolescent health and development in the context of the Convention on the Rights of the Child (CRC). CRC/GC/2003/4. New York: UN. See also: UN. 1989. United Nations Convention on the Rights of the Child. New York: UN.
9 UN. 2000. United Nations Committee on Economic, Social and Cultural Rights. Substantive issues arising in the implementation of the international covenant on economic, social and cultural rights. General Comment No. 14. E/C.12/2000/4. New York: UN.
10 UN. 2006. United Nations Convention on the Rights of Persons with Disabilities. A/61/611. New York: UN.
11 UN. 1994. International Conference on Population and Development. Programme of Action. New York: UN.
12 UN. 1999. Overall Review and Appraisal of the Implementation of the Programme of Action of the International Conference on Population and Development. A/S-21/5/Add.1. New York: UN.
13 UN. 1995. United Nations Fourth World Conference on Women. Platform for Action. New York: UN.
14 UN. 2001. United Nations General Assembly Special Session on HIV/AIDS. Declaration of Commitment on HIV/AIDS. . A/RES/S-26/2. New York: UN.
15 UNESCO. 2000. Dakar Framework for Action: Education for All. Meeting Our Collective Commitments. Paris, UNESCO.
16 UNESCO. 2008. EDUCAIDS Framework for Action. Paris: UNESCO.
17 WHO. 2004. Adolescent Pregnancy Report. Geneva: WHO
18 WHO. 2001. WHO Regional Strategy on Sexual and Reproductive Health. Copenhagen: WHO, Regional Office for Europe.
19 UNAIDS. 2005. Intensifying HIV Prevention, supra note 26, at 33. Geneva: UNAIDS.
20 UNAIDS. 1997. Impact of HIV and Sexual Health on the Sexual Behaviour of Young People: A Review Update 27. Geneva: UNAIDS.