1. Comprehensive Sexuality Education Provision in Schools
Presentation to the Portfolio Committee
on Basic Education
17 September 2019

2. PURPOSE
To present to the Portfolio Committee on the provision of Comprehensive Sexuality Education (CSE) in schools through the curriculum and co-curriculum programmes 2

3. PRESENTATION OUTLINE BACKGROUND KEY ISSUES THAT AFFECT YOUNG PEOPLE
EVIDENCE FOR COMPREHENSIVE SEXUALITY EDUCATION (CSE)
POLICY FRAMEWORK
SECTOR RESPONSE
WHY USE THE INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION (ITGSE)
CSE IMPLEMENTATION THROUGH THE CURRICULUM
CSE IMPLEMENTATION THROUGH COCURRICULA PROGRAMMES
CONCERNS AND MISCONCEPTIONS OF CSE IN SOUTH AFRICA
RECOMMENDATION 3

4. BACKGROUND
South Africa has the largest HIV epidemic in the world with approximately 7.9 million people living with HIV.
The majority of HIV infected adults are women (55-60%)
An estimated 1300 new infections per week among Adolescent Girls and Young Women (AGYW) in 2017
More than a third of girls and boys (35.4%) experience sexual violence before the age of 17
New infections have increased by 11% among males of the same age group. 4

5. BACKGROUND cont.
The number of adolescent girls who had sexual relationships with older sexual partners continue to increase.
HIV prevention knowledge has declined amongst learners.
Lower sexual debut and increasing risky sexual behaviour amongst adolescents
Early sexual debut leads to mental health issues such as depression, vulnerability to violence and poor educational outcomes 5

6. BACKGROUND cont.
Teen births have declined consistently since the 1980s. Significant decrease in young teens (under17), most births to older teens (17-19)
But remains unacceptably high:
10-14yrs
Total: (April 2017-March 2018)
Only one third of girls stay in school during their pregnancy and return following childbirth (GHS focus on Schooling, 2015). This creates poverty traps for families. 6

7. Why CSE in schools?
Great need for age appropriate child abuse prevention education that builds resilience, confidence and assertion
Apartheid patterns of family disruption and parental (male) absence
Cultural barriers and conservative attitudes which prevents open conversations about sex and sexuality 7

8. KEY ISSUES THAT AFFECT YOUNG PEOPLE*
Sexually Transmitted Infections (STIs)
Access to contraceptives
Unsafe abortions
Puberty
Violence, including gender-based violence
Sexual Orientation and Gender Identity
HIV and AIDS
Pregnancy
*UNESCO International Technical Guidance on Sexuality Education 8

9. RELEVANT POLICY FRAMEWORK
YEAR
POLICY
1999
DBE Policy on HIV for Education Institutions
2005
The South African Children’s Act (38) (as amended by the Children’s Amendment Act, No. 41of 2007) refer and require that information on sexual violence be reported to relevant authorities (Act 38 of sec 110 and 150)
2012
Integrated School Health Policy (ISHP)
DBE Integrated Strategy on HIV, STIs and TB
2013
East and Southern African Countries (ESA) Commitment on CSE
2014
National Sexual Reproductive Health Services and Rights Framework
2015
2018
The National Youth Policy
DBE Protocol for Management and Reporting of Sexual Violence in School
2017
Department of Basic Education National Policy on HIV, STIs and TB for Learners, Educators, School Support and Officials in all Primary and Secondary Schools in the Basic Education Sector
2019
Standard Operation Procedures for the provision of sexual reproductive health nad social services in Secondary Schools 7

10. INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION (ITGSE)
The UNESCO International Technical Guidance on Sexuality Education (ITGSE) collates evidence on major health and social issues facing young people, including on sexual reproductive health and rights
ITGSE recommends essential topics and learning objectives that should be covered in CSE curricula for learners.
Outlines the characteristics of effective approaches for planning, delivering and monitoring CSE.
The Guidance is voluntary and non-mandatory, and recognizes the diversity of national contexts in which sexuality education takes place.
A total of 216 623 learner workbooks were and 3585 teacher guides for Grades 7 – 9 were printed to be distributed in 1186 schools in the 8 activity districts 10

11. INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION (ITGSE)
CSE is scientifically accurate.
Incremental.
Age and developmentally appropriate.
Based on a human rights approach.
Based on gender equality.
Culturally relevant and context appropriate.
Supports life skills needed to support healthy and safe choices.
It goes beyond education about reproduction, risks and disease.
CSE provides information on all approaches for the prevention of unintended pregnancy, STIs and HIV.
Schools are central in the provision of CSE.
A total of 216 623 learner workbooks were and 3585 teacher guides for Grades 7 – 9 were printed to be distributed in 1186 schools in the 8 activity districts 11

12. 2016 EVIDENCE REVIEW
Bases its conclusions on evidence from systematic reviews of studies aimed at improving SRH of young people aged
Includes a total of 22 relevant systematic reviews globally.
More than 70 relevant RCTs.
A significant amount of non-trial information from 65 publications and online resources
Includes a wide geographical range of recent, published studies with more than half of the 70 RCTs included in the review from low and middle income countries
Extends the reach of the original guidance to included out of school interventions
A total of 216 623 learner workbooks were and 3585 teacher guides for Grades 7 – 9 were printed to be distributed in 1186 schools in the 8 activity districts 12

13. 2016 EVIDENCE
The 2016 review of ITGSE found that the evidence base for CSE had expanded since This rigorous scientific review found:
CSE does not sexualise children;
Sexuality education does not increase sexual activity, sexual risk-taking behaviour or STI/HIV infection rates (Fonner et.al, 2014; Shepherd et.al, 2010). On the contrary, CSE delays sexual debut and promotes safe sexual behavior;
Increases knowledge of different aspects of sexuality and the risks of early and unintended pregnancy, HIV and other STIs;
Decreases the number of sexual partners;
Reduces sexual risk taking;
Increases use of condoms and other forms of contraception. 13

14. EFFECTIVE CSE PROGRAMMES
Encompass multiple settings including schools, the community, health services, faith based organisations and households/families
Abstinence-only programmes are not effective in delaying sexual initiation, reducing frequency of sex, or reducing number of sexual partners (Kirby 2007, Underhill et.al 2007, UNESCO, 2009, Fonner et.al 2014).
Gender-focused programmes are substantially more effective than ‘gender-blind’ programmes in achieving health outcomes, reducing unintended pregnancy or STIs (Haberland and Rogow 2015).
Multi-component programmes which link CSE with youth friendly services are much more effective
Programmes with implementation fidelity i.e. implemented as intended 14

15. CSE IMPLEMENTATION THROUGH CURRICULUM
Comprehensive Sexuality Education has been part of the Life Orientation Curriculum since 2000.
There is no new CSE content that has been added to the curriculum
Implementation fidelity has however necessitated the following:
A review of the LO curriculum;
An evaluation of the LTSM available for LO and CSE;
A review of teacher training for LO and CSE; and
A review of curriculum delivery modalities.
The above reviews led to the development of scripted lesson plans, the development of state owned LO textbooks, an online teacher training course, the development of the “Teaching for All” initial education teaching programme and considerations of strengthened CPTD courses. 15

16. CSE SCRIPTED LESSON PLANS (SLPs)
Aligned with the Curriculum and Assessment Policy Statements (CAPS);
Age-specific and developmentally appropriate;
Contextualised;
Provide pedagogical guidance to teachers. 12

17. CSE IMPLEMENTATION THROUGH CURRICULUM
Below are the LO CAPS topics in the Intermediate Phase
CAPS TOPIC
Gr 4 Sub-topic
Gr 5 Sub-topic
Gr 6 Sub-topic
Development of Self
Social Responsibility
Health and environmental responsibilities
Respect for my body and the body of others
Culture and moral lessons
HIV and AIDS education
Positive self-concept
Relationship with peers, older people and strangers
Dealing with violent situations
Issues of age and gender in different cultural contexts in South Africa
Positive self-esteem
Peer pressure
Bullying
Gender stereotyping, sexism and abuse 17

18. INTERMEDIATE PHASE TOPICS IN THE SLPs
Focus is on staying safe
4.1 Respect for my own body
5.1 Body image
6.1 Body Image: “ My body is changing”
4.2 Respecting the bodies of others
5.2 (a) I can choose my relationships
5.2 (b) This is my body and I say what happens to it.
6.2 Body image: “I am who I am”
4.3 Dealing with conflict
5.3 The benefit of good and safe relationships
6.3 Body Image: Acceptance of self
4.4 Emotions-Why am I feeling this way?
5.4 Child abuse-“Keeping myself safe from abuse”
6.4 Negative and positive peer pressure
4.5 Bullying
5.5 Sexual grooming: I can say “NO”!
6.5 Behaviours that put pressure on us
4.6 Responding to bullying
5.6 Dealing with violent situations-“What is sexual violence?”
6.6 Bullying and links to gender-based violence
4.7 Culture, society and sexuality
5.7 Learning from our elders
6.7 Bullies can change
4.8 The basics of HIV and AIDS
5.8 Should boys and girls be treated differently?
6.8 What is gender stereotyping, sexism and abuse?
4.9 Transmission of HIV
5.9 Dealing with the stigma of HIV
6.9 Gender equality, stereotypes and bias
4.10 Celebrating the life of Nkosi Johnson
5.10 Changing attitudes towards people infected with HIV and AIDS
6.10 HIV and AIDS, stigma, care, treatment and support
Grade 5
Grade 4
Grade 6 18

19. CSE IMPLEMENTATION THROUGH CO-CURRICULUM
Since 2013 the DBE has been implementing CSE through several co-curricular programmes. These include:
Keeping Girls in Schools;
Breaking the Silence;
Determined, Resilient, Empowered, Aids-Free, Mentored and Safe (DREAMS)
She Conquers; and
ESA Commitment
AGYW exposed to these CSE programmes, adopted health seeking behaviour such as contraception and condom use, and increased HIV testing. 19

20. Sexual behaviour by SBCC exposure level, South Africa, 2017
No exposure - heard/seen/watched/participated in 0
Low exposure - having been exposed to between 1 and 5 SBCC programmes in the last year
Moderate exposure - having been exposure to between 6 to 15 SBCC programmes in the last year
High exposure – heard/seen/watched/participated in 16 or more

21. COMMON CONCERNS ABOUT CSE
Response
CSE leads to early sexual initiation
CSE leads to later debut and more responsible sexual behaviour
CSE deprives children of their innocence
Evidence shows that children benefit from receiving appropriate information that is scientifically accurate, non-judgmental and age and developmentally appropriate
CSE goes against our culture or religion
CSE stresses the need to engage with the local contexts including engagements with traditional leaders, religious communities and local stakeholders. CSE addresses harmful social norms and negative practices that are not in line with human rights or that increase vulnerability and risk, especially for young women and girls
It is the role of parents to educate children about sexuality
Parent play an important role in educating young people about sexuality. However, CSE complements this role by providing holistic education in a safe and supportive environment 21

22. COMMON CONCERNS ABOUT CSE
Response
Teaching of masturbation in Grade 4
No masturbation topic in Grade 4 topics
Teaching of sexual pleasure in the curriculum
The focus of the SA curriculum is not on sexual pleasure but on prevention of HIV, STIs, early and unintended pregnancy, healthy lifestyle choices and avoidance of risky behaviours using a rights based approach
Teaching of UNESCO ITGSE
LO Curriculum is based on SA context. The ITGSE was adjusted to strengthen the content of the CAPS topics. There are no new topics.
The CSE is using pornographic imagery
Images used in the curriculum are based on protocols and standards set by the DBE that ensures protection of human dignity and rights and does not expose learners to offensive content 22

23. CONCERNS AND MISCONCEPTION OF CSE IN SA
Response
Teaching of types of sex in the curriculum
The CSE in the CAPS focuses on the total person and is teaching age-appropriate content that focuses on relationships, life skills, values and does not teach learners how to have any form of sex.
CSE will be rolled out without teacher training and teachers are expected to teach new content they are not comfortable with
Since 2000, the Department has been providing in-service teacher training on Life Skills and Life Orientation. Training manuals on the Sexuality Education Scripted Lessons Plans has also been developed to build the capacity of LO educators to deliver the strengthened content 23

24. RECOMMENDATION
It is recommended that the Portfolio Committee notes and discusses the provision of Comprehensive Sexuality Education in schools through curriculum and co-curriculum programmes. 25

25. THANK YOU