By Estelle Sidze, APHRC and Melissa Stillman, Guttmacher Institute via Conversation Africa
Imagine giving Kenyan students something that has been proven to help them make healthy informed choices about their sexual and reproductive lives.
The solution already exists: comprehensive sexuality education.
To be comprehensive, sexuality education needs to be scientifically accurate, age-appropriate, nonjudgmental and gender-sensitive. The lessons should extend to prevention of HIV and other sexually transmitted infections (STIs), as well as contraception and unintended pregnancy. The students should also learn about values and interpersonal skills, gender, and sexual and reproductive rights. Programmes that cover all of these topics can have a positive impact on adolescents’ sexual and reproductive health.
Previous research shows that nationally more than a third of Kenyan teens between the ages of 15 and 19 have already had sex. About one-fifth are currently sexually active. And while only four in ten sexually active unmarried teenage girls use any modern method of contraception, the vast majority of them want to avoid pregnancy. About one-fifth of them are already mothers, and more than half of these births were unplanned.
Early childbearing may limit girls’ ability to stay enrolled in school and to develop the skills needed to successfully transition to adulthood. Knowledge about HIV infection also remains a concern: around half of adolescents in Kenya do not have comprehensive knowledge of HIV/AIDS.
At a time when a new national school curriculum is starting its pilot phase, our recently released study provides critical evidence of the gaps in the content and delivery of existing sexuality education programmes and an opportunity for strengthening them.
The study, conducted in 2015 in 78 public and private schools, found that three out of four surveyed teachers are reportedly teaching all the topics that constitute a comprehensive sexuality education programme. Yet only 2% of the 2,484 sampled students said they learned about all the topics.
Worse still, incomplete and sometimes inaccurate information is being taught. A majority of surveyed teachers reported emphasising in their classes that abstinence is the best or only method to prevent pregnancy and STIs. Yet numerous studies have shown that abstinence-only programmes do not work.
Only 20% of students in our study had learned about types of contraceptive methods. And even fewer had learned how to use and where to access methods. The majority of teachers also reported very strongly emphasising that having sex is dangerous or immoral for young people. Furthermore, almost six in 10 teachers who teach about condoms incorrectly tell their students that condoms alone are not effective for pregnancy prevention. Something is wrong with this picture.
The reality is that at the time of being surveyed for our study, a quarter of the students – who were mostly aged between 15 and 17 – had already had sex. Students want and need information about how to prevent unintended pregnancies, HIV and other STIs.
Kenya already has the policy infrastructure for a comprehensive programme. Its National School Health Policy was developed by the Ministry of Education and the Ministry of Public Health and Sanitation and their partners in 2009. The policy underscores the need to ensure that students receive quality health education, including sexuality education.
Kenya has also been a signatory since 2013 of a joint health and education ministerial commitment to provide comprehensive and rights-based sex education starting in primary school. Twenty-one other countries of East and Southern Africa are also part of this initiative.
However, implementation has been slow and uneven. Nairobi City county has acknowledged this gap and is working to increase coverage of sexuality education. Recently the county launched a plan of action to strengthen school health programming to increase the number of schools that offer comprehensive sexuality education.
Sexuality education is primarily taught under the subject Life Skills, which is compulsory but not examinable. Teachers face pressure to focus on examinable subjects, such as Mathematics and English. Even in schools that teach a wider range of sexuality education topics, many teachers lack the training to teach them effectively.
We owe it to young people
That’s why the ministries of Health and Education should honour their prior commitments. An immediate priority should be fostering partnerships between schools and community health care providers. Health care providers may be better placed to provide some particularly sensitive sexuality education content, such as where to access and how to use contraceptive methods.
As a longer term priority, the ministries should invest in improved pre-service and in-service teacher training in how to teach sexuality education effectively. They should also ensure that teachers have sufficient time to cover the full range of topics in their classes.
Increased focus on pregnancy and STI prevention strategies should cover a broad range of contraceptive methods and negotiation skills within relationships. This is necessary to ensure that all Kenyan youth have the knowledge to make informed decisions about their sexual and reproductive health. We owe it to young people to do much better.