Imagine there is something you can give to Kenyan students to help them make healthy informed choices about their sexual and reproductive lives, including increased contraceptive use. It already exists:
Comprehensive sexuality education.
Our study of 78 secondary schools, conducted in 2015, found that although three out of four teachers say they teach all the topics that comprise a comprehensive sexuality education curriculum, only two per cent of the students say they learned this material. Something is wrong.
At a time when the revised national curriculum is about to be piloted by the government, the release of our new study assessing sexuality education policies, curricula, and their implementation in Nairobi, Homa Bay, and Mombasa counties provides evidence and an opportunity for policymakers and other decision makers to explore how best to strengthen the content and delivery of comprehensive sexuality education.
To have a positive impact on adolescents’ sexual and reproductive health, sexuality education needs to be age-appropriate, non-judgmental and gender-sensitive, and should include appropriate and scientifically accurate information on sexual and reproductive physiology; prevention of HIV and other sexually transmitted infections; contraception and unintended pregnancy; values and interpersonal skills; and gender and sexual and reproductive rights. Kenya has the policy infrastructure in place.
QUALITY HEALTH EDUCATION
The National School Health Policy developed by the Ministries of Education and Public Health and Sanitation and their partners in 2009, underscores the need to ensure that students receive quality health education, including sexuality education.
In 2013, Kenya signed, along with 21 other countries in East and southern Africa, a joint health and education ministerial commitment to provide comprehensive and rights-based sexuality education starting in primary school.
However, the implementation has been slow and uneven. Nairobi City County has acknowledged this gap, and is working to increase coverage of sexuality education with the recent launch of its Plan of Action to Strengthen School Health Programming to increase the number of schools offering comprehensive sexuality education.
Sexuality education is primarily taught in Life Skills, which is compulsory but not examinable.
Teachers face pressure to focus on examinable subjects such as Mathematics and English. Even in the schools that teach a wider range of sexuality education topics, many teachers lack the training to effectively handle them.
Worse, incomplete and sometimes inaccurate information is being taught. A majority of teachers reported emphasizing in their classes that abstinence is the best or only method to prevent pregnancy and sexually transmitted infections.
Studies have shown that abstinence-only messages do not work.
Yet only 20 per cent of students had learned about contraception at all, and even fewer about how to use and where to access contraceptive methods.
The majority of teachers also reported very strongly emphasizing that having sex is dangerous or immoral for young people.
Almost six in 10 teachers incorrectly tell students that condoms alone are not effective for pregnancy prevention.
The reality is that at the time of being surveyed for our study, a quarter of the students—mostly aged 15 to 17—had already had sex. Students want—and need—information on how to prevent unintended pregnancies, HIV and other STIs.
That’s why we urge the Ministries of Health and Education, Science and Technology leaders to honour their prior commitments.
An immediate priority should be fostering partnerships between schools and community health care providers, who may be better positioned to provide some sexuality education content, particularly on sensitive issues such as how to use contraceptive methods and where to get them.
The ministries should invest in improved pre-service and in-service teacher training on how to teach sexuality education effectively, and ensure that they have sufficient time to cover the full range of topics in their classes.
Increased focus on pregnancy and STI prevention strategies that cover a broad range of contraceptive methods and negotiation skills in relationships is necessary to ensure that youth have the knowledge to make informed decisions about their sexual and reproductive health. We owe it to young people to do much better.
Ms Sidze is an associate research scientist with the Nairobi-based African Population and Health Research Centre and Ms Stillman, a research associate with the New York-based Guttmacher Institute