Navigating comprehensive sexuality education in India: Cultural sensitivities and implementation challenges

Navigating Comprehensive Sexuality Education in India: Cultural Sensitivities and Implementation Challenges

Introduction

Comprehensive Sexuality Education (CSE) in India is at a critical juncture, balancing between progressive educational goals and deep-seated cultural sensitivities. This report explores the multifaceted landscape of CSE in India, examining its successes, setbacks, and the nuanced efforts required to make it a robust and impactful component of adolescent education.

Sustainable Development Goals (SDGs)

• Goal 3: Good Health and Well-being
• Goal 4: Quality Education
• Goal 5: Gender Equality
• Goal 10: Reduced Inequalities
• Goal 17: Partnerships for the Goals

Importance of Comprehensive Sexuality Education

The need for accurate and inclusive sexual health information is undeniable. A study from 2019 noted dependence upon peers for information regarding sex among college students in Tamil Nadu. Moreover, information asymmetry uniquely impacts women and girls; according to the NFHS-5, only 21.6 percent of women have comprehensive knowledge of HIV-AIDS as compared to 30.7 percent of men.

CSE can fill this knowledge gap by imparting critical information on subjects ranging from sex, gender, roles, sexual orientation, pleasure, intimacy, and reproduction. In 2021, a systematic literature review of 80 articles on school-based sexual education found that it was associated with an increased understanding of gender and gender norms; improved knowledge and skills that support healthy relationships, and reduced dating and intimate partner violence.

Advocates of sexual health have called for a rights-based approach to sexual education that recognises the right of adolescents to access information and services related to sexual health.

The challenge lies in effectively integrating CSE into a societal framework often resistant to open discussions about sexuality. As key socialising institutions, schools can effectively disseminate messages promoting sexual health through the delivery of CSE. Advocates of sexual health have called for a rights-based approach to sexual education that recognises the right of adolescents to access information and services related to sexual health. The UNFPA’s International Technical Guidance on Sexuality Education (2018) understands CSE as a curriculum-based process of teaching- entailing a comprehensive discussion of all domains of sexuality- aimed at encouraging respectful relationships and informed decision-making among children.

School-based Sexual Education Policy and Programmes in India

The School AIDS Education Programme (SAEP) was first introduced in 2002 to ensure compliance with India’s national AIDS policy regarding sexual health, contraception, and prevention of STIs by providing relevant information and counselling services. In 2006, the Government of India recognised the significance of Adolescent Reproductive and Sexual Health (ARSH) under the Reproductive Child Health (RCH II) programme. The Adolescent Education Programme (AEP) was introduced in the same year to equip adolescents with the knowledge to tackle the risk of HIV infection and address underlying sexual and reproductive health concerns. After a largely positive report from the UNFPA in 2010, there has been no independent evaluation of the AEP.

The National Health Policy, 2017, expands the ambit of Reproductive and Sexual Health to include issues like inadequate calorie intake, nutrition status, and psychological problems linked to the misuse of technology but falls short of addressing sexuality.

Adolescent Friendly Health Clinics (AFHC), established under the RMNCH+A programme (Reproductive, Maternal, Newborn, Child, and Adolescent Health), provide out-of-school sexuality education on contraception and STI/HIV prevention, in addition to counselling on sex, gender, delaying marriage, and pregnancy. The Rashtriya Kishore Swaasthya Karyakram (RKSK), launched in 2014 as part of a national Adolescent Health Programme, strengthened ARSH by introducing peer educators responsible for imparting information on five key components of adolescent health. The National Health Policy, 2017, expands the ambit of Reproductive and Sexual Health to include issues like inadequate calorie intake, nutrition status, and psychological problems linked to the misuse of technology but falls short of addressing sexuality.

Consensus Building for CSE

The AEP was suspended in 2007 due to conservative backlash, with resistance to sexual education ranging from opposition to specific curriculum content to calls for stopping sex education programmes altogether.

In his seminal work “The Division of Labour in Society” (1893), Durkheim argued that social institutions give rise to shared values that create social cohesion. As key social institutions, schools are expected to reinforce normative behaviours and attitudes among students. CSE is, thereby, viewed as a challenge to the status quo because it equips students to challenge norms surrounding relationships, families, and gender roles as evaluations indicate that there is a greater propensity for progressive attitudes towards gender and homosexuality among students who received CSE. The resistance to CSE in India can be understood as a clash between the commonly held cultural norms regarding sexuality and the principles of autonomy promoted by CSE.

A cross-sectional study of 233 parents of adolescent children in Coastal South India indicates general acceptance of the inclusion of sex education in the academic curriculum.

That said, the response to sex education in schools has been receptive in some cases. A cross-sectional study of 233 parents of adolescent children in Coastal South India indicates general acceptance of the inclusion of sex education in the academic curriculum. Community engagement is pivotal to the success of such sex-education programmes: Literature on Udaan in Jharkhand and a large-scale sexuality education programme in Pakistan emphasise community sensitisation through regular meetings, counselling sessions, and community-level activities as key to consensus building. It is untenable for sexual education programmes to be divorced from the cultural framework in which sex and sexuality are understood. In contexts where sexual and reproductive choices are community-driven, comprehensive sexuality education programmes must strive to foster inclusive intergenerational dialogue, rather than merely conveying scientific facts in isolation.

Administrative and Policy Challenges to Implementing CSE

In addition to a lack of consensus, effective implementation of sex education is hindered by administrative challenges. Though training for AEP facilitators is mandatory, there is ambiguity regarding the quality of instruction, the number of teachers trained, and the number of students who may have benefitted from the programme. Given the stigma associated with school-based sex education, teachers and facilitators need to undergo rigorous training that enables reflexive examination of their misconceptions, thereby aiding them in creating open and safe learning spaces for students.

Rigorous impact assessment in conjunction with stakeholder consultations can provide valuable insight into the quality of services and interventions.

Public-private partnerships between government departments, NGOs, and civil society organisations can improve programme sustainability through utilisation of NGO resources. Furthermore, NGOs can be instrumental in independently assessing programme efficacy. Presently, monitoring largely focuses on administrative indicators such as the number of training sessions conducted and students covered. Rigorous impact assessment in conjunction with stakeholder consultations can provide valuable insight into the quality of services and interventions. A rapid review of adolescent health programming in India points to difficulties in organising interdepartmental collaboration due to a lack of formalised structures. The review recommends the development of a formal strategy with clear mechanisms, roles, and responsibilities to build meaningful linkages.

A 2014 review of the AEP training resources highlights ineffective curriculum design, pointing to the obfuscation of sex in sexual education through the use of euphemistic terminologies such as “life skills education”, and the restriction of sex to the contexts of conception and reproduction. Subsequent programmes and policy frameworks addressing adolescent health (RKSK 2014, NHP 2017) have similarly evaded mention of sexuality, sexual diversity, relationships and communication which are essential components of CSE.

While there have been calls to limit sex education to abstinence-only education, a systematic review from 2021 indicates that programmes exclusively advocating for abstinence are unsuccessful in reducing both the age of sexual initiation and instances of sexual risk behaviours. It is essential for the curriculum to include frank and open discussion on the basics of sexuality, including the accessibility of contraceptives, and maintaining healthy and respectful relationships. Furthermore, the course material should be made inclusive of sexual and gender minorities.

Evidence from a randomised controlled trial indicates increased sexual health knowledge and safer sex norms and attitudes within the target group exposed to a Web-based sexual health programme.

There has been an emphasis on the integration of technology into the delivery of sex education. There is a simultaneous dearth and overload of information available online for adolescents grappling with questions of sexuality. Despite India’s record rates of Internet penetration in 2023, the reliability of information online remains a concern for adolescent sexual health. At the same time, technology-based interventions that employ text messaging or mobile and computer applications can be leveraged to deliver comprehensive and private sexual health education efficiently. Evidence from a randomised controlled trial indicates increased sexual health knowledge and safer sex norms and attitudes within the target group exposed to a Web-based sexual health programme.

Conclusion

Sustaining CSE in India necessitates adopting an adaptive and inclusive approach that prioritises community involvement, robust policy support, and technological innovation. By embracing these strategies, India can develop a CSE framework that promotes healthy, informed, and respectful attitudes toward sexuality among the youth.

Saberi Mallick is a Research Intern at the Observer Research Foundation

The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.

SDGs, Targets, and Indicators Analysis

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities
• SDG 17: Partnerships for the Goals

The article discusses the need for comprehensive sexuality education (CSE) in India to address the knowledge gap and promote sexual health. This is connected to SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. The article also highlights the role of schools in delivering CSE, linking it to SDG 4, which focuses on quality education. Additionally, the article mentions the impact of CSE on gender norms and attitudes, aligning with SDG 5 on gender equality. The issue of cultural sensitivities and the need for community involvement and partnerships are relevant to SDG 10 and SDG 17, respectively.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
• Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship, and appreciation of cultural diversity and of culture’s contribution to sustainable development.
• Target 5.3: Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.
• Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.
• Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships.

Based on the article’s content, the identified targets are related to ensuring universal access to sexual and reproductive health services (Target 3.7), acquiring knowledge and skills for sustainable development (Target 4.7), eliminating harmful practices (Target 5.3), reducing inequalities (Target 10.3), and promoting partnerships (Target 17.17).

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator: Percentage of women with comprehensive knowledge of HIV-AIDS compared to men (related to Target 3.7)
• Indicator: Increased understanding of gender and gender norms among students (related to Target 4.7)
• Indicator: Attitudes towards gender and homosexuality among students who received CSE (related to Target 4.7)
• Indicator: General acceptance of the inclusion of sex education in the academic curriculum by parents (related to Target 5.3)
• Indicator: Number of training sessions conducted and students covered (related to Target 10.3)
• Indicator: Impact assessment of program efficacy through stakeholder consultations (related to Target 17.17)

The article mentions or implies several indicators that can be used to measure progress towards the identified targets. These indicators include the percentage of women with comprehensive knowledge of HIV-AIDS compared to men, increased understanding of gender and gender norms among students, attitudes towards gender and homosexuality among students who received CSE, general acceptance of sex education by parents, number of training sessions conducted and students covered, and impact assessment of program efficacy through stakeholder consultations.

Table: SDGs, Targets, and Indicators

Source: orfonline.org