ArticleInternational journal for equity in health2019
Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia.
Article in International journal for equity in health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06330428 (Investigation of the Effect of Sexuality-Based Family Planning Education Given to Women Via Podcast on Contraceptive Method Selection and Sexual Life Quality), which is not on this map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Investigation of the Effect of Sexuality-Based Family Planning Education Given to Women Via Podcast on Contraceptive Method Selection and Sexual Life Quality
Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 124 citations in OpenAlex.
- Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review.Reproductive health · 2022Pooled it
- The impact of the SKILLZ intervention on sexual and reproductive health empowerment among Zambian adolescent girls and young women: results of a cluster randomized controlled trial.Reproductive health · 2025Trial
- Lessons from an intervention study on the sustainability of after-school comprehensive sexuality education in Zambia: the perspectives of teachers, health workers and guardians.Reproductive health · 2024Trial
- Comprehensive sexuality education linked to sexual and reproductive health services reduces early and unintended pregnancies among in-school adolescent girls in Zambia.BMC public health · 2023Trial
- Application of community dialogue approach to prevent adolescent pregnancy, early marriage and school dropout in Zambia: a case study.Reproductive health · 2022Trial
- Trial
- Parents' and Teachers' Perceptions of Comprehensive Sexuality Education in Early Childhood and Primary Education in Greece.European journal of investigation in health, psychology and education · 2026Article
- Drivers of child marriage in Eastern and Western provinces in Zambia and effective preventive interventions: Findings from a rapid document review and three stakeholder meetings.Reproductive health · 2026Review
- Association Between a History of Sexually Transmitted Diseases and Reproductive Health Knowledge Among Adolescents of Peru: A Cross-Sectional Study.International journal of environmental research and public health · 2026Article
- Adolescents' engagement with comprehensive sexuality education in Zambian schools: implications for strengthening responses to risky sexual behaviours.BMC public health · 2026Article
- Exploring multisectoral collaboration in implementing comprehensive sexuality education framework at the provincial level in Zambia: a qualitative study.Global health action · 2025Article
- 'Our rights, Our lives, Our future': evaluation of a 5-year multi-country programme to enhance sexuality education in sub-Saharan Africa.Reproductive health · 2025Article
- Identifying health outcomes and future research directions of group antenatal care among adolescents in low and middle-income countries: a scoping review.BMJ global health · 2025Article
- Knowledge of sexual and reproductive health and rights among University of Rwanda students: a cross-sectional study.BMJ public health · 2025Article
- Sources and Types of Sexual Information Used by Adolescents: A Systematic Literature Review.Healthcare (Basel, Switzerland) · 2024Review
- Exploring comprehensive sexuality education experiences and barriers among students, teachers and principals in Nepal: a qualitative study.Reproductive health · 2024Article
- "The ones at the bottom of the food chain": structural drivers of unintended pregnancy and unsafe abortion amongst adolescent girls in Zambia.Archives of public health = Archives belges de sante publique · 2024Article
- Stakeholders' Experiences and Preferences Regarding Comprehensive Sexuality Education in Zambia: Implications for Determining Programme Priorities and Strategies.International journal of environmental research and public health · 2024Article
- Adolescents' risky sexual behaviours and practices: Implications for sexuality education implementation in Zambia.African journal of primary health care & family medicine · 2024Article
- Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReproductive health problems such as HIV, unwanted pregnancy and unsafe abortion among adolescents are closely linked to insufficient knowledge about sexuality and reproduction and lack of access to contraceptives. Supported by international agencies, Zambia has introduced an ambitious nation-wide program for comprehensive sexuality education (CSE) to be implemented into ordinary school activities by teachers. The curriculum is firmly based in a discourse of sexual and reproductive rights, not commonly found in the public debate on sexuality in Zambia. This paper explores how teachers perceive the curriculum and practice discretion when implementing the CSE in mid-level schools in Nyimba district in Zambia.
methodsUsing a case study design, data were collected through in-depth interviews with 18 teachers and analyzed thematically drawing upon theories of discretion and policy implementation.
resultsIndividual teachers make decisions on their own regarding what and when to teach CSE. This discretion implies holding back information from the learners, teaching abstinence as the only way of preventing pregnancy or cancelling sexuality education sessions altogether. Teachers' choices about the CSE program were linked to lack of guidance on teaching of the curriculum, especially with regards to how to integrate sexuality education into existing subjects. Limited prioritization of CSE in the educational sector was observed. The incompatibility of CSE with local norms and understandings about adolescent sexuality combined with teacher-parent role dilemmas emerged as problematic in implementing the policy. Limited ownership of the new curriculum further undermined teachers' motivation to actively include CSE in daily teaching activities. Use of discretion has resulted in arbitrary teaching thus affecting the acquisition of comprehensive sexual and reproductive health knowledge among learners.
conclusionThe CSE had limited legitimacy in the community and was met with resistance from teachers tasked with its' implementation. In order to enhance ownership to the CSE program, local concerns about the contents of the curriculum and the parent-teacher role dilemma must be taken into consideration. Not addressing these challenges may undermine the policy's intention of increasing knowledge about sexuality and reproduction and empowering adolescents to access contraceptive services and avoid unwanted pregnancies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.