Comprehensive sexuality education,culture and gender: the effect of the cultural setting on a sexuality education programme in Ethiopia

Comprehensive sexuality education (CSE) is recognised as an effective method of sexual health education, with the school identified as a fitting site of implementation. Its holistic and participatory nature endeavours to develop the knowledge, attitudes and life-skills of students to help them secure their sexual and reproductive health and rights (SRHR). This qualitative study aimed to better understand aspects of CSE implementation in one context. Specifically, it focuses on the effects of the cultural setting, considering how gender and sexuality norms influence teacher and student implementation strategies. The research was carried out in one secondary school in Ethiopia, which delivered a Dutch-developed programme throughout 2013. Over 50 in-depth interviews were conducted with teachers and students, influential community members and experts in SRHR. Data were also gathered through focus group discussions and classroom observations. Results show that CSE teachers and students, both male and female, were able to discuss issues of sexuality. However, the cultural context was seen to affect interpretation of programme information, influencing the nature of this discussion. For an impactful implementation, it is recommended that sexuality education aims to engage with and involve the wider community, to reduce contradictory messages and increase programme support. Furthermore, teachers should undergo extensive and comprehensive pre-programme training that addresses their attitudes and values, not just their knowledge.     

Mechanisms of adopting and reformulating comprehensive sexuality education policy in Ethiopia

ABSTRACT

Over the past few years, international organisations have advanced Comprehensive Sexuality Education (CSE) as a global policy to promote sexual and reproductive health and rights (SRHR) and address gender-based violence in schools. This paper analyses policy adoption, transfer mechanisms, and reformulation of CSE in Ethiopia, a late adopter of the policy. To do this, we identify education policy transfer mechanisms and apply a gender analysis by focusing on conceptualisations of gender relations in the uptake and reformulation of CSE policies. Drawing on document analysis and stakeholder interviews, the paper reveals that CSE in Ethiopia is largely a donor-driven agenda, advanced through dissemination and networking strategies. CSE is particularly embraced by the Ministry of Health, international organisations and NGOs in Ethiopia, but at the same time, the Ministry of Education and other critics continue to resist adoption, emphasising cultural differences. As a result, CSE in Ethiopia is (re)formulated and reflects narrow conceptualisations of how CSE can address gender-based violence, restricting its focus to health and development outcomes.     

Islamic parents’ attitudes and beliefs towards school-based sexual and reproductive health education programmes in Oman

School-based comprehensive sexuality education (CSE) programmes play an important role in reducing young people’s sexual risk behaviour and promoting health and well-being. There is limited evidence regarding the attitudes and beliefs of parents towards the implementation of school-based CSE programmes in Islamic cultural settings, including Oman, which this mixed-method study set out to explore. A convenience sample of 250 parents, with equal numbers of mothers and fathers of children aged 12–14 years (grades 7–9) at two urban public pre-secondary schools in Saham, completed a paper-based self-administered questionnaire in Arabic. We found most parents (72.8%) supported school-based CSE programmes that conformed to Islamic requirements of pre-marital sexual abstinence, but there was some opposition. Almost all parents supported comprehensive age-appropriate CSE being taught to students aged 10–15 years, including topics perceived as controversial in Omani culture, except for birth control and safer sex. Most parents considered themselves, school teachers and school nurses to be important sources of CSE. The study findings which suggest strong parental support for CSE programmes can facilitate education policy, CSE curriculum decision-makers and school healthcare-providers in Oman, other Middle Eastern countries, and countries with Muslim immigrant populations.     

Towards comprehensive sexuality education: a comparative analysis of the policy environment surrounding school-based sexuality education in Ghana,Peru, Kenya and Guatemala

The successful implementation of comprehensive sexuality education (CSE) programmes in schools depends on the development and implementation of strong policy in support of CSE. This paper offers a comparative analysis of the policy environment governing school-based CSE in four low- and middle-income countries at different stages of programme implementation: Ghana, Peru, Kenya and Guatemala. Based on an analysis of current policy and legal frameworks, key informant interviews and recent regional reviews, the analysis focuses on seven policy-related levers that contribute to successful school-based sexuality education programmes. The levers cover policy development trends; current policy and legal frameworks for sexuality education; international commitments affecting CSE policies; the various actors involved in shaping CSE; and the partnerships and coalitions of actors that influence CSE policy. Our analysis shows that all four countries benefit from a policy environment that, if properly leveraged, could lead to a stronger implementation of CSE in schools. However, each faces several key challenges that must be addressed to ensure the health and wellbeing of their young people. Latin American and African countries show notable differences in the development and evolution of their CSE policy environments, providing valuable insights for programme development and implementation.     

Computer self-efficacy of university faculty in Lebanon

Faculty use of technology is a critical issue in higher education; administrators and students are expecting faculty instruction to incorporate technology in classroom and distance education. Competition is demanding technologically proficient graduates for schools and colleges. Research indicates that computer self-efficacy (CSE) may be one determinant of who uses technology and who does not. A survey of education faculty at the Lebanese University in Beirut, Lebanon, conducted in 2006, revealed varying degrees of CSE; of 127 respondents, 14 had low levels of CSE; 68 were at a moderate level, and 45 self-evaluated themselves to have high CSE. Although other barriers may deter the implementation of technology in teaching, strategies and techniques for increasing CSE should be developed. For those with low CSE, special attention must be given to enhancing their levels of CSE.

Dynamic three-dimensional virtual environment to improve learning of anatomical structures

Increasing number of medical students and limited availability of cadavers have led to a reduction in anatomy teaching through human cadaveric dissection. These changes triggered the emergence of innovative teaching and learning strategies in order to maximize students learning of anatomy. An alternative approach to traditional dissection was presented in an effort to improve content delivery and student satisfaction. The objective of this study is to acquire three-dimensional (3D) anatomical data using structured-light surface scanning to create a dynamic four-dimensional (4D) dissection tool of four regions: neck, male inguinal and femoral areas, female perineum, and brachial plexus. At each dissection step, identified anatomical structures were scanned using a 3D surface scanner (Artec Spider™). Resulting 3D color meshes were overlaid to create a 4D (3D+time) environment. An educational interface was created for neck dissection. Its implementation in the visualization platform allowed 4D virtual dissection by navigating from surface to deep layers and vice versa. A group of 28 second-year medical students and 17 first-year surgery residents completed a satisfaction survey. A majority of medical students (96.4%) and 100% of surgery residents said that they would recommend this tool to their colleagues. According to surgery residents, the main elements of this virtual tool were the realistic high-quality of 3D acquisitions and possibility to focus on each anatomical structure. As for medical students, major elements were the interactivity and entertainment aspect, precision, and accuracy of anatomical structures. This approach proves that innovative solutions to anatomy education can be found to help to maintain critical content and student satisfaction in anatomy curriculum.     

The relationship between sources of self-efficacy in classroom environments and the strength of computer self-efficacy beliefs

Motivation and success in computer-science courses are influenced by the strength of students’ self-efficacy (SE) beliefs in their learning abilities. Students with weak SE may struggle to be successful in a computer-science course. This study investigated the factors that enhance or impede the computer self-efficacy (CSE) of computer-science students. Data collection involved a survey of 524 undergraduate computer-science students from 10 Thai universities. The survey measured four items of CSE, 13 items pertaining to the classroom learning environment (CLE), and 14 items related to information sources of SE. Results revealed that perceptions of a CLE with autonomy, meaningfulness, and involvement were positively associated with strong CSE. In addition, perceptions of social persuasions such as meaningful and encouraging feedback or judgment from influential people demonstrated a statistically positive relationship with CSE. Perceptions of vicarious experiences whereby students determine and compare their own abilities with observational experiences of role models also demonstrated a statistically positive relationship with CSE. Perceived physiological and affective states such as anxiety and stress demonstrated a negative influence CSE. Implications for practice relate to students’ perceptions of autonomous learning, the value of positive feedback, students’ input into learning content and activities, role models for students and observation of how peers perform tasks better or worse.     

Commercially sexually exploited youths’ health care experiences,barriers, and recommendations: A qualitative analysis

The current study sought to understand commercially sexually exploited (CSE) youths’ health care experiences, barriers to care, and recommendations for improving health care services. We conducted focus groups (N = 5) with 18 CSE youth from February 2015 through May 2016 at two group homes serving CSE youth in Southern California. We performed thematic content analysis to identify emergent themes about CSE youths’ perspectives on health care. Youth described facilitators to care, including availability of services such as screening for sexually transmitted infections, knowledge about sexual health, and a strong motivation to stay healthy. Barriers included feeling judged, concerns about confidentiality, fear, perceived low quality of services, and self-reliance. Overall, youth emphasized self-reliance and “street smarts” for survival and de-emphasized “victimhood,” which shaped their interactions with health care, and recommended that health providers develop increased understanding of CSE youth. Our findings suggest that providers and community agencies can play an essential role in raising awareness of the needs of CSE youth and meet their health needs through creating a non-judgmental environment in health care settings that validates the experiences of these youth.     

Probing the politics of comprehensive sexuality education: ‘Universality’ versus ‘Cultural Sensitivity’: a Dutch–Bangladeshi collaboration on adolescent sexuality education

As part of Western European development aid policy, comprehensive sexuality education (CSE) is increasingly promoted in resource-poor countries. This paper engages with CSE promotion in Bangladesh funded by the Dutch Government. It unpacks the ‘collaboration’ by looking at how a paradox is played out between the universal ideals underlying a broader transnational rights-approach and the intended cultural sensitivity by adapting CSE to the targeted context. Feminist scholarship on the ideological, moral and affective underpinnings of CSE is used to question this model’s implied universality and neutrality. The various negotiations, concerns and strategies of NGO-representatives as co-producers of sexuality knowledge in Bangladesh are focused upon. Analysis focuses on how a ‘speakable’, middle-class-oriented ‘proper’ sexuality is invented and managed through affect; how cultural insensitivity and secular normativity with respect to CSE are challenged in discussions concerned a rights-versus-health approach; and how a confident and knowledgeable adolescent or young person is imagined through the emancipatory project attributed to sexuality education. Rather than via equal collaboration, it is argued, adolescent sexuality education in these development aid settings is shaped by powerful transnational and local processes of Othering.     

An evaluation of local teacher support strategies for the implementation of inquiry-based science education in French primary schools

This article presents the results of an evaluation of local teacher support strategies for implementing inquiry-based science education (IBSE) in French primary schools. The research objective was to determine which aspects of the French model of IBSE are implemented in class, and the efficiency of each teacher support strategy. Data were recovered through class observations. Findings confirm the need for long and continuous forms of teacher support, and expose the advantages and disadvantages of support delivered by pedagogues and support delivered by university science students. Writing in science class, which isa fundamental aspect of the French IBSE programme, is far from being implemented according to advocated practices.     

Learner and instructor identified success factors in distance education

To better understand their perceptions of optimal tools and strategies for success, this research analyzed the experiences of learners and instructors in an online distance education environment. A qualitative constant comparative analysis methodology supported by an appropriate conceptual framework guided the study. Data were collected over multiple years and from multiple stakeholders. The study identified the following significant conclusions: the availability of multiple tools added flexibility to the learning environment; technology tools should appeal to multiple learning styles; collaboration, reflection, and building a learning community were important strategies supported by multiple tools; and participant satisfaction, appropriate prerequisite skills, and faculty and administrative involvement ensured programmatic success. According to this study, optimal distance education environments should address factors identified in the conceptual framework.     

Explicating the influences that explain intention to use technology among English teachers in China

Given the paradox between pervasive promotion of technology use in English teaching and lack of studies about teachers’ technology acceptance in China, this study aims to examine intentions of English teachers in China to use technology in their classroom teaching. Based on the technology acceptance model, eight variables including perceived usefulness (PU), perceived ease of use (PEU), attitude toward use, behavioral intention (BI), computer self-efficacy (CSE), technology complexity (TC), facilitating conditions (FC), and constructivist teaching beliefs (CTBs) were incorporated to examine relationships among these variables. Data were collected from 183 English teachers at 5 Chinese universities via a self-report questionnaire and analyzed using a structural equation model. Results indicated that the proposed model has a good fit. Three variables – PU, FC, and CTBs were found to be significant predictors of attitude toward use, while PEU and TC were not. Additionally, PU, CSE, and CTBs are significant antecedents for teachers’ BIs to use technology. This study contributed to the understanding of technology acceptance theories by contextualizing the current study to Chinese educational context. It also provided valuable references for technology-related policy-making and teachers’ professional development.     

Scaling up comprehensive sexuality education in Nigeria: from national policy to nationwide application

Nigeria is one of few countries that reports having translated national policies on school-based comprehensive sexuality education (CSE) into near-nationwide implementation. We analysed data using the World Health Organization-ExpandNet framework, which provides a systematic structure for planning and managing the scaling up of health innovations. We examined how Nigeria's nationwide programme was designed and executed. Since 2002, Nigeria has developed a well thought through strategy to scale up CSE. Crucial attributes that facilitated the scaling up included technical consensus about the innovation and clarity about its components, dissection of a complex intervention into manageable components for implementation by organisations with complementary expertise, strong political leadership and championship in concert with advocacy and technical support from non-governmental organisations, proactive and energetic involvement of community stakeholders, effective programme management, and improvements to the information management system to ensure on-track implementation and mid-course corrections to keep stakeholders, including funders, informed and engaged. Challenges included programmatic values, competing priorities for available human resources and a lack of predictable funding for sustaining a rapid scale-up effort. Despite some weaknesses, implementation has largely proceeded according to plan. The lessons learned from Nigeria's experience can and should be used in other settings to achieve wide-scale coverage.     

The Translation of Teachers’ Understanding of Gifted Students Into Instructional Strategies for Teaching Science

This study examined how instructional challenges presented by gifted students shaped teachers’ instructional strategies. This study is a qualitative research grounded in a social constructivist framework. The participants were three high school science teachers who were teaching identified gifted students in both heterogeneously- and homogeneously-grouped classrooms. Major data sources are classroom observations and interviews. Data analysis indicated that these science teachers developed content-specific teaching strategies based on their understanding of gifted students, including: (a) instructional differentiation, e.g., thematic units, (b) variety in instructional mode and/or students’ products, (c) student grouping strategies and peer tutoring, (d) individualized support, (e) strategies to manage challenging questions, (f) strategies to deal with the perfectionism, and (g) psychologically safe classroom environments.     

Sexual and reproductive health education attitudes and experience in India: how much support is there for comprehensive sex education? Findings from an Internet survey

This study assessed the extent to which an Internet-recruited sample of residents of India was supportive of the provision of comprehensive sexual education in school in a country where youth sexual health is poor. We sought to determine whether attitudes differed for those of varying demographic backgrounds (age, sex, education level, religion), the extent of support for comprehensive coverage, the school or age levels deemed appropriate for delivery, and whether own sex education history influenced support. We conducted an anonymous online survey with 1140 Indian adults using crowdsourcing methods. We found widespread support for the provision of sex education to youth in India among members of our largely well educated, middle-class sample. However, most participants believed sex education should be provided relatively late (i.e., in mid- to late-adolescence). Few opposed sex education altogether and attitudes were not predicted by background, own school-based sex education, or parent-child communication about sex. Less than one-third of participants endorsed the coverage of all topics, indicating that support for truly comprehensive coverage was not strong. However, the findings counter politicised efforts to ban sex education by state leaders despite the availability of a progressive, comprehensive curriculum offered by the Central government.     

Managing Sex Education Controversy Deep in the Heart of Texas: A Case Study of the North East Independent School District (NEISD)

Abstract

Comprehensive sexuality education (CSE), one of the key evidence-based strategies in our programmatic toolbox to address adolescent pregnancy and birth rates, remains a politically-charged issue countrywide. Though there is some funding available at the federal level, there are no national policies mandating the provision of sex education; as such, most decision-making occurs at the state or even the local level. Consequently, the provision of sex education and the quality and comprehensiveness of curricula used to do so are highly variable across the country, and are heavily influenced by the level of support or resistance in communities. This paper analyzes the experience of institutionalizing an evidence-based sex education in a large suburban school district in San Antonio, Texas, a socially conservative context. Understanding the politics of sex education is key to developing effective policies and strategies to ensure quality sex education programs are provided in public schools. However, there are no published papers documenting specific experiences with resistance to sex education in local communities in the USA. Given this, the strategies employed by opponents and the response by district officials can be informative for other school settings in the USA and around the world.

Abbreviations: AFLA: Adolescent Family Life Act; CHAMPSS: Choosing And Maintaining effective Programs for Sex education in Schools Model; CSE: Comprehensive sexuality education; DTL/RTL: Draw the Line/Respect the Line; HSAE: Human Sexuality and Abstinence Education, the middle school sex education curriculum in NEISD prior to 2008; NEISD: North East Independent School District; SAFA: San Antonio Family Association; SHAC: School health advisory council; STI: Sexually transmitted infection; TEC: Texas Education Code; TPIA: Texas Public Information Act; USA: United States of America; UTHSC: University of Texas Health Science Center     

Sexuality education in India: examining the rhetoric,rethinking the future

Comprehensive sexuality education (CSE) has been recognised globally as key to helping young people assert their sexual and reproductive rights. In India too, there is growing awareness of the importance of providing CSE not only to reduce sexually transmitted infections, unintended pregnancies and abortions but also to teach important life skills. Simultaneously, lack of political will and conflicting interests among certain religious and political factions have ensured that no uniform CSE curriculum has been implemented throughout the country. This paper analyses the Adolescent Education Programme teacher curriculum as revised in 2009–2010 by the National Council of Educational Research and Training and the United Nations Population Fund. It highlights some of the opportunities presented by the curriculum and argues that despite its intent of providing relevant sexuality education for young people, the language of the curriculum is vague, thus potentially exacerbating confusion, and excluding people who do not conform to societal stereotypes of sex, gender, and ability. In order to be holistic, any CSE programme must be inclusive, cater to diverse needs and present content in a rights-based language without adding to the socio-cultural context of mystery and shame attached to sexuality.     

Exploring student beliefs and understanding in elementary science and mathematics

This study had the goal of investigating the association among elementary students' (N = 276) science and math beliefs and the relationship between those beliefs and teachers' ratings of mathematical and science understanding. Results of structural path analysis indicate that in science, intellectual risk‐taking (IRT; the willingness to share tentative ideas, ask questions, attempting to do, and learn new things) was positively related to teachers' ratings of science understanding, while creative self‐efficacy (CSE) beliefs (i.e., students' confidence in their ability to generate ideas and solutions in science) were indirectly related (working through IRT). Results also indicate that students' scientific certainty beliefs (i.e., the belief that science knowledge is stable, fixed, and represented by correct answers) were negatively related to teachers' ratings of science understanding. With respect to math, results indicate that students' CSE beliefs were positively related to teachers' ratings of math understanding; whereas students' mathematical source beliefs (i.e., believing that math knowledge originates from external sources) were negatively related. © 2012 Wiley Periodicals, Inc. J Res Sci Teach 49: 942–960, 2012     

IMPACT OF A RESTORATIVE CARE PROGRAM IN THE NURSING HOME

The purpose of this study was to determine the impact of a progressive mobility restorative program on nursing home residents' ability to perform selected activities of daily living (ADLs) and the amount of staff assistance needed to help residents complete these ADLs. A one group repeated measures design study was conducted in a 255-bed university affiliated geriatrics center. A certified nursing assistant (CNA) specially trained in restorative mobility techniques worked with residents individually for at least 15 minutes per day, five days per week to achieve their individualized mobility goals. Items on ADL Self-Performance and ADL Support Provided from the Minimum Data Set (MDS) were collected at baseline, three months, and six months. Thirty-eight of 42 residents (90%) were included in the analyses and 31 residents (82%) completed at least 25 days of restorative activities. Some residents improved their ADL self-performance at three and six months (15% and 33%, respectively) and decreased in the amount of ADL support provided at three and six months (26% and 31%, respectively). Total ADL self-performance and support provided did not change significantly over the six-month period. Most residents maintained their baseline ADL self-performance and level of ADL support provided over the six-month study. A progressive mobility restorative program implemented by a certified nursing assistant specially trained in restorative techniques resulted in most residents maintaining their baseline ADL self-performance abilities and the level of assistance provided by staff. Studies are needed to determine if these types of programs can actually improve functional abilities and decrease the level of staff assistance needed to complete ADLs or if they are effective in maintaining or delaying functional loss and staff burden.     

Level of Internet Use Among Science Teachers Involved in a Professional Development Project

This study examined the level of instructional use of Internet among science teachers involved with an in-service professional development project. An instrument on Level of Use of innovation was modified for the study. A criterion sample of teachers to be interviewed via telephone was randomly selected from a pool of 347 K–12 teachers. Somers' d and contingency coefficients were determined to see whether any relationship exists between a teacher's Level of Use and the following categories: (a) amount of experience with the Internet; (b) availability of resources support and access to the Internet in classroom and at home; (c) number of teacher and student users at school, (d) gender; and (e) type of school. Results of step-wise multiple regression indicate that classroom access, instructional experience of using Internet with students, availability of resource support and number of teacher users at school are the best predictors of teacher's Level of Use. Chi square test for comparisons between groups of completers and noncompleters of On-Line West Virginia K–12 RuralNet courses also revealed that a lack of classroom access to Internet and lack of resource/technical support at school contributed significantly to lower level of use among noncompleters.