Comprehensive Sexuality Education
1. Context and background
India has a population of 1.2 billion people, with 2022 figures showing a youth population (aged between 15 – 24) of about 254 million (27% of the total population). India has achieved some progress in the area of sexual and reproductive health (SRH) in the last decade, including an observed decline in the maternal mortality ratio, an increase in the use of modern contraceptive methods among married women, and a decrease in child marriage and adolescent pregnancy. In spite of these successes, SRH rights for young people cannot be fully exercised. While there has been some progress in the ending of child marriage and adolescent pregnancy, there are still major obstacles: one in three of the world’s child brides lives in India; nearly one in four women (23% of all women) was married before her 18th birthday, and 6.8% of women in the 15–19-year age groups was pregnant in 2021 (17 of every 1,000 girls).
2. Terminology
The 2017 National Health Policy uses the term ‘adolescent and sexual health education’. Concepts of comprehensive sexuality education (CSE) is included within the School Health & Wellness Programme.
3. Laws and policies
3.1. Relevant international/regional agreements to which the country is a signatory
| INTERNATIONAL | |
|---|---|
|
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)
Signed: 30th July 1980 Ratified: 9th July 1993 |
Acknowledges the need to guarantee sexuality education free from discrimination and stereotypes, conveying gender equality values. |
|
Convention on the Rights of the Child (CRC)
Ratified: 11th December 1992 |
Commits to the right to access appropriate health-related information. |
|
Convention on the Rights of Persons with Disabilities (CRPD)
Signed: 30th March 2007 Ratified: 1st October 2007 |
Commits to the highest attainable standard of health for persons with disabilities. |
| International Covenant on Economic, Social and Cultural Rights | Acknowledges that the right to sexual and reproductive health is an integral part of the right to health. |
| UNESCO Convention against Discrimination in Education | Reaffirms that education is a human right. It highlights states' obligations to ensure free and compulsory education, bans any form of discrimination and promotes equality of educational opportunity. |
| The 1994 International Conference on Population and Development (ICPD) Programme of Action | Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics. |
|
UN General Assembly 2016 Political Declaration on HIV and AIDS |
Includes commitments and calls to scale up and/or pay attention to scientifically accurate age- and culturally appropriate comprehensive sexuality education. |
|
Commission on the Status of Women 2016 Resolution on Women, the Girl Child and HIV and AIDS
Elected member in 2020 |
Includes commitments to make universally accessible and available quality comprehensive sexual and reproductive health-care services, commodities, information and education. |
| REGIONAL | |
|
The Asia and Pacific Ministerial Declaration on Population and Development (2013) (Asia Pacific)
Signed in 2013 |
Commits to the design, funding and implementation of ‘comprehensive sexuality education and life skills’ programmes that ‘provide accurate information on human sexuality, gender equality, human rights, relationships, and sexual and reproductive health, while recognizing the role and responsibilities of parents’. |
3.2. Relevant national laws and policies mandating comprehensive sexuality education
The 2017 National Health Policy envisages the attainment of the highest possible level of health and wellbeing for all ages, through preventative and promotional health care. The policy prioritizes investment in school health by including health education in the curriculum and promoting hygiene and healthy practices within the school environment.
In 2013, the Indian government launched the Rashtriya Bal Swasthya Karyakram under the National Rural Health Mission for the early detection and timely management of illnesses among children (categorized as between the ages of 0–18 years) by periodic screening through schools and Anganwadi centres. In 2014, the Ministry of Health and Family Welfare also launched the Rashtriya Kishor Swasthya Karyakram as an adolescent health programme under the National Health Mission. The programme aimed to expand the range of topics covered in the health programme beyond sexual and reproductive health, such as: nutrition; injuries and violence (including gender-based violence); non-communicable diseases; mental health; and substance abuse. Interventions under the Rashtriya Kishor Swasthya Karyakram programme include PEER education programmes, the promotion of menstrual hygiene and adolescent-friendly health clinics.
The New Education Policy 2020 focuses on the health and wellbeing of learners.
3.3. Curricula
In partnership with the National AIDS Control Organization (NACO) and the United Nations Children's Fund (UNICEF), the Indian government, launched the Adolescent Education Programme, which aimed to address a range of issues relevant to adolescents, including: body image; violence and abuse; gender and sexuality; sexually transmitted infections (STIs); substance abuse, particularly drug use; and other harmful behaviours. It was the only standardized government programme. It was conceptualized as the Life Skills Education programme and was introduced at secondary-school level. In 2009, the programme was relaunched to focus on life skills development and it was implemented in over 5,000 schools, both government and private. The programme was discontinued in 2020.
In 2018, the School Health Programme under the health and wellness component of the Ayushman Bharat Programme, was initiated as a joint effort between the Ministry of Health and Family Welfare and the Ministry of Education to strengthen preventative and promotional aspects of health education. In 2020, the School Health & Wellness Programme curriculum was introduced with 11 thematic areas. The curriculum is to be delivered by two teachers per school designated as ‘health and wellness ambassadors‘ as a co-curricular programme.
Mandatory or optional
The School Health & Wellness Programme under Ayushman Bharat is a co-curricular program that addresses topics related to health education. The Curriculum on Health and Wellness of School-going Adolescents is being implemented in government, government-aided and private schools.
Model of delivery
The School Health & Wellness Programme is being implemented in grades 6 to 12 in all states and union territories.
The School Health & Wellness Programme trains teachers as ‘health and wellness ambassadors’. These should be two teachers, preferably one male and one female, in every school, to be trained to instruct health promotion and disease prevention through 11 thematic areas in an interesting and creative way for one hour every week.
Comprehensiveness of content
Through the Curriculum on Health and Wellness of School-going Adolescents programme curricula, the School Health & Wellness Programme spans 11 thematic areas: growing up healthy; emotional well-being and mental health; interpersonal relationships; values and citizenship; gender equality; nutrition, health and sanitation; prevention and management of substance abuse; promotion of healthy lifestyles; reproductive health and HIV prevention; safety and security against violence and injuries; and the promotion of internet safety and responsible social media behaviour.
Learning resources
The Curriculum on Health and Wellness of School-going Adolescents is prepared by the National Council for Educational Research and Training from the . Forming part of the Ayushman Bharat programme, it provides curriculum guidance and training material related to the health and wellness of school-going children.
In 2018, as a joint initiative of the Ministry of Health and Family Welfare and the Ministry of Human Resources and Development, the Operational Guidelines on School Health Programme were released for the designated ‘health and wellness ambassadors’ in schools, under Ayushman Bharat.
The National Council of Educational Research and Training has developed a resource book, ‘Guidelines on Comprehensive Sexuality Education: An Introduction for School Teachers’ to help teachers understand and implement CSE in the classroom.
3.4. Teachers
Teacher preparedness and capacity building: As part of the School Health & Wellness Programme, teachers in every school who are designated as ‘health and wellness ambassadors’ are trained to instruct health promotion and disease prevention in an interesting and creative way.
The government of India has undertaken a number of initiatives to promote teacher training in sexuality education. For instance, the Rashtriya Madhyamik Shiksha Abhiyan programme provides in-service teacher training in CSE and the National Council of Educational Research and Training has developed training modules on sexuality education.
Whether teachers are mandated to be trained on the provision/delivery of sexuality education either as part of PRESET or INSET: A curriculum has been incorporated into school textbooks and integrated into a programme for the training of current teachers and the preparation of future teachers. A dedicated staff member per school is assigned the role of coordinating and offering administrative assistance for the programme. This initiative stands out as the only nation-wide large-scale, government-administered effort in the country.
3.5. Schools
Access to school-based health services, including SRH: Some schools and educational institutions, particularly in urban areas, may have access to SRH counselling services as part of broader health and well-being programmes. However, the extent and quality of these services can differ significantly from one school to another and from one region to another.
4. Governance
4.1 Responsible ministries
The Ministry of Health and Family Welfare bears the mandate for formulating policies and executing programmes relating to reproductive health and family welfare. Initiatives linked to adolescent reproductive health and promoting awareness of SRH issues might fall within their jurisdiction.
The Ministry of Education is responsible for comprehensive educational policies, including the development of all curricula. The National Council of Educational Research and Training, which operates under the umbrella of this ministry, has been involved in the development of the School Health & Wellness Programme address specific facets of sexuality education.
4.2. Level of responsibility/decentralization and autonomy
The implementation of CSE under the New Education Policy 2020 is left to individual states and schools. The curriculum for sexuality education may vary, depending on the context and needs of each state.
4.3. Government budget allocation
Information was not found.
5. Monitoring and reporting
The School Health Programme had implemented a structured monitoring system to oversee clinic-based services, and third-party evaluations were conducted. However, the monitoring process was mainly administrative, and it is unclear whether the limited data that were collected were used for programme planning or quality improvement. The primary focus of monitoring efforts is on administrative indicators, such as the number of trainings conducted and clients served.
