Comprehensive Sexuality Education
1. Context and background
Jamaica is the third-largest island in the Caribbean and part of the Caribbean Community (CARICOM). The population is fairly young, with approximately two-thirds under the age of 25. According to the most recent HIV/AIDS National Knowledge, Attitude, Behaviour and Practices (KAPB) Survey, high-risk sexual behaviours among youth, such as having multiple partners, have increased. Only one-third of respondents in the Survey were able to correctly identify ways to prevent HIV/AIDS transmission. Early sexual activity, accompanied by a very low rate of physical examinations by medical practitioners, and inadequate contraception, are have led to adolescent pregnancies, an ongoing concern. Although the number of adolescent pregnancies in Jamaica has been decreasing, it remains one of the highest in the region. Maternal and infant mortality rates have improved in recent years. Contraceptive use in the country is also relatively high and has been steadily increasing
Concerns about adolescent sexuality and reproductive health (SRH) in Jamaica were expressed as early as 1958. In 1962, basic ‘sex education’ materials were developed by a joint health and education committee. A Personal Development curriculum was developed in the 1970s and 1980s and the national implementation of the curriculum was achieved by 1983. However, the curriculum was deemed insufficient as it was heavily knowledge-based and didactic in its approach. The current programme, Health and Family Life Education (HFLE), was first introduced into the primary curriculum in 1998 and mandated in 2004 through a cabinet decision. The curriculum has since been launched, removed, and relaunched several times over the years. In 2007, the Ministry of Education adapted the Health and Family Life Education Regional Curriculum Framework for students in Jamaica. The curriculum was revised again in 2012, with support from several international organizations. However, the curriculum was met with controversy. As mentioned in the National Integrated Strategic Plan for Sexual and Reproductive Health & HIV, some religious and other public opinion and interest groups have been advocating for maintaining laws criminalizing same-sex intimacy. The stigmatization and discrimination also hinder prevention efforts, such as in Jamaica’s sexuality education curriculum. In 2016, the curriculum again faced a revision process.
2. Terminology
Sexuality education in Jamaica is taught under the term ‘sexuality and sexual health’, which falls within the Health and Family Life Education (HFLE) curriculum. According to the CARICOM Health and Family Life Education Teacher Training Manual, ‘HFLE is a comprehensive, life skills-based programme, which focuses on the development of the whole person in that it: enhances the potential of young persons to become productive and contributing adults/citizens; promotes an understanding of the principles that underlie personal and social well-being; fosters the development of knowledge, skills and attitudes that make for healthy family life; provides opportunities to demonstrate sound health-related knowledge, attitudes and practices; increases the ability to practice responsible decision-making about social and sexual behaviour; and aims to increase the awareness of children and youth of the fact that the choices they make in everyday life profoundly influence their health and personal development into adulthood.’
In the glossary of terms of the 2014 -2019 National Integrated Strategic Plan for Sexual and Reproductive Health & HIV, comprehensive sexuality education (CSE) is defined as: ‘Education about all matters relating to sexuality and its expression. Comprehensive sexuality education covers the same topics as sex education but also includes issues such as relationships, attitudes towards sexuality, sexual roles, gender relations and the social pressures to be sexually active, and it provides information about sexual and reproductive health services. It may also include training in communication and decision-making skills.’
Sexual and reproductive health (SRH) is defined as: ‘Sexual and reproductive health (SRH) is an essential component of the universal right to the highest attainable standard of physical and mental health. services for family planning; infertility services; maternal and new-born health services; prevention of unsafe abortion and post-abortion care; prevention of mother-to-child transmission of HIV; diagnosis and treatment of sexually transmitted infections, including HIV infection, reproductive tract infections, cervical cancer, and other gynaecological morbidities; promotion of sexual health, including sexuality counselling; and prevention and management of gender-based violence.’
3. Laws and policies
3.1. Relevant international/regional agreements to which the country is a signatory
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INTERNATIONAL |
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Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratified in 1984 |
Acknowledges the need to guarantee sexuality education free from discrimination and stereotypes, conveying gender equality values. |
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Convention on the Rights of the Child (CRC) Ratified in 1991 |
Commits to the right to access appropriate health-related information. |
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Convention on the Rights of Persons with Disabilities (CRPD) Ratified in 2007 |
Commits to the highest attainable standard of health for persons with disabilities. |
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International Covenant on Economic, Social and Cultural Rights Ratified in 1971 |
Acknowledges that the right to sexual and reproductive health is an integral part of the right to health. |
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UNESCO Convention against Discrimination in Education Ratified in 2006 |
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. |
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The 1994 International Conference on Population and Development (ICPD) Programme of Action Attended the conference |
Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics. |
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UN General Assembly 2016 Political Declaration on HIV and AIDS |
Includes commitments and calls to scale up and/or attention to scientifically accurate age- and culturally appropriate comprehensive sexuality education. |
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Commission on the Status of Women 2016 Resolution on Women, the Girl Child and HIV and AIDS |
Includes commitments to make universally accessible and available quality comprehensive sexual and reproductive health-care services, commodities, information and education. |
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REGIONAL |
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The Latin America and the Caribbean (LAC) Ministerial Declaration ‘Preventing Through Education’ (Latin America & Caribbean) |
Agrees to ensure the effective implementation of ‘comprehensive sexuality education’ from an early age, with an emphasis on participation and intercultural approaches. |
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Montevideo Consensus on Population and Development (2013) (Latin America & Caribbean) |
Commits to ensure the effective implementation from early childhood of comprehensive sexuality; education programmes, recognizing the emotional dimension of human relationships, with respect for the evolving capacity of boys and girls and the informed decisions of adolescents; and young people regarding their sexuality, from a participatory, intercultural, gender sensitive, and human rights perspective. |
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3.2. Relevant national laws and policies mandating comprehensive sexuality education
In 1994, the CARICOM Standing Committee of Ministers of Education passed a resolution supporting the development of a comprehensive approach to Health and Family Life Education. The objectives were to develop policy, including advocacy and funding, for the overall strengthening of Health and Family Life Education in and out of schools; to strengthen the capacity of teachers to deliver Health and Family Life Education programmes; to develop comprehensive life-skills based teaching materials; and to improve coordination among all the agencies at the regional and national levels in the area of Health and Family Life Education.
Jamaica’s 1980 Education Act governs the school system in the country. It does not mention sexuality education, health, or gender. The 2011-2020 National Education Strategic Plan called for the creation and implementation of the National Health and Family Life Education Policy, which established a framework to ‘assure the systematic development and implementation of HFLE by institutionalizing innovative approaches to strengthen HFLE delivery in the formal and non-formal sectors throughout the education and training system’.
The Health and Family Life Education Policy establishes the current programme in schools and provides guidelines for implementation. The curriculum aims to ensure that students will ‘be more able and willing to make better choices concerning self and inter-personal relationships; practise responsible decision making about social and sexual behaviours; demonstrate sound health-related knowledge, attitudes and practices; and contribute to an environmentally friendly society’.
The 2004 National Youth Policy acknowledges that education can impact youth behaviour in relation to SRH. It notes that teaching good behavioural patterns is critical for the health and well-being of youth and for the whole Jamaican population in the future.
The 2007-2012 National Strategic Plan for HIV/AIDS states that the Ministry of Education should reach more youth through an enhanced Health and Family Life Education curriculum and new partnerships with private schools. A comprehensive HIV & AIDS programme must be developed for the sector, and this extends to the tertiary level.
The 2004 National Policy for HIV/AIDS Management in Schools states that a continuing Health and Family Life Education and HIV & AIDS education programme must be implemented in all schools and institutions for all students and school personnel. The policy also seeks to ensure that education and information on HIV & AIDS must be delivered and imparted in an accurate and scientific manner, through accessible language and terminology.
Jamaica’s 2011 National Policy for Gender Equality calls for gender equality in both health and education. It includes key targets such as to ‘promote a human rights approach to issues of sexuality’ through public education programmes and transforming prevailing gender ideologies.
The 2004 National Policy for the Promotion of Healthy Lifestyles in Jamaica seeks to ‘decrease the incidence of chronic diseases, high risk sexual behaviour and violence and injury through the promotion of appropriate behaviours and by building self-esteem, resiliency and life skills in the population, particularly among young children, adolescents and young adults’.
Jamaica’s 2014-2019 National Integrated Strategic Plan for Sexual and Reproductive Health & HIV designates a ‘National Authority for Sexual Reproductive Health’, which is to: provide and encourage sexuality education; undertake and disseminate research on family and population planning; reduce STIs including HIV; improve contraceptive choice and safety; and promote healthy sexuality. Specific key action points include promoting age-appropriate SRH and HIV education within school settings, as well as for out-of-school adolescents and youth. Laws and policies should also be regularly reviewed in order to ensure that they facilitate universal and equitable access to SRH information and services.
3.3. Curricula
Mandatory or optional
Health and Family Life Education is mandatory for all students. According to the Health and Family Life Education Policy, it is a part of the core curriculum and should be taught weekly at all grade levels.
Model of delivery
While Health and Family Life Education has been prepared as a stand-alone curriculum, it is integrated into other subjects.
Comprehensiveness of content
In the CARICOM 2020 Health and Family Life Education Regional Curriculum Framework for primary school and the regional CARICOM standards, standards and objectives are organized around four themes: Sexuality and Sexual Health; Self and Interpersonal Relationships; Eating and Fitness; and Managing the Environment. For Sexuality and Sexual Health, students are expected to ‘demonstrate an understanding of the concept of human sexuality as an integral part of the total person that finds expression throughout the life-cycle; analyse the influence of socio-cultural and economic factors, as well as personal beliefs on the expression of sexuality and sexual choices; build capacity to recognise the basic criteria and conditions for optimal reproductive health; develop action competence to reduce vulnerability to priority problems, including HIV/AIDS, cervical cancer, and STIs; and develop knowledge and skills to access age-appropriate sources of health information, products, and services related to sexuality and sexual health.’
In the implementation of Health and Family Life Education in Jamaica, there is more emphasis on students acquiring life skills. The curriculum was developed by representatives of the Ministry of Education with the support of international organizations such as UNICEF, UNESCO, UNFPA, the National Family Planning Board and the National HIV Programme. The programme is developed around the same four themes as the regional framework. In a 2007 curriculum for Health and Family Life Education in grades 7-9, content includes lessons on the reproductive system, puberty, self-esteem, interpersonal relationships, gender roles, sexual content in media, STIs and HIV & AIDS, contraception, and how to access reproductive healthcare.
The more recent Jamaican Health and Family Life Education curriculums (published in either 2012 or 2016) could not be found.
Learning resources
The 2009 Health and Family Life Education Teacher Training Manual by the Ministry of Education is available as a resource. It includes lesson plans, resources, activities and rubrics for assessment. The curriculum guides also provide lists of further resources for teachers to use in their classrooms. The CARICOM 2020 Health and Family Life Education Regional Curriculum Framework also provides sample lesson plans and resources for teachers.
The Health and Family Life Education Policy called for the creation of relevant learning resources that were creative, age-appropriate, gender-sensitive and youth- friendly. They were also required to include all forms of media that would facilitate interactive learning and be appropriate for students with special needs.
3.4. Teachers
A conceptual framework and training guide has been developed by CARICOM to train Health and Family Life Education teachers in the Caribbean region. Suggested competencies include: an appreciation of local factors and context; basic knowledge of health problems which children and youth are vulnerable to; the setting up of learning experiences for children that will enable them to critically analyse, make decisions, and develop skills to maintain their own health; the setting up of participatory, experiential and action-oriented experiences; the development of appropriate evaluation strategies; and maintenance of personal health. The framework also contains a matrix of standards for teachers based on five themes. For the Human Sexuality theme, teachers are expected to demonstrate an understanding of human sexuality, assess risks and consequences of unhealthy sexual choices scientifically and with cultural considerations, and use health information, products and available services to take the necessary precautions to protect reproductive health.
The 2011-2020 National Education Strategic Plan established a licensing system for teachers in Jamaica. The Health and Family Life Education Policy ensures that Health and Family Life Education is offered as a compulsory subject in all teacher training institutions. Ongoing in-service training and training opportunities will be provided by the Government and non-governmental organizations to help teachers with the implementation of the curriculum in the formal and non-formal sectors. A year-long professional training course on Health and Family Life Education Instruction is provided for in-service teachers at the University of the West Indies.
3.5. Schools
Principals are required to designate school personnel to establish and maintain an area for students to access information on health services. The National Integrated Strategic Plan for Sexual and Reproductive Health & HIV ensures the availability of youth-friendly services within all health facilities. The Jamaican 2007 Health and Family Life Education curriculum teaches young people how to access information and services for reproductive health such as ‘contraception, teen pregnancy, support for pregnant teens, abuse, coping with violence, avoiding cigarettes, as well as drug and alcohol abuse, and finally incest and rape’.
4. Governance
4.1 Responsible ministries
The Ministry of Education is the agency with principal responsibility for implementing the Health and Family Life Education programme.
The Ministry of Health is responsible for the SRH of youth.
The Ministry of Youth, Sports and Culture has the chief responsibility for gender affairs.
4.2. Level of responsibility/decentralization and autonomy
School principals are responsible for timetabling, implementation and delivery of the Health and Family Life Education programme. Teachers are asked to plan, implement and evaluate age-appropriate lessons for students.
4.3. Government budget allocation
National funding for Health and Family Life Education was provided by the Jamaican government in 2012.
5. Monitoring and reporting
The Statistical Institute of Jamaica collects data on the education system in Jamaica. However, details on the monitoring of sexuality education could not be found. The Health and Family Life Education Policy recognizes the importance of monitoring and evaluation, stating that ‘monitoring and evaluation is critical to assess whether the HFLE programme objectives are being achieved. Both processes can be used to track progress and make any adjustments/corrections necessary.’ Health promotion education officers and designated school personnel are deployed to each regional education authority/agency to monitor the implementation and delivery of the Health and Family Life Education programme. Teachers provide accurate and timely data to inform the programme reviews. At the regional level, the Education Development Center conducts monitoring and evaluation on the Health and Family Life Education programme.
