Comprehensive Sexuality Education

Ethiopia is an eastern African country located in the horn of Africa. It is one of the most populated countries in Africa with approximately 130 million residents. About 60% of residents are under the age of 25 and the median age is just 20 years. The median age for women’s first births is also around 20 years’ and on average, every woman gives birth to four children. Adolescent pregnancy rates remain high. Modern contraception use in the country has been slowly increasing, though rates remain low. One-quarter of all women, and just one-tenth of sexually active adolescents, use modern contraception methods. The rate of contraceptive use in Ethiopia is among the lowest in sub-Saharan Africa and unmet family planning needs for adolescent girls among the highest. Ethiopia has a relatively high infant and maternal mortality rate, though there have been significant improvementes in the past decade. Due to concentrated efforts by the government and international organizations, Ethiopia’s HIV rate has decreased significantly in the past few decades and is one of the lowest in the region. According to the 2021-2025 National Adolescent and Youth Health Strategy, the major sexual and reproductive health (SRH) problems among adolescents and youth include ‘risky sexual practices, child marriage, early childbearing, unintended pregnancy, unsafe abortion and its complications and STIs including HIV.’ Public education in the country is free at the primary level for children aged 7–12 years.  

Comprehensive sexuality education (CSE) has increasingly been integrated in adolescent and youth SRH programme interventions. However, levels of comprehensive knowledge on HIV continue to be low. There are many non-governmental organizations (NGOs) and other organizations in the country that teach sexuality education to the youth.

Article 35 of Ethiopias’ Constitution of 1994 guarantees the rights of women. It states that: ‘To prevent harm arising from pregnancy and childbirth and in order to safeguard their health, women have the right of access to family planning education, information and capacity.’ The federal government is obligated to establish and implement national standards and basic policy criteria while the different states are obligated to follow national standards. 

While there is no official education law in Ethiopia, legislation has been developed and is expected to be endorsed in the near future. Education is predominantly governed by the Constitution and the 1994 Education and Training Policy. According to the Education and Training Policy, the general education that will be offered will be focused on indigenous knowledge, vocational and academic subjects and ethical education, all supported by appropriated technology. 

The objectives of the 2009 Education Sector Policy and Strategy on HIV & AIDS objectives are to: ‘mainstream HIV & AIDS information, knowledge, skills, and attitudes into the school curriculum, educational materials, and research’. All learning institutions are required to integrate HIV education into formal/non-formal school curricula and programmes and put in place co-curricular activities which include the development and acquisition of age-appropriate information, knowledge and skills in relation to HIV. 

The main aim of the 2021-2025 National Adolescent and Youth Health Strategy is for the improved health status of Ethiopian adolescents and youth. Health-related goals include: ensuring a greater proportion of adolescents and youth who have comprehensive knowledge of HIV; increasing the contraceptive prevalence rate among female youth; reducing the unintended adolescent pregnancy rate; and increasing the rate of consistent and appropriate condom use among sexually active youth. One of the main areas for action is ‘increasing access to Adolescent Youth Health information and age appropriate CSE and life-skills education.’ Priority action includes the integration of ‘comprehensive life skills, family life, sexuality education and nutrition into in-school, out-of-school, and higher learning programs and training Curricula.’ The most recent strategy for the goal of the period 2021-2025 is to attain full health and well-being of adolescent and youth through ensuring equitable access and utilization of comprehensive health services. 

The 2015-2020 Education Sector Development Programme V categorizes HIV & AIDS as a cross-cutting issue in the education sector. It calls for the revision of the curriculum to integrate life skills that will increase awareness of health issues such as HIV, sexual education, and drugs and substance abuse. Delivery of the content is primarily through school clubs, student services and broadcasting local digital content. Strategies in the later 2020-2025 Education Sector Development Programme VI include, to ‘strengthen life skills, HIV/AIDS, sexual and reproductive health (SRH), gender, deworming and drug abuse education’.

Teacher preparedness and capacity building: Life-skill manuals have been developed on how to integrate HIV, SRH and gender issues into subjects such as biology, civic education and English for grades 9–12. Accordingly, teachers from all the regions and two city administrations have been trained on the manuals to deliver the contents to learners.  

Whether teachers are mandated to be trained on provision/delivery of sexuality education either as part of PRESET or INSET: Pre-service teacher training on gender and life skills is mandatory. The Education Sector Policy and Strategy for HIV&AIDS requires that PRESET and INSET teacher education must prepare educators to tackle HIV at the personal and professional levels. It states that: ‘the teacher education curriculum (pre-service and in-service) must prepare educators to respond to HIV and AIDS within their own lives, and as professionals to build positive attitudes and skills for HIV&AIDS prevention and control among all their learners.’ All teachers who complete training at teacher training institutions (TTIs) should acquire expertise in HIV prevention and mitigation through both pre-service and in-service training, and ongoing teacher development programs. HIV education is integrated into cross-cutting subjects such as developmental psychology. The policy explicitly mentions ‘capacity building and continuous professional development’ for education personnel.