Comprehensive Sexuality Education
1. Context and background
Nigeria has one of the highest numbers of HIV cases in the world, with an estimated 1.9 million people living with HIV. The Family Life and HIV Education curriculum was introduced in Nigeria in 2001, as a response to the increasing rate of STIs and HIV infection rates in the country, particularly among young people.
The first attempt at institutionalizing Family Life and HIV Education was by Action Health Incorporated, through its collaboration with the Sexuality Information and Education Council of the United States. This led to a national coalition of leading youth organizations in the country and the development of the Family Life and HIV Education curriculum by the Nigerian Educational Research and Development Council. At its 48th session in 2001, the National Council on Education formally approved a sexuality education curriculum for Nigerian schools. The curriculum was developed in 2003 by the Nigerian Educational Research and Development Council through a participatory and consultative process that involved non-governmental organizations from all regions in the country, as well as international agencies.
In principle, the curriculum’s content was comprehensive and included information on contraception, sexual abuse, gender roles, female genital mutilation, sexual orientation, masturbation, and abortion, among other subjects. However, the curriculum was met with strong resistance from religious and conservative political sectors, resulting in the content of the curriculum being diluted to cover abstinence only. In addition, the title was changed from the ‘Sexuality Education Curriculum’ to ‘Family Life and HIV Education’.
Family Life and HIV Education was introduced into schools in 2004, with 40,000 copies of the curriculum distributed to all states in Nigeria. In 2008, the Federal Ministry of Education issued guidelines for the implementation of Family Life and HIV Education in collaboration with Action Health Incorporated, to ensure adequate and effective teaching. By 2008, 34 states were at various stages of implementing the curriculum, as a stand-alone course. Starting in 2009, the Family Life and HIV Education was to be mainstreamed into various carrier subjects, depending on the particular issue covered. This was based on two main assumptions: that all the topics and issues in the stand-alone curriculums had been fully mainstreamed; and that every teacher involved in the curriculum implementation would have received focused curriculum training as a student-teacher.
2. Terminology
Sexuality education is termed 'Family Life Health Education'. In the 2003 National Family Life and HIV Education Curriculum, the term is defined as a 'planned process of education that fosters the acquisition of factual information, formation of positive attitudes, beliefs and values as well as development of skills to cope with the biological, psychological, sociocultural and spiritual aspects of human living'. Similar terminology is used in the 2021 National Policy on Safety, Security and Violence-Free Schools. The 2021-25 National HIV and AIDS Strategic Framework defines Family Life and HIV Education as a curriculum-based process of acquiring information about sexual development and reproductive health issues and life skills to enable young people to be better informed and empowered to adopt positive health and social behaviours.
3. Laws and policies
3.1. Relevant international/regional agreements to which Nigeria is a signatory
|
INTERNATIONAL |
||
|
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 1985 |
Acknowledges the need to guarantee sexuality education free from discrimination and stereotypes, conveying gender equality values. |
|
|
Convention on the Rights of the Child (CRC) Ratification date: 1991 |
Commits to the right to access appropriate health-related information. |
|
|
Convention on the Rights of Persons with Disabilities (CRPD) Ratification date: 2010 |
Commits to the highest attainable standard of health for persons with disabilities. |
|
|
International Covenant on Economic, Social and Cultural Rights Ratification date: 1993 |
Acknowledges that the right to sexual and reproductive health is an integral part of the right to health. |
|
|
UNESCO Convention against Discrimination in Education Ratification date: 1969 |
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 Endorsed by Nigeria |
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 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 |
Includes commitments to make universally accessible and available quality comprehensive sexual and reproductive health-care services, commodities, information, and education. |
|
3.2. Relevant national laws and policies mandating comprehensive sexuality education
The Federal Republic of Nigeria has 36 states and a Federal Capital Territory located in Abuja. Its legal system is a mix of states‚ legislation, customary law, Islamic law and English common law. Each state has an independent legislature. It is possible for a federal law not to be adopted by all the states, such as the 2003 Child Rights Act, which is yet to be passed by 9 northern states.
The 1999 Constitution of Nigeria states that local governments should participate in the provision and maintenance of primary, adult and vocational education, as well as the provision and maintenance of health services.
Education is regulated at the federal, state, and local levels. Federal education laws in Nigeria do not mention comprehensive sexuality education- (CSE) -related issues. The 2004 Universal Basic Education Act makes no reference to reproductive health education, HIV, or family life education.
Policies, plans and strategies mainly support the implementation of Family Life Health Education.
The 2005 National Policy on HIV and AIDS for the Education Sector provides a framework for guiding the formulation of appropriate interventions, which will be effective in: preventing transmission of HIV & AIDS and other STIs; protecting and supporting vulnerable groups; and mitigating the social and economic impacts of HIV & AIDS in the sector. One of the objectives of the policy is to promote awareness and to educate young people on HIV & AIDS and other STIs, specifically aiming for the Family Life and HIV Education curriculum to be produced, distributed, and implemented nationwide at all levels of the education system. It specifically states that the education system should guarantee universal access to quality HIV & AIDS preventative education, which also includes HIV & AIDS prevention and awareness training programmes and the establishment of functional anti-HIV clubs.
The 2017-21 National HIV and AIDS Strategic Plan identifies Family Life and HIV Education as a key strategy for reducing the incidence of HIV in Nigeria. It specifically supports: the expansion of access by in- and out-of-school youth to Family Life and HIV Education, which includes reviewing policies, guidelines and coordinating structures to create an enabling environment for implementation; the monitoring of a sustainable Family Life and HIV Education programme; and building in-school teacher capacity on gender and cultural sensitivity in the delivery of the Family Life and HIV Education curriculum.
The 2016-20 National HIV Strategy for Adolescents and Young People similarly promotes intensive sexual health education, through the combination of teacher-led activities, peer-led activities, and the use of media to relay messages.
The 2021-25 National HIV and AIDS Strategic Framework also has a dedicated section on Family Life HIV & AIDS Education with similar objectives.
The 2020-24 National Policy on the Health and Development of Adolescents and Young People in Nigeria has one of its priority programmatic areas and targets focused on sexual reproductive health (SRH) and rights, urging Ministries of Education to review and revise the Family Life and HIV Education curriculum to ensure that it responds to the changing needs of adolescents and young people and conforms to global best practices in CSE curriculum design and delivery. It also aims to scale up teacher training in Family Life and HIV Education, as well as to expand the coverage and effectiveness of the programme at all levels of formal education, integrating it into mass literacy, and adult and non-formal educational programmes to cater for out-of-school adolescents and other young people; monitor its implementation at all levels; and ensure its effective implementation through curricular, co-curricular, and extra-curricular approaches, as well as the adoption of innovative processes and technologies. Specific targets include for: at least 75% of students in upper primary and secondary school students (private and the public sector) to be provided with school-based family life and HIV education by 2024; increasing the proportion of adolescents and young people (15-24 years) who have comprehensive knowledge of HIV transmission to at least 80% by 2024; and for at least 80% of early adolescent girls (10-14 years) and 67% of early adolescent boys (age 10-14 years) to have adequate knowledge regarding menstruation and menstrual hygiene management by 2024.
The 2021 National Policy on Safety, Security and Violence-Free Schools sets guidelines to address and respond effectively to sexual and gender-based violence, abduction, rape, forced marriage, sexual assault and harassment in schools. It specifically highlights that training in health promotion strategies, disease prevention concepts, health-enhancing behaviours and life skills form an important component of the school curriculum and should be appropriately tailored to suit different age groups. The policy establishes the roles and responsibilities of stakeholders in ensuring safe, secure, and violence-free schools. Parent-teacher associations need to have a role in ensuring that life skills and Family Life Health Education are adequately taught to learners.
The 2021 National Policy on Gender in Education aims to carry out gender-responsive sensitization at all levels of education on SRH. This includes the production and dissemination of gender-sensitive information, awareness materials on informed sexual choices, maturation, and confidence-building strategies. These will involve the use of banners; posters; information, education and communication materials; jingles; flyers; and so on.
The 1996 Guidelines for Comprehensive Sexuality Education in Nigeria were published by Action Health Incorporated to support the implementation of CSE in Nigerian schools.
The 2018-22 Education for Change Ministerial Strategic Plan mentions life skills, but not HIV or family life education.
3.3. Curricula
According to the 2021-25 National HIV and AIDS Strategic Framework, the Family Life and HIV Education curriculum is comprised of three components: classroom delivery; communication of reproductive health and HIV prevention information to students on the school assembly ground; and peer education combined with peer-led informal strategies for prevention messaging. The curriculum is implemented in educational institutions including lower and upper primary, junior and senior secondary schools. The different age groups at the different levels inform the content of the curriculum implemented at each level, to ensure age-appropriate teaching and learning materials.
Mandatory or optional
The Family Life and HIV Education curriculum is mandatory, as issues relating to CSE are mainstreamed into mandatory school subjects at different levels.
Model of delivery
The National Council on Education formally approved Family Life and HIV Education curricula at the basic, secondary and tertiary levels as stand-alone documents in 2002. In 2007, the relevant issues and topics from the curricula were mainstreamed into specific subjects such as social studies, physical and health education, basic science, and English studies in junior secondary schools levels 1-3, indicating various degrees of incorporation. In 2009, the integration of the relevant issues into various subjects at other levels was completed. However, there is a significant gap in how all the issues covered in stand-alone curricula have been mainstreamed into different subjects.
For children at lower primary level (ages 5-8) the way the content addresses issues related to body parts, how people can help each other, right of the child to care, attention and protection by parents is considered to be weak. The curriculum does not cover issues related to feelings, human rights, gender, and social norms. With regard to sexual health content, the secondary school Family Life and HIV Education curriculum is mainly focused on abstinence, omitting other issues such as abortion, contraception use, masturbation, and sexual diversity.
At upper primary level (ages 9-12), the curriculum covers issues including values for healthy interpersonal relationships, behaviours that eliminate or reduce risky pregnancy or STIs, such as abstinence, condoms and contraceptives and non-penetrative sexual behaviour, effective communication, decision-making, and treatment for AIDS & HIV treatment. Other key topics such as feelings, human rights, gender and social norms are either not reflected or inadequately dealt with relative to global best practice.
At junior secondary level (ages 12-15), there is contents related to knowledge with specific reference to the harmful effects of discrimination, stigma and bullying including people living with HIV & AIDS, and the use of condoms and contraceptives to reduce unintended consequences.
The senior secondary school curriculum (15-18 years) largely indicates weak features due to wide discrepancy between its content and the SERAT.
At lower primary (ages 5-8), the subjects into which issues related to Family Life and HIV Education are mainstreamed include: i) physical and health education; ii) civic education; iii) Christian religious studies; iv) home economics; v) social studies; vi) culture and social values; vii) religion and national values; and viii) basic science.
At upper primary (ages 9-12), the subjects include i) basic science & technology; ii) science; iii) creative and cultural arts; iv) religion and national values; v) social studies; and vi) English Language.
At junior secondary (ages 12-15), subjects include: social studies; ii) mathematics; iii) basic science; iv) Islamic studies; v) computer studies; vi) cultural and creative arts; vii) business studies; viii) Igbo Language; ix) home economics; x) physical and health education; xi) Yoruba Language; xii) Christian religious studies; and xiii) Hausa Language.
At senior secondary level (ages 15-18), subjects include: i) civic education; ii) English Language; iii) biology; iv) government; v) music; and vi) health education.
Comprehensiveness of content
The Family Life and HIV Education curriculum comprises five themes: i) human development (puberty, body image); ii) personal skills (values, self-esteem, goal-setting, decision-making, communication, assertiveness, negotiation, finding help); iii) HIV infection (STIs, HIV, abstinence, body abuse); iv) relationships (families, friendship, love); v) society and culture (humanity, cultural norms, gender roles, humanity and the law, religion, diversity, arts and media). Each theme comprises learning contents and activities, teaching and learning materials, and appropriate evaluation guides.
In 2018, a comprehensive assessment of the Family Life and HIV Education programme was conducted, using UNESCO’s global Sexuality Education Review and Assessment Tool (SERAT) to gain empirical insight into the extent to which Family Life and HIV Education enables young people to access comprehensive sexuality information and prevent HIV.
For children aged 5-8 (lower primary), how the content covers issues related to body parts, how people can help each other, right of the child to care, attention and protection by parents is considered to be weak. The curriculum does not cover issues related to feelings, human rights, gender, and social norms. With regard to sexual health content, the secondary school Family Life and HIV Education curriculum is mainly focused on abstinence, omitting other issues such as abortion, contraception use, masturbation, and sexual diversity.
At upper primary level (ages 9-12), the curriculum covers issues including values for healthy interpersonal relationships, behaviours that eliminate or reduce risky pregnancy or STIs such as abstinence, condoms and contraceptives and non-penetrative sexual behaviour, effective communication, decision-making, and the treatment of HIV & AIDS. Topics that are effectively covered include: parts of the body, values, goal-setting, decision-making, communication, and HIV transmission, humanity and religion, and humanity and diversity. Other key contents such as feelings, human rights, gender and social norms are either not reflected or are inadequately dealt with relative to global best practice.
At junior secondary level (ages 12-15), there is contents related to knowledge with specific reference to the harmful effects of discrimination, stigma and bullying, including people living with HIV & AIDS, and the use of condoms and contraceptives to reduce unintended consequences. A number of issues and topics were effectively mainstreamed into subjects: puberty, values, STIs and HIV, families, humanity and society, humanity and religion, humanity and diversity, humanity and the arts, and humanity and the media. Decision-making and communication were adequately mainstreamed.
The senior secondary school curriculum (15-18 years) largely indicates weak features due to the wide discrepancy between its content and the SERAT indicators.
According to the 2021-25 National HIV and AIDS Strategic Framework, the Family Life and HIV Education programme needs to be urgently reinvigorated nationally, better supported, and expanded to also reach out-of-school youth. The 2020-24 National Policy on the Health and Development of Adolescents and Young People similarly supports the review and revision of the Family Life and HIV Education curriculum to ensure that it responds to the changing needs of adolescents and young people and conforms to the global best practices in CSE curriculum design and delivery.
Learning resources
According to the 2003 National Family Life and HIV Education Curriculum, different teaching and learning materials are suggested for teaching activities: labels, posters, charts with places to go to for help, magazines, pictures and films, among others. The curriculum also covers the provision of hygiene products for boys and girls.
3.4. Teachers
The Family Life and Emerging Health Issues curriculum was introduced in 2010 to tackle the shortage of qualified Family Life and HIV Education teachers in Nigerian schools. The goal was to guide and quicken the scaling up of pre-service teacher training and the effective implementation of the Family Life and HIV Education curriculum in the country.
Several government policies aim to strengthen teacher training in Family Life and HIV Education. The 2005 National Policy on HIV and AIDS for the Education Sector states that all staff within the sector shall be fully informed and involved, as appropriate, on HIV & AIDS education programmes through additional professional education that may be required and all pertinent information materials (information, education and communication, and behaviour-change communication) on AIDS. These materials should also be updated and supplied to all duty stations by Ministries of Education and their affiliates. The 2021-25 National HIV and AIDS Strategic Framework and the 2017-21 National HIV and AIDS Strategic Plan similarly support the in-school training of teachers on gender and culturally sensitive Family Life and HIV Education. Finally, the 2020-24 National Policy on the Health and Development of Adolescents and Young People aims to scale up the training of teachers in Family Life and HIV Education as well as expand its coverage and effectiveness at all levels of formal education.
To ensure extensive coverage among student teachers, the Family Life and Emerging Health Issues curriculum was designed as a compulsory course for first-year students in colleges of education.
3.5. Schools
Nigeria has several policies that support access to school-based SRH services.
The 2005 National Policy on HIV and AIDS for the Education Sector provides for voluntary counselling and testing to be made available to learners, staff, spouses and their children, either at on-site voluntary counselling and testing services within the sector, or through linkages with reproductive health clinics. The education sector works in collaboration with Ministries of Health to strengthen school-based clinics and referral systems to ensure that orphans and vulnerable children who are adolescents have access to reproductive health services. Costs are borne in line with the Ministries of Education and private educational institutions' medical benefits policy, as applicable. This aims to ensure that work and learning environments are healthy and safe for the prevention of the transmission of HIV. The policy also aims for quality male and female condoms to be made available to staff. Access is either free or subsidized.
The 2020-24 National Policy on the Health and Development of Adolescents and Young People aims to strengthen the capacity of the school health system and its linkage with the health sector, to improve the health knowledge, health literacy, and self-care competencies of school-attending adolescents and youths, and to facilitate their access to relevant health and health-related services. One of its policy objectives includes the provision of improved and equitable access of adolescents and young people to a comprehensive range of adolescent- and youth-friendly services in the health facility, school, and community setting. Specific policy targets are that at least two-thirds of all public and private sector primary and secondary schools will have a school health service or be linked to such a service by 2024.
The 2010 National Action Plan for Advancing the Health and Development of Young People plans for the integration of adolescent youth-friendly health services into the primary health centre system as one of the key actions for improving the access of young people to appropriate youth-friendly services, as part of a strategy to achieve universal health coverage and, by extension, improving their SRH.
The 2021 National Policy on Gender in Education similarly aims to provide access to gender-friendly health care services at all levels of education, in line with SDG 3. This includes the provision of counselling clinics, resource and information centres, updating health care centres at all institutions with gender-friendly facilities and state-of-the-art infrastructure, carrying out gender-responsive sensitization on SRH at all levels of education, and conducting advocacy on gender-responsive sexual and health education.
The 2021 National Policy on Safety, Security and Violence-Free Schools supports the provision of emergency and primary health care facilities and first aid to schools in council areas that do not have such facilities.
4. Governance
4.1 Responsible ministries
The Federal Ministry of Education has overall responsibility for the coordination and implementation of Family Life and HIV Education curricula in Nigerian schools, including the design, endorsement and distribution of the materials, as well as the revision of the Family Life and HIV Education curricula and other learning materials, such as teaching aids and guides, teacher training in Family Life and HIV Education, and monitoring implementation at all education levels. The Ministry has an established HIV Unit, which plays a crucial role in ensuring comprehensive HIV knowledge in schools. It works with relevant agencies and partners such as the Nigerian Education Research and Development Council, Action Health Incorporated, the National Agency for the Control of AIDS, the Association for Reproductive and Family Health, among others, to provide the institutional structure for the implementation of Family Life and HIV Education curricula.
The Federal Ministry of Health is responsible for the development and implementation of national standards, minimum health packages, tools, instruments and materials in support of adolescent/youth-friendly health services in Nigeria, including clinical, counselling and health communication services. It collaborates with the Federal Ministry of Education to strengthen school-based clinics and referral systems. The Gender, Adolescent, School Health and Elderly division of the Department of Family Health of the Federal Ministry of Health is the secretariat of the National Adolescent Health and Development Working Group. Its functions include the provision of leadership for programmes in Gender, Adolescent School Health and Elderly Care, the coordination of activities in Gender, Adolescent School Health and Elderly Care Programmes, management resources for Gender, Adolescent/School Health and Elderly Care Programmes, and other functions assigned by the Minister of Health through the head of department.
Non-governmental organizations have also been central to the development and scaling up of the Family Life and HIV Education programme, which was initially integrated into official government programmes. Three categories of organizations played complementary roles in this: youth and reproductive health-oriented non-governmental organizations, which have been central to the development and scaling up of Family Life and HIV Education, providing in-service teacher training and ongoing support to schools; secondary schools involved in classroom teaching and extracurricular activities; and teacher training institutes delivering training to student teachers. Action Health Incorporated supported the development of the Family Life and HIV Education curriculum, conducted advocacy that led to strong gender content in the programme, and supported the development and implementation of a teacher training curriculum.
4.2. Level of responsibility/decentralization and autonomy
The nationwide programme to scale up Family Life and HIV Education was decentralized to all 36 states and is credited with reaching near-nationwide implementation, with the decentralized model allowing for tailored implementation across all 36 states. Individual states are responsible for rolling out and scaling up the Family Life and HIV Education programme. The Federal Government has given all states the permission to modify the content of the Family Life and HIV Education curriculum to adopt to local circumstances so that content can be tailored to conform with local socio-cultural sensitivities. State implementation involves partnerships with Ministries of Education and non-governmental organizations.
4.3. Government budget allocation
National scale-up efforts of Family Life and HIV Education are funded jointly by the Government at the federal and state levels, along with a range of donors. No information was found on exact government budget allocation.
5. Monitoring and reporting
According to the SERAT analysis, there is a lack of a monitoring and evaluation framework for sexuality education implementation. Although the Guidelines for Implementing the National Family Life and HIV Education Curriculum included a monitoring and evaluation component, this activity was undertaken very infrequently when it was implemented as a stand-alone subject. The 2021-25 National HIV and AIDS Strategic Framework and the 2020-24 National Policy on the Health and Development of Adolescents and Young People also support the monitoring of National Family Life and HIV Education implementation at all education levels.
Different surveys have been conducted to determine the SRH situation of young people, including the National HIV and Reproductive Health Survey, the National Demographic Health Survey, and the HIV Sentinel Survey, but these do not offer insight into the delivery or quality of Family Life and HIV Education.
