Comprehensive Sexuality Education
1. Context and background
Liberia has a high fertility rate and a large youth population under the age of 25. According to Liberia’s 2019 Demographic Health Survey, the country has a high prevalence of teenage pregnancy, which increases with age. The prevalence of early pregnancy is higher in rural areas than in urban areas. Early childbearing is also higher among young women with no education compared to those with senior secondary education. Although the infant mortality rate has been decreasing, Liberia’s maternal mortality rate remains one of the world's worst. Violence against women has also been on the rise over the years, with over half of women experiencing some form of spousal emotional, physical, or sexual violence. Child marriage is an ongoing issue, with more than one-third of girls marrying before they turn 18. Female genital cutting affects more than two-thirds of women and girls. The level of HIV knowledge among youth is also low.
Life Skills Population Family Life Education was first introduced in 1999, and integrated into the science, mathematics and social studies curricula. Recent policy has mandated that age-appropriate and gender-sensitive sexuality education is provided for all adolescents in the country.
2. Terminology
The Public Health Law (revised in 2019) defines sexuality education as 'the provision of information about bodily development, sex, sexuality, and relationships, along with skills-building to help young people communicate about and make informed decisions regarding sex and their sexual health'.
3. Laws and policies
3.1. Relevant international/regional agreements to which Liberia is a signatory
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INTERNATIONAL |
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Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 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) Ratification date: 1993 |
Commits to the right to access appropriate health-related information. |
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Convention on the Rights of Persons with Disabilities (CRPD) Ratification date: 2012 |
Commits to the highest attainable standard of health for persons with disabilities. |
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International Covenant on Economic, Social and Cultural Rights Ratification date: 2004 |
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 Ratification date: 1962 |
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
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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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Ministerial Commitment on comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in Eastern and Southern African (ESA) Not ratified |
Commits to ensuring comprehensive sexuality education and sexual and reproductive health services for young people. |
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3.2. Relevant national laws and policies mandating comprehensive sexuality education
The Public Health Law (revised in 2019) establishes that all adolescents have the right to attain the highest standard of age-appropriate and gender-sensitive sexuality education and to make informed choices regarding access to sexual and reproductive health (SRH) care services free from discrimination, coercion, or violence. The Law instructs the Ministry of Health to work with the Ministry of Education, the Ministry of Gender, and the Ministry of Youth and Sports to ensure access to quality sexuality education. The Law mandates the inclusion of quality sexuality education into the curriculum of the basic primary, secondary and tertiary levels, including formal, non-formal and indigenous learning systems. In addition, the legislation mandates collaborative work with the Ministry of Youth and Sports to ensure out-of-school adolescents receive quality sexuality education in community settings. When the integration of the information into the curricula is considered inappropriate, the aforementioned ministries shall develop special modules and strategies for sexuality education.
In 1999, Life Skills Population Family Life Education was introduced and integrated into the science, mathematics and social studies curricula. In 2019, Liberia launched the reformed national curriculum. The new curriculum is competency-based, with students acquiring life skills together with academic learning. The new curriculum for both public and private schools includes comprehensive sexuality education (CSE) to promote reproductive health, peace building, human rights, a general history of Africa, and other emerging issues that are based on skills development rather than content development. Relevant teaching-learning materials including textbooks, workbooks and teacher guides are not provided. The primary goal of sexuality education programmes is to reduce the risks of potentially negative outcomes from sexual behaviour, especially early sexual behaviour, such as early and unintended pregnancy and STIs, including HIV. The programme also focuses on effective behaviours such as avoiding sexual intercourse through abstinence, the consistent and correct use of condoms, and identifying forms of pressure to have sexual intercourse.
The 2010 National Sexual & Reproductive Health Policy (Ministry of Health & Social Welfare) aims to provide essential sexual reproductive health (SRH) services, including maternal and newborn health, family planning, and quality care to survivors of gender-based violence and sexual gender-based violence. The Policy seeks to encourage schools to incorporate information on sexual gender-based violence and the prevention of domestic violence into health education curricula. Goals include preventing and managing STIs and HIV, and ensuring that adolescents have adequate access to the full range of SRH services. In 2009, the Government launched the Education Sector HIV and AIDS Policy with the objective of preventing the spread of HIV and other STIs, and protecting, supporting and mitigating the social and economic impacts of HIV & AIDS on staff and learners in the education sector by 2013. The sector policy aligns with the National HIV & AIDS Strategic Plan, the most recent iteration for the 2015-2020 period. The national Plan also calls for HIV education for in-school youth, as well as SRH and HIV education for out-of-school youth.
Under the Vulnerable Girl Project (2018), the Government provided educational opportunities for 152 girls from under-privileged and vulnerable contexts between the ages of 10-17 to ensure access to, and retention at, school. A code of conduct and students’ handbook was developed, and a health club was established to guide the girls in SRH education issues.
The National Health and Social Welfare Plan (2011-2021) focuses on increasing access to health and social welfare, and increased utilization of it. The Plan addresses adolescent SRH through two types of programmes: behaviour change communication programmes, and information, education and communication programmes on SRH, HIV and sexual gender-based violence. The integration of youth-friendly services into health facilities is seen as having the potential for greater youth participation in these programmes.
3.3. Curricula
Mandatory or optional
According to the Public Health Law (revised in 2019) sexuality education is mandatory.
Model of delivery
Sexuality education is treated as a cross-cutting them, and not as a stand-alone subject, and it is also integrated into extra-curricular programmes.
Comprehensiveness of content
The law mandates that sexuality education should include information about puberty and reproduction; abstinence; contraception and condoms; relationships; sexual violence prevention; and body image. The education sector should also provide lessons and activities promoting equality between men/boys and women/girls. There is zero tolerance for any form of violence against women and girls or any form of sexual exploitation of children. Students should also know how to reduce or eliminate the risk of sexual violence and coercion. Life skills, such as self-esteem, are also included in the curriculum.
The provision of information on the causes, modes of transmission and ways to prevent STIs, including HIV, is also mandated. The sexual and reproductive rights and responsibilities of girls and boys, including girls' right to refuse sex, the right and ability to negotiate safer sex, and the right to access health and reproductive services independently; and boys' obligation to take equal responsibility for SRH; how to avoid rape, sexual assault and domestic violence, inside and outside of marriage, is also included.
According to the National HIV & AIDS Strategic Plan, HIV prevention information and education should include activities and training to promote abstinence, including delaying sexual debut, promoting fidelity (mutual faithfulness) in sexual relationships, avoiding multiple concurrent sexual partnerships, and eliminating harmful social and community practices such as female genital cutting, widow inheritance, and sexual and gender-based violence. This should be part of a balanced prevention message approach, with social marketing and messaging campaigns for the correct and consistent use of condoms in cases of high-risk sex. Activities are also to educate individuals on the availability of routine and confidential testing and counselling, which must adhere to the approved national policies, guidelines, and protocols.
The main themes addressed in the primary education in grades 1-3 (5-8 years) social studies curricula are self-identity and values; caring for sick and disadvantaged people, especially those living with HIV & AIDS; ways to protect and care for family members; and the effects of HIV on the economic status of the family. This section helps students understand self-identity, which is a key factor in understanding and accepting others and building good interpersonal relationships and values. The values component focuses on the definition of family, how it influences lives and how their expectations affect the lives of people. The objective of this component is to help students analyse and come to terms with emotions caused by problems at home and how to accept people’s diversity. It also deals with health in a broad sense (as per the WHO definition of health) and considers ways in which those who are sick can be assisted.
Themes under HIV include the definition of HIV, the identification of causes and modes of transmission and the behaviour of people living with HIV. The objectives are to discuss ways of relating to people living with HIV, understanding their needs, identifying plans for support, and ways in which to associate freely with people living with HIV. The unit on gender is concerned mainly with the roles and responsibilities of family members. The unit describes, identifies and discusses the roles, responsibilities, and relationships within the household. In Mathematics, sexuality education is covered under sets to show that boys and girls are important subsets (members) of the family. The issues of rights are not addressed under this age segment.
For students age 9-12 (grades 4-6 in primary school) the integrated Life Population Family Life curriculum for social studies addresses many relevant issues related to sexuality education, including HIV & AIDS (except for treatment). The mathematics curriculum is designed to assist students to use the concepts of these topics to understand the gravity of aspects of population dynamics in Liberia (such as the dependency ratio and the segment of the population that are most vulnerable to STDs, including HIV). Well-developed themes in the curriculum are interpersonal relationships, communication, negotiation, and decision-making, as well as human development and youth empowerment.
For students aged 12-15, the main themes addressed in sexuality education programmes have been integrated into mathematics, social studies, and science courses. The Lifeskills Population Family Life Education guide for science deals with adolescent pregnancy, STIs, and growth and development, including puberty, sex and sexuality. The mathematics guide has a portion on probability and statistics with the objectives of being able to promote family planning as it relates to marriage and calculating the probability of contracting HIV. It also aims to foster adherence to preventative measures against the spread of HIV. Topics covered in the social studies curriculum for this age group do not really cover sexuality, except for a unit on family and parenthood, which explores a number of issues related to self- identity, resistance to peer pressure for early sex, and the consequences of adolescent pregnancy.
The curriculum for students aged 15-18 addresses several issues related to sexuality. The mathematics guide covers some relevant sexuality education topics, such as measuring fertility and mortality (for example, maternal and infant mortality). The probability and statistics component measures the probability of contracting HIV and statistics for the age group most vulnerable to HIV. The objective of this unit is to enable students to avoid practices that put them at risk of getting HIV and subscribe to a healthy lifestyle. Additionally, matrices and determinants provide the skills required to analyse and construct STI networks. The social studies guide does not provide sufficient information on sexuality as social studies is not taught in high school (grades 10-12) as a core subject. The biology curriculum includes many themes on sexuality. According to the Sexuality Education Review and Assessment Tool (SERAT) many of the elements that make up a CSE programme are addressed in this curriculum.
The Ministry of Education’s Sexuality Education Programme helps students understand the physiological, social and emotional changes they experience as they mature, develop healthy and rewarding relationships, and make wise, informed, and responsible decisions on sexuality matters. Topics include some of the legal international and legal standards and documents with reference to age of consent, child marriage, rape, sexual abuse, and people’s access to SRH Services. However, laws about female genital mutilation and sexual orientation are not covered.
Learning resources
Quality teaching guidelines and materials for classroom activities are not available for all teachers and students.
3.4. Teachers
Teachers are given orientation on school life skills and HIV & AIDS, but sexuality education is not an integral component in the curriculum for the professional preparation of all new teachers. Teachers are made to understand not to pressure students to communicate about personal or sensitive topics. They are also taught that there is a wide diversity of bodies, beliefs, attitudes, behaviours, norms and values. Additionally, there are in-service training programmes for teachers on sexuality education, but not for peer educators.
The National Health and Social Welfare Plan (2011-2021) aims to train educators, but information on content could not be found.
According to the Public Health Law (revised in 2019), in order to be authorized to teach or provide information on sexuality education, teachers, instructors and any other persons involved in the lesson or teaching modules must: be qualified teachers; have access to the necessary instructional materials; be trained in the sexuality education curriculum by either the Ministry of Education, in the case of in-school instruction, or the Ministry of Youth and Sports, with respect to the out-of-school curriculum, in collaboration with the Ministry of Health.
3.5. Schools
The National Health and Social Welfare Policy and Plan's School Health Programme is jointly implemented by the Ministry of Health and the Ministry of Education and includes family planning counselling, life skills and health promotion.
According to the Public Health Law, the sexuality education curriculum should include information about where to access SRH services
4. Governance
4.1 Responsible ministries
The Ministry of Education, Ministry of Health and Ministry of Youth and Sports work together to develop and adapt the curriculum and teaching modules to each level of instruction, after consultation with student-parent associations, private schools and community groups, traditional and religious leaders, and other stakeholders.
4.2. Level of responsibility/decentralization and autonomy
No information was found.
4.3. Government budget allocation
No information was found.
5. Monitoring and reporting
There is available national-level information or data on the SRH needs of young people, indicators derived from elements of sexuality education curriculum or syllabus within the National EMIS, the National Demography and Health Survey, the National Monitoring and Evaluation Framework on HIV & AIDS, and school inspection tools. However, no data on the coverage of sexuality education programmes for young people and the cost of sexuality programmes appears to be available. There is also no data on the outcomes and impact of sexuality education programmes for young people.
