Comprehensive Sexuality Education

1. Context and background

The first National Adolescent Health and Development Strategy was launched by Nepal’s Ministry of Health and Population in 2000. The National Adolescent Sexual and Reproductive Health (SRH) Programme, which forms part of the Strategy, has been implemented since 2010. Components of Comprehensive Sexuality Education have been incorporated into the curriculum, starting in 2000 in the Health and Population Education curriculum in grades 9 and 10, and then in grades 6, 7, and 8 in 2002. According to the 2020 revised curriculum, Health, Physical Education, and Creative Arts is a compulsory subject for grades 4-8. On the other hand, for grades 9-10, Health, Population and Environment is an optional subject.

Although many policies have been introduced to include components of CSE into formal education, school-level sexuality education has been met with strong objections and concerns from most actors of society, including parents, teachers, politicians, and others, as it is perceived to be too sensitive an issue to include in general school education.

2. Terminology

A definition of 'comprehensive sexuality education' (CSE) was not found.

3. Laws and policies

3.1. Relevant international/regional agreements to which Nepal is a signatory

INTERNATIONAL
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 1991	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: 1990	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: 1991	Acknowledges that the right to sexual and reproductive health is an integral part of the right to health.
The 1994 International Conference on Population and Development (ICPD) Programme of Action The country attended the conference	Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics.
REGIONAL
The Asia and Pacific Ministerial Declaration on Population and Development (2013) (Asia Pacific) The country voted in favour of the declaration	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 first National Adolescent Health and Development Strategy was launched by Nepal’s Ministry of Health and Population in 2000. References to some components of CSE are also included in the Population and Reproductive Health Policy (2003), the National Nutrition Policy and Strategy (2004), the National AIDS/STI Policy (2011), the National Youth Policy (2010), and the Education Sector Policy on HIV in Nepal. The National Youth Policy (2010) refers to the inclusion of health education in the curriculum and education on sexual health safety, with a particular focus on sexual violence and HIV prevention. References to life-skills development are made in the Non-formal Education Policy, although there are no details on the content. Both the National Health Policy (1991) and the Second Long Term Health Plan (1997-2017) note the need for the provision of adolescent reproductive health services. Nepal’s 2018 Right to Safe Motherhood and Reproductive Health Act mandates unbiased, non-judgemental SRH services to be provided to adolescents and to be disability-friendly. The Act also aims to expand and improve the quality of reproductive health care services and prohibits discrimination against people accessing reproductive health care. In addition, it requires the provision of free reproductive health services from the Government and addresses the right to safe abortion.

The 2019 National Education Policy and the Nepal National Education Framework 2030 ensure inclusive and equitable access to quality education for all Nepali citizens. Through the School Sector Development Plan 2016/17-2022/23, the Government of Nepal has affirmed its commitment to integrating age-appropriate CSE in formal and non-formal education, as well as to build human resource capacity through introducing CSE modules into the mandatory in-service teachers’ training.

The National Adolescent Sexual and Reproductive Health (SRH) Programme has been implemented by the Ministry of Health and Population since 2010. The Ministry updated the National Adolescent Health and Development Strategy in 2018 to include adolescent-friendly services in public health facilities and CSE in schools.

3.3. Curricula

Mandatory or optional

The 2020 revised curriculum makes Health, Physical Education and Creative Arts compulsory for grades 4-8 (upper primary level and lower secondary level); Health, Population and Environment is optional for secondary education.

Model of delivery

In 2020, the curriculum for grades 4-12 was revised and CSE components were introduced into specific subjects. According to the amended curriculum, Health, Physical Education, and Creative Arts is mandatory for grades 4-8 (upper primary and lower secondary). At secondary level (grades 9-10) Health, Population, and Environment is optional.

Comprehensiveness of content

Although there is no specific CSE curriculum, certain components and topics are included, such as: puberty; the definition of sexuality; the concept and importance of SRH; the anatomy and physiology of the male and female reproductive systems; family planning methods; abortion; STIs; menstruation; the definition of gender; HIV; and adolescent-friendly health services. However, the content is not comprehensive as it does not cover all components recommended in international guidance. SRH rights are not introduced with clarity, and the concept is largely limited to biological aspects rather than from a human rights perspective. For example, it includes the anatomy of the reproductive organs, the reproductive process, family planning methods, STIs and HIV, and abortion, but it does not address the concepts of virginity, abstinence, faithfulness, the correct way to use a condom and other family planning devices. Nor is there adequate information on adolescent-friendly health services. The curricula also lack appropriate information about sexual rights, pleasure and diversity. Sexual violence is not mentioned, and nor are the characteristics of healthy and unhealthy relationships, issues of trust, and friendships.

Learning resources

The Government has endorsed the teacher training guide and teacher’s resource materials on CSE. This manual is used to train teachers for the delivery of CSE in schools.

3.4. Teachers

No information was found on teacher preparedness and capacity building. No CSE curriculum content has been incorporated into the in-service teacher training courses. However, at the policy level, the School Sector Development Plan 2016/17 – 2022/23 aims to provide pre-service training and in-service training in CSE.

3.5. Schools

The curriculum lacks information about available health services, resulting in the underutilization of designated adolescent-friendly health services and safe abortion sites. In 2020, the Government endorsed the Adolescent Friendly Information Corner operational guidelines, to ensure that the Information Corners operate at a high standard, to improve access to CSE information and education materials.

4. Governance

4.1 Responsible ministries

The Curriculum Development Centre has been the leading government agency to design and implement the Health, Population and Environment curricula. Local and international non-governmental organizations have been collaborating around advocacy, funding and the provisions of resources. Some studies point to the lack of coordination between the Ministry of Education and the Ministry of Health regarding the implementation of CSE programmes in schools.