Comprehensive Sexuality Education
1. Context and background
Tunisia is a North African country with a population of over 11 million, of whom about 18% are of school-going age. The country has made progress in improving the state of the population’s health, particularly in terms of reducing the rates of maternal, infant and neonatal mortality. However, gender-based violence (GBV) is a major challenge and there is a need to accelerate the achievement of effective sexual and reproductive health (SRH) education.
Tunisia is an exception in the region in that it has initiated population policies, starting in the 1960s, as part of a plan to have an integrated approach to solving demographic and development problems. From the demographic point of view, since the (early) 2000s, Tunisia has recorded the end of the period of demographic transition under family planning programmes and an increase in the age of marriage. Demographic trends over the past five years show the stabilization of the population growth rate, the synthetic fertility index, and the crude birth rate.
In 2019, Tunisia mainstreamed a Comprehensive Sexuality Education (CSE) framework into the school curriculum, mandating sexuality education for all learners in the 5–18 age range. In 2020, a pilot programme for sexual health education was implemented in primary schools in 13 pilot governorates. The instruction is geared toward children beginning at age 5 and is based on age-appropriate objectives, reference systems, and educational tools.
For the CSE framework, the Ministry of Education established a group of experts including representatives from the Ministry of Health; the Ministry of Women, Family and Children; education unions; teachers; and youth. They worked together to integrate topics and learning objectives guided by the revised International Technical Guidance on Sexuality Education (ITGSE) into the curriculum across several subjects, which also took the local context into account. There has been some opposition from parents, conservative political parties and religious leaders throughout the process, and efforts have been made by the Ministry of Education, UNFPA and civil-society organizations (CSOs) to address misconceptions and ensure that the broader community understands the rationale for CSE.
2. Terminology
The term ‘health education’ is used in the National Plan of Sexual and Reproductive Health 2021-2030. Organic Law No. 2017-58 mentions the term ‘health and sexuality education’.
3. Laws and policies
3.1. Relevant international/regional agreements to which the country is a signatory
INTERNATIONAL |
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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. |
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Convention on the Rights of the Child (CRC) Ratification date: 1992 |
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: 2008 |
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: 1969 |
Acknowledges that the right to sexual and reproductive health is an integral part of the right to health. |
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The 1994 International Conference on Population and Development (ICPD) Programme of Action |
Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics. |
3.2. Relevant national laws and policies mandating comprehensive sexuality education
Article 7 of the 2017 Organic Law No. 2017-58 relating to the elimination of violence against women establishes that the ministries responsible for education, higher education, vocational training, culture, health, youth, sport, childhood, women and religious affairs must take all the necessary measures to prevent and combat violence against women in institutions under their jurisdiction. Initiatives include the development of educational and cultural programmes to prohibit and combat violence and discrimination against women, to enshrine the principles of human rights and gender equality, as well as programmes on health and sexuality education.
The National Plan of Sexual and Reproductive Health 2021-2030 was developed to guide the implementation of an integrated approach to sexual and reproductive health (SRH) planning and programming over the next 10 years. It includes target 3, which aims to ensure that more than 80% of adolescents and young people benefit from sexuality education. Specifically, target 3.1 is to: ‘Generalize Comprehensive Sexuality Education (CSE) programmes on a regular basis and adapt to the different target audiences in order to develop individual skills for SRH. It also aims to develop sexuality and family life education programmes for adolescents and young people in community settings, in educational settings and at all levels of care.’
According to the National Multisectoral Adolescent Health Promotion Strategy and Youth 2020-2030,programmes and interventions targeting the positive health development of adolescents and young people essentially revolve around five components: i) health promotion in schools; ii) hygiene and nutrition,; iii) the contribution of health services to mechanisms and programmes for the protection of children; iv) health education; and v) the promotion of the skills in preventing the use of psychoactive substances in the school environment or risks in SRH.
3.3. Curricula
Mandatory or optional
No information was found.
Model of delivery
Sexuality education will not be taught as an independent subject but will be integrated into other subjects in the curricula, such as Arabic, physical education and earth sciences.
Comprehensiveness of content
Information on the pilot programme being implemented was unavailable to access.
Learning resources
Teaching and learning resources that support the CSE framework have also been developed, and braille and audio adaptations are planned to be made for learners with disabilities. There are plans for all teaching and learning tools to be made available online.
3.4. Teachers
Teacher preparedness and capacity building: No information was found on binding regulations on CSE teacher training.
At a policy level, the National Plan of Sexual and Reproductive Health 2021-2030 includes setting up key tools in higher education and vocational training establishments, creating clubs, and ensuring the training and coordination of teams of SRH education work towards a view to strengthening CSE in these structures. The aim is also to train a pool of teachers with complementary profiles per governorate who are capable of covering all schools at both primary and secondary levels.
The National Multisectoral Adolescent Health Promotion Strategy and Youth 2020-2030 aims to promote the ‘healthy schools concept. The ministries of Education, Health, Local Affairs and Environment and Industry will initiate programmes to build the capacities of teachers and education professionals in support of adolescents. They will also coordinate with volunteer municipalities to form ‘local healthy school committees’ responsible for: i) promoting the ‘healthy schools’ concept; ii) assessing community health problems; and iii) the development of a ‘healthy school’ action plan.
3.5. Schools
No information was found.
4. Governance
4.1 Responsible ministries
The Ministries of Education and Higher Education and Scientific Research are responsible for the effective implementation of the age-appropriate SRH curriculum in primary, secondary and vocational and university institutions or programmes. However, the CSE framework was developed with the CSE steering committee established to oversee the development of a culture-relevant, science-based, and age-appropriate CSE curriculum. The committee consists of education experts, school inspectors, sexology experts, CSE trainers, and SRH professionals.
4.2. Level of responsibility/decentralization and autonomy
Local and regional governments are responsible for implementing decisions made by the Ministry of Health for the school health programme, which includes a doctor, head of department and school supervisor. Broader health promotion currently tends to be led by individual schools, with some activities supported by school policies (such as forbidding fast food in schools). Such initiatives are usually led by school principals and may also be strongly advocated by parents and caregivers.
The School Health Programme is a fairly structured programme and is mandatory for public and private schools. Three levels are involved in the programme: national (Ministry of Health, Directorate of School and University Medicine); regional (regional health directorate, school health service); and local (schools). Each level has distinct roles and responsibilities in implementing the programme.
4.3. Government budget allocation
No information was found.
5. Monitoring and reporting
No information was found.