Comprehensive Sexuality Education
1. Context and background
Ghana has a large population of people under the age of 25 years, and contraceptive use among adolescents is relatively low. As a follow-up action to Ghana's commitment to the Jomtien World Declaration on Education for All and its ratification of the United Nations Convention on the Rights of the Child, the Ghana School Health Education Programme was established in 1992. In 1992, the Government mandated that the Ministry of Education and the Ministry of Health implement integrated health education and health delivery services to supplement the academic components of formal education. The Government issued its first Adolescent Reproductive Health Policy in 2000, adopting a multisectoral approach to addressing adolescent reproductive health issues. The emergence of HIV as a global crisis affecting young people provided an additional impetus for the Government to address sexual and reproductive health (SRH) and rights among young people, and in 1998, HIV was added to the Life Skills curriculum (Panchaud et al., 2018).
In 2013, the Ministry of Education’s HIV and AIDS Policy advocated for the inclusion of age-appropriate SRH education into the school curriculum, which would include lessons on HIV. In 2015, the Government revised and renamed the Adolescent Reproductive Health Policy as the Sexual and Reproductive Health Policy for Young People in Ghana. The Ministry of Education published the Guidelines for Comprehensive Sexuality Education in 2019; however, protests from a range of social groupings have halted the process of its inclusion into the curriculum and the Guidelines are not currently being implemented.
2. Terminology
In Ghana, the term sexual and reproductive health education is widely employed.
3. Laws and policies
3.1. Relevant international/regional agreements to which the country 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: 1986 |
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: 1990 |
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: 2000 |
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 Attended |
Calls for sexuality education, counselling and support mechanisms for adolescents, and identifies essential topics. |
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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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Ghana has signed the commitment drafted at the Abuja Regional Conference on HIV/AIDS (2001), the Maputo Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (2003), and 2019. All have informed government decisions and actions on sexual and reproductive health (SRH), including specific changes to improving access to information and services for adolescents.
3.2. Relevant national laws and policies mandating comprehensive sexuality education
The 1969 Population Policy (as amended in 1994) includes Objective 4.3.7, which seeks to educate youth on population issues such as sexual relationships, fertility regulation, adolescent health, marriage, and childbearing, in order to guide them towards responsible parenthood and maintaining small families.
The 2014 HIV and AIDS, STI Policy provides broad guidelines for the coordination of all HIV programmes to prevent new HIV infections and mitigate the impact of HIV in the education sector.
The 2016 Sexual and Reproductive Health Policy for Young People in Ghana includes guiding principles that state that ‘the development of young people underlines the promotion of positive sexuality and reproductive health’ and ‘the right to information is key to the realization of young people's right to health’. The Policy also states that every individual has the right to the highest achievable standards of physical and mental health, and that teenagers need accurate and trustworthy information about their sexuality, the physical changes occurring within them, and shifting human relationships during this developmental stage. In addition, it states, ‘Education on sexuality and sexual and reproductive health in schools provides vital information to young people and prepares them for a complete life, including being responsible members of society’. Reinforcing these ideas and principles, BE 2.3.3 of the Education Strategic Plan 2018-2030 instructs that those responsible for implementing policy are to ‘Enforce policies to ensure that all basic schools meet national standards for health, sanitation, and safety, including national initiatives to reduce HIV and sexually transmitted diseases’.
3.3. Curricula
Mandatory or optional
In 2019, a new CSE curriculum was developed. Called the Guidelines for Comprehensive Sexuality Education in Ghana, it has not yet been implemented.
Model of delivery
SRH education is incorporated into specific subjects using a cross-curricular approach. Basic SRH education topics are introduced during the fourth year of elementary school, when all subjects are compulsory. In secondary education, SRH issues are integrated into two core, compulsory courses (social studies and integrated science) and two elective courses (biology and management in living). The School Health Education Programme and the HIV Alert programme are two of the most important extracurricular programs that provide additional activities during or after school hours.
Learning resources
SRH is incorporated into the national curriculum's core classes. The curriculum includes scope, objectives, sequence of instructions, and goals and expected outcomes.
3.4. Teachers
All teachers in Ghana are required to complete pre-service training, regardless of subject or grade level. SRH topics are included to some extent in pre-service and in-service training, but there is no training designed specifically to prepare teachers to cover SRH topics.
3.5. Schools
The Guidance and Counselling Unit at the Ghana Education Service works to ensure students’ well-being in educational and psychological support. The Unit undertakes a number of activities to meet its goals: planning, coordinating and supervising guidance services across the country; training school-based as well as regional and district guidance and counselling coordinators for effective guidance service delivery; and guidance and counselling for basic school teachers through a proactive approach that encourages prevention. The idea is to equip basic school teachers to integrate guidance philosophy and practices through the curriculum, using the guides, manuals and toolkits that have been developed for teachers, as well as having counsellors in schools.
4. Governance
4.1 Responsible ministries
With support from the Ministry of Health, the Ministry of Education and the Ghana Education Service the School Health Education Programme was implemented in schools. which was developed in collaboration with several ministries and non-governmental organizations. The development of national in-school curricula for the basic education system is the responsibility of the National Council for Curriculum and Assessment of the Ministry of Education. In order to ensure the quality of the content developed, as well as to secure buy-in from necessary government entities and other key stakeholders, the Council works in consultation with a range of national and regional bodies—including the Ghana Health Service, the Ghana Education Service, the Ghana National Association of Teachers, the National Association of Graduate Teachers, the education units of religious bodies that administer schools, the National Youth Authority, traditional leaders, civil society organizations and various Parent-Teacher Associations (PTAs)—to ensure the quality of the content developed, as well as to secure buy-in from necessary government entities and other key stakeholders.
4.2. Level of responsibility/decentralization and autonomy
At the local level, two groups have significant influence: the Board of Governors at senior high school level, and the School Management Committee at the basic school level. The Board of Governors is the highest level of authority in the management of schools and is made up of representatives from the community, teachers, the parent-teacher association, past students, the Ghana Education Service and other members selected for their specific expertise. Although schools in Ghana operate with the same curriculum and syllabi, the Board, particularly in religious and private schools, has the power to influence the scope and topics of what is taught, as well as regulating co-curricular activities, including those regarding sexuality. The role of parent-teacher associations is to contribute to the fostering of congenial school and academic environments and effective teaching and learning, provide resources, such as buses, classrooms, and dormitory accommodation in some schools, and support extracurricular activities. Through their activities and representation on the school Board, parent-teacher associations can influence what topics are taught, especially in potentially controversial areas such as SRH education. (Awusabo-Asare K et al., 2017)
4.3. Government budget allocation
No information was found.
5. Monitoring and reporting
As SRH topics are integrated into examinable subjects, the coverage of the syllabus implies that these are covered too. However, there are currently no tools to specifically monitor or evaluate the teaching of SRH education. In 2017 the Maternal Health Survey included statistics on teenage childbearing, the incidence of first sexual intercourse, marriage and birth, and family planning. Ghana’s Education EMIS includes the basic national, regional and district parameters, including enrolment by sex. The Ghana AIDS Commission monitors and evaluates programmes for the national response to HIV. Further statistics on child marriage, gender-based violence and abortion have also been gathered through specific reports such as the 2016 UNFPA 2016 UNFPA Situational Analysis of Adolescent Girls and Young Women In Ghana.
