Comprehensive Sexuality Education

1. Context and background

The Kyrgyz Republic is an ethnically diverse country. Islam is the most widely observed religion, followed by the Russian Orthodox Church, with a small percentage following minority religions. About two-thirds of the population live in rural areas. There has been an increase in incidences of bride kidnapping (ala kachu) — despite this practice being officially made illegal in 1994. There is also a growing trend of early marriage, leading to increased rates of teenage pregnancy, childbirth and abortions among adolescents, and the number of STI and HIV infections in children and adolescents. The maternal mortality ratio is also high. Sexual violence against children is increasing. Opposition to sexuality education comes primarily from religious groups and some political parties. Nevertheless, there has been public discussion about this issue, with strong advocacy from non-governmental organizations, and medical and educational specialists. (BZgA and IPFF, 2018).

The 2015 Law of the Kyrgyz Republic On The Reproductive Rights Of Citizen (amended in 2019) addresses the rights of children and adolescents in the area of reproductive rights protection and includes the right to education and training in the field of sexual and reproductive health (SRH).

2. Terminology

According to the 2015 Law of the Kyrgyz Republic On The Reproductive Rights Of Citizen (amended in 2019), sexuality education is the acquiring of knowledge that provides reliable and scientifically sound information on reproductive health issues and develops skills related to decision-making, communication, and risk reduction in reproductive system diseases.

Reproductive rights are defined as the rights of citizens to: the reproduction of offspring; protection of their reproductive health; free decision-making regarding the birth or refusal to give birth to children in or out of wedlock, contraceptive methods, childbirth, and access to medical, social, information and advisory assistance in this area. Sexual health is described as a state of physical, mental and social well-being that determines safe conduct of sexual life, in which there are no elements of violence, coercion or discrimination.

3. Laws and policies

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

INTERNATIONAL
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 1997	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: 1994	Commits to the right to access appropriate health-related information.
Convention on the Rights of Persons with Disabilities (CRPD) Ratification date: 2019	Commits to the highest attainable standard of health for persons with disabilities.
International Covenant on Economic, Social and Cultural Rights Ratification date: 1994	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: 1995	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.
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

Article 31 of the 2003 Law on Education (amended in 2021) on ‘protection of the health of children and students’ dictates that educational organizations and local self-government bodies shall create conditions that guarantee the protection and promotion of the health of children and students, their workload and study schedule, including physical education – as determined by educational organizations on the basis of proposals by the public education and public health authorities. Article 18 of this law mentions a wide range of physical, cultural and extracurricular environmental activities to meet the various interests and needs of children and adolescents. All activities that contribute to the health, vocational guidance, and moral and intellectual development of the individual take place through a network of out-of-school educational organizations, which are funded by the Government.

The 2015 Law of the Kyrgyz Republic on the Reproductive Rights of Citizens (amended in 2019) describes the Government’s responsibility to develop and implement standards for the protection of the reproductive health of citizens, taking into account gender and age characteristics, as well as for the development of curricula and training of personnel in the field of reproductive health. In addition, as stated in Article 11 of the Law of the Kyrgyz Republic on the Reproductive Rights of Citizens, citizens have the right to receive information on contraception methods, on the conditions and methods for obtaining services for the protection of their SRH, and on any other information necessary for the exercising of their sexual and reproductive rights. Article 13 of the same Law concerns the rights of minors in relation to SRH. It establishes that minors have the right to protection of their SRH rights, as well as to information and education, and to have adequate and appropriate preparation for family life. In line with the Law, educational organizations are responsible for providing information and education, and health organizations are responsible for ensuring that the minors have access to specific information and services. The Law further states that training providers need to be subject specialists. In the family context, parents or their legal representatives are responsible for certain aspects of SRH education of minors.

The 2012 Decree on Strategic Directions of Education System Development in the Kyrgyz Republic, which includes the Action Plan for the implementation of the Education Development Strategy of the Kyrgyz Republic for 2012-2020, highlights two key tasks: creating a safe educational space in pilot general education institutions and reducing the risk of and deterioration in physical, psychological, and mental health through appropriate health technologies in the educational process; and introducing an anti-discrimination mechanism that ensures that all documents and teaching materials emphasize the importance of non-discrimination, specifically in relation to gender identity and sexual orientation.

According to the Education Development Program in the Kyrgyz Republic for 2021-2040, ‘by 2040, the education system will allow people of any age to discover their intellectual, creative and emotional potential, ensure a healthy lifestyle and well-being of students and the country, regardless of geography, gender, religion, health, financial status and other factors. It will provide equal access to education for different categories of citizens. Priority will be given to innovations that contribute to the development of human resources in the education system, the development of quality and competitive education that forms a person capable of taking responsibility for their own development, mobility, demand in the labor market.’

The Kyrgyz Republic’s first long-term National Gender Strategy on Achieving Gender Equality by 2020 was adopted in 2012 in compliance with CEDAW. The Strategy outlines five key areas for achieving gender equality: (i) strong, effective institutional mechanisms; (ii) economic empowerment; (iii) an education system that promotes gender equality; (iv) access to justice for women; and (v) gender-equitable political participation. The Strategy is further referenced and explained through national action plans on gender equality. (Asian Development Bank, 2019)

3.3. Curricula

Mandatory or optional

There is no compulsory comprehensive sexuality education (CSE) curriculum. However, since 2015, sexuality education has been integrated into the Healthy Lifestyle course for students of grades 6 – 11 (12 years and older). In September 2018, the Ministry of Education and Science issued a decree (№ 1168/1) which obliged all schools in the country to conduct ‘healthy lifestyle’ homeroom lessons in line with the curriculum and lesson plans, detailed in the teacher guide Conceptualizing health education classes for students in grades 6-11. In June 2021, the Ministry of Education and Science, in its Instructive and Methodological Letter № 03-2/1949 reminded all heads of regional and municipal education departments and school principals to ensure obligatory delivery of Healthy Lifestyle education, in line with this decree.

Model of delivery

Certain CSE-related topics have been incorporated into the Healthy Lifestyle course, described above.

Comprehensiveness of content

The purpose of the Healthy Lifestyle course is ‘to create conditions, to use the full potential of children and adolescents in the field of health and development’. A key objective is ‘to promote and protect the health of children and adolescents, to instil in them the values of health and a healthy lifestyle’. The course is designed for 10 academic hours for grades 6-9 and 5 hours for grades 10-11. These lessons are delivered as extracurricular activities during homeroom classes.

The Healthy Lifestyle course includes topics, such as: ‘Me and my health’; personal hygiene; communicable disease prevention; adolescence; bodily hygiene during adolescence; sexuality; gender; sexual health of adolescents; sexual relationships; HIV and STI prevention; responsible behaviour; teenage pregnancy and family planning; reproductive health and rights; early marriages and bride kidnapping; prevention of psychoactive substance use; the ‘ABC’s of communication; violence prevention; tolerance; and suicide prevention The topics are spread across different grades. For students in grades 6–7, most topics are related to healthy eating and hygiene, HIV prevention and the prevention of psychoactive substance use. Starting from the 8th grade, more topics related to SRH rights are included, such as reproductive rights, gender equality ,and sexuality. Information on where to receive SRH services is not included.

Learning resources

In 2021, a series of 24 video lessons (24 in Kyrgyz and 24 in Russian) were produced and uploaded to the national educational portal Sanarip Sabak to ensure the uninterrupted delivery of online health education during the COVID-19 pandemic and to improve the overall quality of Healthy Lifestyle classes by providing standardized, evidence-informed, and age-specific content. The video lessons are intended for students in grades 6-7 and grades 8-11, and are based on the lesson plans provided in the teacher guide Conceptualizing health education classes for students in grades 6-11. Avoiding a didactic approach, the videos only present facts, allowing students to draw their own conclusions. Relevant illustrations, short quizzes, catchy animations and inserts from feature films make the video lessons easy to understand and engaging.

In 2022, a teaching manual – Using video lessons for healthy lifestyle homerooms classes in grades 6-11 – was developed to help teachers use the video lessons. Available in both Kyrgyz and Russian, the manual provides tips on how to demonstrate and discuss each video lesson. It also recommends other interactive teaching methods such as brainstorming, problem-solving, and role-playing to maximize students’ engagement and achieve better learning outcomes. Open and friendly conversations during Healthy Lifestyle classes create a trusting relationship between students and the teacher, helping students acquire new knowledge and develop critical skills for making safer choices.

3.4. Teachers

Kyrgyz State University has introduced training on the methodology of delivering the Healthy Lifestyle course in homeroom classes, using the guide ‘Designing homeroom classes on healthy lifestyle for students of grades 6-11’ from 2017- 2021’. In addition, a training module has been introduced to train students specializing in pedagogy. The module intends to provide a holistic view of the comprehensive approach to preserving and maintaining students’ health, preventing HIV, shaping knowledge, skills and attitudes for a healthy lifestyle, and promoting responsible behaviour.

3.5. Schools

The Ministry of Health and Social Development has taken steps to introduce youth-friendly services that are to be available in health facilities. A Counselling adolescents course was introduced in the postgraduate programme of medical specialists at the Kyrgyz State Medical Institute of Retraining and Advanced Training.

4. Governance

4.1 Responsible ministries

According to the 2015 Law of the Kyrgyz Republic on the Reproductive Rights of Citizens (amended in 2019), in the area of reproductive rights of citizens, the Government of the Kyrgyz Republic: i) determines the main directions of the unified state policy in the field of protection of the reproductive rights of citizens; and ii) develops and adopts state programmess aimed at realizing the reproductive rights of citizens. The institutions that are mainly responsible for the curriculum development are the Ministry of Education, the Kyrgyz Academy of Education, and the parent committees of individual schools (Federal Centre for Health Education (BZgA), 2018).

4.2. Level of responsibility/decentralization and autonomy

Article 31 of 2002 Law on Education (amended in 2021) states that the ‘workload, study schedule of students, including physical education is determined by the educational organization on the basis of proposals of public education authorities of the Kyrgyz Republic in coordination with public authorities of the Kyrgyz Republic in the field of health’. The Healthy Lifestyle course is delivered differently, for example, depending on the level of preparedness of teachers, the kind of religious observance in the region where the school is located, the availability of suitable materials for teachers, the willingness of the school administration to include it in the curriculum, as well as other factors such the remuneration of teachers (Federal Centre for Health Education).