Comprehensive Sexuality Education
1. Context and background
In South Africa, comprehensive sexuality education (CSE) (in the form of Life Skills and Life Orientation courses) has been part of the curriculum since 2000. The country has the highest number of people living with HIV worldwide (approximately 7.7 million people), with most new HIV infections occurring among young people and adolescents (particularly young women). The country also has high rates of adolescent pregnancies that lead to school dropouts and high levels of gender-based violence and child abuse.
The 1999 National Policy on HIV and AIDS for Learners and Educators in Public Schools and Students and Educators in Further Education and Training Institutions was the education sector’s first effort at responding to the impact of HIV on the schooling system, creating a basis for systemic interventions in schools. The policy was initiated to respond to the fight against HIV & AIDS and identified as one of the priorities of the former Department of Education, with specific objectives including: the provision of information on HIV & AIDS to reduce transmission; the development of life skills that would result in healthy behaviour in youth; and the creation of an environment of awareness and tolerance in youth for those infected and affected by HIV & AIDS.
The Policy advocated for the provision of Life Skills Education in pre-primary, primary and secondary schools. The course was initially only taught in grades 4-6 and eventually scaled up to cover grades R-12, due to strong political commitment and the establishment of various national policies and strategies. According to the Department of Basic Education, the main aims of adopting CSE are to: reduce HIV infections and other STIs among learners and teachers, adolescent teenage pregnancy, and gender-based violence; delay sexual debut; and ensure that all learners are connected to health and psycho-social services offered by the Department of Health and the Department of Social Development through the Integrated School Health Programme.
Due to some resistance from certain sectors in society, the Department of Basic Education published information and materials on CSE on its website to help reassure parents and others who may have misconceptions about the content of the curriculum.
2. Terminology
CSE is integrated into the Life Skills course in primary schools and the Life Orientation course in secondary schools and referred to in those terms in the school curriculum. However, the Government uses the term 'comprehensive sexuality education' in various national documents, such as the 2012-16 Department of Basic Education Integrated Strategy on HIV, STIs and TB, the 2014-19 National Adolescent Sexual and Reproductive Health and Rights Framework Strategy, and 2017-22 South Africa’s National Strategic Plan on HIV, tuberculosis and STIs.
In the 2012-16 Department of Basic Education Integrated Strategy on HIV, STIs and TB, sexuality education is defined as 'an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic and non-judgemental information. Sexuality education provides an individual with opportunities to explore their values and attitudes and to build decision-making, communication and risk reduction skills about many other aspects of sexuality.' This definition has been informed by UNESCO’s International Technical Guidance on Sexuality Education.
The 2014-19 National Adolescent Sexual and Reproductive Health and Rights Framework Strategy includes definitions of a number of relevant terms, such as 'sexual and reproductive health and rights', 'reproductive health', 'reproductive rights', 'sexual health', 'gender equity', 'gender equality', and 'sexual and gender-based violence'. Sexual and reproductive health (SRH) and rights are defined as 'the rights of all people, regardless of their nationality, age, sex, gender, health or HIV status, to make informed and free choices with regard to their own sexuality and reproductive well-being, on condition that these decisions do not infringe on the rights of others. This includes the right to access education and information, services and healthcare on SRHR'.
3. Laws and policies
3.1. Relevant international/regional agreements to which South Africa is a signatory
South Africa has ratified several international agreements that are relevant to sexuality education, including the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) in 1995, the Convention on the Rights of the Child (CRC) in 1995, the Convention on the Rights of Persons with Disabilities (CRPD) in 2007, and the International Covenant on Economic, Social and Cultural Rights in 2015.
In 2013, South Africa endorsed the Eastern and Southern Africa (ESA) Ministerial Commitment on sexuality education and sexual and reproductive health services for adolescents and young people. The Commitment provides a policy framework and sets targets towards scaling up comprehensive sexuality education and access to sexual and reproductive health services. The ESA Ministerial Commitment was then renewed and expanded by South Africa in 2021.
The table below provides a summary of how the international commitments relate to sexuality education.
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INTERNATIONAL |
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Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) Ratification date: 1995 |
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: 1995 |
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: 2007 |
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: 2015 |
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: 2000 |
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 Attended |
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) 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
South Africa has a strong legal and policy environment to support the provision of CSE and access to SRH services. The Government, and specifically the education, social development and health sectors are mandated to combine efforts in addressing the general health and well-being of the population and in particular in the areas of sexuality education, life skills, prevention, and care and support in relation to HIV, STIs and tuberculosis.
The 1996 Constitution of the Republic of South Africa (last amended in 2013) and the Bill of Rights stipulate the right of all citizens to life and health, including reproductive health care and education, with specific guarantees for children. The 1996 South African Schools Act refers to 'life sciences' and forms the basis upon which the National Curriculum Statements (grades R-12) is determined. The national curriculum statements are supported by various documents such as the 2012 National Protocol for Assessment Grades R-12, 2012 Regulations Pertaining to the National Curriculum Statement (Grades R-12) (last amended in 2015), 2011 Curriculum and Assessment Policy Statement for Life Skills (Grades R-3), and 2011 National Policy Pertaining to the Program and Promotion Requirements of the National Curriculum Statement (Grades R-12) (as amended in 2013), all of which include the provision of Life Skills and/or Life Orientation subjects.
The implementation of Life Skills and Life Orientation (which integrate CSE), including access to SRH services, is supported by a number of national policy and strategic documents. The 1999 National Policy on HIV and AIDS for Learners and Educators in Public Schools and Students and Educators in Further Education and Training Institutions was the country’s first effort to equip students with the knowledge and skills to protect themselves against HIV infection, supporting the idea that 'age-appropriate education on HIV/AIDS must form part of the curriculum for all learners and students, and should be integrated in the life-skills education program for pre-primary, primary and secondary school learners'. The 2012 Integrated School Health Policy outlines the minimum package of health services and health education that should be provided in all schools (including SRH).
The 2012-16 Department of Basic Education Integrated Strategy on HIV and AIDS supports the importance of CSE and SRH rights as human rights, with specific sections on curriculum content and teacher training. The Strategy aims to go 'beyond the HIV and AIDS Life Skills Education Programme … towards providing a more holistic response to the challenge of HIV and TB, ensuring safe and caring schooling and work environments, free from discrimination and stigma'. The Strategy similarly outlines the minimum SRH packages that must be available in all schools, including private schools and 'special schools' (schools for children with disabilities) and main topics that should be covered in sexuality education, with outcomes including 'increased HIV, STIs and TB knowledge and skills among learners, educators and officials' and a 'decrease in risky sexual behaviour among learners, educators and officials'. South Africa’s 2017-22 National Strategic Plan on HIV, tuberculosis and STIs strongly emphasizes the reduction of sexual risk, which includes a 'renewed commitment to provide comprehensive sexuality education in all high schools' and 'to ensure that there are youth-friendly sexual and reproductive health clinics in all areas'. One of the sub-objectives of reducing HIV infections by 2022 includes providing 'appropriate sexual and reproductive health services and comprehensive sexuality education'. The 2020 Education Action Plan: Towards the realisation of schooling 2030 refers to the development of the Life Orientation curriculum, and life skills more more broadly. Finally, the 2014-19 National Adolescent Sexual and Reproductive Health and Rights Framework Strategy is a multisectoral framework that supports the scale-up of CSE and access to SRH services for adolescents and youth. Strategies identified in the Plan include 'to develop a comprehensive sexuality education curriculum and implementation framework for the country' (based on international best practices) and 'to educate adolescents of their sexual and reproductive health responsibilities and rights (as covered in national legislation, policies and guidelines)'.
3.3. Curricula
CSE has been part of the curriculum since 2000 and is integrated into the subjects Life Skills (at primary level, covering grades R-7) and Life Orientation (at secondary level, covering grades 8-12). Details on the content of Life Skills and Life Orientation can be found in the National Curriculum Statements (grades R-12), supported by various documents, such as the 2012 National Protocol for Assessment Grades R-12, 2012 Regulations Pertaining to the National Curriculum Statement (Grades R-12) (last amended in 2015), 2011 Curriculum and Assessment Policy Statement for Life Skills (Grades R-3), and 2011 National Policy Pertaining to the Program and Promotion Requirements of the National Curriculum Statement (Grades R-12) (as amended in 2013).
Following the 2009 release of the International Technical Guidance on Sexuality Education by UNESCO, in 2011 the Government undertook a process of reviewing the Life Skills and Life Orientation curricula against these international guidelines. When gaps were identified, scripted lesson plans were developed and piloted with the aim of integrating them into the curricula and ensuring alignment with international standards.
Since 2013, the Department of Basic Education has also been implementing CSE in schools through various co-curricular programmes, including 'Keeping Girls in Schools', 'Breaking the Silence', 'She Conquers', and 'Determined, Resilient, Empowered, Aids-Free, Mentored and Safe' (DREAMS).
Mandatory or optional
The subjects of Life Skills and Life Orientation are compulsory, stand-alone subjects in all public primary and secondary schools. Both subjects are examinable.
Model of delivery
CSE is integrated into two stand-alone subjects: Life Skills in primary (Grades R-7) and Life Orientation in secondary (Grades 8-12). These subjects have been taught as part of the national curriculum since 2000.
Comprehensiveness of content
The Life Skills and Life Orientation curricula cover a diverse number of topics through different phases of learning (foundation phase, intermediate phase, senior phase, and further education and training phase). Topics range from the conception of self, goal-setting, decision-making, sexuality, relationships and friendships, sexual behaviour and sexual health, HIV & AIDS, and chronic illnesses, to human rights, nation-building, cultural diversity, dealing with abuse, health and safety related to violence, among others. The foundation phase (grades R-3) includes 'beginning knowledge', creative arts, physical education, and personal and social well-being; the intermediate phase (grades 4-6) covers the development of the self, health and environmental responsibility, and social responsibility. The senior phase (grades 7-9) includes topics related to the development of self in society, health, social and environmental responsibility, constitutional rights and responsibilities, and the world of work, while the further education and training phase (grades 10-12) covers topics related to the development of self in society, social and environmental responsibility, democracy and human rights, careers and career choices, study skills, and physical education. The programme also covers substance abuse, child abuse, peer education, assertiveness, peer pressure, anti-bias, gender issues and other skills needed by children and youth to cope in the face of difficult everyday situations.
The 2012 Integrated School Health Policy outlines which topics must be covered, including abuse (sexual, physical and emotional abuse, including bullying and violence), SRH, menstruation, contraception, STIs including HIV, male circumcision, adolescent pregnancy, choice of termination of pregnancy, HIV counselling and testing, stigma mitigation, and mental health issues, including drug and substance abuse, depression, anxiety and suicide. The 2012-16 Department of Basic Education Integrated Strategy on HIV, STIs and TB takes the definition of CSE from UNESCO’s technical guidance, aiming to cover all the topics that make the content 'comprehensive'.
Learning resources
The Department of Basic Education is responsible for supplying existing teaching and learning materials for Life Skills and Life Orientation to all schools.
In 2015, the Department developed scripted lesson plans to guide educators and strengthen the teaching of CSE in schools. Scripted lesson plans are teaching and learning support materials that are designed to aid teachers and students in addressing these important topics in a systematic way. These materials describe each activity, how to complete the activity, its duration, the information to be presented, and the points that should be emphasized. Once the piloting phase is complete, the work aims to be expanded to all nine provinces, with training materials for education officials and orientation materials for parents. In 2019, the Department of Basic Education released the scripted lesson plans that were being used in the pilot phase of CSE in selected schools on its website. This has helped to reassure parents and others who had misconceptions about the content of the curriculum. The lesson plans were developed though closely consulting the revised International Technical Guidance on Sexuality Education.
3.4. Teachers
Regular training and capacity building is provided to all teachers by the Department of Basic Education to ensure quality implementation of CSE as part of the curriculum and the use of up-to-date information and methodologies. The Department of Basic Education also trains district officials as master trainers, who in turn train teachers to teach the programme as an integral part of the curriculum.
Since 2015, teachers in South Africa have also been supported with the provision of scripted lesson plans, which were introduced alongside teacher training to guide teachers in lesson delivery, and build their skills and confidence to discuss topics that may otherwise be considered uncomfortable. The core aim of these lesson plans is to ensure that teachers can help students lead safe and health lives and build an understanding of concepts, content, values and attitudes related to sexual behaviour and sexuality.
3.5. Schools
According to the Department of Basic Education, one of the aims of teaching and learning CSE is to 'ensure that learners are linked to health and psycho-social services offered by the Department of Health and Department of Social Development through the Integrated School Health Program (ISHP)'. Students seeking SRH services are referred to health facilities outside school, with the 2012-16 Department of Basic Education Integrated Strategy on HIV, STIs and TB providing for access to these services through the Integrated Health Programme. The 2012 Integrated School Health Policy emphasizes that 'learners receive or have access to sexual and reproductive as well as mental health services where these are required' and that 'all learners should be counselled with regard to sexual and reproductive health'. According to the Policy, a package of on-site services should be provided in all schools, which include SRH services where indicated. The focus is stated to being on the 'provision of dual protection (to prevent pregnancy and STIs including HIV infection) and the provision of HCT'.
In addition, the Department of Basic Education implements services and programmes such as the Young Women and Girls Programme service package, which includes health sessions, and the Determined Resilient Empowered AIDS-free Mentored Safe (DREAMS) programme, which provides linkages to health and social services in selected primary and secondary schools.
4. Governance
4.1 Responsible ministries
At the national level, the Department of Basic Education is responsible for developing guidelines and policies and designing curricula that provide a favourable environment for implementing CSE in schools through the Curriculum Policy, Support and Monitoring Branch. The National Treasury provides financial resources to schools to implement the Life Skills Education programme through the Life Skills Conditional Grant. The South African National AIDS Council supports the multisectoral response of the government to HIV, STIs and tuberculosis, while the Department of Health supports schools in the provision of SRH services and education through the Integrated School Health Programme. The Department of Social Development is responsible for the provision of CSE for out-of-school youth.
In addition, as a result of the 2014-19 National Adolescent Sexual and Reproductive Health and Rights Framework Strategy, an interministerial technical committee led by the Social Development Populations Unit was established in 2015. Comprising representation from the Department of Education, the Department of Health, the Department of Social Development, and civil society its aim is to support the scaling up of CSE and SRH services through coordination and collaboration.
4.2. Level of responsibility/decentralization and autonomy
At the provincial level, the provincial Departments of Education guide and supports the implementation of Life Skills and CSE in schools, with districts and schools directly responsible for the implementation of the school curriculum and examination. The Chief Directorate of Care and Support in Schools has a dedicated deputy director who is responsible for managing and guiding provincial life skills coordinators on the implementation of the Life Skills programme. These coordinators are responsible for ensuring the implementation of CSE through the Life Skills and Life Orientation subjects in schools, working in collaboration with district coordinators who support Life Skills and Life Orientation in schools.
4.3. Government budget allocation
CSE, through the Life Skills and Life Orientation subjects, is funded by the Government through the Life Skills Conditional Grant, aiming to ensure long-term sustainability .
5. Monitoring and reporting
The national EMIS tracks the implementation of CSE in South African schools. National education statistics from 2016 (the latest available detailed and lengthy statistical publication from the Department of Education) also include an indicator for the Life Orientation and Life Sciences subjects, which measures the number of students who were assessed for the National Senior Certificate examination in these subjects and their pass rate (by gender). The Life Skills and Life Orientation curricula are also assessed and monitored by curriculum specialists within the Department of Basic Education, which provides quarterly monitoring visits to schools and provinces through the national coordinator of the Life Skills program. Inter-provincial meetings are also held on a six-month basis to assess progress and implementation gaps and to share information and best practice.
