Comprehensive Sexuality Education
1. Context and background
Mali faces significant health challenges, including persistently high maternal and child mortality rates, the highest adolescent fertility rate in the world, low basic child immunization coverage, malnutrition, and a relatively high burden of infectious diseases. The country also has one of the lowest densities of health workers globally, low national expenditure on health, and suboptimal laboratory capacity and supply chain systems (WHO, 2020). Mali has a rapidly expanding population, with the number of young people doubling in the last two decades.
In 2017, it was envisioned that sexuality education would be incorporated into the National Development Plan of Education for 2019-2028, but in 2018 the Government of Mali abandoned efforts to amend its comprehensive sexuality education (CSE) programme due to ongoing controversy about it and opposition to its implementation. A law prepared by the Malian Ministry for the Promotion of Women, Children, and Families in 2019 to prevent, minimize, and effectively manage gender-based violence was challenged by some religious authorities. There is still no law prohibiting gender-based violence in Mali.
Although a specific definition was not found, the reviewed policies and laws refer to ‘reproductive health’ and emphasize educational concepts relating to HIV.
3. Laws and policies
3.1. Relevant international/regional agreements to which the country is a signatory
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.
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: 2017
Commits to the highest attainable standard of health for persons with disabilities.
International Covenant on Economic, Social and Cultural Rights
Ratification date: 1974
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
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
The Law No. 02-044 Law on Reproductive Health (2002) is the most important law for sexuality education. It states that ‘men and women have equal rights and dignity in reproductive health’. It emphasizes the right of women and men to be well informed and use the planning method of their choice, ‘to access reproductive health services and benefit from the highest quality care possible’.
The overall objective of the Reproductive Health Strategic Plan (2017) (Santé et droits sexuels et de la procréation des adolescent·e·s au Mali) is to improve the reproductive health status of the population. This objective is broken down into four specific objectives: i) increase the accessibility and availability of reproductive health services; ii) increase demand-creation efforts and the use of reproductive health services; iii) improve the quality of reproductive health services and improve capacities for coordination, governance and leadership; iv) and carry out monitoring and evaluation of reproductive health services. Several strategies are planned to achieve each of these objectives, including one that seeks to strengthen sexual education for adolescents and young people, and another that aims to improve access to reproductive health services of women, men, teenagers and young people.
The Mali National Family Planning Action Plan (2014-2018) aimed to ‘respond in satisfactory and innovative ways to the enormous needs in family planning and to achieve a contraceptive prevalence of 15% by 2018’. Activities covered in the plan targets young people and adolescents, such as through innovative communication strategies aimed at schooled and unschooled young people and strengthening partnerships with organized groups of young people in the field of reproductive health.
The goal of the Multisectoral Adolescent and Youth Health Action Plan (2017-2021) is ‘to put in place a system that guarantees adolescents and young people access to quality health care and services adapted to their needs anywhere and at any time’. Among the 16 specific objectives of the plan, 9 are dedicated to the sexuality and reproductive health (SRH) rights of adolescents and young people: reduce the incidence of STIs/HIV & AIDS; reduce the incidence of early marriages; increase the use of family planning services; reduce the incidence of early and unintended pregnancies; ensure the management of unsafe abortions among adolescents and young people; strengthen communication on menstruation among adolescents and young people; reduce the incidence of female genital mutilation and other harmful practices among adolescent girls and young people; reduce the rate of absenteeism among girls by improving school hygiene conditions using a gender-sensitive approach; and reduce the incidence of the raping of girls and women during their search for water.
One of the strategic axes of the 2011 National Gender Policy of Mali aims for the ‘improvement of the access to local health services (reproductive health)’. Another strategic axis of the policy is to sensitize and educate the population specifically in relation to the SRH of adolescent girls: ‘Intensify awareness and education campaigns with a view to eradicate practices that are harmful to the integrity and health of women and young girls and advocate responsible behaviour in terms of reproductive health.’
In 2019, the Ministry of Health and Social Development enacted the documents on the Reproductive Health Policy, Standards And Procedures. The documents integrate all the elements of reproductive health, thus reflecting the focus on health of women, children, adolescents/young people and adults, as well as reproductive health rights. Although the policy is focused on non-school settings, it also provides information for school-age children.
The 2019 Reproductive Health Policy, Standards And Procedures cover components addressing SRH in adolescents and young people. These include the management of problems related to puberty and the prevention and treatment of STIs and HIV & AIDS; sensitizing the community on the nature of male-female relationships and the importance of mutual respect between the sexes; adopting improved social norms at community level that are protective towards women and girl children; promoting the development of responsible sexuality; sensitizing the community on practices that are harmful to the health of women, including the girl child; making reproductive health services available to all people; identifying cases and complications related to practices that are harmful to health; and ensure the management of complications related to these practices.
The 2019 Reproductive Health Policy, Standards And Procedures also includes the goal of improving health in adolescents and young people (3.13 on adolescent and youth health). Its objectives are: to reduce the incidence of sexual and reproductive health problems of adolescents and young people, in particular, STIs and HIV & AIDS, early and unintended pregnancies and their consequences, and sexual violence; to reduce the incidence of other health problems with some link to SRH in adolescents and young people, such as: nutritional diseases (micronutrient deficiencies and obesity); the use of psychoactive substances for health (alcohol, tobacco, and drugs); and accidents on public roads. More specifically, objectives are to: inform and educate adolescents and young people about their sexuality, rights, and risky behaviour; identify and manage problems related to puberty; identify and take care of other health problems that have some link to SRH in adolescents and young people; and offer quality services (adapted and accessible) to adolescents and young people.
The Mali National Action Plan 2019-2023 prioritizes relief and recovery (priority 4), which looks at women and girls’ access to basic social services in conflict zones, including the availability and quality of accessible services, and those relating to SRH.
The Framework Policy for Youth Development and Action Plan developed and adopted in 2012 by the Malian government is being reviewed. It targeted young people aged between 15 and 25. In its original formulation, one of its eight strategic objectives concerned sexual and reproductive health as: ‘[to] improve access to health and actively involve young people in prevention and health education programs’ in the fight against HIV & AIDS.
Mandatory or optional
There is no formal CSE curriculum in Mali's educational system. However, some components of CSE are addressed in certain core subjects.
Model of delivery
Certain core subjects, such as language and communication, and civic and moral education, home economics and life skills address some aspects of CSE.
Comprehensiveness of content
The language and communication, and civic and moral education curricula components for students aged 5-8 address certain CSE topics. The language and dialogue curriculum emphasizes communication, negotiation, and decision-making, especially the right to free expression. In civic and moral education, SRH topics, including information about health and illness and HIV, are addressed.
The curriculum for students aged 9-12 includes some material on interpersonal relationships and SRH. Regarding the material determined by the learning objectives, there is some information on knowledge, feelings, abilities, and social norms, but the emphasis is on HIV-related topics. The programmes exclude information on social norms, gender, and human rights (specifically discussions on child marriages and the role of religion and tradition).
The curriculum for students aged 12-15 contains some information on sexuality and sexual behaviour, and communication, negotiation and decision-making, and youth empowerment, in relation to sexuality, as well as SRH. However, there is greater emphasis on HIV prevention and non-discrimination.
The curriculum for students aged 15-18 addresses reproduction, STIs, HIV, pregnancy, contraception, and gender-based violence. However, social norms, youth empowerment, feelings, skills, sexuality, sexual behaviour, communication, negotiation, and decision-making are not covered.
There is no formal guidance for teachers on how to approach SRH topics.
CSE is not integrated into the curricula of teacher training institutes.
No information was found regarding the referral of students by schools to health clinics. However, the Communication For the Promotion of Reproductive Health & Quality of Reproductive Health Care and Services (2019) proposes training for public, private and non-governmental providers delivering first-line care on topics related to SRH, including women, children, adolescents/young people, and the development of a new reproductive health training curriculum.
The Ten-year Health and Social Development Plan 2014-2023 defines 11 priority objectives, some of which relate to SRH. The plan covers the school health initiative that ‘aims to improve the health of children in the school environment, to train citizens who are aware of health problems so that they adopt responsible behaviour’.
4.1 Responsible ministries
The Ministry of Education is responsible for all curricular reform in Mali. However, other ministries work on reproductive health and related issues, such as the Ministry of Health and the Ministry for the Advancement of Women, Children, and the Family.
4.2. Level of responsibility/decentralization and autonomy
No information was found on the role of schools in the policies and revised laws. In the absence of clear guidelines, teachers have the autonomy to include relevant topics in their teaching. However, given the complexity of the issues to be addressed, there needs to be social consensus to work on reproductive health education or any component of CSE.
4.3. Government budget allocation
No information was found.
5. Monitoring and reporting
No information was found on the monitoring of sexuality education in Mali or the existence of the systematic collection of CSE-related data and the generation of CSE-related statistics.