WASHINGTON, D.C. – In developed countries like the United States, youth sexuality education often receives more than its fair share of furtive snickers from adolescents. However, for those in the developing world, comprehensive sexuality education is no laughing matter.
Sexual education serves as a vital tool of public health by providing youth with the skills and knowledge to make informed choices regarding their sexuality. It encompasses subjects such as anatomy, physical development, pregnancy, contraception and STIs. Sexuality education also discusses communication skills and seeks to inspire confidence in sexual relationships. An important, but often overlooked component of sexuality education covers issues of gender roles, equality and sexual abuse.
Sexuality education has numerous benefits. Multiple studies have found that knowledge of contraception and STIs leads to less risky sexual behavior. It also serves to bolster human rights. By reducing adolescent pregnancy, which often causes girls to drop out of school, it helps to protect the right to education. Research has proven that young people with informed notions of gender roles and equality tend to postpone their first sexual experiences and to use contraception. As one might expect, they also contracted fewer STIs, had fewer unintended pregnancies and had fewer violent relationships.
So then, considering its importance, how does comprehensive sexuality education fare in the developing world?
The data is both startling and disheartening. In Eastern and Southern Africa (ESA), only 40 percent of youth have sufficient knowledge of HIV prevention. In 2011, a regional scan conducted by UNESCO, UNICEF and UNFPA found that the sexual education curriculum in 70 percent of ESA countries showed concerns and gaps. Often these educational regimes relied on fear-based rhetoric and insufficiently addressed issues like contraception and gender equity. According to an UNESCO report, “most curricula did not pay enough attention to empowering young people, building agency, or teaching advocacy skills.”
These inadequacies carry immense health consequences. In the ESA region, 2.6 million young people aged 15 to 24 had HIV while another 10.5 million children had lost one or both parents to AIDS. As one might expect, HIV/AIDS often poses more than just health repercussions. The disease often interrupts schooling, impoverishes families and increases the chances of child exploitation and abuse.
A lack of sexuality education imposes an excessive burden on women and girls in developing countries. For girls ages 15 to 19 living in the under-developed ESA region, the average fertility rate is 108.2 live births out 1000, which is double the global average of 53.4. In some countries such as Malawi, 50 percent of girls will have given birth by the time they are 20 years old.
Another preventable issue is child marriage. The United Nations Population Fund estimated that 34 percent of women aged 30 to 34 had married by 18. In some countries like Mozambique the rate is much worse, with 52 percent of women married by the age of 18, according to UNESCO.
Although sexual health issues run rampant throughout underdeveloped regions of Africa, many still hesitate to embrace comprehensive sexual education efforts, mainly because sexuality education remains a sensitive and taboo topic. Frequently, people oppose sexuality education simply because they assume it authorizes promiscuity. However, as far back as 1993, WHO studies have found no basis for this belief. Even still, these definitive findings have not yet proven entirely persuasive.
While it has been a tough sell in regions like central and eastern Africa, countries such as Estonia have quickly adopted comprehensive sexuality education with exceptional results. Before 1991, Estonia, a former Soviet State on the Baltic coast, had no national sexuality education program. Instead they relied on smaller, less effective NGOs to educate its citizens.
After initiating a national program in the early 1990s, Estonia experienced a notable improvement in sexual health. In 2000, only 22 percent of 18 to 24 year old women and 27 percent of men had used a condom during their first sexual experience. By 2007, 75.2 percent of men and women ages 18-24 reported using a condom. While in 2001 Estonia reported 560 cases of HIV among 15 to 19 year olds, by 2009 only 25 new cases were reported. Even better, the program was overwhelmingly cost effective. With only a $5.6 million budget from 1991 to 2009, it prevented enough cases of HIV to theoretically have paid for itself.
Clearly, national comprehensive sexuality education programs have massive potential. Although they remain controversial in some parts of the world, they have the capacity to save lives and money. It’s time to get the developed world on board.
– Andrew Logan