Module 1: Understanding Comprehensive Sexuality Education (CSE)

What CSE is, what it is not, and why it matters

“Comprehensive Sexuality Education” is a technical term that UNESCO describes as a —

“curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: realise their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives.”

This definition is useful when engaging with policymakers, media, and in formal written materials. However, the term CSE is rarely used in national policy in Malawi, Uganda or Ethiopia, and as such, is not easily recognisable by community audiences. To connect with more informal audiences such as parents, and community and religious leaders, it may be helpful to lead with that country’s own familiar terms instead, rather than starting off with having to explain the acronym CSE. Once you have connected with the audience, the term CSE and its corresponding definition can be introduced. The below table shares some useful guidelines on what language may be more accessible within each country:

• Malawi: “Life Skills Education” at primary level; “HIV Education” or “Sexual and Reproductive Health Education” at secondary level.
• Uganda: “Sexuality Education” is taught as part of “Life Education”.
• Ethiopia: “Sexual Education”, “AIDS Education” or “Life-skills Education”.

In addition, this Toolkit centres around the following master narrative that connects the definition of CSE with the shared values and goals of individuals and communities:

“CSE protects young people so that they can grow up healthy, safe and equipped to build strong families and communities reflecting the very values of care, protection and responsibility that families, faiths and traditions already hold.”

Every message in this Toolkit traces back to this statement, and to the three pillars below.

What is CSE?

In order to effectively counter mis and dis-information surrounding CSE, it is vital that stakeholders understand what it is, what it is not and why accurate and reliable CSE is important for individuals and communities to thrive. CSE can be described using the below three pillars of Protection, Partnership, and Investment:

Protection

CSE keeps children and young people safe from HIV, unintended pregnancy, sexual violence, and abuse.

This is directly relevant to the issues facing individuals in many African countries. For example:

• In Uganda, approximately 5,000 new HIV infections were recorded weekly in 2024, with 70% of these among adolescents and youth.
• In Malawi, unsafe abortion is estimated to occur roughly 141,000 times annually, contributing to between 6–18% of maternal deaths.
• In Ethiopia, 13% of adolescent girls aged 15–19 have begun childbearing.

This is exactly the kind of harm CSE is designed to help prevent.

Partnership

CSE should be nationally owned and implemented. Its effectiveness depends on partnerships between:

• National ministries and education sectors; and
• families, faith and cultural communities.

For example:

• Uganda’s Ministry of Education and Sports developed and owns the National Sexuality Education Framework (2018).
• Malawi’s Ministry of Education, Science and Technology has overseen Life Skills Education since it was introduced in 2002; and
• In Ethiopia, the Ministry of Health is responsible for delivery of “life skills” under the National Adolescent and Youth Health Strategy (2021–2025).

Investment

CSE is a smart, cost-effective investment in health, education and economic development. Evidence shows that CSE results in:

• Reduced adolescent pregnancy.
• Girls staying in school; and
• That life-skills gains link to better long-term economic outcomes for young people and their communities.

At their core, UNESCO’s technical guidance on sexuality education states that CSE policies should aim to:

• Prioritise the establishment of youth-friendly health services for accessible and non-judgmental stigma-free care;
• Prevent early and unintended pregnancy through comprehensive strategies that address the social issues that drive adolescent pregnancy.
• Combat gender-based violence (GBV) by advocating for legal reform and expanding access to holistic support services;
• Promote meaningful youth participation in policy design and implementation;
• Prioritise data collection and research to inform SRHR policies and programmes

What CSE is not?

CSE is NOT a single-fixed curriculum but should be adapted to each country and context. CSE is NOT and should NOT be a replacement for parents, faith or culture.

Why it matters?

CSE matters because the harms it addresses are real, and because families, schools and communities already share the goal of protecting young people from them. The country evidence below is offered as support for that shared goal, not as the starting point of the conversation. Module 2 sets out the comprehensive evidence base to further inform conversations around why CSE matters. For example:

Malawi

• Young people aged 10–35 make up over half of Malawi’s population and disproportionately experience SRHR challenges, including high rates of HIV, adolescent pregnancy and unmet contraceptive need.
• The YPAR Report for Malawi indicates that early pregnancy remains closely associated with school dropout, early marriage, and long-term socioeconomic vulnerability for girls in Malawi.

Uganda

• Uganda is one of the world’s youngest countries with children aged 0–17 years constituting about half of the population. An estimated 649,000 adolescent girls aged 15–19 are sexually active and do not wish to conceive within the next two years, yet over 55% have an unmet need for modern contraception.
• According to YPAR findings, young people between 10–24 years in Uganda face many SRHR challenges because of early, unprotected, and forced sexual activity.

Ethiopia

• Adolescents and youth comprise 33% of Ethiopia’s population with 13% of adolescent girls aged 15–19 having begun childbearing. YPAR evidence shows that early marriage remains a major reality for young women, with nearly 40% of women aged 20–24 years reported being married before the age of 18 in some regions.
• Furthermore, adolescents and young people account for a substantial proportion of new HIV infections, particularly among young women, who are disproportionately affected due to gender inequality and limited access to information and services.

Who should CSE reach?

CSE is designed for every young person, not only those most easily reached through mainstream, in-school, urban programming. YPAR research found that although the positive outcomes of CSE are reflected across learner groups, including in-school and out-of-school youth, and for youth with disabilities, access to and effective delivery of CSE is still focused on urban areas within mainstream schooling. YPAR research in Ethiopia specifically noted the need for CSE to “extend to rural youth and young people with disabilities, given how they are often marginalised from the kind of urban centric and able-bodied NGO programmes available to urban and able-bodied youth.”

Where do youth and adolescents’ access CSE?

While young people access CSE primarily through exposure within the school setting, YPAR findings indicate that they also access it through multiple other sources including from health facilities, youth centres, and during activities facilitated by local NGOs and community-based organisations (CBOs). Further, YPAR findings show that young people are increasingly accessing CSE related content online. To this end the report shows that:

“When youth did attempt to speak with their parents, aunts, or uncles, they felt shame and were sometimes silenced. Thus, youth often turned to social media and peer networks to gain exposure to CSE and knowledge about SRHR. Researchers in all three countries worried about the reliability and safety of accessing accurate, reliable sexuality-related information from the internet, because of the lack of regulation of online messaging on popular platforms such as TikTok, YouTube, and Instagram. These sites were major sources of information for youth in the three countries, which shows that African youth are actively part of a global youth culture that is expressed, negotiated, and regulated in online communities.”

Resources

In order to engage these online spaces, the Digital Messaging Toolkit contains social media templates to be used by all Stakeholder groups. These are specifically useful for reaching youth audiences across each country. They are editable and customisable for use within each context specific setting. Examples of some of the templates include: