Comprehensive Sexuality Education (CSE) instruction was introduced into the Rwandan National curriculum in 2016; since then, there has been a significant positive impact, according to activists and civil society organizations. CSE has been implemented in all public primary and secondary schools.
CSE aims at giving students the knowledge, attitudes, skills, and values necessary to make appropriate and healthy choices in their sexual lives. It encompasses sexual and reproductive health, human growth and development, communication, relationships, gender, prevention of STIs, HIV, and AIDS, unwanted pregnancies, and gender-based violence (GBV) among others.
The addition of CSE into the Rwandan curriculum came just one year after the adoption of the ESA Ministerial Commitment on comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in Eastern and Southern African (ESA). Ministers of education and health from 21 countries in Eastern and Southern Africa (ESA) committed to scale up CSE and youth-friendly sexual and reproductive health (SRH) services for children and young people in the region by 2020, setting nine targets along the way.
Eight years after the commitments, the countries will gather again and reflect on the progress, challenges and make new commitments with regards to the implementation of comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in the ESA region.
In Rwanda, for example, in addition to the development and implementation of CSE in primary and secondary schools and in youth centers, other reached targets include having CSE training programmes for teachers, having youth-friendly SRH service training programmes for health and social workers, and offering the standard minimum package for adolescents and youth-friendly SRH services where each health facility has a youth corner dedicated for young ASRH services.
The other time-bound targets set by the ESA commitment included: increasing the number of adolescents and young people who demonstrate comprehensive HIV prevention knowledge levels to 95%; reducing early and unintended pregnancies among young people by 75%; Eliminating gender-based violence; eliminating child marriage, and increasing the number of schools and teacher training institutions that provide CSE to 75%.
While Ministers assess the situation regionally, local civil society organizations are assessing the internal situation. During a consultative meeting held on August 30th, 2021 in Rwanda, civil society organizations, Rwanda Biomedical Centre, UNFPA, UNAIDS and UNESCO stressed that the curriculum was needed to raise awareness on reproductive health issues and improve access to services
They observed that the curriculum has cleared up some myths that have arisen regarding sexuality education in Rwanda. Participants informed that CSE has given young people the opportunities to explore attitudes and values and to practice decision-making and other life skills needed to make informed choices about sexual and reproductive health and relationships.
With regards to CSE controversies, Dr. Athanase Rukundo, the Senior Director of Programs at Health Development Initiative (HDI) highlighted that CSE content was developed taking into account the age of the target audience, Rwandan culture and values, and the current scientific evidence.
"Disapproving that young people are not sexually active or depriving them of accessing correct SRHR information and services only leaves youth more vulnerable to coercion, abuse, exploitation, unintended pregnancy, STIs, and HIV/AIDS. Young people must be provided the knowledge and skills they need to make them informed and make responsible decisions about their sexual and reproductive health,” he adds.
According to Eliphaz Karamage, the Adolescent Health Officer at the Rwanda Biomedical Center, a number of surveys conducted before the new curriculum indicated that 62% of children did not have someone to talk to regarding their sexual and reproductive health.
"The high number of new infections among young people in Eastern and Southern Africa (ESA) remains a serious concern, as the majority of adolescents and young people living with HIV are growing up in the same region. HIV-related stigma and discrimination – including attitudes based on laws and policies – continue to hamper the region’s responses to the epidemic, by preventing young people from accessing a range of key sexual and reproductive health (SRH) services," he explained.
"Children asked questions to teachers and the teachers sent them to parents. When asking parents, they were sent back to the teachers. So the children were left in a dilemma but now schools have created space for young people to discuss their reproductive health.” he said.
Laurence Niyodusenga, a student who was present in the meeting, said that she came to know her rights during the CSE courses at school.
"Through this course, I got to know my rights as a teen, I learned what I should do in case I meet any sexual abuse or assault, where and when to report, and how I should deal with the case instantly,” she said.
Despite the progress in Rwanda, the journey is far from over, according to Therese Karugwiza, the head of the Adolescent and Youths’ Unit at UNFPA.
"We still need youth-friendly teachers to be able to deliver [CSE] courses in a friendly manner and we need adolescent-friendly health professionals whom the kids will find at health centers and feel open to talk to,” she said.
"CSE is a cross-cutting subject now, but we wish it could be taught as a standalone subject. We hope that a standalone subject would show the importance of CSE and increase students’ knowledge,” she expressed.
Dr Rukundo at HDI called for a regular monitoring framework to assess the progress and impacts of the curriculum.
"Through the reports we get from the Ministry of Education, we would also like to see the progress made towards the implementation of ESA commitments. We would like to see the number of students who received comprehensive information on Sexual Reproductive Health and Rights. How many got pregnant despite having this information? Did all of them [those who got pregnant] drop out? How many were supported to go back to school? How many schools are fully implementing CSE? How much is being allocated to CSE implementation by different stakeholders? Those are the kinds of questions we need to get answered for proper monitoring of the curriculum,” he said.
In December 2021, ministers of health and education from the region will gather together to renew their commitments on the ESA commitments on CSE and SRHR for young people. In the meantime, stakeholders are leading consultative meetings in Rwanda and the region to ensure all partners including young people are contributing to the upcoming commitment.