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Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. School of Public Health, Department of Health Promo‑ tion and Policy Management, University of Zambia, Ridgeway Campus, Lusaka, Zambia.ORCID-id: 0000-0003-1189-7194
School of Public Health, Department of Health Promo‑ tion and Policy Management, University of Zambia, Ridgeway Campus, Lusaka, Zambia.
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.ORCID-id: 0000-0001-7087-1467
2022 (Engelska)Ingår i: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 19, nr 1, artikel-id 196Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

BACKGROUND: Comprehensive sexuality education (CSE) plays a critical role in promoting youth and adolescent's sexual and reproductive health and wellbeing. However, little is known about the enablers and barriers affecting the integration of CSE into educational programmes. The aim of this review is to explore positive and negative factors influencing the integration of CSE into national curricula and educational systems in low- and middle-income countries.

METHODS: We conducted a systematic literature review (January 2010 to August 2022). The results accord with the Preferred Reporting Items for Systematic Reviews and Meta-analysis standards for systematic reviews. Data were retrieved from the PubMed, Cochrane, Google Scholar, and Web of Hinari databases. The search yielded 442 publications, of which 34 met the inclusion criteria for full-text screening. The review is guided by an established conceptual framework that incorporates the integration of health innovations into health systems. Data were analysed using a thematic synthesis approach.

RESULTS: The magnitude of the problem is evidenced by sexual and reproductive health challenges such as high teenage pregnancies, early marriages, and sexually transmitted infections. Awareness of these challenges can facilitate the development of interventions and the implementation and integration of CSE. Reported aspects of the interventions include core CSE content, delivery methods, training materials and resources, and various teacher-training factors. Reasons for adoption include perceived benefits of CSE, experiences and characteristics of both teachers and learners, and religious, social and cultural factors. Broad system characteristics include strengthening links between schools and health facilities, school and community-based collaboration, coordination of CSE implementation, and the monitoring and evaluation of CSE. Ultimately, the availability of resources, national policies and laws, international agendas, and political commitment will impact upon the extent and level of integration.

CONCLUSION: Social, economic, cultural, political, legal, and financial contextual factors influence the implementation and integration of CSE into national curricula and educational systems. Stakeholder collaboration and involvement in the design and appropriateness of interventions is critical.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2022. Vol. 19, nr 1, artikel-id 196
Nyckelord [en]
And rights, Collaboration, Comprehensive sexuality education, Factors, Health, Integration, Sexual reproductive
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-199982DOI: 10.1186/s12978-022-01504-9ISI: 000861892400001PubMedID: 36175901Scopus ID: 2-s2.0-85138856592OAI: oai:DiVA.org:umu-199982DiVA, id: diva2:1700967
Tillgänglig från: 2022-10-04 Skapad: 2022-10-04 Senast uppdaterad: 2022-10-13Bibliografiskt granskad

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Chavula, Malizgani PaulZulu, Joseph MumbaHurtig, Anna-Karin

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