comprehensive sexuality education unfpa

Every young person will one day have life-changing decisions to make about their sexual and reproductive health. Yet research shows that the majority of adolescents lack the knowledge required to make those decisions responsibly, leaving them vulnerable to coercion, sexually transmitted infections and unintended pregnancy.

Comprehensive sexuality education enables young people to protect and advocate for their health, well-being and dignity by providing them with a necessary toolkit of knowledge, attitudes and skills. It is a precondition for exercising full bodily autonomy, which requires not only the right to make choices about one’s body but also the information to make these choices in a meaningful way. And because these programmes are based on human rights principles, they advance gender equality and the rights and empowerment of young people. 

UNFPA works with governments to implement comprehensive sexuality education, both in schools and outside of schools through community-based training and outreach. UNFPA also promotes policies for, and investment in, sexuality education programmes that meet internationally agreed upon standards.

Comprehensive sexuality education is a rights-based and gender-transformative approach, whether in school or outside of school. It is most effective when comprehensive sexuality education is taught over several years by integrating age-appropriate information that accounts for the developing capacities of young people. 

Comprehensive sexuality education includes scientifically accurate information about human development, anatomy and reproductive health, as well as information about contraception, childbirth and sexually transmitted infections (STIs), including HIV.

But it also goes beyond information, helping young people to explore and nurture positive values regarding their sexual and reproductive health and rights. This education includes discussions about family life, relationships, culture and gender roles, and also addresses human rights , gender equality , bodily autonomy and threats such as discrimination, sexual abuse and violence.

Comprehensive sexuality education should recognize the unique needs of learners, especially vulnerable youth groups – such as LGBTQ+ youth, youth living with disabilities, young people in humanitarian settings, young people who use drugs, young people living with HIV, and young transgender people – and should be tailored to reflect their realities.

Taken together, these programmes help young people develop self-esteem and life skills that encourage critical thinking, clear communication, responsible decision-making and respectful and empathetic behaviour.

According to the International Technical Guidance on Sexuality Education , comprehensive sexuality education must be:

• Scientifically accurate
• Incremental 
• Age - and developmentally - appropriate
• Curriculum based 
• Comprehensive 
• Based on a human rights approach
• Based on gender equality 
• Culturally relevant and context appropriate 
• Transformative
• Able to help develop life skills needed to support healthy choices  

8 Key Concepts of Comprehensive Sexuality Education according to the International Technical Guidance on Sexuality Education

This education may go by other names, such as “life skills,” “holistic sexuality education”, “family life,” “healthy lifestyle,” “sex ed”, or “HIV” education. These names may imply differences in emphasis. For example, life skills education may include a focus on caring for sick family members, coping with loss or other similar issues.

No matter what it’s called, comprehensive sexuality education empowers all young people to know, demand and protect their rights. The importance of sexuality education has been recognized by numerous international agreements, including the 2030 Agenda for Sustainable Development and the Political Declaration on HIV and AIDS.

• Comprehensive sexuality education does not lead to earlier sexual activity or riskier sexual behaviour.
• In fact, these programmes reduce risky behaviours: About two thirds of evaluations show reductions in targeted risky behaviours. About 60 per cent of programmes had a positive effect on at least one behavioural or biological outcome, such as increased condom use or reduced unplanned pregnancies.
• Studies of abstinence -only programmes are either inconclusive or show abstinence-only education to be ineffective at improving health outcomes.
• Delivering high-quality comprehensive sexuality education requires training and support.
• Addressing gender and power issues also leads to better health outcomes.
• To be most effective, curricula must be tailored to the specific context and needs of young people.
• Engaging parents and communities as part of this education is critical. Sexuality education is most effective when school-based programmes are complemented by community-based initiatives.

UNFPA works to empower young people to shape the lives they want. That means mitigating adolescents’ risk of developing harmful behaviours, while promoting positive, protective actions and attitudes.

Comprehensive sexuality education is a key component of this strategy. UNFPA works with governments and partners to develop and implement comprehensive sexuality education programmes that meet international technical standards. UNFPA also advocates for policies on, and investments in, comprehensive sexuality education, both in and out of schools. For example, recognizing that traditional sexuality education does not meet the needs of all young people, such as populations outside of school, UNFPA and partners (UNESCO, WHO, UNICEF, UNAIDS) launched the International Technical and Programmatic Guidance on Out-of-School Comprehensive Sexuality Education in 2020 . This guidance provides evidence-based, human rights-centered guidelines and recommendations for reaching the most vulnerable young people. Out-of-school programmes often include community-based training and education, and may target groups such as married adolescent girls, youth engaged with sex work, homeless youth, migrants and refugees, LGBTQ+ youth, youth in remote rural areas, youth living with disabilities, or those living in conflict zones. 

In 2019, UNFPA launched an initiative for out-of-school comprehensive sexuality education specifically targeting frequently left-behind young people. This programme proved timely; it was adapted to continue reaching youth through digital technology during the COVID-19 global pandemic. For example, Latin America and the Caribbean region established a Centre of Excellence with digital training courses based on the out-of-school guidance. In Iran, UNFPA’s mHealth digital platform was adapted to allow young people to communicate with health experts. In Albania, online platforms were able to reach 35,000 young people during school closures.

Many countries have also been expanding the breadth of their curricula in response to UNFPA’s International Technical Guidance on Sexuality Education . In Lao People’s Democratic Republic, a participatory process was used to develop lesson plans and learning objectives after an analysis revealing a lack of gender, rights, sexual behavior and equitable social norms content in the existing Life Skills curricula. In South Africa, the guidance was used to develop lesson plans and training for teachers to empower them to address important sensitive topics that might otherwise be left out of the curriculum. Other examples can be found in The Global Status Report on Comprehensive Sexuality Education . For more information regarding what UNFPA is doing, please contact [email protected] .

Updated 13 September 2021.

Unpacking 5 truths about equality in sexual and reproductive health and rights today

• 16 April 2024

UNITED NATIONS, New York – Over the past 30 years, global commitments to sexual and reproductive health and rights have made remarkable advances: Maternal death rates have dropped by almost a third, the number of women using modern contraception has doubled and more than 160 countries have passed laws against domestic violence.

A new report by UNFPA, the United Nations sexual and reproductive health agency, traces the path that led to this progress and empowered millions with increased freedom and autonomy. But it also lays bare how little these improvements have affected the world’s poorest and most marginalized, for whom rights and choices remain largely out of reach.

These disparate realities are driven by inequality and discrimination, often hidden within our health systems and economic, social and political institutions. Achieving equity, then, requires exposing inequalities so that inclusive solutions can be imagined and implemented.

Below, read about where and how inequality shows up in our societies, lifting some communities up while pushing others behind – and about what can be done to counteract it and ensure a peaceful, prosperous future for all.

1. Inequalities in sexual and reproductive health and rights are everywhere .

In Ashgabat, Turkmenistan, Alia* and her husband were told that it was “undesirable” for them to have a baby. The reason? They were both blind.

Women and girls with disabilities often face discrimination when it comes to sexual and reproductive health, limited access to services and exclusion from comprehensive sexuality education. Some are even forcibly sterilized.

The particular challenges Alia and other women with disabilities face during pregnancy and childbirth reinforce one of the report’s main themes: That access to health and rights vary greatly from one region, country and person to another.

Disability status represents just one facet of identity that affects the right to health. Geography is another, with women in Africa around 130 times more likely to die from pregnancy complications than women in Europe. And as for women and girls from ethnic minorities, disparities in health-care access were found in all countries surveyed for UNFPA’s report.

2. Progress on sexual and reproductive health for all is stalling, and by many counts, unravelling.

For nearly 20 years, the global annual reduction in maternal deaths has been zero – meaning there has been no progress. Meanwhile, one quarter of women today report not being able to say no to sex with their husband or partner.

This means that despite investments, advocacy and rafts of legislation, women’s ability to exercise decision-making over their own bodies is diminishing. And while barriers to health have fallen quickly for the most privileged, they are standing firm for the most disadvantaged.

“Even in better-off countries, maternal death rates are higher among communities that continue to confront racial and other prejudices in everyday life,” UNFPA Executive Director Dr. Natalia Kanem said in her World Health Day statement . “We can and must do better.”

3. Sexual and reproductive health and rights are being politicized – and opinions polarized.

As half the world goes to the polls this year, many leaders have decided to base their political strategies on sowing division.

Anxieties over migration as well as low- and high-fertility rates are being weaponized by some policymakers to strike down sexual and reproductive health and rights agreements. Meanwhile others are making their legal systems less equitable by decriminalizing female genital mutilation or restricting the rights of LGBTQIA+ people, for instance.

Harmful stereotypes about women, girls and people with diverse sexual orientations and gender identities are too often peddled to justify gender inequality and homophobia, with dangerous consequences. As Efram*, a refugee from Syria who was struggling to access sexual health care in a new country, explained to UNFPA: “I can’t tell anyone that I’m gay because of the stigma. We are not recognized, and we don’t have any kind of rights”.

4.But there is hope: Where inequalities exist, community leaders are helping to bridge gaps in services.

Gender inequality, racial discrimination and misinformation are deeply embedded in many health systems: UNFPA research has found that in the Americas, Afrodescendent women are more likely to die during childbirth due in part to racist abuse in the health sector.

For these reasons and others – including cost and distance to facilities – Afrodescendent women may avoid going to hospitals for health care. “It wasn’t the environment I wanted,” Shirley Maturana Obregón from Colombia told UNFPA about her birth plan.

Instead, she delivered with a partera, a traditional birth attendant and practitioner of knowledge ancestral to Colombia’s Afrodescendent community.

Parteras provide culturally sensitive care among Colombian communities that remain largely disconnected from the country’s formal health system – and for whom getting to a doctor can require expensive travel across hazardous, conflict-affected terrain.

Ms. Maturana Obregón said her delivery with a partera was beautiful and unforgettable; she later became a traditional birth attendant herself. “We are there, making women’s dreams come true,” she said.

5. Progress is achievable, but we must reject division and embrace collaboration.

UNFPA’s report shows above all that we cannot divide and conquer on our way to ensuring universal health and rights. Rather, we must find political consensus, tailor solutions to communities and mobilize urgent funding to achieve our aims.

Grassroots leaders are essential to this work: Sarah Sy Savané, who advocates against female genital mutilation and child marriage in Côte d’Ivoire, says programmes aimed at eliminating harmful practices are designed by people working in the communities they target. “Safe spaces, husbands’ clubs and other interventions are making a real difference, shining a light where young girls thought they had no rights,” she told UNFPA.

Initiatives like these have tangible impacts, but they need more support. Spending an additional $79 billion in low- and middle-income countries by 2030 would avert 400 million unplanned pregnancies, save 1 million lives and generate $660 billion in economic benefits. Training more midwives could also prevent about 40 per cent of maternal and neonatal deaths and over a quarter of stillbirths. 

Funding saves lives, while a lack of investment endangers them.

The truth is that inequality is everywhere we look – and once its devastating consequences have been revealed, they cannot be unseen. As UNFPA Executive Director Dr. Natalia Kanem said, “We have every reason to act – for human rights, for gender equality, for justice and for the world’s bottom line.

There is only one way to achieve a future of dignity and rights for all: By working together.”

Related topics

• Sexual & reproductive health
• Maternal health
• Comprehensive sexuality education

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Interwoven lives, threads of hope - State of the World Population report 2024

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Tinubu launches UNFPA 2024 State of World Population report

P resident Bola Tinubu on Wednesday launched the United Nations Fund for Population Activities’ (UNFPA) State of the World Population report with a reaffirmation of his administration’s commitment to enhancing the welfare and empowerment of girls, women, and young people in Nigeria.

Speaking at the unveiling of the report at the Presidential Villa, Abuja, Tinubu emphasized the need to address the challenges facing this vulnerable demographic.

The UNFPA’s flagship State of the World Population Report is titled, “Interwoven Lives, Threads of Hope: Ending inequalities in sexual and reproductive health and rights.”

Wednesday’s launch followed the global launch, which held in Geneva on April 17, 2024.

The president, who was represented by the Minster of Health and Social Welfare, Prof. Muhammad Ali Pate, noted the imperative of ensuring that girls stay in school and avoid early motherhood, providing access to quality healthcare and services, and implementing laws to end gender-based violence and harmful practices such as early/forced marriages and female genital mutilation.

ALSO READ:FG partners IOM to enhance border security

He said his administration is committed to keeping hope alive for girls, women, and young people by fulfilling its promises to accelerate actions in Nigeria, adding that his government will ensure that no woman dies giving birth, and that every girl has access to quality education and healthcare.

Tinubu said that with a focus on strengthening the four D Principles of Development, Democracy, Demography, and Diaspora, the government aims to integrate modern solutions into policies and programs that benefit this demographic.

He stated: “Meeting the aspirations of the population affected by these inter-woven threads, who are mostly women, girls and young people, places a great demand and a sense of duty on us all to keep that hope alive. We must fulfil the promises to accelerate actions in Nigeria and ensure no woman dies giving birth.

“We must ensure that girls stay in school instead of becoming mothers at tender ages, provide access to quality health care and services everywhere, including accelerated access to family planning as fundamental for managing our population.

“Also, we must ensure the implementation of laws to end gender-based violence and harmful practices like early/forced marriages, female genital mutilation, that are against women and girls and indirectly against true and enduring development of our nation and people.

“The narrative in the paragraph that was just quoted above, are part of the concerns that formed the Renewed Hope Agenda, particularly anchored on strengthening the four D Principles: Development, Democracy, Demography and Diaspora, aimed at integrating modern solutions into our policies.

“With a dynamic population of 220 million that is youthful, growing fast and projected to 450 million by 2050, making us among the fourth or fifth largest, most populous countries in the world by then, and with our rich cultural diversity, we are poised to harness our demographic potential for development of our country.

“I want to assure you, that we are taking bold steps and committed to addressing issues that affect our youth reproductive health, and in December 2023 I launched the Nigeria Health Sector Renewal Investment Initiative, through the Ministry of Health and Social Welfare, which is anchored in a sector-wide approach and the Basic Healthcare Provision Pact.”

In her remarks, the Executive Director, United Nations Population Fund (UNFPA), Dr. Natalia Kanem, said that the State of World Population report highlights that since global measurements have been kept, two countries – India and Nigeria – have recorded the highest number of maternal deaths.

However, she noted that Nigeria has reduced the maternal death rate by more than 11 percent between 2013 and 2018, which she said must be applauded.

She said the remarkable reduction in the number of women worldwide dying in childbirth – 34 per cent since 2000 – is largely attributable to progress in Nigeria and India.

Kanem stated that the State of World Population report presents important data that show that in many countries inequalities in such key measures as access to health care have been reduced.

But she noted that in other places, disparities are actually widening

and inequalities still persist everywhere.

“Indeed, in some places, the rights of women, girls and gender-diverse people are the subject of increasing pushback,” she regretted.

According to her, there have been advances in combatting gender-based violence and harmful practices which has seen a 10 per cent drop in adolescents subjected to female genital mutilation in the past decade in Nigeria.

She also noted that as of 2023, 34 of the 36 states and the Federal Capital Territory have adopted the Violence Against Persons Act of 2015 into their own legal structures.

The UNFPA boss lamented that progress is slowing, adding: “After the impressive gains made in combatting maternal mortality, annual reductions in the number of maternal deaths have flatlined: since 2016, the world has made zero progress in saving women from preventable deaths in pregnancy and childbirth.

“One woman in four cannot make her own health-care decisions. One woman in four cannot say no to sex. And nearly 1 in 10 are unable to make their own choices about whether to use contraception.

“We have, for the first time, data on whether women’s bodily autonomy is strengthening over time – and in 40 per cent of countries with data, it is actually diminishing.

Kanem stressed: “We need to redouble our efforts to achieve comprehensive, universal and inclusive health care grounded in human rights and modern science.

She further said: “Despite progress the maternal mortality rate in Nigeria remains high, at over 1047 per 100,000 live births. UNFPA stands shoulder to shoulder with the government and people of Nigeria to change that statistic.

“Our report shows how investing in sexual and reproductive health benefits all of us.

“Comprehensive sexuality education, ending gender-based violence, promoting gender equality and ending unmet need for contraception, these steps would contribute trillions of dollars to the global economy, and unleash gains in terms of education, productivity, workforce participation, and human happiness.

“We have every reason to act – for human rights, for gender equality, for justice and for the world’s bottom line.”

Speaking earlier, Chairman of the National Population Commission, Nasir Isa Kwarra, noted that as the world population reached the 8 billion recently, Nigeria stood out as a major contributor and is among countries for the anticipated increase for the next 20 years.

“This calls for a re-think on the best and smart investments to undertake that will transform our numbers from quantity into quality for a peaceful and prosperous nation and indeed the African continent,” he said.

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