Introduction 

Ghana has a large youthful population between the ages of 15-35 constituting more than 50 percent of the total population according to 2010 population census. Notwithstanding the fact that more than half of the population being youthful, less attention have been given to this cohort group.Youthful period especially adolescents stage is characterized by a lot of confusion since most changes that occur in human growth occur within this period and changes such as physical, biological, psychological and social are evident at this stage. 

What is CSE?

Comprehensive sexuality education (CSE) is a rights-based and gender-focused approach to sexuality education, whether in school or out of school. It is taught over several years, providing age-appropriate, culturally sensitive and scientifically proved information consistent with the evolving capacities of young people. CSE includes information about human development, anatomy and reproductive health, as well as information about contraception, childbirth and sexually transmitted infections (STIs), including HIV.CSE is thesystematic approach to equip young people with the knowledge, skills, attitudes and values they need to determine and enjoy their sexuality - physically and emotionally, individually and in relationships. CSE encourage confidence and improved communication skills. Lastly CSE addresses gender inequality, vulnerabilities, exclusion and human rights violation, including gender-based violence and sexual abuse. 

History of CSE in Ghana

The history of CSE in Ghana dates back to the early 1957, where schools were teaching Civics and Hygiene and they covered human biology, personal hygiene and civic responsibilities. After Ghana gained independence in 1957, Civics and Hygiene were taught in schools. In 1967, the Planned Parenthood Association of Ghana (PPAG) was established and two years later, a government policy on “Population Planning for National progress”was published. This made Ghana, one of three African countries with a population policy. In the 1970s, PPAG pioneered the in-school teaching of adolescent sexual and reproductive health. In 1972, government introduced the Environmental/Social Studies syllabus, with aspects such as sexual and reproductive health, the family, reproduction and sexuality with emphasis on abstinence. Later in 1987, the government introduced a new Structure of education and with it, came the introduction of Life Skills. In 1998, the Life skills syllabus was replaced with Social Students and was expanded to include issues on HIV and AIDS

In 2000, the government published its first Adolescent Reproductive Health Policy (ARHP), which adopted a multi-sectoral approach to addressing adolescent reproductive health issues. The policy explicitly encouraged and led to the inclusion of a reproductive health component in the educational curriculum at the primary, junior high and senior high school levels. In 2013, the National HIV and AIDS, STI Policy advocated for the inclusion of age-appropriate SRH education in the school curriculum, which includes lessons on HIV/AIDS and other STIs. In 2015, the Government revised the ARHP and renamed it, the Sexual and Reproductive Health Policy for Young People in Ghana.The vision for the new policy is “to have young people who are well informed about their sexual and reproductive health and rights, and are healthy.”

Benefits of CSE

The Programme of Action of the 1994 International Conference on Population and Development tasked governments to provide sexuality education to all manner of people including adolescents, specifying that such education should take place both in schools and at the community level, be age-appropriate, begin as early as possible, foster mature decision-making and aim to eliminate gender inequality.  CSE provides an opportunity to equip young people with the knowledge and skills to make responsible choices in their lives, particularly where HIV prevalence is high. Other benefits include abstinence from or delay having sexual relations, avoiding the frequency of unprotected sex when they become sexually active, know the risk of having several sexual partners and so therefore will stick to one partner, understanding the benefits of family planning methods during adulthood stage.  CSE help adolescents understand themselves biologically and prepare to face the world so that they do not fall victim to sexual predators. Researches indicate that adolescents who received CSEs are 50% less likely to experience teenage pregnancy.  Adolescents who have been exposed to CSE know more and feel better prepared to handle different situations and difficult decisions than those who have not. Adolescents who have comprehensive sex education are NOT more likely to become sexually active or experience negative sexual health outcomes; instead, 30% of comprehensive sex education programmes reduce the frequency of sex.

Efforts of PPAG 

In 2017, a National CSE Guidelines was developed by the National Population Council with support from several CSOs including PPAG and it is being used to develop curriculum for in and school adolescents as well as a training guide for out of school adolescents. The national guidelines has nine broad themes which covers areas including Culture, Values and Attitudes, Keeping Healthy, Human Development and Family and Building Good Relationships with Others.  In 2012, UNESCO and International Planned Parenthood Federation (the mother body of PPAG) started a process of assessing the quality and comprehensiveness of both public and CSO based CSE content and delivery approaches. The objective of this assessment was to help facilitate the review of CSE interventions across the world ensuring that content, approach and targeting met the UNESCO set standards. This led to the development of a CSE Manual called “All-In-One”.  PPAG initiated a similar review process in 2016 within the National context. This lead to the development of the “KnowItOwnItLiveIt” CSE manual for young people, which was launched in May 2017 by the Minister of Education. A large portion of the National Guidelines on CSE was extracted from the manual. 

Conclusion

It will be recommended that, government treats the inclusion of the CSE National Guidelines into the school curriculum, as a matter of urgency. The Ministry of Education, Ministry of Youth, the Ministry of Health and their respective agencies that work in the areas of CSE and the Youth should buy into the adoption of CSE and ensure that, the youth of this country get access to comprehensive and fact based information and services on CSE. The National Youth Authority will be tasked to equip its Youth Leadership Training Institute across the ten regions with the needed structures to educate out of school adolescents on CSE. CSOs should also be trained and registered to reach out to the youth in their areas of operation with CSE. The Media should help explain the importance of CSE to the nation and help clear the myth that, promotion of CSE means promotion of irresponsible sexual behaviours among the youth. 

Several researches have shown shows that CSE does not encourage adolescents to engage in sexual activities but rather it gives them the right information on their sexuality and exposes them to the several benefits of staying away from sex.  The era of “Don’t do that or Don’t do this” concerning education on sexuality is over. Adolescents in Ghana need honest and effective CSE to ensure that, they have access to the right information and services on their sexuality. Failing to put in place such a system will not only jeopardize their lives but also that of the country and generations yet unborn. 

The author - Archibald Adams - is the Advocacy Coordinator of the Planned Parenthood Association of Ghana (PPAG), the leading CSO on Sexual Reproductive and Health Rights in Ghana. His email address is [email protected]