Philippines Toolkit: AYSRH Community Support
Comprehensive Sexuality Education
Youth need and have the right to comprehensive information about their sexual and reproductive health. There is growing international consensus and evidence that this information should be age- and developmentally-appropriate and scientifically accurate. Comprehensive Sexuality Education (CSE) should be curriculum-based and incremental, starting at an early age and providing new information that builds upon prior learning. CSE is comprehensive in that it provides an understanding of sexual and reproductive health and rights (SRHR) in the broader context of young people’s lives to equip them with the knowledge and life skills they need to make informed decisions, to enjoy their sexuality, to mitigate vulnerabilities (including those specific to the urban environment), and to protect their health, well-being and rights.
In the Philippines, comprehensive sexuality education is governed by the following two policies:
- Republic Act 10354, The RP-RH Act of 2012 This is a national policy that mandates the Philippine Government to comprehensively address the needs of the Filipino citizens when it comes to responsible parenthood and reproductive health. Relevant salient provisions include: 1) access to reproductive health and family planning services; 2) maternal health care services, including building capacities of skilled birth attendants and improving facility-based deliveries; 3) delivery of comprehensive sexuality education for the youth.
- DepEd Order #31, series of 2018. This issuance is entitled, the Policy Guidelines on the Implementation of Comprehensive Sexuality Education, was enacted pursuant to the provisions of the RP-RH Act of 2012. Learning materials on CSE was developed in 2018 and submitted to DepEd Central Office for quality check, approval and launching.
What are the benefits of CSE?
- Enables positive health-seeking behaviors by increasing knowledge about different aspects of sexuality, behaviors and risks.
- Reduces risky sexual behaviors, increases knowledge and use of contraception and can protect adolescents and young people from HIV by improving attitudes related to SRH.
- Can reduce adolescent and youth vulnerabilities to violence by promoting bodily integrity, self-confidence and negotiation skills, and gender-equitable norms.
How to implement
CSE has been shown to improve adolescent SRH knowledge, attitudes and behaviors when implemented well. Before commencing the development of a CSE program, stakeholders—including youth—should agree on the program’s aims. This has already taken place. As a result, this approach simply provides the materials and guidance for rolling out CSE trainings and providing teachers with how-to materials to develop their own session guides.
For the National CSE Training, DepEd has prescribed that most teachers intend to implement CSE but only a few of them have started. They need support to increase intention and behavior in implementing CSE and improve the quality of outcomes. See the helpful tips on the right sidebar for examples.
The below steps are prescribed based on the insights from a Baseline Assessment of Capacities in Teaching CSE of Philippines Public School Teachers from Regions 1, 7 and 11.
Step 1: Increase awareness about CSE
Awareness campaigns and orientations should be rolled out to clarify the scope and limitations of implementing the CSE curriculum. The awareness campaigns must emphasize the features desired for an effective CSE curriculum and clarify the common misconceptions about CSE. Aligned with the common misconceptions about CSE, some teachers are apprehensive about implementing CSE due to questions or concerns about CSE’s age appropriateness, CSE possibly leading to sex or confusion and CSE going against cultural or religious beliefs. The teachers should also be reminded that using up-to-date scientific knowledge can be balanced with being culturally responsive. Furthermore, interventions should include information on where and how to access the different resources such as funding, learners’ materials, teachers’ resources, co-curricular programs and mentoring.
Step 2: Increase self-efficacy in teaching CSE
Having more experience in teaching CSE and being able to picture themselves teaching CSE would increase one’s self-efficacy. For teachers to have actual experience, the DepEd and school administration should ensure that CSE is being implemented through concrete monitoring and evaluation processes instituted in the school. More than the required lesson plans and logs, the administration could support teachers in coming up with their own way of monitoring their progress in implementing CSE. They know what would work best in their school context and this could also deepen their ownership in implementing CSE. They could start the process by having a workshop or structured learning experience to determine their goals and success indicators, then brainstorm and prototype simple and easy-to-implement solutions for monitoring their progress.
See the presentations used during the Nationwide Training of Teachers for guidance on how best to integrate the CSE curriculum.
Step 3: Map and convene lead stakeholders in the city that are involved or can be involved in CSE
- Mayor to call for meeting, he/she can utilize existing governance or coordinative body like the city’s school board, CIT or TCI’s City Leadership Team to discuss CSE implementation
- City Health Officer/Local Population Officer or specific person assigned by the city mayor to do pre-work meeting with the Department of Education through Regional Superintendent covering the city to level off areas of objectives and target outputs during the Mayor’s meeting with the stakeholders
- Proposed objectives of the meeting:
- Determine the current updates of the CSE development/implementation at the national level as per (1) DepEd Order #31, series of 2018 and (2) DepEd Memorandum No. 2020-0237 subject: National Online Training of Teachers on the integration of CSE in the K to 12 Basic Education Curriculum
- Explain the situational analysis of the City’s school system and Adolescents and Youth Profiles based from the deep dive activity and other primary and secondary data available
- City’s Health system detailing the number of schools, teachers, accomplishments and challenges and the education indicators like completion rate and dropout rates, etc.
- Existing CSE efforts or its equivalent that have started/done by the city
- Number of students particularly ages 10-19 years old enrolled as per current school year vis a vis some vis past two years at all levels: Elementary, High school and Vocational schools and College/University
- Number of students that are city residents and non- residents (in-migrants); if available
- Number of students become pregnant or first time parents while in school in the current year and in the past two years if available
- Recognize the importance of CSE implementation of the city and how serious is the issue of teenage pregnancy
- Identify immediate next steps as to the implementation of CSE in the city despite the limitations of the national government rolling it out to non-pilot cities yet.
- Proposed objectives of the meeting:
|Note: As of September 2020, the national government held a national training of trainers on CSE for identified pilot regions, covering specific provinces and cities only: Region 1-Pangasinan I and La Union, Region 7-Cebu City and Dumaguete City and Region 11-Davao del Norte and Compostela Valley.|
Step 4: City sends formal communication to Department of Education at the Central and Regional level regarding CSE implementation
Signed by the City Mayor, the letter can contain the city’s recognition of teenage pregnancy as “national social emergency” (as per Former NEDA Chair Ernesto Pernia, 2019) thereby city’s expression to call for urgency in reducing teenage pregnancy and adolescent births and its city support and interest to start the CSE implementation already or for the interim develop localized CSEs if nationwide rollout is not yet available. City to request all the possible resources that can be solicited from the national government for technical assistance, fund support, human resource complement, etc.
Step 5: Mayor with TCI City Leadership Team/CIT or its equivalent body together with DepEd Regional Director calls for a high level meeting with the schools
Mayor calls for a high level meeting together with the DepEd Regional Director, Divisions schools superintendent and elementary and high school principals from private and public schools, Alternative Learning System (ALS) as well as the University Officials to share his vision for the city and explain how the CSE will be used as an approach in faster reduction of teenage pregnancy and adolescent births in the city.
Step 6: Create a detailed plan and budget for the implementation of localized CSEs in the schools under the target barangay utilizing existing materials
If the TCI Geographies/TCI Diffusion sites are not a CSE pilot city of the national government then a city technical working group on CSE led by the City Population officer together with DepEd should create a plan and budget for the implementation of localized CSEs in the city, particularly in schools under the target barangays that have high rates of teenage pregnancies and adolescent births.
Step 7: Conduct preparatory work prior to the CSE launch for school year 2021-2022
The city should already conduct preparatory works prior to the CSE launch, i.e., training of trainers or retooling on currently available modules/materials.
Materials for Teachers to Adapt Locally
- Learning Now, Learning New, Learning Next: Orientation of Teachers on the Awareness of CSE
- CSE Primer for Parents and Guardians: Manual, PowerPoiints, and Printables
- SHAPE modules
- Training designs for teachers
- Other CSE Resources, such as Roots for Health’s K-12 CSE curriculum
Due to CoVID-19 pandemic, it is safe to assume that face-to-face learning set up in schools by school year 2021-2022 may not be happening. Therefore, the modalities of delivery of the localized CSEs should be in a synchronous and asynchronous set up.
Step 8: Roll out of localized CSEs in target barangays
As the CSEs are being rolled out in the city, the following are examples of leadership acts of TCI-engaged leaders at the city and barangay level. These will be covered in greater detail as part of the practicum in Leadership for Adolescent and Youth Friendly Cities (LAYFC).
- Issue or endorse policy to implement localized comprehensive sexuality education
- Present to DepEd and other stakeholders the progress of localized CSE efforts and solicit support to strengthen it
- Instruct the team to adjust the localized CSE once the national CSEs has been rolled out
City Leadership Team led by the City Population Officer
- Recommend and remind to Mayor the possible of CSE budget if needed
- Engage youth leaders participation in service delivery and demand services
- Local Population Officer leads the meetings developing the CSE modules
- Coaches others by identifying development opportunities to help them make the
most of their skills and potential
- Encourages participation of other stakeholders who may have different perspectives on CSE
- Monitor the CSE implementation in the schools covered by his/her barangay
- Issue or endorse policy to implement localized comprehensive sexuality education
Youth Group Leaders
- Participate in CSE in schools covering his barangays
- Promote in social media and other platform the CSE
Step 9: Monitor and Evaluate the CSE implementation
The city must conduct a mid-year, end of year and post-school year monitoring and evaluation of its milestones, accomplishments and challenges. The data analysis should include number of students reached with CSE versus number of adolescent births and teenage pregnancies. Also, a survey can be done to see if CSE has association and correlations with delays in sexual debut among adolescents and youth and reduction of second pregnancies for adolescent and youth first-time parents who are currently enrolled in school.
Step 10: Adjust localized CSEs in the event that the nationwide CSE is ready for implementation
The TCI geographies/Diffusion sites must adjust and complement their existing localized CSE efforts in the event that the national government is set to roll out the CSE in their city. This is with the assumption that the city will develop and implement localized CSEs first, while waiting for the nationwide’s roll out by SY 2021-2022 or the year after.
Indicators for success
The CSE integration is considered successful when these have been attained:
- Policy issuances of the LGUs supporting CSE
- Training of teachers
- Actual integration of CSE in lesson plans of teachers
- Evidence of its short-term impact (i.e., quick survey on knowledge and attitudes of students receiving lessons with CSE integration)
- Evidence at the outcome level (e.g., changes in adolescent birth rate)
Resources needed for interpersonal interface:
- Printed materials
What’s the evidence that CSE strengthens AYSRH programming?
- CSE advances knowledge and use of contraception, particularly condoms.
- UNAIDS recommends CSE as one of the five pillars of HIV prevention, along with economic empowerment and access to SRH services for young women and adolescent girls and their male partners (particularly in high-prevalence locations).
- An analysis of evaluated CSE programs by Haberland (cited in Chandra-Mouli) reveals that programs that incorporated an empowerment approach emphasizing gender and rights were particularly effective in improving reproductive health outcomes.
- Interventions to increase demand for SRH services are most effective when education and communication efforts are directly linked to the supply of services; where there is community and social support for the provision of services; and where there are multisectoral approaches (e.g., operating in both the health and education sectors).
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- Conduct awareness campaigns and orientations to familiarize teachers and other stakeholders about the scope of CSE and to clarify common misconceptions.
- Institute concrete and easy-to-implement monitoring systems in schools to allow teachers to gain experience in teaching CSE.
- Nurture peer learning opportunities and support systems through learning action cells (LACs) and CSE-related conferences.
- Hold community-based interventions and events related to CSE to provide the social encouragement that teachers need.
- Having school teachers teach CSE is often challenging due to lack of skills and training in this area as noted in the baseline assessment. Skills related to explaining facts tend to have higher mean self-efficacy ratings than those related to having more open-ended discussions and a learner-centered approach. The skills with the lowest mean ratings involve using up-to-date scientific knowledge and creating age-appropriate activities.
- While some teachers reported that they are equipped with teaching strategies, other teachers have apprehensions. They have concerns about handling different topics and specific age groups. Some teachers also see technology as a helpful factor in teaching CSE, but some see online teaching as a weakness.
- Collaborations among teachers should be encouraged and teachers could benefit from having CSE-specific LACs within their school. However, only 42.15% of teachers said they had access to CSE-related peer education opportunities and 34.04% to CSE-related mentoring or supervision.
- The teachers’ responses to items on perceived norms also reflected concerns about perceived negative attitudes from others in the community about CSE.