Despite its reported positive deliverables, comprehensive sexuality education (CSE) in South African schools is unable to document an influence in reducing alarming statistics regarding adolescent sexual health. Prior research points to a gap that exists between what studies suggest and what is implemented in practice.
Drawing on Freire’s theory of praxis, the aim of this study was to involve the voice of adolescents in reforming CSE – specifically, how the programme could be developed with the objective to co-construct a praxis in order to support sexuality educators in a delivery of CSE that is more responsive to the needs of adolescents.
Ten participants were purposively selected from all five school quintiles in the Western Cape province of South Africa to take part in this study.
A qualitative descriptive design with aspects of a phenomenological approach was utilised. Rich data were collected by means of semistructured interviews and were analysed thematically with ATLAS.ti.
The results illustrate the suggestions made by the participants towards the improvement of the CSE programme. They reported on approaches and strategies used to teach CSE that imply that it is often not delivered comprehensively – confirming the disjuncture between what the curriculum envisages and what is executed in practice.
The contribution might lead to change in disconcerting statistics and consequently an improvement in the sexual and reproductive health of adolescents.
The participants from this study assisted in co-constructing a praxis for CSE teachers to inform their practice.
Comprehensive sexuality education (CSE) has been part of the South African school curriculum – more specifically, within the subject Life Orientation (LO) – since 2000. However, in all that time it has not succeeded in impacting the sexual behaviour of learners to such an extent that significant changes were evident in alarming statistics regarding the sexual health of young people in South Africa.
Since the implementation of CSE, numerous research studies have been conducted that investigated its status in South Africa. A systematic review by Koch and Wehmeyer,
To attend to this gap that often exists between theory and practice,
Furthermore, praxis is distinct because its explicit goal is to empower marginalised people and help them challenge their oppression,
Consequently, it was the aim of this study to involve adolescents who are taught CSE in South African schools, to understand from their perspective how the programme could be developed, with the objective to co-construct a praxis to support sexuality educators in a delivery of CSE that is more responsive to the needs of adolescents. The authors aimed to answer the research question: How can the lived experiences of adolescents be used to co-construct a praxis that educators can use to deliver the CSE programme for it to be more responsive to their needs?
A descriptive qualitative research design was deemed most appropriate, with aspects of a phenomenological lens of inquiry, because the authors were interested in obtaining insight into the life-worlds
Moreover, the authors were interested in co-constructing a praxis with adolescents – the worldview that was most suitable for this study was an advocacy or participatory one.
After obtaining ethical clearance from the Faculty of Education Ethics Committee at the University of the Free State, together with permission from the Western Cape Education Department and school principals, possible participants were identified by LO teachers from respective schools. The participants and their parents or guardians signed assent and consent forms, whereafter data were collected at the respective schools by means of semistructured individual interviews. Probing and follow-up questions were posed to enable a comprehensive exploration of the life-worlds of adolescents.
For a qualitative descriptive study with aspects of a phenomenological lens, a smaller unit of analysis is advised.
As suggested by Miller and Salkind,
All of the ethical aspects of research, such as voluntary participation, informed consent and assent, the avoidance of harm, no deception, anonymity and confidentiality, no violation of privacy and the debriefing of participants after the completion of the project, were adhered to.
The research process was cleared by the University of the Free State’s General and Human Research Ethics Committee (ref. no. UFS-HSD2021/0024/123).
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The confidentiality of data is maintained by storing data on a double password-protected device that only the primary author has access to.
Seven themes emerged from the data analysis, deriving initially from 58 codes and 12 subcategories. By relying on the lived experiences of adolescent participants, the following recommendations were made by them with the aim to improve the current CSE programme. Quotes were added
The most dominant theme that emerged from the data was that the participants would like teachers to cover all the content as prescribed by the curriculum and to cover it in depth. It was mentioned how the textbook sometimes covers content more extensively than what is in fact dealt with in the classroom:
‘I also read every now and then and through the textbook before I write test and then I will see that the textbook is much more open about it. So, the textbook is not always one-sided. Like in class, with the teacher, then I would just say also have more conversations about it and not always be one-sided about it.’ (P2GQ5)
The participants specified that they view it as being to their disadvantage if teachers decide to exclude certain content from their learning experience. They were of the opinion that if the content were covered comprehensively, they would be better prepared to deal with the challenges that might come their way. They passionately requested that nothing should be kept from them:
‘People have to tell me what’s going on. So, I will listen to anything. If you tell me what is contraception, and what is that, then I will listen. Because why? I need to know this; I need to know everything to adjust in life.’ (P9BQ1)
‘You might end up when you grow up and you maybe fall pregnant and you’re like, no one told me this, I wasn’t taught, I didn’t know! Why didn’t anyone tell me those were the procedures that I could follow in this? So, I feel like the education is very important.’ (P4GQ4)
Even if a variety of topics are covered, the participants were dissatisfied regarding topics that are merely touched on superficially. They would like content to be covered objectively, comprehensively and thoroughly. The participants mentioned how teachers tend to decide what to include and exclude from the curriculum based on their subjective and sometimes moralistic views as to what is appropriate, as well as their level of comfort in discussing the topics with learners. When teachers use this approach, the participants were of the opinion that there is no room for other views, and it discourages participation from learners with varying opinions. Some of the participants felt that they are judged by teachers and peers when asking questions. It is as if their questions are an indication of what is going on in their personal lives, and this further discourages interaction:
‘He [
‘Now the one might be asking a question, then the learners think it’s about that one’s life.’ (P10GQ1)
In general, the participants also shared their opinion that too little time is spent on SE. They argued that such an important topic is deserving of more time. Some believed the topic to be of the utmost importance, stating that it should be a subject in its own right, taught separately from LO:
‘It’s like a chapter or two in your textbook and they also move very quickly over it.’ (P2GQ5)
‘Many learners do not pay attention in LO periods, it’s where people sleep or do homework, so I think maybe if one every now and then like a course like that we had in Grade 6, a course that learners can attend during their grade period or grade assembly meeting because then one also pay more attention than in LO.’ (P2GQ5)
‘I think, instead of making the sex ed part of LO, it should be made his own [
The second biggest theme that emerged was that teachers still tend to rely on traditional methods of teaching where learners are passive onlookers in the process of learning. The participants voiced their dissatisfaction with such methods, stating that they prefer to be more actively part of lessons:
‘Do you know there are a lot of teachers I’ve heard of already, who uhm, they do not talk to the children, they basically read what’s going on in the book.’ (P5BQ3)
‘Last year, we had to copy the textbook, the whole textbook … it does not benefit the children to write everything down, Miss. They get nothing out of it, not even examples.’ (P6GQ3)
‘Sometimes it’s just words and words and words and words, and read and read and read, which a person doesn’t actually absorb.’ (P4GQ4)
‘Teacher has not yet asked us questions about what we think about sex or so, but he is with the book. He will open his notes and then he will read to us what sex is about, he will read it to us more, but he will not ask questions.’ (P10GQ1)
One of the participants mentioned specifically how a teacher used two hard-boiled eggs to explain sexual promiscuity. She smashed one egg, comparing it to a girl who is sexually active, and the other egg without any damage to a girl who preserves her virginity. The participant mentioned how she recently got a boyfriend, and how she still thinks she would like to be a ‘good egg’ and not a ‘bad egg’, but she lacked the skills on how to say ‘no’ to the pressure of wanting to engage in sexual activity with her boyfriend. The participants would like the learning experience to be one where skills could be practised:
‘I do not know, like when you’re in a relationship, like the temptation is always there and I think they do not always teach you, you are always going to sit with it, and it’s hard and yeah, like for example, I got a boyfriend like two months back and it’s always sitting there, but it’s like no I can’t, I have to wait. And they do not teach you that.’ (P2GQ5)
The participants would also like lessons to be more interactive and hands-on, where they are allowed to reflect upon their own realities:
‘I want them to show me, for example, sorry if this is inappropriate … They put something here, then they say this is how you put [
‘You can also ask them what is happening in their community, especially now like teenage pregnancy … I believe it happens in every community. You can ask them questions about their community and so on. As what is happening in reality around them and how can they improve it.’ (P10GQ1)
The participants, in fact, praised teachers who make use of interactive methods to teach SE:
‘I feel like my teacher personally, she’s really good because she really gets to interact with the learners. She actually connects with the children, like, tells them, like, yeah. It’s a more intimate conversation with each and every one of the learners in the classroom.’ (P4GQ4)
The participants revealed that their exposure to SE through LO has been limited or once-off – for some even nonexistent – and that most of their exposure to SE has been through outside organisations who visit the school for the purpose of educating children mainly about the prevention of harmful consequences of having sex. They shared the belief that teachers sometimes think it is better for learners to receive no information at all, as the sharing of information will put ideas in their heads that will cause them to think and do things that they would otherwise not have considered. The participants were of the opinion that learners who are excluded from SE are at a disadvantage, because they will not be prepared for the choices they will have to make. They emphasised the importance of SE, and that it should be a compulsory subject:
‘So, I don’t know why the teachers don’t do it but I think it would be amazing if they were forced to teach us, not to choose. It should be mandatory.’ (P3BQ4)
‘I cannot really remember in Grade 11 that we did anything about sexuality education at all, but I do not know if they just took it out due to COVID, but I cannot remember anything about it at all. But in Grade 10 it was also very quick. In high school we do very little about it, but sexuality education I do not think I have heard any of it from school.’ (P2GQ5)
‘In Grade 6 people came to our school and talked to us about it. They showed us photos of what the stuff looks like. I think it’s one of the biggest encouragers not to be sexually active [
‘So, they talked about it once-off?’ (Interviewer)
‘Yes, today is the [
‘No, in LO we mostly only deal with stress management. Not really sex education.’ (P10GQ1)
In contrast to the preference of participants for teachers to deal with content in the above-mentioned manner, the participants revealed that in general, teachers tend to focus mostly on the harmful effects of sexual activity, and they neglect and omit other content:
‘We have very few LO lessons, but it’s more like, okay yeah, uhm, this is sex, don’t do it. Next topic.’ (P2GQ5)
Some of the tactics used by teachers are so shocking that the participants could remember it years after being exposed to it, such as being shown graphic images of sexually transmitted infections. The participants believed that teachers use such tactics to try and scare them away from sex:
‘It almost scares you away from sex. Uhm, but that is also unhealthy, because it does not balance out by teaching you that your sexuality is okay and healthy and normal. If it makes sense?’ (P1BQ5)
Although the participants acknowledge the importance of learning about contraception and the prevention of diseases and infections, they find this one-sided approach harmful and would appreciate a more objective approach where the personal beliefs of teachers are not forced onto learners and where positive aspects of sex and sexuality are included:
‘I think the off-putting aspect, of how sexuality is not portrayed as a healthy, normal part of you, because I also think with teenagers it’s a big problem. We are all terribly uncomfortable with our bodies and who we are. Uhm, and … [
The participants often mentioned, intentionally and unintentionally, how different gender roles, gender biases and gender discrimination are at play and reinforced in CSE. They indicated that specifically girls and women who engage in sexual activity lose their worth because of their actions. One of the boy participants shared the example he heard from a teacher where a woman who had more than one sexual partner was compared with a gift that was opened and then regifted, losing her value after each regift. More examples were shared that place an emphasis on how particularly girls and women are judged for being sexually active:
‘I think they should talk more about how the girls should protect themselves from every boy out there and they should say no … the time is not right now. And who is looking for a wife now after a few years, that he thinks it is the woman I want to marry, and then you find out that she’s been lying with so many boys already, and stuff … What do you have left for yourself then.’ (P7BQ2)
‘You feel you will lose some respect for her?’ (Interviewer)
‘Yes.’ (P7BQ2)
‘Now your boyfriend leaves you, you get another boyfriend, and so on … then people are going to classify you as bad, because you’re going from boyfriend to boyfriend. So many failures will happen. So, they’re also going to classify you as bad, and I think mostly one can wait until you are married.’ (P10GQ1)
In addition, the onus seems to lie specifically on girls, rather than on both genders, to abstain from sex and take responsibility for its consequences:
‘I think it’s because if they managed to get this message in the girls’ heads. If the girls can decide, no we’re going to abstain, then the boys won’t have anyone to actually have sex with. If they get one party on the right path, then, yeah.’ (P4GQ4)
The male participants, however, felt frustrated. They are often viewed as scapegoats and blamed for things that go wrong in sexual relationships:
‘What I like the least is when they keep blaming the boys over the matter. It’s always the boys’ fault. But what my mother told me is that the girl always has the last say about her body. So, it depends on both.’ (P7BQ2)
The SE of boys is specifically deemed to be neglected, and the advice provided by the participants is that equal attention should be given to both genders:
‘I feel most of the time when they speak about sexuality, they speak more to girls than boys.’ (P4GQ4)
‘Ever since primary school it was always the girls, because they would be given their stuff for their periods and everything, but we were never taught anything.’ (P3BQ4)
The participants highlighted how they benefit from learning from other people’s experiences, especially from people who have made mistakes in the past. They welcome case studies or class visits from individuals who share their insights with them:
‘People have to just volunteer themselves to say I will talk about my experience with it and so on. Schools should get this. Just get people to come talk. This will help a lot. For example, if someone went through the same experience, then they will just feel but look where that one actually is and see where I am now, I also have a younger baby, so I can rise above my circumstances and so on.’ (P8GQ2)
‘Maybe if we show you a bit real life consequences, they will be able to understand why it should not be done.’ (P3BQ4)
‘Do you mean like a video of someone who talks about, or maybe a visitor?’ (Interviewer)
‘Yes, someone who actually went through it.’ (P3BQ4)
‘I think people talk to kids about this but only to inspire them too about what they went through, and not to lead them on the same path they went through. To keep them on the right path.’ (P7BQ2)
‘Or like examples of people who ended up in the situation and how they dealt with it so you more or less have an idea of how you can deal with it.’ (P2GQ5)
The results of this study indicate that based on the lived experiences of the participants as receivers of CSE, they are aware of the misalignment between CSE and their lived experiences. The participants would like content to be covered comprehensively concerning the amount of time spent on it, as well as the depth in which they are allowed to delve into topics, and no content should be omitted from what is discussed with them in class. They prefer interactive learning where they can actively participate in the process of learning. It should be highlighted that although the participants deemed it important to know about the consequences of irresponsible sexual activity, a more positive approach should be employed when teaching about sexuality, such as intimate relationships, desire and pleasure, without causing shame for wanting to explore such aspects. The participants proposed that egalitarian gender norms should be advocated, rather than gender biases and discrimination that are often projected onto them based on the subjective views of teachers. Lastly, the participants favoured learning from real-life examples through case studies shared in the textbook or class visitors who share their experiences.
It is ironic that most of the issues highlighted by the participants are already supposed to be part of practice, as CSE forms part of a compulsory, well-researched and developed curriculum
The participants identified the problem with CSE delivery to be twofold: (1) SE content delivered is not comprehensive enough, meaning that only certain topics (mostly pertaining to the prevention of harmful consequences of sex) are attended to as decided subjectively by teachers, and (2) topics are not taught comprehensively, which means teachers only touch the surface of topics that they do in fact teach about, but they do not allow for in-depth discovery, reflection and discussion. Some of the approaches followed by teachers are not responsive to the needs of adolescents and could even be viewed as damaging, as ignorance will hamper adolescents in their ability to protect themselves from harmful practices or sexual exploitation.
The themes that emerged from this study indicate a unified, categorical appeal from learners to teachers to change their teaching approaches firstly by making learners a more active part of SE lessons. This request is supported by Kolb’s
Secondly, the participants implore that more positive approaches be used when teaching about sexuality. Research confirms that CSE is predominantly taught from a discourse of danger and disease,
Thirdly, the promotion of egalitarian gender norms in the SE classroom relates to another appeal made by the participants. The United Nations Educational, Scientific and Cultural Organization (UNESCO)
A study by McRee
This discussion leaves one to draw the inference that what adolescents are asking for is already well reported but that a change in practice is necessary. In 2010, it was reported that the CSE programme was not being implemented uniformly.
What could devise self-reflexivity and a paradigm shift is a praxis in the form of a workbook for CSE teachers that is co-constructed with the participants from this study, aimed to attend to matters that obscure the successful implementation of CSE. Such a workbook could be used by tertiary institutions for the training of preservice CSE teachers and by the Department of Basic Education (DBE) when they perform in-service training with CSE teachers. Student and practising teachers are then prepared to be responsive to varying contextual demands, ethical imperatives, the diverse learning needs of learners, new modes of delivery and specific professional expectations and transformation priorities when training and teaching CSE. A recommendation for future research is to develop a workbook as such and to make use of preservice and in-service teachers as participants to use the workbook and to afterwards reflect upon their experience in a focus group discussion to make recommendations for theory-building
The strength of the study lies in the fact that the oppression of adolescents as a previously marginalised group was eliminated and that recommendations for a praxis were created to improve the CSE programme taught in South African schools, so that research recommendations that often do not go beyond that level could be transferred to practice. Limitations could be that a larger sample size could possibly deliver more suggestions with increased meaning saturation,
To respond to the troublesome state of the sexual health of adolescents in South Africa, it was necessary to investigate why the CSE programme in South African schools is not yet capable of making a significant difference. Results from this study and other studies prove that valuable recommendations were made towards the improvement and development of the programme but that a gap still exists between research and practice (knowing in theory what needs to change, but neglecting to put this into action). In this research study, the participants were adolescents who were typically historically excluded from research that is about them. They took action by participating in research that was about them, as informed by Paulo Freire’s theory. Their lived experiences were reflected upon to form the foundation of a co-constructed praxis for sexuality educators. The findings could establish fidelity in the delivery of the CSE curriculum and the implementation of scripted lesson plans to ensure that SE in South African schools is in fact comprehensively taught and successful in contributing positively to the sexual health of adolescents in this country.
The authors would like to thank Professor Stephen Whitney, who was the interrater for this study, and Professors Stephen Whitney and Anna Strebel for mentoring and critical reading.
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
R.K. was responsible for data collection and the data analysis. C.B. was the supervisor of this research. R.K. wrote the manuscript with guidance from C.B. Both authors approved the final article.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
The data sets generated and analysed during this study are not publicly available because of the sensitive and identifiable nature of the qualitative data but extracts of the raw data and interview questions are available from the corresponding author on reasonable request. To illustrate the complex story of the data – the content goes beyond a description of the data and convinces the reader of the validity and merit of the analysis.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.