University of Groningen School-Based Sexuality Education in Tanzania Omondi, Francis; de Haas, Billie; Oulu, Kennedy; van Enck, Jorik IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2019 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Omondi, F., de Haas, B., Oulu, K., & van Enck, J. (2019). School-Based Sexuality Education in Tanzania: A Reflection on the Benefits of a Peer-Led Edutainment Approach. 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For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 02-10-2021 SCHOOL- BASED SEXUALITY EDUCATION IN TANZANIA: A REFLECTION ON THE BENEFITS OF A PEER-LED EDUTAINMENT APPROACH www.share-netinternational.org Share-Net Netherlands Written By: Francis Omondi, Enhance Interconsult Ltd, Nairobi, Kenya Billie de Haas, Population Research Centre, Faculty of Spatial Sciences, University of Groningen Kennedy Oulu, In-Depth Consulting Group, Arusha, Tanzania Jorik van Enck, Dance4Life, Amsterdam (at time of writing); Amsterdam University of Applied Sciences (current) School-based sexuality education in Tanzania: A refelection on the benefits of peer-led edutainment approach 2 Share-Net Netherlands ABSTRACT School-based sexuality education in Tanzania often does not meet learners’ needs. This paper reflects on the findings of a study that compared two secondary school-based sexuality education programmes: the Dance4Life sexuality education edutainment approach implemented by Restless Development, a non-governmental organisation (intervention), and an HIV prevention education approach implemented by the government (comparison), to understand into what extent a peer-led edutainment approach can be beneficial in increasing young people’s empowerment, as measured by knowledge, life skills and self-efficacy, ultimately contributing to improved sexual and reproductive health outcomes. Findings from an exploratory quantitative and qualitative study among secondary school students aged 14- 24 years from four intervention schools (n=96) and two comparison schools (n=49) indicate that a peer-led edutainment approach can increase students’ knowledge levels of HIV and AIDS and contraception and their life skills, such as the ability to solve problems and to make informed decisions, higher self-esteem and confidence. These findings support the growing body of literature that a peer-led edutainment approach and implementation fidelity can improve the effectiveness of school-based sexuality education in Tanzania. Key words: peer education, comprehensive sexuality education, edutainment, empowerment, secondary schools, Tanzania School-based sexuality education in Tanzania: A refelection on the benefits of peer-led edutainment approach 3 Share-Net Netherlands 1. INTRODUCTION Since the 1994 International Conference on Population and Development (ICPD), many interventions have been developed and implemented to realise young people’s sexual and reproductive health and rights worldwide (Fathalla 2015; Haberland and Rogow 2015; Chandra- Mouli, Lane, and Wong 2015). Nowadays, there is ample knowledge about which type of interventions work and which do not. However, evaluation studies show that sexual and reproductive health interventions for young people are often not effective because they do not reach their intended target groups or lack implementation fidelity (Chandra-Mouli, Lane, and Wong 2015). Comprehensive sexuality education is one of the interventions that has been proven to be effective in advancing young people’s sexual and reproductive health and rights, provided that it is implemented well (Kirby 2008). Traditionally, many school-based sexuality education programmes tend to focus mainly on the dissemination of knowledge. In addition, the content of comprehensive sexuality education programmes is often considered controversial by sex educators and in communities (Green et al. 2017; Helleve et al. 2009; Ahmed et al. 2009; de Haas and Hutter 2019). As a result, the information delivered regularly does not meet the needs of the learners, as learners feel that the topic of sexuality is portrayed negatively and that the topics relevant to sexually active learners are not being discussed (Pound, Langford, and Campbell 2016; de Haas, Hutter, and Timmerman 2017). As such, practice shows that many sexuality education programmes do not meet the international standards for ‘comprehensive’ sexuality education, especially where it concerns inclusion of young people’s sexual and reproductive rights (UNESCO 2018). Taking these considerations into account, the knowledge provided could be complemented with activities that focus on young people’s own motivations and feelings. This ‘innerwork’ is important as it enables young people to understand themselves, their peers, and how they influence each other. This helps them to make their own choices, which is an important step towards developing empowerment (Taylor and Murphy 2014, 22). School-based sexuality education in Tanzania: A refelection on the benefits of peer-led edutainment approach 4 Share-Net Netherlands Empowerment can be understood as ‘a social process of recognizing, promoting and enhancing people’s abilities to meet their own needs, solve their own problems and mobilize the necessary resources in order to feel in control of their own lives’ (Gibson 1991, 359). This definition suggests an individual understanding of empowerment, whereas empowerment can also be understood at the collective or community level and in interaction with others and the social context (Spencer 2014; Cense 2019). Although there is little supporting empirical evidence, the development of individual empowerment is generally understood to positively contribute to young people’s health (Spencer, Maxwell, and Aggleton 2008). Accordingly, Haberland and Rogow (2015) emphasize the need for including an empowerment approach to comprehensive sexuality education programmes to increase their effectiveness. Such ‘empowerment approaches’ emphasize the role of gender and power, by helping learners to critically reflect on socially-constructed gender norms and social inequities. These critical reflections are considered to empower learners as they ‘adopt more egalitarian attitudes and relationships’, which will instigate behaviour change, such as delay of first sexual debut and use of condoms and other contraception, resulting in better sexual and reproductive health outcomes (Haberland and Rogow 2015, S17). Globally, sexuality education is implemented by a variety of stakeholders and at multiple levels. At the national level, many governments have policies or curricula in place that address young people’s sexual and reproductive health. These programmes often concern teacher-led school-based HIV prevention and life skills building of young people. Pound, Langford, and Campbell (2016) found that teachers are often seen as a valuable source to deliver school-based sexuality education but that students might not find teachers appropriate facilitators because of their familiarity with the students and potential lack of confidentiality. In addition, students can perceive teachers as moralistic or judgemental, especially where it concerns young people’s sexual practices. In contrast to teachers, students feel that peer educators might be better able to create a safe space through engaging activities and by the sense of affinity students have with their peers. As a result, peer educators can create an egalitarian relationship that allows for open conversations. Despite the perceived benefits of peer educators teaching school-based sexuality education, peer educators School-based sexuality education in Tanzania: A refelection on the benefits of peer-led edutainment approach 5 Share-Net Netherlands might be a less sustainable and cost-effective option compared to teachers, as new peer educators need to be trained regularly (Pound, Langford, and Campbell 2016). It is also suggested that peer educators may be the ones benefiting most from peer-led sexuality education (Chandra-Mouli, Lane, and Wong 2015). Tanzania has one of the youngest populations in the world, with 63 percent of the population aged 24 or below (United Republic of Tanzania 2013). A range of sexual and reproductive health initiatives are being undertaken targeting this group. These initiatives are developed and implemented by the Tanzanian government