The role of comprehensive sexuality education on child sexual abuse and teenage pregnancy among secondary school learners

The introduction of Comprehensive Sexuality Education (CSE) in the Zambian school curriculum has raised debate among stakeholders. Despite the Ministry of Education using Comprehensive Sexuality Education as a way of reducing various challenges faced by learners with regards to their sexuality education, the effectiveness and mode of implementing CSE is a source of concern. This study sought to explore the perceptions of learners and teachers on the role of Comprehensive Sexuality Education (CSE) in reducing child sexual abuse and teenage pregnancy. The total number of 60 participants who included 40 secondary school learners and 20 secondary school teachers from two secondary schools in Kitwe District on the Copperbelt Province of Zambia. The findings revealed that 50% of the learners were of the view the CSE had failed its goal of reducing child sexual abuse. The study further indicated that 60% of the teachers and 50% of the learners agreed that CSE helped to prevent early sex and teenage pregnancies in learners. The study concluded that both teachers and learners were of the views that CSE increased awareness on child sexual abuse to learners. The study recommended the need by the Ministry of Education to promote guidance and counselling services in schools with emphasis on peer counselling and peer-led life skills education to address issues of child sexual abuse and teenage pregnancy as well as the need by teachers to implement CSE by integrating its content in currier subjects and not teaching it as standalone subject. The study was guided by the following objectives: (1) To explore the perceptions of secondary school learners and teachers on the role of Comprehensive Sexuality Education with regards to sensitisation of learners on child sexual abuse; and (2) To establish the views of secondary school teachers and pupils on the role Comprehensive Sexuality Education in archiving its goal of reducing teenage pregnancy in school. The study was guided by the following research questions: (1) What are the perceptions of secondary school pupils and teachers on the role of Comprehensive Sexuality Education with regards to sensitising learners in schools on child sexual abuse?; and (2) What are the views of secondary school teachers and pupils on the role Comprehensive Sexuality Education in archiving its goal of reducing teenage pregnancy in schools?.


INTRODUCTION
Provision of education to learners requires stakeholders to pay attention to cross cutting issues.
Learners and young people are perceived to have inadequate preparation for their sexual lives, thus making them potentially vulnerable to coercion, abuse, exploitation, having unintended pregnancies and sexually transmitted infections (UNESCO, 2009). Sustainable Development Goal number 4 focuses on 'quality education' (UNESCO, 2017), but it has to be noted that provision of quality education can be affected if crossing cutting issues in the education system are not attended to. The Ministry of Education launched integration of Comprehensive Sexuality Education (CSE) into the National Education Curriculum for grades 5 to 12 learners in 2014 in order to provide the platform for learners to have access to information on sexuality education in schools (Ministry of General Education, 2013), under the guidance of teachers.
Comprehensive Sexuality Education (CSE) framework in Zambia was developed to enrich the provision of Reproductive Health and Sexuality Education (RHSE), which features as a cross cutting theme in Zambia Education Curriculum Framework (MoGE,2013). Implementation of Reproductive Health and Sexuality in Zambian schools is not meant to be a standalone subject, but integrating its content in subjects such as; Integrated Science at Primary and Junior Secondary level, Biology at Senior Secondary level and Civic Education at Senior Secondary level. Other subjects include Home Economics and Religious Education. The aforementioned subjects are stand alone and examinable subjects (MoGE, 2013).
Prior to the introduction of CSE, the Zambian education system recorded cases of learners dropping out of school as a result early marriages, pregnancies and child sexual abuse cases, which prompted the integration of CSE. For instance, data from research indicated high numbers of school dropout due to pregnancies (MoGE, 2013 can decline due to Comprehensive Sexuality Education (Onyango, 2010).
Integration of Comprehensive Sexuality Education in the Zambian school curriculum was aimed at reducing various challenges faced by learners that occur due to limited information on sexuality education among learners (MoGE, 2013). Exploring the effectiveness of CSE in reducing sexually related challenges such as sexual abuse and pregnancies among learners in secondary schools prompted this study.
The study sought to explore the perceptions of learners and teachers on the role of Comprehensive Sexuality Education (CSE) in reducing child sexual abuse and teenage pregnancy in selected schools of Kitwe District in Zambia. The study was guided by the following objectives: (1) To explore the perceptions of secondary school learners and teachers on the role of Comprehensive Sexuality Education with regards to sensitisation of learners on child sexual abuse; and (2) To establish the views of secondary school teachers and pupils on the role Comprehensive Sexuality Education in archiving its goal of reducing teenage pregnancy in school. The study was guided by the following research questions: (1) What are the perceptions of secondary school pupils and teachers on the role of Comprehensive Sexuality Education with regards to sensitising learners in schools on child sexual abuse?; and (2) What are the views of secondary school teachers and pupils on the role Comprehensive Sexuality Education in archiving its goal of reducing teenage pregnancy in schools?.

Concept of Comprehensive Sexuality Education
Comprehensive Sexuality Education is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality, which aims at providing learners and young people with knowledge, skills, attitudes and values that can empower them to realise their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others, and help them understand their rights throughout their lives (Bezuidenhout, 2004;;MoGE,2013;Avert, 2009;Vergnani & Frank, 1998). Comprehensive Sexuality Education helps young people to develop a positive view of their own sexuality and sexual relationships (Vergnani & Frank, 1998) and provide them with the necessary information, to clarify and learn values and skills necessary to make wise informed decisions about all matters relating to their relationships and sexuality (Avert,2009

Perceptions of stakeholders on the role of Comprehensive Sexuality Education
Individuals from different cultures, beliefs and traditions have various views concerning the role of comprehensive sexuality education in reducing early marriages and child abuse. Sexuality education seeks to reduce both the risks of potentially negative outcomes from sexual behaviours, like unwanted or unplanned pregnancies, getting infected with Sexually Transmitted Infections (STIs) and also to enhance the quality of Exposure of learners to CSE is perceived to be cardinal for school-going children to have necessary information concerning their sexuality and awareness of all kinds of child abuse for them to make informed decisions and cope with peer pressure that may lead them to early marriages and to reduce the risk of getting infected with HIV and also avoid being abused (Rasing, 1995;2001), unintended pregnancies and other risky sexual behavior that may see them dropping out of school at a tender age. It is perceived that when sexuality education is comprehensive, age-appropriate, gender-sensitive, rights-based, contextually adapted, and scientifically accurate and life skills based it can help learners develop and maintain safer behaviours toward HIV prevention and healthy lives for young people (MESVTEE, 2013) and that CSE provides in a building-block approach to prepare adolescents and young people for puberty and beyond, helping them to understand their bodies, to make informed decisions about relationships and develop critical decision making skills.
Curricula professing to represent a CSE approach are perceived to be full of controversial topics, including teaching very young children about sexual pleasure, sexual orientation, gender identity, and access to and use of contraceptives, abortion, and other drugs and medical procedures that carry their own health risks (Stephano, 2018), thus perceiving Comprehensive Sexuality Education as likely to jeopardize their health and wellbeing. Educators, community and religious leaders have been viewed to be apprehensive and uncomfortable at the thought of sex being discussed openly with the young people for fear of encouraging more promiscuous behaviour (Kelly, 2010).
Parents tend to feel uncomfortable talking with children about the subject, others become reluctant to expose their own lack of knowledge about anatomy, physiology, or other related information (Boonsra, 2002) and that parents may worry about how much information to give at what age, based on the belief that the provision of this information will lead young people to experiment with sex. It has been observed that many adults do not receive sexuality education themselves and that some have fear to expose their own negative sexual experiences (Kirby et al., 2005). For this reason, adult family members tend to shy away from actively educating the youth about issues relating to sexuality. In this context, Moore et al. (2002) note that what many fail to realise is that giving no information or evading young people's questions can send negative messages about sexuality.
It is also argued that the perception that contraception makes sex safer leading to increased sexual risk taking behaviour among adolescents, the behavioral phenomenon termed as "risk' compensation (Huber, 2009). Comprehensive Sexuality Education curricula is also perceived to neglect almost entirely that parents have the prior right, and duty, to educate their children, as recognised in the Universal Declaration of Human Rights and binding international law (Pinkerton, 2006) in that parents are primarily responsible for the education and well-being of children.
School-based sexuality education is regarded essential owing to the fact most parents are unable to discuss sexual matters with their children. Buga et al.(1996) found that school adolescents were having sexual relationships at increasingly young ages, often from as young as 12 years and that 64 percent of the 13-year old girls and 76 percent of boys of the same age were already sexually experienced (Buga et al, 1996) and that parents were unable to discuss sexual matters with their children. Beausang & Fowler (1998) argued that pupils need to learn about sexuality because it is part of their social, personal and health education, thus CSE provide them with structured opportunities to develop the knowledge, attitudes, values, beliefs and practical skills necessary to establish and sustain healthy personal relationships as children and adults.

Importance of Comprehensive Sexuality Education
Comprehensive Sexuality Education is cardinal in that it helps learners to be able to exercise responsibility regarding their sexual relationships, giving them opportunities to question, explore, and assess attitudes, values, and insights about human sexuality, develop their concept of responsibility and to exercise that responsibility in sexual relationships, contribute to healthy individual behaviour (Bezuidenhout, 2004;Barnett, 1997;Nichcy, 1992;Yuen et al., 2017).
The goals of sexuality education are to provide accurate information about human sexuality, and to provide an opportunity for young people to develop and understand their values, attitudes, and beliefs about sexuality and enable young people to develop relationships and interpersonal skills, and to exercise responsibility regarding sexual relationships(MoGE, 2013), including addressing sexual abstinence, pressures to become prematurely involved in sexual intercourse, and the use of contraception and other sexual health measures (Bezuidenhout, 2004). Sexuality education also gives young people the opportunity to question, explore, and assess attitudes, values, and insights about human sexuality. Through sexuality education, young people are able to understand family, religious, and cultural values, develop their own values and increase their self-esteem, as well as develop insights about relationships with members of both genders, and to understand their own responsibilities to others (Nichcy, 1992). Sexual education also helps young people develop skills in communication, decision-making, assertiveness, peer refusal skills, and the ability to create satisfying relationships. Thus, providing sexuality education helps young people to develop their concept of responsibility and to exercise that responsibility in sexual relationships (Barnett, 1997).
Comprehensive Sexuality Education can provide young people with age appropriate culturally relevant and scientifically accurate information and is well structured for young people to gain appropriate Comprehensive Sexuality Education plays a central role in addressing the health and well-being of children and young people. Through the application of learner-centered approach, CSE does not merely provides teenagers and young people with age-appropriate and phased education on human rights, gender equality, relationships, reproduction, sexual behaviours risks and prevention of ill health, but also provides an opportunity to present sexuality with a positive approach, stressing emphasis on values such as respect, inclusion, non-discrimination, equality, empathy, responsibility and mutual benefit (Chandra et al., 2015).
Comprehensive sexuality education provides the much needed information that enables young people to develop necessary skills to avoid coercion and being sexually abused by rich male adults who often take advantage of poverty stricken young girls who are vulnerable and cannot defend themselves from abuse (M'kandawire, 1997), thus CSE helps prevent unwanted pregnancies, Sexually Transmitted Infections (STIs), dropping out of school and early marriages.

METHODS
A mixed approach involving Concurrent design was used as research design in that concurrent design allows the collection of both qualitative and quantitative data at the same time (Kumatongo & Muzata, 2021). Open and closed ended questionnaires were used to generate data from 60 participants who included 40 secondary school learners and 20 secondary school teachers who were from two secondary schools in Kitwe District in Zambia. The learners were in their secondary grades of 10 and 11.
Simple random sampling was used to select learners while teachers were selected purposively using convenience sampling. Analysis of data was done using both quantitative and qualitative methods.
Quantitative data was coded in the Statistical Package for Social Sciences (SPSS-Version 21), whereas qualitative data was analysed thematically based on emerging themes from the responses of participants with regards to role of CSE on child sexual abuse. Permission was sought from participants prior to collection of data and participants informed of the nature of the study. To ensure confidentiality of participants, respondents were coded using numbers and no names were used.

RESULTS AND DISCUSSION
The findings of the study are based on the participants' responses and presented statistically using tables and graphs while qualitative views are presented descriptively. Table 1 below shows responses from participants on CSE increasing child sexual abuse among learners.  Table 1 shows that 12 or (60.0%) of the teachers strongly agreed that CSE increases awareness on child sexual abuse among the learners in schools and that 28 or (70.0%) of the learners strongly agreed that CSE increases awareness on child sexual abuse whereas 4 or (10.0%) of the learners strongly disagreed to CSE reducing child sexual abuse in schools.
The findings of the study on CSE providing awareness on child sexual abuse with reference to table 1 was that 90% of both teachers and learners were in agreement that CSE increases awareness. Increasing awareness on child sexual abuse is a positive aspect towards learners' understanding sexual related abuses likely to be experienced by the learners. The findings are in agreement with UNESCO (2009)   Figuere 1 shows that 12 (60.0%) of the teachers agreed that CSE prevents early sex and teenage pregnancy whereas 4 (20.0%) did not agree to the concept of CSE playing a role in the prevention of early sex and teenage pregnancies. The table has also shown that 20 (50.0%) of the learners strongly agreed that sex education prevents teenage pregnancies. Some of the themes that emerged from the respondents with regards to CSE preventing early sex and teenage pregnancies were that; (1) learners were able to avoid improper touch,(2) there was reduction in cases of sexual harassment among learners (2) learners were more enlightened on their sexuality. The following were some of the responses of the respondents: "CSE curriculum is able to equip learners with the right knowledge and skills on how to avoid child sex abuse, by avoiding improper touch and indecent dressing and also being found in awkward places with strangers" (Male Teacher 8) The other response was that: The findings also revealed that 60% of teachers and 50% of learners were of the views that CSE helped to prevent early sex in learners as well as teenage pregnancies. However, it has to be noted that 20% of the teachers did not agree to the notion that CSE helps to prevent early sex in learners and/or teenage pregnancy.  Learners 3 in the response above indicated that CSE was instrumental in the acquisition of skills in decision making and enabling the learner to have productive relationships with friends and family members.
The response from one of the learners was that: "I do not pay much attention when the teacher is teaching CSE because I know that it will not be part of the exam, so I do not care even if she teaches it once in a week… and we do not have text books and references books, most of the time we just discuss in class, which makes the subject a bit boring," (Learner 6; grade 11).
Other learner's response was that; "I feel that CSE does not just increase awareness on child sexual abuse, but also increases sexual behaviours among learners,"(learner 10; grade 11) Another response was that: "I now try to resist early, unwanted or coerced sex, and practicing safer sex, including the correct and consistent use of condoms" (Male Learner 6; grade 11).
The responses from the learners on effectiveness of CSE in archiving its goal of reducing child sexual abuse provide insights on learners' perceptions of CSE in schools and the reasons why 50% of the learners were of the view that CSE had felled to archive its goal of reducing child sexual abuse despite 30% of the learners indicating the positive effects of CSE in reducing child sexual abuse.
Despite some learners noticing benefits of CSE such as enabling them to avoid coerced sex and acquiring knowledge on practising safer sex, for other learners CSE was not important in that it was not examinable, thus they paid no attention to learning CSE. Other learners felt that exposing learners to CSE increased the likelihood of learners engaging in sexual related activities unlike just promoting awareness on child sexual abuse, which was similar to the perceptions of Huber (2009) and Moore et al. (2002) as earlier cited. In this context it is perceived that learners tend to engage in sexual related activities after their exposure to CSE, which may not be the case.
Although the use of discussions during CSE lessons provide opportunities for active participation of both teachers and learners, to some learners lack of appropriate reference learning resources such as books was perceived to hinder their effective learning. It can also be noted that implementation of CSE was taught as a standalone subject, (see learner 6) and that learners were not paying much attention to the subject because it was perceived as non-examinable. The teaching of CSE as standalone subject and the perception of the subject is not examinable could have contributed to learners' lack of attention towards CSE.
Implementation of CSE content should have been integrated in currier subjects which are examinable as guided by the Ministry of General Education (2013), because it is psychologically wise for learners to pay attention to subjects that are examinable and shun non-examinable subjects, thus avoiding CSE by learners could have been attributed to the way its mode of implementation.

CONCLUSION
Based on the findings, the study can conclude that both teachers and learners were of the views that CSE increased awareness on child sexual abuse to learners. Nevertheless, with regards to the effectiveness of CSE in archiving its goal of reducing child sexual abuse, 50% of the learners were of the view that CSE had failed whereas 30% were of the view that CSE had contributed to the reduction of child sexual abuse in learners and 20% were not sure.