Preparing teachers to deliver gender-focused sexuality/HIV education: a case study from Nigeria

Abstract

Evidence shows that a focus on gender and power in sexuality/HIV education increases the likelihood of achieving positive sexual health outcomes, and international agencies have called for a shift to a gender-focused approach. However, questions remain about the implementation of such programmes, including how best to prepare teachers to deliver such curricula. In the development of the national school-based HIV prevention curriculum in Nigeria, several state governments partnered with feminist (or like-minded) non-governmental organisations to collaborate on teacher training. This case study, drawing on teacher interviews and classroom observations, explores the effects of that experience. Teachers reported that the 10-day training developed their competence, confidence, and commitment to foster students' critical thinking about gender issues. Specifically, they reported changes in their own gender attitudes, pedagogic skills and connectedness with students, particularly girls. The findings suggest that high-quality training can prepare teachers – including those in large, resource-poor school systems – to deliver the kind of gender-focused sexuality/HIV education that is proving most effective at advancing sexual health outcomes. Non-governmental organisations can be important partners for providing such training. Further research is needed to assess what additional social and educational outcomes may result from gender-focused sexuality/HIV education.

Keywords:

• sex education
• gender
• sexual
• reproductive health
• HIV prevention
• teacher education

Introduction

Around the world, Ministries of Education have carved out time in school curricula to integrate programmes aimed at reducing health risks, such as HIV infection and unintended pregnancy. Among the numerous concerns regarding the implementation of such programmes is the question of which competencies teachers need to be able to deliver these curricula and what it might entail to help them develop those skills.

For several decades, the dominant approach to sexuality education emphasised individual models of decision-making, with medical information and sexual refusal scripts as keys to adopting healthy behaviours. In recent years, however, based on emerging evidence, there has been a gradual shift away from that model. Increasingly, researchers, policy-makers, civil society organisations, and international agencies have called for models of comprehensive sexuality education that go beyond individual behaviour-change models to explicitly address the social context underlying sexual behaviour, especially issues of gender and relationship power (BZgA and WHO 2010; Haberland and Rogow 2015; UNESCO 2014; UNFPA 2011).1

The momentum behind this shift towards a ‘gender-focused approach’¹ is, in part, evidence of its success in improving sexual health. A review (Haberland 2015) of programmes measuring sexual health outcomes found that those that placed gender and power issues at the heart of a curriculum were five times more successful at reducing sexually transmitted infections and unintended pregnancy than those that ignored these issues. Indeed, while gender-focused programmes were very likely to achieve their health goals, ‘gender-neutral’ programmes were unlikely to do so. This held true across community, clinic, and school-based programmes. These findings resonate with the evidence that gender norms profoundly influence sexual behaviour and health outcomes. For example, young people who adhere to more conservative gender norms and form gender-inequitable intimate relationships are more likely than their peers to have early sex, unsafe sex, sexually transmitted infections, and unintended pregnancy (Greene and Levack 2010; Rogow and Haberland 2005; WHO 2007), and are also more likely to be in relationships characterised by intimate partner violence (Fleming et al. 2015; Gomez et al. 2011).

There exist multiple synergies among gender equality, schooling, and sexual health (UNESCO 2012). While further research is needed, existing evidence drawn from programmes that emphasise gender equality and empowerment – as well as sexuality and sexual health – supports the notion that gender-focused comprehensive sexuality education programmes may affect potential outcomes beyond sexual health alone (UNESCO 2012). The number of school-based empowerment comprehensive sexuality programmes is limited; however, so little is yet known about whether and under what conditions the far-reaching education sector can deliver such programmes.

Advancing gender-equitable norms

The pathway by which curricula focused on gender aim to achieve their sexual health goals is by changing learners' attitudes and behaviours regarding gender and power, i.e., creating more gender-equitable norms. Interventions resulting in more gender-equitable attitudes have been reported in Nepal (Lundgren et al. 2013), South Africa (Colvin 2009), Tanzania (Krishnan et al. 2012), Brazil (Pulerwitz et al. 2006), India (Verma et al. 2006), and Chile (Instituto Promundo 2010). A World Health Organisation (2007) review of gender-focused programmes for boys and men concluded that those that explicitly discussed gender and the ‘social construction of masculinity,’ and sought to question and transform those norms, were more effective at changing attitudes and behaviours.

As noted above, evidence is sparse about whether and under what conditions schools can effectively deliver gender-equitable programmes. That said, limited evidence suggests that this strategy is a viable one for school settings. For example, a study on the Gender Equity Movement in Schools programme in India, which included classroom sessions to engage students in discussion about gender, reported changes in attitudes in the intervention group (Achyut et al. 2011). An early report (Esiet et al. 2009) on the Nigerian Family Life and HIV Education curriculum found reduced tolerance for sexual coercion among students.

Affecting educational environment and outcomes

Evaluations of programmes that aim to affect gender norms and/or sexual health have not to date sought to measure educational outcomes, so little is known about the effects of comprehensive sexuality education in this area. Nonetheless, there is reason to consider the plausibility that these programmes may extend, directly and indirectly, to the educational sphere.

First, when sexuality education reduces the rates of unintended pregnancy or sexually transmitted infections, there are direct implications for education, as these sexual health problems represent a significant obstacle to students' attendance and engagement at school. The most obvious connection is that illness, as well as unintended pregnancy, leads to absenteeism and school dropout. In many settings, girls who become pregnant must leave school. Evidence also suggests that engaging in sexual intercourse is independently associated with school failure (Allen et al. 1997) and with girls' risk of dropping out (Biddlecom et al. 2008; Hinden and Fatsui 2009).

Another way that schooling and sexual health interact is that schools themselves can be sites of sexual abuse and coercion (Leach et al. 2014). By reflecting on abusive practices that are often considered the norm, sexuality education can contribute to creating a safe and respectful learning environment. Lloyd et al. (2000) found that girls who attend schools where they are treated more equitably with regard to support, encouragement in class, and safety are significantly more likely to remain enrolled.

Finally, building young people's sense of school connectedness – the belief by students that adults and peers in the school care about their learning as well as about them as individuals – has been linked to continued schooling and delayed sexual debut (CDC 2009). A study among secondary students in Plateau State of Nigeria found that a lower sense of connectedness to school elevated students' odds of having had intercourse; the authors suggest that promoting students' sense of connectedness to school could help in reducing risky sexual behaviour (Slap et al. 2003).

Gender-focused sexuality education not yet widely implemented in schools

In many countries, the implementation of gender- and rights-based sexuality/HIV programmes has been conducted primarily by non-governmental organisations on a small scale, outside the formal educational system.2 The capacity of large-scale public education systems to implement this approach, therefore, remains an urgent question. Some countries have made attempts to integrate gender and rights into sexuality education programmes within formal education systems, but with mixed results at best. For example, a content analysis of public-school life skills and HIV curricular materials from 10 countries in East and Southern Africa (UNESCO and UNFPA 2012) found that while many materials had a unit on gender equality and/or human rights, this content tended to be weak and was often undermined by other aspects of the curriculum. The Programme for Education about Sexuality and the Construction of Citizenship in Colombia (Beltran et al. 2013; UNFPA 2011) is an explicitly gender-focused and rights-based programme, but is still at the pilot level and currently under evaluation.

Building teachers' competencies to deliver gender-focused sexuality education

Effective teaching about topics related to sexuality, gender, and power in relationships requires facility with participatory pedagogic approaches, as well as personal comfort with the content. In a review for the World Health Organization on the role of schools in promoting adolescent sexual and reproductive health, Lloyd (2010) identified gender bias by teachers as a factor undermining sexual health education. Given the centrality of teachers in shaping the culture of the classroom and the experience of students, strengthening teachers' capacity has been identified as an urgent priority for improving sexuality education globally (Ahmed et al. 2006; UNESCO 2009; UNFPA 2011).

There exist various examples of efforts to train teachers in gender-responsive pedagogies, e.g., in the Republic of Korea (Jung and Chung 2006), Vietnam (MOET 2011), Kenya (Mlama et al. 2005), and Bangladesh (DeJaeghere and Wiger 2013). All of these interventions, however, focused on gender-equitable pedagogic methods. None (with the partial exception of that in Kenya) addressed teaching of content directly related to gender and sexual health. There remains a dearth of evidence about whether it is realistic to expect teachers to deliver gender-focused sexuality education in schools, and in particular, what might be involved in preparing them to do so effectively.

In some developing country settings, governments seeking to pilot or scale up sexuality/HIV programmes have partnered with non-governmental organisations that have a gender perspective, and sometimes an explicit feminist and human rights perspective. Such partnerships vary in depth and breadth, but may involve building support in the community, designing curricula and materials, and/or providing training and ongoing technical assistance to teachers and school officials (Huaynoca et al. 2013; Osakue 2013; Svanemyr et al. 2015). While non-governmental organisations can play a critical role in creating ‘openings for transformation’ (DeJaeghere and Wiger 2013), few such partnerships are documented and little is known about the degree, or manner, by which they may exert an effect.

Purpose of the study

Against this background, this paper set out to document the implementation of a government school-based sexuality education programme, Family Life and HIV Education (FLHE), in four states in Nigeria, where non-governmental organisations committed to sexual and reproductive rights and girls' empowerment have played a critical role in teacher education and training. Specifically, the study sought to gather data and draw insights about the effects of non-governmental organisation-run training programmes on teachers' attitudes towards gender issues and their perceptions about their own practices in the classroom. Furthermore, by preliminarily considering a wider range of possible effects – advancing gender equality and strengthening education overall – the study also pointed to the potential for measuring other outcomes in future evaluations of sexuality/HIV education.

The family life and HIV education programme in Nigeria

The Nigerian Family Life and HIV Education Programme curriculum was approved by the federal government in 2001, after years of advocacy by non-governmental organisations.3 After the programme was piloted in Lagos State, the Federal Ministry of Education began scaling it up, under the aegis of the state ministries of education. In consultation with non-governmental organisation partners, the government decided to introduce the curriculum in junior secondary schools (grades 7–9), aiming to reach students before many of them, especially girls, end their schooling and before most become sexually active. Rather than having a stand-alone Family Life and HIV Education course, the topics in this course were broken up and infused into existing ‘carrier subjects’. This began with science and social studies classes, but has expanded to other subjects, primarily physical education and home economics. Importantly, Family Life and HIV Education content is examinable, so that students are tested on the material.

The original curriculum was produced by a partnership between the federal government and Action Health Incorporated, a gender-sensitive Lagos-based non-governmental organisation that was leading the effort to implement Family Life and HIV Education, with input from allied non-governmental organisations, as well as from religious leaders, educators, and other stakeholders. It included accurate content, not only on contraception, but also on other topics – such as gender roles, sexual orientation, masturbation, and abortion – related to young people's sexual health and rights. The decision in 2002 to scale up the programme across a country as diverse as Nigeria generated heated debate. In response to fierce political opposition, primarily in northern states, about both the content of the curriculum and the imposition of a federal standard curriculum on individual states, the government changed the name of the programme from its original title ‘Comprehensive Sexuality Education’ to ‘Family Life and HIV Education’. Furthermore, conservative opponents – often using religious arguments – were successful in convincing policy-makers to eliminate the content on such important topics as contraception, abortion, and sexual orientation.

The final version of the Family Life and HIV Education curriculum is essentially an abstinence-only curriculum. Nonetheless, it addresses important aspects of sexual health, and touches upon various gender issues, specifically, early marriage, sexual coercion and abuse, gender-based violence, harmful practices, trafficking in persons, and girls' assertiveness.4

Cognisant that most teachers would have substantial learning needs, the Nigerian government invested in a high-quality in-service training programme, one that would enable teachers to reflect on their own attitudes, acquire and practise new skills and knowledge, and deliver the curriculum as intended. Importantly, some topics considered too sensitive for the student curriculum, such as contraception, were maintained in the teacher education and training. For scaling up, the plan was to train two ‘master-teachers’ in each school, through a 10-day period of residential training, including two practicum days – far beyond the norm, especially for public sector programmes.5 In 2010, as part of a national scale-up that involved new funding sources and a shift in non-governmental organisation technical partners, the training time was cut to four days; in addition, the training became a day programme rather than an off-site residential workshop.6

As was the case with the initial Lagos State pilot, some state ministries of education partnered with at least one local non-governmental organisation to implement the programme. In some cases, these partnerships were supported at least in part by outside donors. In a number of states, the non-governmental organisations with the greatest technical expertise and deepest commitment to Family Life and HIV Education were those with a strong gender equality and girls' rights perspective – in some cases, explicitly defining themselves as feminist and rights-based.

Methods

This case study concentrated primarily on four of the states in which the collaborating non-governmental organisation had a commitment to gender equality and girls' rights: Lagos, Calabar, Edo, and Enugu. Initially, gender-sensitive non-governmental organisations from seven states had been identified; of which, six were recommended by the foundation that had supported their participation in the programme rollout and one was added based on the authors' familiarity with its mission and close collaboration with the government in rolling out Family Life and HIV Education.7 Security concerns precluded travelling to three of these states, so the final case study focused on four states in the southern and eastern regions of the country.

A desk review was conducted of the Family Life and HIV Education curriculum and teaching materials, available documents for each partnering non-governmental organisation, policy documents, and published and unpublished reports. Interview guides were developed for the different stakeholders. Teacher interviews focused on what they had learned in the training – knowledge, attitudes, and skills – and how it had influenced them personally and professionally. Principal interview guides explored depth of familiarity with, and commitment to, Family Life and HIV Education. Both principals and teachers were also asked about practices and policies related to school safety. State-level ministry of education officials, as well as other stakeholders, including federal-level officials, were interviewed to gain additional perspectives on the partnership between the government and the non-governmental organisations in implementing the Family Life and HIV Education programme.

In each of the four states, two schools were selected as study sites by the non-governmental organisations, in consultation with the state ministries of education. Selection captured some of the diversity of setting and composition; in three of the states, both co-educational and girls-only schools were visited, while in the fourth, both were girls-only. In-depth individual or group interviews were conducted with a total of 32 teachers in all four states, four school principals in three of the states, 11 officials of state-level ministries of education in three states, and five federal-level officials. Classroom delivery of the curriculum was observed in seven schools. Informal conversations with students reinforced classroom observations, but lack of privacy and time prohibited formal interviews or focus group discussions with students.

All teacher interview responses and noted observations were coded by theme. In all cases, comments and observations are presented anonymously, without identifying individual, school, non-governmental organisation, or geographic state.

Findings

Delivery of the teacher training at the state level and the role of non-governmental organisations

While the 10-day federal teacher-training plan had included some content on gender and rights, the non-governmental organisations in this case study built substantially on this to address these issues more meaningfully. One non-governmental organisation leader explained, ‘We make gender and human rights cross-cutting [such that] we look at the gender and rights issues in all the topics taught.’ In another example, a non-governmental organisation leader explained that they build on the content on female genital mutilation in the federal curriculum, to explore a wider range of harmful practices, such as payment of bride price. They also spend time reflecting on the importance of a safe learning environment, including the problem of teachers sexually harassing female students.

Some non-governmental organisations also sought to enrich a gender perspective by way of additional materials. In two states, they have given some teachers copies of the It's All One Curriculum, a rights-based, gender-sensitive curriculum resource.8 In a third state, the leading non-governmental organisation undertook a complete revision of the student textbook, specifically to ensure more attention to gender issues. The textbook was distributed to every school in the state and the non-governmental organisation trained teachers in a set of pilot schools on delivery of the new content.

The non-governmental organisations also built on the official federal recommendation to emphasise participatory teaching methods (such as games, role-plays, and brainstorming), which, as one trainer explained, ‘are completely different from how they are trained to teach.’ The non-governmental organisations went a step further, consciously engaging teachers in personal reflection and critical thinking.

In these ways, the non-governmental organisations have worked to help teachers understand more deeply how gender norms operate – in their own lives, in the lives of their students, and in society at large. Indeed, one state-level ministry of education official commented that gender was the most interesting aspect of the training.

Effect on teachers' own attitudes about gender and girls' rights

Informants at every level highlighted the influence of the training (most notably, the full 10-day training courses) on transforming teachers' attitudes and skills, as well as their teaching of Family Life and HIV Education and other subjects. One non-governmental organisation staff reflected on the teacher experience, saying, ‘You can't come to FLHE training and go home the same.’ Teachers' comments suggest that they had developed greater understanding of and sensitivity about gender roles. Almost all reported that what they learned had affected them personally and caused them to reflect in new ways. Several shared views of what evolved from the training, as follows9:

[That] being a boy, being a girl has nothing to do with what it means to be a human being…. Boys can help at home with cooking. Even if girls cook, boys can help. Before only boys would play football, but now girls can play too. (Odogwu, a male Health Education teacher)

I realised that someone who looks or touches you without you letting them violates your human rights. (Igoh, a female Social Studies teacher)

I learnt that boys and girls socialising with each other does not mean they have to have sex. (Ngozi, a female Social Studies teacher)

Almost all teachers remarked that they felt more comfortable talking about girls' rights and gender equality with their families and initiating conversations with their children. Moreover, some described becoming bolder about addressing these topics in the community. For example, Odogwu, a male Health Education teacher, commented on his decision to speak at his church about female genital mutilation: ‘I opposed it before, but the training helped me to go forward, to be a voice [against it].’

Teaching about gender equality, sexuality and rights

Importantly, teachers described how they brought their new knowledge and commitment to the classroom. Some informants stressed general issues of gender roles and norms. Many teachers were particularly passionate about girls' rights to understand – and control – their own bodies. Following are typical comments made by teachers:

[The students] learn about the difference between sex and gender. We talk to students about roles and not feeling confined. Now we have been able to tell them that anything you are good at, you can achieve. The girls find that so interesting. They like to learn about self-esteem. (Adekemi, a female Social Studies teacher)

[Useful skills for girls are] negotiation, assertiveness, communication. (Amira, a female Science teacher)

Our male teacher now uses the proper terms for the female anatomy. (Irenegbe, a female Home Economics teacher)

[I teach them] to use the ‘I statement.’ To be emphatic and say it and mean it, and say it with your bodies. (Abiola, a female Science teacher)

Teachers also reported finding ways beyond the formal curriculum to reinforce the importance of learning about one's body and sexuality, as exemplified by the following comments from two female teachers: ‘It is the way that you present it. Any topic can be talked about, for example, the vagina: “When you get home, take a mirror and look at it. It's your body. Look at it.”’ (Abiola, a female Science teacher) ‘We see the importance of knowing about and talking about their sexuality. That barrier has been broken…. When they can talk about it, they can learn to protect themselves.’ (Bose, a female Science teacher)

Classroom observations carried out during the research similarly suggest that the training provided the teachers with concrete tools to reinforce messages about body awareness and comfort beyond the formal curriculum. For example, classes were observed singing a modified version of the children's song Heads, Shoulders, Knees and Toes, in which students matter-of-factly sang about (and pointed to) their Genitals, or in the case of girls-only schools, their Vulvas, instead of their knees.

Student-initiated conversations provide another avenue for transmitting information and messages that are excluded from the curriculum. Teachers reported that students approach them with questions, both inside and outside of class. According to these teachers, students especially want information about the fertile days of the cycle, sexuality, condoms, and where to seek contraceptive and sexually transmitted infection services.

Addressing the classroom and school environment

This case study also sought to gain informants' perspectives about whether and how teachers' increased sensitivity about gender equality and sexual rights, along with the subsequent experience of being a Family Life and HIV Education teacher, might be spilling over to the broader learning environment. Lamidi, a state-level education official, provided one anecdotal example of changes in the culture of the classroom: ‘Before, only boys cleaned the blackboards, the girls swept the floors. Now, boys also sweep floors and girls also clean blackboards. This is the result of Family Life and HIV Education.’

Another nexus between Family Life and HIV Education and the learning environment concerns school safety. Programme implementation did not include an explicit component on ensuring a safe learning environment, but training did seek to raise teachers' awareness about sexual harassment and abuse. Teachers and several school principals noted that students were reporting abuse to Family Life and HIV Education teachers. Moreover, informants in two states mentioned that schools now turn to the non-governmental organisations that trained them for help when a situation of abuse arises. Grace, a non-governmental organisation leader in one state, described two cases referred by the school:

The last call we responded to involved a victim who went to her principal and demanded to be returned to her parents. We were called in [by the school] and found it was a case of trafficking. We brought in the National Agency for the Prohibition of Traffic in Persons, returned the girl to her parents, and saw to it that she is registered in school. [Another time], a principal called us in a case of sexual abuse by a girl's brother in-law who was her guardian, after the girl confided in her teacher. In addition to counselling we saw to her relocation from the home.

Pedagogy and critical thinking

Teachers commented on the pedagogic skills they developed during the training. They unanimously reported that the interactive methods were new for them and that they enjoyed learning them – especially those that they could apply in large classes and in constrained time periods.

Simply fostering a two-way dialogue represented a significant shift for many teachers. Adekemi, a female Social Studies teacher, said, ‘Before the training [teachers] used the lecture method. But since [the training, they are] using the participatory methods. They have more interaction with the students, which encourages their participation. Students like it now. They are happier.’ Eka, a female Science teacher, explained, ‘In FLHE we do what is called facilitation; as the teacher you let children contribute and most of the discussion is made by the students, unlike other classrooms where the teacher pours out everything.’

Teachers described using games, drawing, and other interactive teaching methods that they learned as part of Family Life and HIV Education training. Classroom observations supported these comments. Students were observed enacting role-plays, using flash cards, singing, and brainstorming answers. Significantly, a number of teachers reported that they had begun using more participatory approaches across their teaching, even outside of programme topics. Moreover, some volunteered that these approaches can foster critical thinking10 and civic engagement.11 Ejima, a female Science teacher, reported, ‘We are practising in a way that the learning experience is more advanced; it is more democratic.’

Connectedness to teachers and schools among girls

As noted above, school connectedness may be a factor in shaping academic outcomes, and also play a role in affecting sexual health. Comments from teachers suggest that Family Life and HIV Education may foster such connectedness, although this appears to be primarily among female students. First, many teachers (both male and female) observed that they believed that girls felt more comfortable in class and were more likely to attend and participate in Family Life and HIV Education sessions. As one female teacher explained:

They [the girls] don't want to miss classes anymore; they think there might be FLHE topics. They like FLHE and want to participate, for example, they want to do the acting. They like both the topics and also the teaching methods. FLHE has brought us even closer to them. (Igoh, a female Social Studies teacher)

In addition, a number of female teachers reported that as a result of Family Life and HIV Education, girls have begun approaching them for help with personal problems. Several described girls seeking help in managing menstruation and disclosing sexual abuse to teachers. Feeling safe in class and able to approach a female teacher for support with a personal issue suggests a level of comfort and connectedness that cannot be taken for granted in settings where many girls are vulnerable to sexual harassment and abuse.

Discussion

This report is a case study and the data are self-reported. Because of this, findings should be viewed as illustrative, rather than as conclusive. Nevertheless, they point to a number of issues worthy of further discussion.

Discussion of findings

Given the evidence-informed momentum for a shift to gender-focused sexuality education, and recognition of the central importance of teacher competency to deliver this approach, this study explored how the input of gender-sensitive non-governmental organisations made a difference – through training and other teacher support – in teacher attitudes and practices. Gender equality is not an explicit goal of the Family Life and HIV Education programme; the curriculum addresses gender rather superficially. However, the duration and scope of training established by the government and the involvement of non-governmental organisations provided an opportunity for those non-governmental organisations to infuse a gender and rights perspective in a meaningful way that appears to have helped transform teachers' attitudes.

Informants characterised the 10-day training as having a profound impact on their attitudes and teaching practice. Two characteristics of the training seem particularly salient. The first of these concerned its quality, specifically the involvement of non-governmental organisations with a gender perspective and a depth of experience was perceived as having made a critical difference. The non-governmental organisations involved, with an unswerving belief in young people's right to sexuality education, had already established community-based programmes that allowed them to develop significant technical expertise. As long-time advocates for a national sexuality education programme, they were also fiercely committed to seeing the programme implemented.

The second feature commented upon was the long duration of the training as originally designed and implemented. The residential nature of the training, along with the number of days involved, allowed teachers both to reflect critically on issues of gender and power in their own lives and in the lives of their students, and to practise the new participatory teaching methods. This time (including two practicum days) was perceived as key to internalising what they were learning. Teachers trained after the training had been shortened to four days complained that they lacked time to reflect on their own values and to put new knowledge and skills into practice. Given some of the challenges inherent in removing teachers from the classroom for long periods of time, this finding suggests the need to explore different ways to build teacher capacity, for example, refresher training, classroom support, and additional learning resources.

Although this case study focused on changes in teacher attitudes and practices, it is plausible to suggest that these changes positively affected students. Teachers reported that their own increased sensitivity to gender and sexual rights led them to delve more deeply into these issues in the classroom, thereby generating student reflection and discussion. This echoes the results of an early quantitative evaluation of Family Life and HIV Education in Lagos State, which demonstrated less acquiescent attitudes, especially among girls and teachers, towards sexual coercion (Esiet et al. 2009).

The more gender-egalitarian attitudes among teachers and their new teaching methods may also have exerted a positive effect on school connectedness among girls. Teachers' reports of increases in girls' participation, attendance and their likelihood of confiding in teachers or seeking their help are particularly notable in this respect, given possible links, discussed above, between school connectedness and sexual health outcomes.

Conclusion

The findings in this study suggest that serious investments in teacher training and support can enhance teachers' capacity in regard to gender equality and human rights, and that these gains can carry over to their teaching practice – both within and possibly beyond the formal sexuality/HIV curriculum. In this way, the training may provide a concrete opportunity for preparing teachers for the work of ‘un-doing gender’ (Stromquist and Fischman 2009). Notably, this study also offers evidence that such effects on teachers may be achieved even in large education systems in resource-poor, socially conservative settings.

The case study also demonstrates the potential for successful partnerships between government and gender-sensitive non-governmental organisations for providing training, as programmes go to scale. These non-governmental organisations often have the greatest capacity not only to deliver the training, but also to provide technical assistance for curriculum design and materials development, classroom support and skills-reinforcement for teachers, and ongoing monitoring. Given the recent evidence showing that placing gender and power at the heart of sexuality/HIV education is critical to reducing sexually transmitted infections and unintended pregnancy, decision-makers and funding agencies should increase investment into collaborations with non-governmental organisations able to bring expertise in and commitment to these issues.

This study also contributes to discussions of the role of schools in changing gender norms and reducing related human rights abuses. A sexuality/HIV education curriculum may be an opportune strategy for reaching young people with messages about the right to stay in school and the right to live free of abuse.

Finally, the findings suggest a need for research about additional potential outcomes of comprehensive sexuality education. For example, can engaging young people in critical analysis of gender norms and the right to a safe school environment offer an opportune vehicle for strengthening pedagogy – promoting student-centred learning and critical thinking skills? Can gender-focused sexuality education affect school connectedness and girls' attendance? Further research is needed on these questions, including on indicators that could measure these potential effects. A final question, from a policy perspective, is whether an emphasis on equality and human rights, rather than on sexuality, might prove less controversial in some settings.

Strengthening curricula and teaching alone is not enough, of course. Important steps need to be made across and beyond schools, e.g., policies and practices to ensure safe schools, as well as expanding girls' access, especially beyond the primary grades. Moreover, to capitalise on progress in school settings, links should be made to gender equality efforts across the society, such as youth-friendly sexual and reproductive health services and community-based campaigns to eliminate early marriage, female genital mutilation, gender-based violence and other forms of gender discrimination. Such efforts, both across the education sector and in cooperation with other sectors, can enhance the potential effects of sexuality/HIV education on young people.

Acknowledgements

The authors express their gratitude to non-governmental organisations in Nigeria who facilitated the logistics for this case study and to the many informants: teachers, school principals, staff from international and national non-governmental organisations, and government officials at state and federal levels. The research for this study was generously supported by the John D. and Catherine T. MacArthur Foundation; the Foundation played no role in study design, report writing, or paper submission.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported in part by the John D. and Catherine T. MacArthur Foundation [grant 12-100596-000-INP].

Notes

^1. Programmes that explicitly address gender have been described as offering these elements: (1) provide young people with ‘information about human rights, gender norms, and power in relationships (including consent and decision making, sexual coercion, intimate partner and gender-based violence, and sexual diversity)’; (2) strengthen young people's skills, including their critical thinking; (3) empower learners beyond the curriculum, as agents in their own lives and leaders in their communities; and (4) deliver such education in ‘a safe and healthy learning environment’ (UNFPA 2014).

^2. For example, Project H in Brazil (Pulerwitz et al. 2006), Stepping Stones in South Africa (Jewkes et al. 2008), and Abriendo Oportunidades in Guatemala (Del Valle 2013).

^3. For more on the background and history of Family Life and HIV Education, see Brocato (2005); Huaynoca et al. (2013); UNESCO (2010, 2011).

^4. Curricula dated 2006 for four junior secondary school subjects (social studies, basic science, physical and health education, and home economics) were reviewed for this study. It should be noted that the Family Life and HIV Education curriculum is essentially a framework; each state is expected to build on the framework to develop its own ‘scheme of work’.

^5. Dlamini et al. (2012) note the more robust duration of the Family Life and HIV Education training in comparison to training elsewhere. Training programmes for teachers for sexuality education vary widely in duration. For example, reports document training events of six to eight days duration in Côte d'Ivoire, South Africa, and Kenya; four to five days in Uganda and Burkina Faso; three days in Côte d'Ivoire and Namibia; two days in Guinea; and only one day in Guyana (Tiendrebéogo et al. 2003; Ahmed et al. 2006; Education International 2007). These durations are approximate, as they have been converted from number of hours to number of days.

^6. With new funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2010, training was cut from 10 to 4 days, which has meant less time for values clarification and a practicum that enabled teachers to practise classroom application of new skills and knowledge.

^7. Most of these non-governmental organisations had been funded in the past or the present by the foundation that funded the research for this article. See Acknowledgements. The authors carried out this study as consultants to a separate organisation that has associations with three of the four non-governmental organisations.

^8. The It's All One Curriculum is a resource that provides curriculum developers with flexible content and critical thinking and participatory teaching activities for integrating a gender/rights/critical thinking focus into sexuality/HIV education. Available at www.itsallone.org.

^9. Quotes cited here are reflective of the general consensus of comments, and were selected because an informant's perspective was particularly clear or compelling.

^10. The importance of engaging learners in critical thinking as part of comprehensive sexuality education has received increasing emphasis in recent years (UNFPA 2011, 2014; UNESCO 2012).

^11. Notably, World Values Survey analyses by Pettersson (2003) found a strong correlation between attitudes towards gender equality and towards democracy; indeed, this author concluded that fostering one can help promote the other.