Sexual and reproductive health and rights content in higher education in Norway – a quantitative document analysis

ABSTRACT

Sexual and reproductive health and rights (SRHR) are often insufficiently engaged with in professional higher education. This study presents results from a mapping of SRHR indicators in formal higher education documents relating to 11 higher educational profession programmes in Norway. The findings show a modest level of inclusion of SRHR indicators but a low level of constructive alignment between different levels of educational documents regarding SRHR. These findings likely negatively impact the ability to reach sustainable development goals (SDGs) relating to sexual health (SDG 3: Good health and well-being) and gender equality (SDG 5: Gender equality), both of which highlight SRHR as an important contributor to population health and development. To meet the population’s needs for SRHR, formal documents in higher education should display greater clarity, and ensure that education, regardless of type, placement and context, provides equal knowledge and competence on SRHR for future professionals.

KEYWORDS:

• Constructive alignment
• higher education
• SDG
• sexual and reproductive health and rights
• SRHR

Introduction

In Norway, the national strategy for sexual health 2017–2022 (Snakk om det! Strategi for seksuell helse 2017–2022) states that relevant health staff are expected to acquire sufficient knowledge about sexual health (which according to the strategy includes sexual rights), as part of their basic professional higher education (Ministry of Health and Care Services 2016). However, the extent to which this expectation is met for relevant professions is not yet known. Sexual health is a basic human need and includes mental, physical, social and emotional dimensions. Sexual health is important for quality of life, but the topic is often under-communicated about in health services, just as mental health can be (Smith and Applegate 2018). Sexual health is affected by norms, roles, expectations, power dynamics and gender equality. According to the World Health Organization (WHO), sexual health concerns well-being, not just the absence of illness or disease. It also encompasses opportunities for safe sexual experiences free from violence, discrimination and coercion.

(Starrs et al. 2018, first phrase) have written, ‘Sexual and reproductive health and rights (SRHR) are fundamental to people’s health and survival, to economic development, and to the wellbeing of humanity’. This statement includes having access to and information about services related to decision-making regarding SRHR, without coercion, discrimination, or violence. When professional practitioners in the health and welfare domains meet patients and clients, young people, welfare recipients or the victims of violence, they need to have competence in SRHR to ensure relevant needs are met. SRHR is also key to sustainable development, for example in relation to women’s health, children’s and young people’s health, equality between the sexes, and opportunities for different groups to contribute to the sustainable development of the economy and the environment (Starrs et al. 2018).

Formal national requirements and policy

Norway has national regulations governing a range of professional educational programmes stating what needs to be included in each (Ministry of Education and Research 2019b). The intention is that formal national requirements should ensure constructive alignment within and between offerings. Constructive alignment is an outcomes-based approach and implies a systematic alignment between learning objectives, and teaching and assessment methods. The professional education programmes included in this study, for which there exist formal national requirements, were childcare pedagogy, medicine, nursing, occupational therapy, pharmacy, physiotherapy, psychology, social education and social work. Police and law education were also included in the study but do not currently have formal national requirements.

Research on policy documents in education provides insight into policy implementation and potential impact (Cardno 2018). In addition to policy documents in education, staff and students in higher education are also impacted by external policy guidelines and international goals, such as the Sustainable Development Goals (SDG). Constructive alignment to such policies and formal requirements should be clear in formal documents for each educational programme, including study and course descriptions.

Previous studies exploring SRHR-related content in higher education have shown that the education provided is often insufficient (Areskoug Josefsson et al. 2019; Manninen et al. 2022) or may lack a focus on complex issues (Endler et al. 2022). Complex topics in SRHR include diverse cultural understandings of gender identity, violations of SRHR, and SRHR laws and recommendations (Endler et al. 2022). Most areas in SRHR do not concern topics relevant to specific professions but rather areas in which interprofessional collaboration and expertise are important to create better health and quality of life for the persons involved.

Knowledge of how SRHR is included in formal documents can provide information on the elements of SRHR that need to be improved through professional education and information on potential gaps in competence and knowledge between the professions, which may create barriers to interprofessional collaboration.

Sexual health and the SDG

SRHR has been widely discussed internationally. In 2006, the World Health Organization (WHO) published a ‘working definition’ on sexual rights. Norway has demonstrated a commitment to advancing understanding of these rights through the development of a government action plan (Ministry of Health and Care Services 2016; Norwegian Ministry of Foreign Affairs 2022). In 2015, the United Nations (UN) included reference to sexual and reproductive health and rights in the SDGs (United Nations 2023a). Two of these goals have special relevance to SRHR (Starrs and Anderson 2016):

SDG 3: Good health and well-being

SDG 5: Gender equality

Higher education institutions can contribute to meeting these SDGs through research and innovation, and by providing education and training to professionals and practitioners who require competence in relevant fields.

Each SDG has a number of targets. Target 3.1 for example concerns women’s health, and target 3.7 (United Nations Department of Economic and Social Affairs Sustainable Development 2024b) states the need to ‘ensure universal access to sexual and reproductive health care services’, including family planning and associated information and training (Ministry of Education and Research 2019b). It advocates for the incorporation of reproductive health into national strategies and programmes. Violence against women, human trafficking, sexual exploitation, and the abolition of female genital mutilation are included in targets 5.2 and 5.3. Target 5.6, states the need to ‘ensure universal access to sexual and reproductive health and reproductive rights’ (United Nations Department of Economic and Social Affairs Sustainable Development 2024a).

SRHR – a cornerstone to ensuring equality in welfare and well-being

According to the UN (United Nations 2023b), people need education, training and information about sexual development, sexual differences within gender and identity, and how to prevent unhealthy practices and promote their own sexual health. There is a risk that by not recognising or accommodating to an individual’s need or problem, can negatively affect that person’s quality of life and increase inequality. Discrimination and inequalities can both be harmful to a person’s sexual health and a violation of human rights. Recognising the diversity of sexual expression and behaviour helps to strengthen a sense of health and well-being (World Health Organization 2015).

Healthcare professionals have a responsibility to address SRHR to promote self-care, especially for groups who are harder to reach because of socio-demographic factors such as poverty and being immigrants (Pachauri, Ash, and Komal 2022). However, there is a risk that those groups may have received less communication about SRHR from healthcare professionals than others, as age, sexual orientation, functional ability, culture, ethnicity and gender can affect professionals’ attitudes towards addressing sexual health. For example, younger migrants face greater barriers to SRHR support (Tirado et al. 2020). People need support with their sexual health, both for health promotion and concerning risks related to illness or violence.

Barriers in education and the field of practice

Previous research points out a lack of competence in addressing SRHR for many professional practitioners in health, welfare and the legal professions. There are several reasons for this, including the fact that sex and sexual health have been seen as taboo fields, lack of practice, lack of formal education, not believing SRHR to be part of their professional responsibility, and fear of embarrassment (Fennell and Grant 2019; Manninen et al. 2022; Spaseska et al. 2022).

Having said this, many health professionals do consider communication about sexuality to be part of their responsibilities (Engelen et al. 2020). Some address the theme with patients, but barriers to doing so include a lack of training and knowledge, and the fact that the theme is difficult to discuss (Jonsdottir et al. 2016; Barnhoorn et al. 2022; Young et al. 2020; Saunamaki and Engstrom 2014). Barriers are also experienced by students in their professional programmes (Areskoug Josefsson et al. 2016; Areskoug Josefsson and Fristedt 2019; Areskoug Josefsson et al. 2018; Gerbild et al. 2021; Lunde et al. 2022; Manninen et al. 2022; Spaseska et al. 2022).

Purpose

The purpose of this study was to explore the content of formal education documents and to search for constructive alignment concerning SRHR in professional higher education in Norway in the following 11 types of education: childcare pedagogy, law, medicine, nursing, occupational therapy, pharmacy, physiotherapy, police, psychology, social education and social work. The research questions explored were:

• What patterns are there concerning SRHR indicators in formal documents on professional higher education?

• What are the potential impacts of the identified patterns on efforts to meet SDG targets 3.1, 3.7, 5.2, 5.3 and 5.6?

Methods

The study took the form of a quantitative document analysis (Høglund Nielsen and Granskär 2021). Such an approach can be used to systematically categorise and analyse data from a variety of documentary sources (Coe and Scacco 2017; Cardno 2018).

In Norway, the educational programmes included in the study take place at bachelor’s level and/or through five to six-year programmes or professional studies (Ministry of Education and Research 2019a). Norway also has regulatory system granting permission to work within a particular profession (Norwegian Directorate for Higher Education and Skills 2024). In this study, the following professions required authorisation to practise the profession: physiotherapists, occupational therapists, nurses, pharmacists, social educators, doctors and psychologists. The decision as to which kinds of professional education to include in the study was made by the funder of this project.

The analysed documents were national requirements, study descriptions and course descriptions. For professions with six or fewer universities offering the education, all study descriptions were included in the study. For those where more than six universities offering the education, two-thirds (but no fewer than six) were included in the study. Selection was strategic, based on university size and geography, and also ensured Indigenous programmes were included. Table 1 shows the number of educational programmes included in the study.

Table 1. Professions, number of educational programmes included, and whether the professional programme had formal national requirements.

Educational programme	Number of educational programmes included	Formal national requirements
Childcare pedagogy	8	Yes
Law	3^a	Other
Medicine	4^a	Yes
Nursing	10	Yes
Occupational therapy	5^a	Yes
Pharmacy	3^a	Yes
Physiotherapy	4^a	Yes
Police	1^a	Other
Psychology	4^a	Yes
Social education	8	Yes
Social work	8	Yes

a: All existing educational institutions are included.

Note: There is currently no national framework plan for law. There is no statutory framework description for police education, but it is provided at Bachelor’s level and an institutional document describes what the student should learn during the educational programme.

To explore SRHR content in the documents, 68 SRHR indicators were developed (Figure 1) which together provided a codebook for the analysis (Coe and Scacco 2017). The indicators were based on those used in a previous study in Sweden (Areskoug Josefsson et al. 2019) but were developed further to suit the Norwegian context and changes in the field of SRHR occurring after the Swedish study was performed. The indicators were checked by a reference group representing professionals, educators and researchers in SRHR in higher education. Each indicator was accompanied by explanatory text to ensure that words/phrases related to the meaning of the indicator were included in the mapping.

Figure 1. List of SRHR indicators applied.

Each document was read carefully and documented in Excel. The search for indicators took place manually to ensure that meaningful phrases were included and that the context in which the indicator was written was noted. The final mapping is documented in an online published report in Norwegian (Areskoug Josefsson and Solberg 2022). For each document type, members of the research team

1. Worked through five documents individually, thereafter, meeting to discuss findings and ensure consensus was achieved on the first five documents.

2. Shared the remaining documents between themselves and analysed them individually.

3. Shared questions and concerns arising during the process to ensure consensus.

4. Exchanged documents for quality checking.

5. Analysed patterns in the collected data together.

The analysis was an iterative process, with the researchers working individually, but meeting regularly to discuss and search for patterns in the material. This process enhanced the reliability and validity of the analysis, and ensured a shared understanding of the data collected between the researchers (Coe and Scacco 2017). To further enhance the reliability of the study, for each type of document, a minimum of five documents were cross-checked between the researchers.

The educational institutions included in the study used terms such as ‘programme description’, ‘study description’, and ‘subject description’ with the documents examined to the elements within a type of professional education. These descriptions will be referred to in this article as ‘study descriptions’. Course descriptions, which are subordinate to the study description, contained overall learning outcome descriptions, thematic content, details of how the course was organised, course requirements, and so on. The length and amount of content varied in the documents, both in terms of the amount of text and the credit given to particular components.

Results

The results are presented firstly for the formal national requirements, then the study descriptions, and finally the course descriptions.

Formal national requirement documents

The results showed a modest inclusion of SRHR indicators. Of the 68 indicators, 11 were represented in the formal national requirements. The following six indicators: gender identity, gender, gender expression, sexual identity, and sexual violence, abuse and trauma were present in the formal national requirements of medicine, psychology, nursing, occupational therapy, physiotherapy, social work, social education, childcare pedagogy and pharmacy. Three of the formal national requirements also included additional SRHR indicators. Psychology education included the indicators sexual health and sexuality. Sami nursing education included physical health and sexuality, mental health and sexuality, sexuality and illness/disorder, and obstetrics. Nursing education included the indicator obstetrics.

Study descriptions

The results for the study descriptions revealed a modest number of SRHR indicators, and several study descriptions did not have any SRHR indicators. All childcare pedagogy courses included SRHR in their study descriptions. Descriptions for physiotherapy, medicine, psychology, social work, nursing and social education showed that one or more educational institutions had included SRHR indicators in their study descriptions. Occupational therapy, pharmacy, law and police did not include any SRHR indicators in their study descriptions. This implies that SRHR indicators that are included in national requirement documents do not constitute a common thread to be found across all the study descriptions.

Course descriptions

The results from course descriptions show that many SRHR indicators are not included in the examined forms of professional education. The SRHR indicators found in the course descriptions of most forms of professional education were fertilisation, sex, gender identity, gender expression, sexual orientation and sexual violence, trauma and abuse. There was no single SRHR indicator included in all the examined forms of professional education. The results are summarised below for each professional education programme, and the indicators found were not shown in all the different educational institutions.

Childcare pedagogy: gender, gender identity, gender expression, obstetrics, sexuality, sexual orientation, sexual violence, abuse and trauma.

Law: gender and sexual offences.

Medicine: SRHR (as a comprehensive term), abortion, andrology, fertilisation, family planning, gynaecology, gender, gender incongruence, women’s health, men’s health, obstetrics, contraception, puberty, sexual history, sexuality, sexuality throughout life, sexuality in illness/disorder, sexuality education, sexual health, sexual orientation, sexual violence, abuse and trauma, sexual problems, sexual rights, sexually transmitted infections, trans health, urology.

Nursing (includes Sami nursing education): fertilisation, gynaecology, gender, gender identity, gender expression, women’s health, obstetrics, sexuality, sexuality as a social construction, sexual health, sexual orientation, sexual satisfaction, sexual violence, abuse and trauma (this was the only SRHR indicator that could be found in subject plans for all the course descriptions), sexually transmitted infections, urology.

Occupational therapy: gender, gender identity, gender expression, puberty, sexual orientation, sexual violence, abuse and trauma.

Pharmacy: fertilisation, women’s health and obstetrics.

Physiotherapy: fertilisation, gender, gender identity, gender expression, women’s health, sexual orientation, sexual violence, abuse and trauma, urology.

Police: gender.

Psychology: fertilisation, gender (this was the only SRHR indicator that could be found in all the Psychology course descriptions), gender identity, gender expression, obstetrics, sexuality, sexuality as a social construct, sexual behaviour, sexual health, sexual orientation, sexual violence, abuse and trauma, sexual problems.

Social education: gender, gender identity, gender expression, sexuality, sexuality as a social construct, sexual orientation, sexual violence, abuse and trauma.

Social work: gender, gender identity, gender expression, sexuality as a social construct, sexual orientation, sexual violence, abuse and trauma.

Discussion

The results of this study reveal important patterns with respect to SRHR indicators in Norwegian professional education.

Patterns concerning SRHR indicators in formal documents in professional higher education

Overall, there is a lack of SRHR indicators in Norwegian formal requirement documents, study and course descriptions similar to results from Sweden (Areskoug Josefsson et al. 2019). The level of SRHR indicators in formal documents in higher education in other countries is unknown to the researchers, but both Nordic and international research reveals low levels of SRHR competence in basic education and practice by various professional practitioners (Barnhoorn et al. 2022; Manninen et al. 2022; Saunamaki and Engstrom 2014; Spaseska et al. 2022). Further mapping of SRHR indicators in formal education documents in other countries could lead to a better understanding of the inclusion of SRHR in professionally focused higher education programmes.

There may be several reasons for the low proportion of SRHR indicators. The extent to which the level of SRHR indicators reflect the actual content of teaching is unknown. It may be reasonable to believe that SRHR is insufficiently included if the topic is not linked to course descriptions or learning outcomes, as the learning outcomes in formal education documents provide the main guidelines for what is expected of that education (Ministry of Education and Research 2017).

Research on professional practitioners in the fields focused on in this study shows that many lack competence in SRHR (Fennell and Grant 2019; Haesler, Bauer, and Fetherstonhaugh 2016) and that student feedback emphasis a lack of knowledge dissemination and practical experience in the subject (Areskoug Josefsson and Fristedt 2019; Blakey and Aveyard 2017; Winter et al. 2016). If students miss out on important SRHR knowledge during their education, they may have insufficient competence when required to engage with SRHR issues as part of their professional practice.

The goal of national formal requirements is to ensure equal and sufficient competence within the same profession (Ministry of Education and Research 2017). If this goal is not achieved, there is an increased risk of people receiving different treatment or expertise depending on who they seek help from. When working in interdisciplinary settings, it is essential for all involved professionals to have sufficient knowledge and skills relevant to SRHR and for there to be a close fit between what has been taught in one profession and another.

It was noted in this study that the same educational institution could have educational programmes with both low and high levels of indicators. This may be due to perceived barriers in teaching SRHR. Research has revealed lack of political will, knowledge and time, cultural barriers, sexual health being a taboo topic, and an already overburdened curriculum as factors contributing to lack of inclusion (Aaberg 2016; Endler et al. 2022). Thus, institutions can improve the inclusion and quality of teaching of SRHR in their professional programmes by identifying and limiting the barriers with respect to the teaching of SRHR in their context.

Basic human needs and functions constitute an overarching theme, to which sexual health is subordinate. By not specifically engaging with SRHR as related to a person’s basic needs there is a risk that SRHR related care will be deficient. A study by (Endler et al. 2022) in the field of medical education separated SRHR indicators into clinical and more complex indicators. This division might be useful to explore further in other professions. The teaching of complex SRHR indicators could probably benefit from an interprofessional focus to as to bring in a range of perspectives, especially since complex SRHR issues are rarely dealt with by one profession alone.

SRHR indicators concerning disease states, functional impairments, mental health, the life course, pharmacology, hospital stays, communication tools, or sexual health as a resource were included in the reviewed documents to a very limited extent or not at all. Patients have often reported that their sexual health needs are not met (McGrath et al. 2019; Traumer, Hviid Jacobsen, and Schantz Laursen 2019) and since sexual health is a part of life, this is problematic. For people to be able to achieve their full potential, good health is a prerequisite, and this includes sexual health. How a person feels is affected not only by their social conditions but also by the economy and the environment (United Nations 2023b). By placing SRHR in this context, the term can also be understood as related to factors outside ‘health’ and can be viewed from a broader perspective.

Potential impact on SDG targets 3.1, 3.7, 5.2, 5.3 and 5.6

In relation to social development, the identified patterns create concern about meeting SDG targets related to SRHR by 2030. Failing to do so, will have a major impact on society, especially on health and social systems. In order to meet the targets, the importance of including SRHR in university programmes should be recognised along with the need to ensure clear and constructive alignment within and between different professional programmes.

Professionals working with both vulnerable and well-functioning people in society, need to have good knowledge of relevant issues. They also need practical experience applying this knowledge in meetings with clients. Personal, professional and educational factors can influence, both positively and negatively, attitudes and beliefs related to sexual health in educational institutions (Benton 2021). By not ensuring SRHR competence through professional education, there is a risk that people in receipt of health and welfare services will not receive adequate information or services, as target SDG 3.7 in particular strives for.

In the mapping, SRHR indicators for women’s health and sexual abuse, violence and trauma were given special attention. A clear focus on women’s health is mentioned by SDG 3.1, but its importance has also been stressed in Norway by a Women’s Committee Report launched in 2023, which showed a need for more research and an increased focus on women’s health (Ministry of Health and Care Services 2023). Violence against women remains a challenge in Norway. Goal 5 stresses the importance of empowering girls and women, and justice professionals’ (law and police) education, as well as health and social work education, should promote competence regarding this topic. It is also important to address SRHR using an intersectional lens as there are sub-groups within gender that have special needs relating to SRHR (Schindele, Areskoug Josefsson, and Lindroth 2022a, 2022b; Rosenthal and Lobel 2020).

In this respect, it is important to note that rarely was there mention of men’s health or trans health in the explored educational programmes. When professional practitioners are not educated about these important concerns there is a risk that personal prejudices may affect their actions, for example, their views about men and masculinity (Persson et al. 2022). Transgender people are exposed to harassment and experience living conditions and challenges related to their own mental health and discrimination, impacting life satisfaction (Ministry of Culture and Equality 2023). Transgender people have higher rates of suicide attempts and suicide (Erlangsen et al. 2023) than their cisgender counterparts. It is essential therefore for inclusive forms of gender education to be included in programmes of professional preparation,

Furthermore, the health and well-being of children, young people or the elderly is also rarely highlighted in the documents. SDG 5.6 stresses the importance of ensuring sexual and reproductive health and reproductive rights for all (United Nations Department of Economic and Social Affairs Sustainable Development 2024a). Professional practitioners must help ensure that SRHR is covered for the persons they meet and work with, especially for those who are vulnerable or at risk. If professional practitioners in the fields of justice, health or social care do not have competence in SRHR and/or do not recognise SRHR as being one of their professional responsibilities, the risk of not achieving SDG 5 increases, as well as not achieving the SRHR elements of SDG 3.

Educational interventions to improve SRHR competence

There are examples of successful interventions to strengthen education about SRHR as a component in basic professional education. Even simple interventions can lead to increased competence in SRHR (Wahlen et al. 2020), as the following examples from different fields show.

• Child welfare workers who completed a course on adolescent sexual health showed more positive attitudes, mastery and knowledge about sexual health and rights compared to the control group (Combs and Taussig 2021).

• Police recruits who completed a training programme on child abuse gained increased knowledge and skills and displayed increased sympathy and care towards parents as abusers (Patterson 2004).

• Nursing students who received education about sexual health care acquired strengthened knowledge that helped prepare them to meet sexual health challenges in the future (Sung and Lin 2013).

• Medical students gained increased confidence in communicating about sexual health by participating in a sexual health curriculum (Van Deventer et al. 2023)

• A two-week interprofessional sexual health course showed improvement in attitudes towards addressing sexual health after three months (Gerbild et al. 2018).

There is clear evidence to show that students who are provided with theoretical knowledge and practice in sexual health can develop a positive attitude towards sexual healthcare. However, actions and interventions to increase competence in SRHR are unevenly spread, and many professionals start their working life with inadequate knowledge and skills regarding SRHR. In addition, further competence development in SRHR is often based on personal interest and is not seen as a basic requirement for the profession.

There remains a lack of conceptual models in terms of duration, content and training on how to deliver specialist forms of SRHR education, for example regarding healthcare for LGBTQI+ people (Sekoni et al. 2017), people with depression (Thakurdesai and Sawant 2018), people with rheumatoid arthritis (Bay et al. 2020) and people with heart failure (Tiny 2016). Using previously successful intervention strategies to improve the curriculum is a potential way forward to improve SRHR competence among a wide range of professionals and may contribute to better health and well-being in the population as a whole.

In the light of the above, we recommend a clearer and more consistent focus on SRHR in documentation relation to higher education provision for different health and social welfare professionals if relevant SDGs are to be reached in Norway by 2030. In addition, SRHR must be included in the formal requirements of relevant educational programmes, and at every educational document level, to ensure constructive alignment within and between programmes. This will enhance students’ and professionals’ competence in SRHR, and therefore better accommodate people’s needs.

Strengths and limitations

A limitation in document analysis is often the inability to retrieve documents, and therefore, extra effort was given in this study to ensuring successful data collection. Another common limitation is that the documents available may not be fully up to date, and it should be recognised that the documents in this study, especially the course descriptions, were constantly being revised.

To avoid selection bias, the sampling method used in this study is described and the sample from each field of education is considered large enough to ensure trustworthy data for that field. As sampling is an important part of document analysis (Coe and Scacco 2017), it is a strength that this study includes the majority of all possible forms of higher education in which a focus on SRHR is appropriate.

The validity of the indicators used was strengthened by the fact that they were based on previous research and input from stakeholders. They were also tested throughout the data collection process. Interrater coding reliability was determined for each document level, which both strengthened the study and also ensured that the codes used were exhaustive and mutually exclusive (Coe and Scacco 2017). It was important to make these assessments for each level of documents, as more indicators were found in course descriptions than in the more overarching levels.

The study did not explore the literature made available to students on courses, and there may be content in courses that is not present in the course descriptions. Some educational programmes are not included, but as the patterns for each included profession were quite similar, it is possible that these educational programmes would show similar results.

Conclusion

Findings from this mapping study and from previous research shows the need for additional focus on SRHR in formal educational documentation and the field of practice in order to reach the SDGs by 2030. The importance of researching the inclusion of SRHR in professional education is demonstrated by students reporting both the need for more education on SRHR and a lack of SRHR needs being met in society. SRHR needs to be included in the formal requirements of higher education programmes, study descriptions and course descriptions to ensure an impact in professional practice and meet people’s needs. Universities, programme managers and course leaders should work to ensure constructive alignment between different educational programmes which include a focus on SRHR, not only to ensure that formal requirements are met but also that students understand the need for SRHR competence in preparation for their future professional career.

Acknowledgments

We thank Anchor English for their language editing support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The mapping project was funded by the Norwegian Directorate for Health as commissioned research, but not this written article.