D. Matungwa 1 , C. Chenha 1 , J. Kachuchuru, T. Visser 2 ,

Rethinking the “teacher” in school-based, teacher-led sexuality education programs in rural and urban Tanzania D. Matungwa1, C. Chenha1, J. Kachuchuru, T. Visser2, M. van Reeuwijk2, G. Maro3, A. Massawe4, I. Kalongola5, J. Francis1, J. Changalucha1, G. Mshana1. 1. National Institute for Medical Research – Mwanza Centre, Tanzania 2. Rutgers WPF, Utrecht, The Netherlands 3. African Medical and Research Foundation, Tanzania 4. Health Actions Promotion Association, Tanzania 5. Restless Development, Tanzania

Background • Evidence shows that school-based, teacher led Sexuality Education (SE) programs are effective in promoting and protecting young people’s sexual health (Mavedzenge, Doyle & Ross, 2011). • A considerable number of SE programs implemented in sub-Saharan Africa are school-based, teacher-led (Mavedzenge, Doyle & Ross, 2011). • Some studies have examined what topics young people prefer be covered in school-based SE programs (Mkumbo, 2010).

Others have examined what parents want (and don’t want) covered in school-based SE programs (Mkumbo & Ingham, 2010) • No studies have examined what teachers prefer (and don’t prefer) to teach in school-based SE programs and the reasons behind it. • Without such a study, the reported success of school-based, teacher-led SE programs is questionable.

Study aims • Find out what topics in Comprehensive Sexuality Education (CSE) teachers were willing to teach and the reasons for their unwillingness. • Find out what topics in Comprehensive Sexuality Education (CSE) teachers were not willing to teach and the reasons for their unwillingness. • This presentation focuses on the second aim of the study.

Methods • This study was part of an assessment of the status of Sexual and Reproductive Health and Rights in three regions (Tanga, Singida and Iringa) in Tanzania. • Three districts purposively sampled; one from each of the three regions (Kilindi – Tanga, Iramba – Singida and Iringa Municipality – Iriringa) • Three wards purposively sampled; one from each district in the three regions. • One Secondary school and one primary school purposively sampled from each ward.

Respondents purposively obtained from 6 purposively selected primary and secondary schools in three purposively selected wards. • A total of 45 teachers participated in the study. • Data collected using Focus Group Discussions and Group Interviews. • Data analyzed using NVivo software.

Results (1) • Respondents were asked to mention (and discuss) issues they thought should not be taught to young people, particularly those in schools. • They were also asked the reasons to why such issues (they mentioned) were not supposed to be taught. • Four issues were mentioned and rejected by a large number of the study participants: the importance of sexuality issues, practicing sex and sex positions, condom use and family planning.

Any issue on sexuality can be taught to them; but only the effects (not the importance) should be taught. “They should not be taught about the importance of having sex; to a large extent, let them be taught about it’s effects, the effects they will face when start engaging themselves in these practices” [FGD with secondary school teachers, Iringa Municipality]. • Young people should not be taught about how to have sex and sex positions; that’s encouraging them to practice. “We should completely not teach them about having sex. If you teach them about it; it’ll be like you are encouraging them to have sex” [FGD with secondary school teachers, Iramba district).

“We shouldn’t teach them about how to have sex, let alone sex positions. If you teach them about these; it’ll be like you are encouraging them to have sex” [FGD with secondary school teachers, Iramba district]. “These things about sex should not be taught to young people. There are also these movies full of romantic things; let them be banned so that young people cannot see them. These things will corrupt their minds; they are too young to know about them” [FGD with primary school teachers, Iramba district]. • Young people should not be taught about condom use “In my view, there things you can teach and others not. For instance, if say you teach them about condom use, it’s like you are encouraging a young person to practice sex; it’s like tempting them [FGD with secondary school teachers, Iramba district].

“We should not teach them about condom use. Their performance in class will be poor; they will only be thinking about sex. And many who do like this, end up with early pregnancies and STIs. We should not teach condoms; we should not allow condoms [FGD with primary school teachers, Kilindi district] • Young people should not be taught about family planning “Family planning should not be taught to them (young people); it’ll confuse them because they have nothing to do with it; it’s only for people who are married” [FGD with primary school teachers, Iramba district].

Results (2) • Six topics prompted and the respondents asked to discuss whether they should (should not) be taught to young people, particularly those in schools • Also asked to give reasons to why these topics should (should not) be taught • Topics prompted are those that were also rejected by parents as reported in Mkumbo and Ingham (2012) who used quantitative methods in their study

Topics in the affective dimension [those relating to attitudes and values] • Homosexuality • Masturbation • Condom use • Sexual pleasure and enjoyment • Topics in the behavioural dimension [those relating to relationships and personal skills] • Sexual behaviors other than intercourse • Appropriate and inappropriate touching

(i) Homosexuality • Homosexuality shouldn’t be taught because it is against community sexual norms. • Religious beliefs “It’s my view that this (homosexuality) should not be taught. How can people of the same sex have a sex intercourse? Let’s go into the scripture, our faith; it’s a man and a woman who were created. And now, how will two people of the same sex marry? If you teach this young people, you completely corrupt their minds. This should not be taught” [FGD with primary school teachers, Iramba district]. • Culture “This (homosexuality) should not be taught. If you compare it with African culture, customs and values; it‘s an embarrasing thing to us. It‘s something some people adopt from the Western countries” [FGD with primary school teachers, Iringa Municipality].

Homosexuality shouldn’t be taught to students because as they will learn to practice. They should not be taught (about homosexuality) because they will want to practice it. It should not be taught at all [FGD with primary school teachers, Kilindi district]

(ii) Masturbation • Masturbation should not be taught because you can not practically demonstrate “It should not be taught because we are directed to teach practically. Now, how will you demonstrate this (masturbation) practically? No one can teach this, it’s an embarrassment and a temptation to them (pupils)”.[FGD with primary school teachers, Iramba district] • It should not be taught, young people will want to practice it “It should not be taught because our children are fond of trying everything they come across. Even if you teach them about its effects they will still practice it” [FGD with primary school teachers, Iramba district]

(iii) Condom use • It should not be taught, it’s embarrassing to teach about it practically “To teach them about condom use, you will have to demonstrate practically. And from there, a boy and a girl will go to do the same were you (teacher) were demonstrating! No, not to the pupils, this should be done to adults who are about to marry or are already married” [FGD with primary school teachers, Iringa Municipality] • It should not be taught, it motivates sexual practices “We (teachers) teach about it (though not practically) but in fact we motivate them to use it, to engage in sexual practices. I just don’t know how we have teach about it! They must be taught about abstinence because teaching them condom use is like training them to engage in sexual practices” [FGD with primary school teachers, Iramba district]

(iv) Sexual pleasure and enjoyment • Sexual pleasure and enjoyment shouldn’t be taught to students because it will tempt them to practice sex. “If you teach them this, they will be affected psychologically, they will be enjoying it even before practice. I can imagine, will the pupil understand anything after teaching him/her that (topic); they will only be thinking bout how they will go to practice and enjoy” [FGD with secondary school teachers, Iramba district] It should not be taught. By nature humans want to practice things. I don’t see the reason why we should teach them about this, otherwise we want them to try it out [FGD with secondary school teachers, Iramba district]

(v) Sexual behaviours other than intercourse • If taught, it’ll motivate sexual practices “This is a new cultural practice. For example at my school, if a find a boy and girl in an unusual manner, I punish them. Like if I find them touching one another, I punish them. After touching, what will follow is to have sex; this is not our culture” [FGD with primary school teachers, Iringa Municipality] We should not teach them about this because they will practice sexual intercourse. If we teach them, they will do it in the public, they will even spread it to the young ones [FGD with primary school teachers, Kilindi]

(vi) Appropriate and inappropriate touching • Appropriate touching shouldn’t be taught as it motivates them to engage into sexual intercourse. “I just don’t understand! You mean we should teach these children about how to properly touch one another in the class? Mmmmh, not this please; if we teach them this, they will touch one another even during classes!” [FGD with primary school teachers, Iramba district] • Appropriate touching (and inappropriate touching) should not be taught; they are not part of our culture.

“They should not ne taught about this; it should be taught to those who are about to marry. After all, they are not part of our culture. So they should be touching one another like college students we see! No, no, they will corrupt our little children in our homes. This shouldn't be taught” [FGD with secondary school teachers, Iringa Municipality] “The only relationship that we allow here at school is a brother-sister relationship. Now if you teach them about touching, they will end up having sex. Don’t expect anyone to teach this topic” [FGD with secondary school teachers, Kilindi district] It’s true that this should not be taught. These ‘things’ about kissing, kissing and touching! When you touch some one, it means you love him/her; and so you why do you touch him/her; for what purpose? Will you not end up having sex? No, this shouldn't be taught! [FGD with primary school teachers, Kilindi district]

It’s embarrasing to teach about it practically. “My view is that it should not be taught. We are told to teach everything practically. Ok, now I have finished to teach about it, so I tell them (students) to touch one another as a practice? Now this is dangerous! [FGD with primary school teachers, Kilindi district]

Summary of reasons • If students are taught about these topics, they may practice them and that would fuel sexual activity among them. • Since they have to teach practically, teachers explained that demonstrating these topics would be an embarrassment to them and to the students. • These topics are against sexual norms of the religions and the communities where they (teachers) and students come from.

Conclusions • These findings remind us to rethink the position of teachers in the delivery of CSE. • Being professionals, “teachers”, does not exclude them from abiding by sexual norms of their community and religions that emphasize on the control of sexuality of young people. • Some of their professional ethics contradict with these topics. • By rejecting these topics, it’s clear that teachers adhere to sexual norms of their communities and their religions

To strengthen CSE programmes, there is need for structural interventions to work on sexual norms that hinder the delivery and success of CSE in schools. • There is also need for programmes to focus on teachers

Acknowledgement The authors would like to thank • The Dutch Ministry of Foreign Affairs for funding. • The Sexual and Reproductive Health and Rights Alliance partners – AMREF, Rutgers WPF, SIMAVI and Dance4Life based in the Netherlands. • The partners in Tanzania – AMREF, NIMR – Mwanza Research Centre, HAPA and Restless Development. • The administration of the respective regions, districts, wards and villages in which the study was undertaken. • All the study participants for their time and responses • The International AIDS Society (IAS) for the scholarship to attend the XIX International AIDS Conference (AIDS 2012).

D. Matungwa 1 , C. Chenha 1 , J. Kachuchuru, T. Visser 2 ,