Comprehensive Sex Education Addressing Gender and Power: A Systematic Review to Investigate Implementation and Mechanisms of Impact

Background Delivered globally to promote adolescents’ sexual and reproductive health, comprehensive sex education (CSE) is rights-based, holistic, and seeks to enhance young people’s skills to foster respectful and healthy relationships. Previous research has demonstrated that CSE programmes that incorporate critical content on gender and power in relationships are more effective in achieving positive sexual and reproductive health outcomes than programmes without this content. However, it is not well understood how these programmes ultimately affect behavioural and biological outcomes. We therefore sought to investigate underlying mechanisms of impact and factors affecting implementation and undertook a systematic review of process evaluation studies reporting on school-based sex education programmes with a gender and power component. Methods We searched six scientific databases in June 2019 and screened 9375 titles and abstracts and 261 full-text articles. Two distinct analyses and syntheses were conducted: a narrative review of implementation studies and a thematic synthesis of qualitative studies that examined programme characteristics and mechanisms of impact. Results Nineteen articles met the inclusion criteria of which eleven were implementation studies. These studies highlighted the critical role of the skill and training of the facilitator, flexibility to adapt programmes to students’ needs, and a supportive school/community environment in which to deliver CSE to aid successful implementation. In the second set of studies (n = 8), student participation, student-facilitator relationship-building, and open discussions integrating student reflection and experience-sharing with critical content on gender and power were identified as important programme characteristics. These were linked to empowerment, transformation of gender norms, and meaningful contextualisation of students’ experiences as underlying mechanisms of impact. Conclusion and policy implications Our findings emphasise the need for CSE programming addressing gender and power that engages students in a meaningful, relatable manner. Our findings can inform theories of change and intervention development for such programmes.

Epilogue

The epilogue ties the arguments about vocal expressivity and agency advanced in the previous chapters to questions about accountability, gender, and power raised by recent reports of sexual violence in the music industry. In 2012, Operation Yewtree revealed that high profile celebrities had used their power in the entertainment industry to abuse young people beginning in the 1960s. I ask how the notions of vocal expressivity and sexual liberation that emerged in the 1960s may have enabled these kinds of abuses. This epilogue reflects on how feminist music scholars and critics might honor expressions of agency while condemning abuse. It offers concluding thoughts on how music scholars can listen for agency and demand accountability.

Human Rights, Islam, and Debates around CEDAW

The article explores the tensions between FORB claims and the advancement of women’s rights in Muslim majority state contexts. Forms of Muslim majority state reservations to CEDAW are analysed in critical and comparative fashion. Iran’s historical engagement with CEDAW is studied for insight into how a purported theoretical conflict between CEDAW and FORB may be better understood in terms of the domestic and international politics of gender and power.

Application of the Theory of Gender and Power to Examine Sexual and Reproductive Autonomy among Women in Mahikeng in South Africa

The autonomy of women in sexual and reproductive decision-making within family settings may represent gender equality and reproductive health relief. The theory of gender and power was used to identify socio-economic factors that influence women’s decision-making on sex and family size. A survey of 568 married and cohabiting women was conducted in Mahikeng, South Africa in 2012. Structured questionnaires were used in data collection and were analysed using descriptive statistics and binary logistic regression methods. The Findings of the study revealed 60.7% and 70.1% women participate in decisions on sex and on size of family respectively. Perceptions husbands had the right to sex, experience sexual violence, being in religious and traditional unions had negative impacts on women’s sexual autonomy. Employed women and reporting choosing of partners significantly enhanced women’s sexual autonomy. Traditional union, experienced of sexual violence sex, perceptions that husbands had right to sex, increasing age, and number of living children significantly reduced women’s decision-making autonomy on family size. The findings partially validated the sexual division of constructs of labour and power in the theory of gender and power. We recommend that women need to be empowered socially and economically to decide freely on sex and family size as indicators of sexual and reproductive health.