Abstract
Introduction
Sex education has been shown to improve the sexual health of adolescents. However, many countries, including Saudi Arabia, still lack formal, school-based sex education programmes.
Methods
We examined the views of 28 stakeholders on anticipated barriers and facilitators to formulating and implementing a school-based sex education programme in Saudi Arabia. We conducted semi-structured interviews with policymakers, healthcare providers, teachers and religious scholars in 2017. We used the Walt and Gilson policy triangle framework to guide our analysis.
Results
We report on facilitating and hindering factors related to context, specifically structural, situational, cultural and global factors. Distinguishing between barriers and facilitators proved difficult as many factors served as both potentially facilitating and hindering implementation simultaneously. For example, the hierarchical nature of the governing system in Saudi Arabia was viewed as potentially easing implementation on the one hand and obstructing it on the other. Most of the barriers were related to predicted societal resistance to addressing sex-related topics. The current social and governmental changes were described as increasing ‘openness’ and were seen as providing a window of opportunity for possible implementation and social acceptability.
Conclusion
A general consensus on the need for sex education for adolescents in Saudi Arabia was observed. Barriers and facilitators to designing and implementing a school-based sex education programme were described in relation to the religious and cultural context of the country. However, the current rapid contextual changes related to governmental and social openness were described as providing a window of opportunity for facilitating implementation and delivery with minimal public opposition. Emphasis was placed on framing sex education as a form of health promotion.
Policy Implications
Findings from this study may be useful for policymakers to develop and implement school-based sex education programmes in Saudi Arabia and other similar political and/or cultural contexts.
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Availability of Data and Material
Authors chose to not share study data, including interview transcripts due to the sensitivity of the topic and fear of possible deductive disclosure.
Code Availability
N/A.
Notes
The consultative council is an advisory body to review laws and regulation and provide suggestions related to the annual reports presented by the ministries.
Religious legal opinion.
Schools in Saudi Arabia are segregated by gender, including staff.
The ban on women driving was lifted in September 2017 and activated in July 2018. Women were also allowed to enter stadiums and cinemas. As of July 2019, women at the age of 21 are allowed to apply for and renew their passports and are also officially considered legal guardians alongside men over their children.
The Islamic Awakening movement is an ultraconservative Islamic ideology that developed in the 1960s and 1970s and was influenced by Muslim Brotherhood and Salafi ideologies and influenced the religious discourse in Saudi Arabia throughout the 1990s up until recent years (Lacroix & Holoch, 2011).
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Acknowledgements
We would like to thank all the participants in the study, in addition to everyone who facilitated in conducting this research.
Funding
Funding for the study was through the Saudi Arabian Cultural Bureau in Britain (SACB) as part of funding of the first author’s doctoral scholarship at London School of Hygiene and Tropical Medicine.
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All authors contributed to the study conception and design. Material preparation and data collection were performed by Nour Horanieh. Analysis of the data was performed by all authors. The first draft of the manuscript was written by Nour Horanieh, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Ethical approval was granted on March 2017 by the London School of Hygiene and Tropical Medicine (Ref. No. 12064) and King Saud University (Ref. No. 17/0273/IRB).
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Written, informed consent was obtained from all participants included in the study.
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Horanieh, N., Wellings, K. & Macdowall, W. Barriers and Facilitators for Formulation and Implementation of a Sex Education Programme in Saudi Arabia: Stakeholders’ Perspective. Sex Res Soc Policy 19, 1561–1571 (2022). https://doi.org/10.1007/s13178-021-00678-4
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DOI: https://doi.org/10.1007/s13178-021-00678-4