The Impact of Contextual Factors on Comprehensive Sexuality Education for Learners with Intellectual Disabilities in South Africa


Adolescents and youth with disabilities in South Africa still lack access to sexual and reproductive health and rights services including comprehensive sexuality education, which may increase their vulnerability to SRHR issues such as HIV and sexual violence. This is exacerbated for learners with intellectual disabilities whose educators often lack skills and tools to accommodate these learners in comprehensive sexuality education lessons. The following paper outlines the findings of a formative evaluation of an innovative sexuality training approach for educators of learners with diverse disabilities (Breaking the Silence approach). This approach was developed and piloted with educators across eight schools for learners with intellectual disabilities in KwaZulu-Natal, South Africa. The paper discusses the educators’ understanding and experiences of using this approach. The findings revealed that although educators were able to implement parts of the approach, contextual factors impacted the degree of implementation. These factors were related to perceptions of socio-cultural norms, interpersonal engagement with peers and management, the structural environment of school settings, and the wider community setting. Educators began to address cultural taboos related to talking about sexuality, but were challenged by untrained staff and the larger socio-cultural context, which includes a heighted risk of sexual violence against their learners. The paper concludes with recommendations for a further investigation of the approach within a whole school setting considering the needs of educators to not only acquire skills and knowledge but also to address their larger socio-cultural context in which they have to implement comprehensive sexuality education.

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We would like to thank WCFID for providing some of the picture material for the manual development. We would also like to thank HEARD for providing the funds for the needs assessment, intervention development and part of the evaluation through its SIDA grant. In addition, we would like to thank all participating educators and KZN representatives of the Department of Basic Education for their participation in this project and courage to try out something new and daring. In addition, thanks go to the developmental team who assisted during the needs assessment namely Leandri Pretorious, Sophie Henken and Liset de Reus, who provided their time to the project on a voluntary basis.

Author information




JHH conceptualised this project and led the needs assessment, intervention and manual development, pilot of the intervention, the formative evaluation and development of this paper. RJ co-led the manual development, co-facilitated the pilot intervention, and has been part of the writing team. PC co-designed the manual, took part in the data analysis and has been part of the writing team. SN conducted the fieldwork, supported the data analysis and has been part of the writing team.

Corresponding author

Correspondence to Jill Hanass-Hancock.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study received ethical clearance from the University of KwaZulu-Natal Biomedical Research Ethics Committee (HSS/0959/013PD) and the Kwazulu-Natal Department of Basic Education. Participation was voluntary and participants were fully informed about the study and signed informed consent forms.

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Hanass-Hancock, J., Nene, S., Johns, R. et al. The Impact of Contextual Factors on Comprehensive Sexuality Education for Learners with Intellectual Disabilities in South Africa. Sex Disabil 36, 123–140 (2018).

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  • Disability
  • Sexuality education
  • Adolescents
  • Africa