Skip to main content
SpringerLink
Log in

Implementation Research on Comprehensive Sexuality Education in Ghana: Lessons for Health Promotion Research

  • Chapter
  • First Online:
Global Handbook of Health Promotion Research, Vol. 1

Abstract

Classroom implementation of Ghana’s comprehensive sexuality education (CSE) curriculum faces diverse challenges, ranging from teacher preparedness to community and parental acceptance of certain topics. While there is some evidence of acceptance at the student, teacher and community levels, we know less about what happens in the classroom. In 2014, a research programme was developed to investigate CSE curriculum content in relation to how classroom implementation occurs. This chapter reflects on the research trail and draws lessons for implementing similar research programmes in related contexts. Our work revealed that by collaborating and developing strong partnerships with different interest groups, research on sensitive public health topics can generate evidence that broadly mirrors the opportunities and challenges of translating sexuality education policies and curricula into classroom realities. The local ownership of the research problem and research questions increased acceptance and led to the immediate application of the results to create new guidelines for teaching sexuality education in Ghana’s pre-tertiary school system.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 149.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Anderson, L. W., Krathwohl, D. R., Airasian, P., Cruikshank, K., Mayer, R., Pintrich, P., et al. (2001). A taxonomy for learning, teaching and assessing: A revision of Bloom’s taxonomy. Longman Publishing.

    Google Scholar 

  • Andreou, T. E., McIntosh, K., Ross, S. W., & Kahn, J. D. (2015). Critical incidents in sustaining school-wide positive behavioral interventions and supports. The Journal of Special Education, 49(3), 157–167.

    Article  Google Scholar 

  • Awusabo-Asare, K., Stillman, M., Keogh, S., Doku, D. T., Kumi-Kyereme, A., Esia-Donkoh, K., et al. (2017). From paper to practice: Sexuality education policies and their implementation in Ghana. Guttmacher Institute.

    Google Scholar 

  • Bialystok, L., & Wright, J. (2019). ‘Just say no’: Public dissent over sexuality education and the Canadian national imaginary. Discourse: Studies in the Cultural Politics of Education, 40(3), 343–357.

    Google Scholar 

  • Biddlecom, A. E., Hessburg, L., Singh, S., Bankole, A., & Darabi, L. (2007). Protecting the next generation in sub-Saharan Africa: Learning from adolescents to prevent HIV and unintended pregnancy. Guttmacher Institute.

    Google Scholar 

  • Bloom, B. S., Krathwohl, D. R., & Masia, B. B. (1984). Bloom taxonomy of educational objectives. Allyn and Bacon.

    Google Scholar 

  • Bodnar, K., & Tornello, S. L. (2019). Does sex education help everyone?: Sex education exposure and timing as predictors of sexual health among lesbian, bisexual, and heterosexual young Women. Journal of Educational and Psychological Consultation, 29(1), 8–26.

    Article  Google Scholar 

  • Braeken, D., & Cardinal, M. (2008). Comprehensive sexuality education as a means of promoting sexual health. International Journal of Sexual Health, 20(1–2), 50–62.

    Article  Google Scholar 

  • Chandra-Mouli, V., Garbero, L. G., Plesons, M., Lang, I., & Vargas, E. C. (2018). Evolution and resistance to sexuality education in Mexico. Global Health: Science and Practice, 6(1), 137–149.

    Google Scholar 

  • Clark, L., & Stitzlein, S. M. (2018). Neoliberal narratives and the logic of abstinence only education: Why are we still having this conversation? Gender and Education, 30(3), 322–340.

    Article  Google Scholar 

  • Cohen, L., Manion, L., & Morrison, K. (2013). Research methods in education. Routledge.

    Book  Google Scholar 

  • Creswell, J. W., Plano Clark, V. L., Gutmann, M. L., & Hanson, W. E. (2003). Advanced mixed methods research designs. In Handbook of mixed methods in social and behavioral research (pp. 209–240).

    Google Scholar 

  • Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. Sage.

    Google Scholar 

  • Darteh, E. K. M., Dickson, K. S., Rominski, S. D., & Moyer, C. A. (2020). Justification of physical intimate partner violence among men in sub-Saharan Africa: A multinational analysis of demographic and health survey data. Journal of Public Health, 1–9.

    Google Scholar 

  • Dusenbury, L., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Education Research, 18(2), 237–256.

    Article  PubMed  Google Scholar 

  • Gerritsen-van Leeuwenkamp, K. J., Joosten-ten Brinke, D., & Kester, L. (2019). Students’ perceptions of assessment quality related to their learning approaches and learning outcomes. Studies in Educational Evaluation, 63, 72–82.

    Article  Google Scholar 

  • Ghana Census Office. (1962). The 1960 population census of Ghana. Ghana Census Office.

    Google Scholar 

  • Ghana Education Service. (2019). Guidelines for comprehensive sexuality education in Ghana. M. o. Education.

    Google Scholar 

  • Ghana Statistical Service, Ghana Health Service & ICF. (2015). Ghana demographic and health survey 2014. GSS, GHS, and ICF International.

    Google Scholar 

  • Ghana Statistical Service, Ghana Health Service, & ICF International GSS, GHS, and ICF (2018) Ghana maternal health survey 2017. Accra, Ghana.

    Google Scholar 

  • Gollust, S. E., Seymour, J. W., Pany, M. J., Goss, A., Meisel, Z. F., & Grande, D. (2017). Mutual distrust: Perspectives from researchers and policy makers on the research to policy gap in 2013 and recommendations for the future. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017705465.

    Google Scholar 

  • Green, J., Oman, R. F., Vesely, S. K., Cheney, M., & Carroll, L. (2017). Beyond the effects of comprehensive sexuality education: The significant prospective effects of youth assets on contraceptive behaviors. Journal of Adolescent Health, 61(6), 678–684.

    Article  Google Scholar 

  • Greene, J. C. (2007). Mixed methods in social inquiry. Wiley.

    Google Scholar 

  • Guba, E. G., & Lincoln, Y. S. (1994). Competing paradigms in qualitative research. Handbook of Qualitative Research, 2(163–194), 105.

    Google Scholar 

  • Haas, P. M. (1992). Introduction: Epistemic communities and international policy coordination. International Organization, 46(1), 1–35.

    Article  Google Scholar 

  • Haberland, N., & Rogow, D. (2015). Sexuality education: Emerging trends in evidence and practice. Journal of Adolescent Health, 56(1), S15–S21.

    Article  Google Scholar 

  • Hanson, J. H. (2017). The Ahmadiyya in the Gold Coast: Muslim cosmopolitans in the British empire. Indiana University Press.

    Book  Google Scholar 

  • Harn, B., Parisi, D., & Stoolmiller, M. (2013). Balancing Fidelity with flexibility and fit: What do we really know about Fidelity of implementation in schools? Exceptional Children, 79(2), 181–193. https://doi.org/10.1177/001440291307900204

    Article  Google Scholar 

  • Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19(1), 173–202.

    Article  CAS  PubMed  Google Scholar 

  • Izugbara, C., Wekesah, F., Amo-Adjei, J., Kabiru, C., Dimbuene, Z. T., & Emina, J. (2017). Young people in west and Central Africa: Health, demographic, education and socioeconomic indicators. African Population and Health Research Center.

    Google Scholar 

  • James-Traore, T. A., Finger, W., Ruland, C. D., & Savariaud, S. (2004). Teacher training: Essential for school-based reproductive health and HIV/AIDS education. Youth Issues Paper, 3.

    Google Scholar 

  • Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14–26.

    Article  Google Scholar 

  • Johnson, R. B., Onwuegbuzie, A. J., & Turner, L. A. (2007). Toward a definition of mixed methods research. Journal of Mixed Methods Research, 1(2), 112–133.

    Article  Google Scholar 

  • Keogh, S. C., Stillman, M., Awusabo-Asare, K., Sidze, E., Monzón, A. S., Motta, A., et al. (2018). Challenges to implementing national comprehensive sexuality education curricula in low-and middle-income countries: Case studies of Ghana, Kenya, Peru and Guatemala. PloS One, 13(7).

    Google Scholar 

  • Kershner, S. H., Corwin, S. J., Prince, M. S., Robillard, A. G., & Oldendick, R. W. (2017). Support for comprehensive sexuality education and adolescent access to condoms and contraception in South Carolina. American Journal of Sexuality Education, 12(3), 297–314.

    Article  Google Scholar 

  • Kirby, D., & Laris, B. (2009). Effective curriculum-based sex and STD/HIV education programs for adolescents. Child Development Perspectives, 3(1), 21–29.

    Article  Google Scholar 

  • Kwankye, S. O., & Cofie, E. (2015). Ghana’s population policy implementation: Past, present and future. African Population Studies, 29(2).

    Google Scholar 

  • Lebel, J., & McLean, R. (2020). Research quality plus: Another way is possible. Transforming Research Excellence.

    Google Scholar 

  • Li, C., Cheng, Z., Wu, T., Liang, X., Gaoshan, J., Li, L., et al. (2017). The relationships of school-based sexuality education, sexual knowledge and sexual behaviors—A study of 18,000 Chinese college students. Reproductive Health, 14(1), 103. https://doi.org/10.1186/s12978-017-0368-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Loughran, J., Berry, A., & Mulhall, P. (2012). Pedagogical content knowledge. In J. Loughran, A. Berry, & P. Mulhall (Eds.), Understanding and developing science teachers’ pedagogical content knowledge (pp. 7–14). SensePublishers. https://doi.org/10.1007/978-94-6091-821-6_2

    Chapter  Google Scholar 

  • Marsh, D., & Furlong, P. (2002). A skin not a sweater: Ontology and epistemology in political science. Theory and methods in political science, 2, 17–41.

    Article  Google Scholar 

  • McCarty-Caplan, D. M. (2013). Schools, sex education, and support for sexual minorities: Exploring historic marginalization and future potential. American Journal of Sexuality Education, 8(4), 246–273.

    Article  Google Scholar 

  • McQueen, D. V. (1991). The contribution of health promotion research to public health. The European Journal of Public Health, 1(1), 22–28.

    Article  Google Scholar 

  • Ofir, Z., Schwandt, T., Duggan, C., & McLean, R. (2016). Research quality plus (RQ+): A holistic approach to evaluating research.

    Google Scholar 

  • Ormston, R., Spencer, L., Barnard, M., & Snape, D. (2014). The foundations of qualitative research. Qualitative Research Practice: A Guide for Social Science Students and Researchers, 2, 52–55.

    Google Scholar 

  • Panchaud, C., Keogh, S. C., Stillman, M., Awusabo-Asare, K., Motta, A., Sidze, E., et al. (2019). Towards comprehensive sexuality education: A comparative analysis of the policy environment surrounding school-based sexuality education in Ghana, Peru, Kenya and Guatemala. Sex Education, 19(3), 277–296.

    Article  Google Scholar 

  • Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013a). Implementation research: What it is and how to do it. BMJ, 347, f6753.

    PubMed  Google Scholar 

  • Peters, D. H., Tran, N. T., & Adam, T. (2013b). Implementation research in health: A practical guide. World Health Organization.

    Google Scholar 

  • Quarshie, E. N., Waterman, M. G., & House, A. O. (2020). Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: A systematic review. BMC Psychiatry, 20, 1–26.

    Article  CAS  Google Scholar 

  • Richards, S. D., Mendelson, E., Flynn, G., Messina, L., Bushley, D., Halpern, M., et al. (2019). Evaluation of a comprehensive sexuality education program in La Romana, Dominican Republic. International Journal of Adolescent Medicine and Health.

    Google Scholar 

  • Roodsaz, R. (2018). Probing the politics of comprehensive sexuality education:‘Universality’versus ‘cultural sensitivity’: A Dutch–Bangladeshi collaboration on adolescent sexuality education. Sex Education, 18(1), 107–121.

    Article  Google Scholar 

  • Santelli, J. S., Kantor, L. M., Grilo, S. A., Speizer, I. S., Lindberg, L. D., Heitel, J., et al. (2017). Abstinence-only-until-marriage: An updated review of US policies and programs and their impact. Journal of Adolescent Health, 61(3), 273–280.

    Article  Google Scholar 

  • Santelli, J. S., Grilo, S. A., Choo, T.-H., Diaz, G., Walsh, K., Wall, M., et al. (2018). Does sex education before college protect students from sexual assault in college? PLoS One, 13(11), e0205951. https://doi.org/10.1371/journal.pone.0205951

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shannon, B. (2016). Comprehensive for who? Neoliberal directives in Australian ‘comprehensive’ sexuality education and the erasure of GLBTIQ identity. Sex Education, 16(6), 573–585.

    Article  Google Scholar 

  • Sumner, A., & Tribe, M. (2004). ‘The nature of epistemology and methodology in development studies: What do we mean by ‘rigour’’ Development Studies Association Annual Conference.

    Google Scholar 

  • Tenkorang, E. Y. (2013). Myths and misconceptions about HIV transmission in Ghana: What are the drivers? Culture, Health & Sexuality, 15(3), 296–310.

    Article  Google Scholar 

  • Tenkorang, E. Y., Amo-Adjei, J., & Kumi-Kyereme, A. (2020a). Assessing components of Ghana’s comprehensive sexuality education on the timing of sexual debut among in-school youth. Youth & Society, 0044118X20930891.

    Google Scholar 

  • Tenkorang, E. Y., Amo-Adjei, J., Kumi-Kyereme, A., & Kundhi, G. (2020b). Determinants of sexual violence at sexual debut against in-school adolescents in Ghana. Journal of Family Violence, 1–12.

    Google Scholar 

  • UNESCO, UNAIDS, UNFPA, UNICEF, UN Women, & WHO. (2018). International technical guidance on sexuality education: An evidence-informed approach. Paris UNESCO Publishing.

    Google Scholar 

  • United Nations Department of Economic and Social Affairs. (2020). World population prospects, 2020. Accessed: 18th June 2020.

    Google Scholar 

  • Uzochukwu, B., Onwujekwe, O., Mbachu, C., Okwuosa, C., Etiaba, E., Nyström, M. E., et al. (2016). The challenge of bridging the gap between researchers and policy makers: Experiences of a health policy research group in engaging policy makers to support evidence informed policy making in Nigeria. Globalization and Health, 12(1), 67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vasilenko, S. A., Kugler, K. C., & Rice, C. E. (2016). Timing of first sexual intercourse and young adult health outcomes. Journal of Adolescent Health, 59(3), 291–297.

    Article  Google Scholar 

  • Wagner, L. M., Eastman-Mueller, H. P., Oswalt, S. B., & Nevers, J. M. (2017). Teaching philosophies guiding sexuality instruction in US colleges and universities. Teaching in Higher Education, 22(1), 44–61. https://doi.org/10.1080/13562517.2016.1213231

    Article  Google Scholar 

  • Wang, B., Stanton, B., Deveaux, L., Poitier, M., Lunn, S., Koci, V., et al. (2015). Factors influencing implementation dose and fidelity thereof and related student outcomes of an evidence-based national HIV prevention program. Implementation Science, 10(1), 44.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Population and Health, University of Cape Coast, Cape Coast, Ghana

    Joshua Amo-Adjei

  2. Department of Sociology, Memorial University of Newfoundland, St. John’s, NF, Canada

    Eric Y. Tenkorang

Authors
  1. Joshua Amo-Adjei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric Y. Tenkorang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric Y. Tenkorang .

Editor information

Editors and Affiliations

  1. School of Public Health, University of Montreal, Montreal, QC, Canada

    Louise Potvin

  2. UNESCO Chair and WHO Collaborating Centre in Global Health & Education, University of Clermont Auvergne, Clermont-Ferrand, France

    Didier Jourdan

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Amo-Adjei, J., Tenkorang, E.Y. (2022). Implementation Research on Comprehensive Sexuality Education in Ghana: Lessons for Health Promotion Research. In: Potvin, L., Jourdan, D. (eds) Global Handbook of Health Promotion Research, Vol. 1. Springer, Cham. https://doi.org/10.1007/978-3-030-97212-7_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-97212-7_28

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-97211-0

  • Online ISBN: 978-3-030-97212-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation