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Table 2 Summary of findings from the qualitative study of the content on CSE in Rwanda

From: “Not just the consequences, but also the pleasurable sex”: a review of the content of comprehensive sexuality education for early adolescents in Rwanda

Area of CSE

Topics arising from interviews

Illustrative quotes

Good and safe relationships

Safe relationships

“We do not teach them to be lonely, but we teach them how to behave in good and safe relationships between boys and girls.“ (P07, Male, FBO)

Importance of Biblical virtues

“… The bible says that he who has a good wife has a good home. So we start preparing children at their early stages to become good husbands and wives who will start strong families.” (P11, Male, FBO)

Values, rights, culture and sexuality

Sexual abstinence

“Teaching a child about not having sex is spiritual because the seventh commandment prohibits us from having unauthorised sex.“ (P11, Male, FBO)

Dressing norms

“It is prohibited in our religion to put on trousers, miniskirt, having artificial hairs styles.” (P03, Female, FBO)

Prevent sexual abuse

“The law protects those who are under 18. It is against the law for adults to date a minor. They get arrested.“ (P16, Male, Public Institution)

Understanding gender

Gender equality

“Gender does not mean favouring boys or girls, but instead giving equal opportunities to all. They [boys and girls] should all be supported the same way and benefit equally from education.” (P17, Female, Government)

Gender roles

“We teach them that there are no roles specific to boys and girls; their roles are interchangeable. We want them to understand that one is capable of doing what another is supposed to do.” (P01, Female, Ministry)

Fostering self-confidence

“We focus on the development of self-confidence, decision-making, and teaching them to have self-trust and how to make informed choices, and critical thinking.” (P08, Male, FBO)

Sexual diversity

“…we know it [LGBTI] is also part of sexuality… I feel the framework around sexuality should incorporate that because it is how they are. Maybe it is not easy to find it among early adolescents, but at 16 to 19 years, you might have cases. So it would be good if programming could also look at this.“ (P02, Female, NGO)

Violence and staying safe

Refusing unwanted sexual activity

“Sexual and reproductive health education of early adolescents covers … saying NO to unwanted sexual activity, resist temptations and reporting information related to rape. (P14, Female, Public Institution)

Skills for health and well-being

Independent decision-making

“We teach them to make informed decisions and their rights, they can get married. They can take decisions without being easily influenced” (P16, Male, Public Institution)

Condom use

“… provide open information on access to condoms. It is very confidential. Girls and boys go and go back and obtain the information they need.”(P02, Female NGO)

Human body and development

Understanding human body

“We focus on teaching children about body anatomy and physiology so that they understand how they [their bodies] work… know when it is risky and how they can protect themselves.“ (P16, Male, Public Institution)

Sexual pleasure

“…you should also approach the positive side. Boys and girls want to talk about it, they have questions, and sometimes questions are not just the consequences of unprotected sex and early pregnancy but also how can I have pleasurable sex. Sometimes it is very difficult to ignore the positive side of the information.“

Sexuality and sexual behaviour

Appropriate behaviour

“They [educators] mostly talk about how early adolescents should behave, and the consequences of inappropriate behaviours.” (P10, Female, Public Institution)

Sexual instinct

“Sexual instinct is something natural which increases as someone grows, but you will not find teachers or parents telling their children about that… but if they were to be taught this earlier to know how to behave in such a situation, to know that sexual intercourse is a natural need”. (P01, Female, Public Institution)

Sexual and reproductive health

Prevention of pregnancy and STIs

“Girls do not misbehave like boys. Society does not perceive it as a big deal when boys misbehave. However, it is shameful when girls misbehave. They [adults] fear having girls with an unexpected pregnancy, but boys do not conceive.“ (P03, Female, FBO)

Circumcision

“They are taught about circumcision, and I would not say that circumcision is still considered strange as it was before.“ (P13, Female, Public Institution)

SRH services

“We focus mainly on access to information. We provide information about services provided regarding reproduction such as contraceptives, going to the hospital for delivery, pregnancy tests, ante- and post-natal care.“ (P16, Male, Public Institution)

Pros and cons of birth control methods

Some [people] believe that teaching contraceptives may encourage [early adolescents] to have sex… sexual activity is already there. Therefore, [we] have a program of teaching [early adolescents] about birth control and different methods they can use.” (P12, Male, FBO)

“They advise parents to provide condoms to their children when they go to school, but I think that is not the first thing to teach” (P05, Male, Public Institution)