SEXUALITY EDUCATION AND GENDER EQUALITY IN SCHOOL CURRICULA IN CROATIA:
2. Croatia - Description of Current Situation
4. International 'Best Practices'
5. Insights from Focus Group Discussions
7. Gender-Based Sexual Health Education Program - Draft Proposal
'Sexual education for young people should be about what they should care about and not about what they should fear. This means that we must leave our mostly problem oriented education and find out instead how to supply young people with consciousness of sexuality as pleasure and resource in life, and as such something WORTH learning and caring about.'
Gisele Helmius, Dept. of Sociology, Uppsala University (personal communication, October 19, 2002)
The main purpose of this research study is dual. An analysis part, including the identification of key issues and concerns, and the assessment of regional and international experiences and evidence, intends to provide a solid body of reference, a foundation for policy makers to argue for the integration of systematic and comprehensive sexuality education in (Croatian) school curricula, as well as for the inclusion of gender equality perspective in schoolwork (on sexual and reproductive health). On the other hand, proposed policy measures - including a draft proposal for an experimental (pilot) gender-based sexual health education program - meet the directives of the National Policy for the Promotion of Gender Equality 2001 -2005 (***, 2001a) and the National Program of Activities for the Young 2003 -2008 (***, 2002a). Working Plans and Implementation Programs of both these documents, adopted by the Croatian Parliament, oblige relevant governmental bodies that within set time-periods develop and implement school-based (1) educational program(s) in the areas of 'sexually transmitted infections (STIs) including HIV/AIDS', 'reproductive health', 'gender equality and sexuality', 'sexuality', and 'sexual and reproductive health'; the specific phrase depending on the particular policy sector and its focus.
In the course of this paper, for reasons of parsimony, I will be using the term sexuality education (SE), unless referring directly to the title of a distinct program or curriculum (2). However, for reasons of straightforward argumentation, it is needed to elucidate the concept of SE as employed in the scope of this analysis. This paper's position builds upon the understanding of SE as formal, systematic and comprehensive (school-based) educational work that addresses the wider concept of human sexuality, and is based on cognitive and affective learning, as well as on the development of behavioral and communication skills (***, 1996; ***, 2001c; ***, 2001d; Harrison, 2000; Forrest & Kanabus, 2002; Lenderyou, 1994; Trudell, 1995). Moreover, SE programs in schools are recognized as an important educational strategy - 'a building block' - for the promotion of sexual and reproductive health that many health care professionals and researchers have studied and recommended, including the meta-analysis commissioned by the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) (***, 1997a; Grunseit et al, 1997).
This research, as its basic working definition, considers sexuality as a central, positive and healthy component of human life that incorporates 'sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction'; is 'experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships' (3); and is being constantly 'influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical and religious and spiritual factors' (***, 1996; ***, 2001d; ***, 2002b). Correspondingly, the concept of sexual health is not 'merely the absence of disease, dysfunction or infirmity', but also implies 'the integration of the physical, emotional, mental and social aspects of sexual being' through 'free and responsible expressions of sexual capabilities in ways that are positively enriching and that enhance personality, communication and love'. The achievement and sustainability of sexual well-being requires a positive and respectful approach to sexuality and sexual relationships (including both pleasure and procreation), as well as the protection and fulfillment of sexual rights, counting the right to SE.
The right to comprehensive and systematic SE, as 'a lifelong process that should involve all social institutions', is acknowledged and affirmed in several international agreements and documents as a part of the boarder recognition of sexual rights as human rights (4), and more explicitly, in the context of (young people's) sexual and reproductive health, as the right to 'seek, receive, and impart' sexuality information. At the level of national programmatic responses, this also translates to a call for 'reliable and effective SE in schools as a mandatory part of a curriculum'. The key international declarations and treaties ratified by the Republic of Croatia that provide a justification (5) for program actions to include sexual and reproductive health issues, as well as gender equality perspective, within formal schooling for young people, include: the International Covenant on Civil and Political Rights; the Convention on the Rights of the Child; the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW); as well as the Action Plans of the 1994 United Nations International Conference on Population & Development (UN ICPD, Cairo), and the 1995 UN Fourth World Conference on Women (Beijing) and their five-year follow up conferences in 1999 (ICPD +5, The Hague) and 2000 (Beijing +5, New York) (***, 1994; ***, 2000a; ***, 2001a; ***, 2001e; ***, 2001f; ***, 2002d). In summary, both the IPCD (+5) Program of Action and the Beijing (+5) Declaration and Platform for Action - in terms of advancing and protecting (young people's) sexual and reproductive health and rights - require that governments, among other stipulated actions, devise comprehensive, gender-sensitive, SE programs and ensure that provision of SE, as a part of a comprehensive national (youth) policy, is integrated in primary and secondary school education at the national level. This also entails adopting gender-equality perspective through specific actions, such as 'to eliminate stereotypes in educational materials that reinforce existing inequities between males and females' (6), as well as to insist that 'school curricula must also change to reflect a commitment to eliminate all gender bias'. Furthermore, the provision of SE in a gender-sensitive way is additionally stressed in two recent EU documents that request both Member States and candidate countries to improve their efforts in relation to that specific (youth's) sexual and reproductive health right, the right to comprehensive SE (***, 2002e; ***, 2002f).
However, the rights of young people to school-based SE are often the most controversial part of both relevant sectors: sexual and reproductive health agenda and needed policy directions in educational system as well (***, 2001e; ***, 2001g; Massey, 1995; Meredith 1989). SE in school, as the systematic process of young people's sexual socialization, also plays an important role in the determining of sexual rules, norms and values of a given society, and consequently in the wider structuring of social, political and economical relations (Epstein & Johnson 1998; Irvine, 1995; Sears, 1992). Therefore, the issues of SE objectives, contents and working methods - as well as the question of actual integration of SE programs in school' s curriculum - are frequently imbedded with tensions between 'traditionalistic' versus 'progressive' ideological trends in regards to (adolescent) sexuality (Deven, 1992; McKay 1999).
In recent global developments and debates in the area of SE policy (and politics), comprehensive school-based SE practices are emerging as a distinct European social tradition (7) (Berne & Huberman, 1999; Levine, 2002; Lottes, 2002; Vilar, 1994), as opposed to current efforts in the 'globalization' (8) of American 'family values' and 'the virtues of virginity', furthermore embodied in the Bush administration's increase of funding for domestic 'abstinence-only' programs (9) (Howell, 2001; McGuire, 2002; Rosenberg, 2002). Indeed, it seems that the future course of SE development in the USA (10) is directed by the Government's politics and ideology rather than by findings from a number of scientific evaluations indicating the ineffectiveness of programs that promote abstinence-only(-until-marriage) as the single effective protection against 'the hazards of nonmarital sex' (11) (Levine 2002). Despite the complete lack of proven educational impact of these 'fear-inducing' (highlighting sexual risks and censoring information about condoms and contraception) programs on adolescent behavior (Barnett, 1997; Jacobs & Wolf, 1995; Howell, 2001; Kirby et al, 1994; Kirby, 2000; Kirby, 2001), seven hundred abstinence-only programs are being implemented in more than one third of US secondary schools in all 50 states (12) (Levine 2002; Rosenberg, 2002).
On the other hand, governments (and other decision-makers) willing to develop SE policy and curriculum that is grounded in scientific research and trend analysis can rely on the significant body of evaluated best practices. Especially informative for program planners are meta-analyses that synthesize findings from various peer-reviewed evaluation studies of SE programs conducted in the last 30 years the world over. On the basis of these analyses (***, 1997a; ***, 2000b; Jacobs & Wolf, 1995; Finger, Lapetina & Pribila, 2002; Grunseit et al, 1997; Kirby et al, 1994; Kirby, 2000; Kirby, 2001) it can be affirmed that SE programs:
* have proven ability to increase knowledge about reproduction, pregnancy,
STIs, and prevention methods;
* do not promote earlier or increased sexual activity in young people and can
lead to increased safer sex practices, such as use of condoms and contraceptives;
* show promise for influencing sexual attitudes, skills and behaviors, and for
reducing rates of unintended pregnancy.
The next step entails the comparison of successful and ineffective programs, and the detection of characteristics that make SE effectual. These elements include:
* focus on a small number of specific behavioral goals (e.g. consistent condom
use) and give a clear message ('I have safe sex or no sex!') (13);
* start before the onset of sexual activity;
* have a theoretical framework proven to change behavior;
* focus on active learning through experiential activities and the use of real-life
situations (e.g. role-playing);
* incorporate goals, teaching method and materials appropriate to major developmental
stages of a target group;
* provide basic, accurate information on sexual risks and protection methods;
* encourage openness in communicating about sex;
* address social and cultural influences and pressures on sexual behavior (e.g.
media, peer culture);
* incorporate practice of communication, negotiation skills, and autonomous
decision making (e.g. 'how to say no');
* encourage adoption of values and attitudes that strengthen self-esteem and
support responsible behavior;
* deploy motivated and trained teachers (educators).
However, without diminishing the importance of all these components, this research argues that gender issues and gender perspective must be at the core of any realistic and considered SE program. For the purpose of this analysis 'gender' is defined in line with international working definitions (WHO, PAHO, UNAIDS, UNIFEM) and refers to 'the economic, social and cultural attributes and opportunities associated with being male or female in a particular point in time' (14) (*** 1998a; ***. 2000c; ***, 2000d; ***, 2002b, Hartigan et al, 1997). The present social organizations of gender in most countries are rooted in unequal power relations that favor males (men) over females (women). As (hetero)sexual relationships take place within wider power relations between women and men, existing gender inequalities have serious consequence for young people's sexual and reproductive health. There is a growing number of social science and public health research studies focusing on the active role that traditional terms and structures of gender inequality have in supporting sexual vulnerability of girls and certain risk behaviors of boys, and in that way directly influencing adolescents' (sexual and reproductive) health (e.g. Hodžic & Bijelic, 2003; Holland at al, 1992, 1998, 2000; Lewis & Clift 2001). These concerns were recognized, addressed and translated to specific recommendations for programmatic efforts - mostly directed to HIV/AIDS interventions, but also including the area of school-based SE - to address gender issues as a key-component of the effective promotion of safer sexual behavior, as well as to 'ensure that comprehensive SE always include gender analysis and particularly stresses the right of men and women to sexual equity and equality'. (***, 2000a; ***, 2000c; ***, 2001a; ***, 2001d; ***, 2001f; Aggleton, Ball, & Mane, 2000; de Bruyn, 1999; Garcia-Sanchez et al, 2002; Harrison, 1997; Henry Shears, 2002; Lewis, 2001, 2002; Nilsson & Sandstrom, 2001; Rivers & Aggleton, 1999; Sundby, 2001). UNAIDS resources provide further valuable insights in interventions that integrate work on gender awareness and gender equality issues in sexual health education and HIV/AIDS prevention (***, 1997a; ***, 1998a; ***, 1999c).
In the light of the above-mentioned context, this research stresses the importance of gender considerations in developing and implementing SE programs in schools, but also emphasizes a need to integrate elements of gender equality education across the curriculum, as to avoid the marginalization of gender issues. Following on these directions, the issues dealing with gender (equality) perspective in this paper will not be discussed separately, but rather adequately integrated in the whole structure of the text. With reference to the organization of my argument, after this introductory part that provides international (policy) context for the researched topic, follows the description of the current Croatian situation relating to school-based SE. The next segment presents a regional overview, a 'snapshot' rather, given that in all three included countries (Bosnia and Herzegovina, Serbia, and Slovenia) systematic SE is not a part of schoolwork. The following section of the paper provides examples of international 'best practices' in the field of SE in schools, namely the cases of Sweden and the Netherlands. The additional data concerning Croatian circumstances - findings from Focus Group Discussions (FGDs) with students and teachers on the issue of school-based SE, and results from a gender-focused research on adolescents' attitudes and sexual behavior - is presented in a continuation of the analysis. The final part, based on the synthesis of major findings from the whole research year, outlines the structure of an experimental gender-based sexual health education program, and offers specific recommendations for the adequate integration of systematic and comprehensive SE in Croatian school curricula.
Methodology employed in the course of this research involves document search and survey, literature review, stakeholder survey (FGDs), interviews, as well as my active participation (e.g. 'Initiative for the implementation of school-based sexuality education'). Particular research methods are described further in the text, fittingly to research phases and related insights. While this project aims to provide a reliable foundation and a good starting point for the process of including SE in Croatian schools, it is obvious that further curriculum developments in this educational field - in concordance with the prevailing principles of interdisciplinarity, coherence and consistency - will demand a close collaboration with academics, experts and practitioners from various branches of learning. Moreover, a prospective follow-up work to this project would have to be synchronized with the broader efforts in the area of educational (curricular) reform at the national level.
At the end of March 2002, the same time as I was starting with this research, the editors of a popular Croatian daily 'Jutarnji list' dedicated their, so-called 'Focus' page to the issue of school-based SE in Croatia. Under the headline 'Experts: Sexuality Education Should be Introduced to Primary Schools' (15), the article focuses on the health education program 'Youth for Youth', developed and implemented in five secondary schools in Zagreb by the Reproductive Health Department of the Children Hospital (16). This peer-education program on sexual and reproductive health is mostly information-based, and implemented through peer-led lectures on the issues such as STIs, contraception, abortion, and condom use. The newspaper article's main message is that the number of sexually active adolescents in general (17), and the number of those engaging in risky sexual behaviors (RSB) (18) in particular, is increasing and that there is still no systematic and comprehensive SE program in Croatian schools. In addition to the article's claim, it should be evident that, besides encouraging safer and responsible sexual behavior in response to current negative epidemiological tendencies (the spread of so-called 'new STIs' (19)) and inconsistent use of condoms (20), any upcoming national school-based SE program have to be gender sensitive (21) for both girls and boys, as well as sensitive to different sexual choices in order to develop needed tolerance to sexual minorities, which during 2002 became a significantly more visible part of Croatian society (22).
The only period when school-based SE was actively practiced in Croatia is now almost exactly 30 years behind us. In the end of the Sixties, an experimental SE program was implemented in ten primary schools in Zagreb; in 1972 SE elements became an obligatory part of the curriculum for primary schools, and the year after a manual for teachers was published (Maleš, 2000). SE contents were integrated in the teaching subject of 'nature and society' (1st and 2nd grade), student community class (3rd-8th grade) and biology (8th grade). However, this intended 'integral approach to human sexuality' resulted in the fragmentation of educational contents, and in the weakening of the conception of comprehensive SE, which was renamed as 'Education for human relations between sexes'. The whole project was soon shut down, mostly due to the lack of a clear concept and program, and the lack of initiative and motivation of class-teachers who were identified as key-educators for this area. Class-teachers were also responsible for the development of particular SE lessons - that needed to be additionally adapted to pupils' developmental stages - based on the teacher's manual (Košicek et al, 1973).
In the current national curricula for primary (compulsory) school education relevant SE contents are fragmentarily included in the 'nature and society' program for the first six grades (age 6(7) - 11(12)) and in the biology curriculum for 8th grade (age 13-14) (***, 1999d). The stated program tasks for the knowledge area of nature and society refer, among others, to the systematic and planned development of pupils' health habits, as well as to the development of their moral values. Related educational themes (e.g. family members, sex difference, body parts, healthy lifestyles) are part of the teaching units 'family and home' and 'our body and health'. Instructions for teachers point that pupils' acquisition of health habits should be put into 'a functional relation' with the educational area of 'human relations between sexes'. The didactical and methodical principles for 'natural science' curriculum for 5th grade additionally emphasize that program themes should provide a frame for health education concerns, especially in the relation to puberty issues, and to the development of pupils' sense of one's own responsibility for one's own health. The biology curriculum for 8th grade includes some SE contents (genital organs, anatomy and reproductive process, STI's (including HIV), family planning) and related learning assignments (to understand biological basis of sex difference, to develop pupils' sense for responsible sexual behavior, to develop a positive attitude to human relations between sexes in relation to gender equality legislation and human rights in general). However, the actual implementation of these teaching tasks usually means one to three 45-minutes lessons (lectures) throughout compulsory education, primarily focused on the transmission of basic factual knowledge about human bodies and the reproductive dimension of human sexuality (***, 2000a; ***, 2001f).
Almost the same topics are indicated in the biology curriculum for secondary grammar schools. The other subjects' curricula for grammar schools, which involve educational contents that can be recognized as parts of some prospective cross-curricular SE and/or gender equality education, are sociology (social roles and institutions, family, marriage, socialization) psychology (emotions, adolescence, stereotypes, prejudices, love, parenthood), history, and 'politics and economy' (human rights). Likewise, some other educational themes that can be linked to the topic of this study are present in the syllabi for the elective subject of ethics, and include the issues of identity, responsibility, love, gender relations, parenthood, family, friendship, human rights, new reproductive technologies, and abortion (***, 2002h). However, for many Croatian adolescents, the only school-based provision of education on sexual matters - not taking into account those curriculum-scattered segments without unifying conception - is a sporadic (medical) expert lecture, usually about 'teenage pregnancies', HIV/AIDS, and contraception, given once or twice during the whole schooling. Nevertheless, there are also young people who do not receive a single school lesson on the issues concerning human sexuality (23).
School-based SE was again in the media 'focus' five months later, at the end of August 2002. In the same newspaper, this time the article's headline states that 'Instead of Sexuality Education, Health Education Should be Introduced to Schools' (24). This claim for 'refocusing' of educational priorities (and consequently contents) is based upon, and reflects the new National Program of Activities for the Young (***, 2002a). One of the 26 principle objectives of this comprehensive national youth policy is 'to provide adequate support to young persons in the areas of family planning, family life, sexual and reproductive health, and the prevention of STIs and risk behavior'. The measures specified to achieve this goal is 'the planning and conducting of a pilot study on the topic of Health Education in elementary and secondary schools, in which the required modules would be as follows: sexual and reproductive health, risk behavior, harmful habits and the prevention of addiction'. The implementers of this activity are the Ministry of Education and Sport (MoES) and the Ministry of Health (MoH) as coordinating bodies, in co-operation with the Bureau for the Advancement of Education (BAE), and the Croatian Bureau for Public Health (CBPH). Besides the suggested health education pilot program, other recommended actions in the area of 'Healthcare and Reproductive Health' include establishing of counseling centers within the healthcare system at the county level. Apart from providing information and professional advice, these units should also ensure the availability of contraceptive devices. In addition, the counseling centers, with the support of the educational system and non-governmental organizations (NGOs), should implement 'quality programs in connection with venereal diseases, addiction, assistance in crisis situations, risk behavior, sexual problems, sexuality and reproductive health'. The Action Plan regulates that in the next five-year period (2003-2008) entitled governmental bodies should implement the recommended actions according to operative plans that need to be confirmed by the coordinating implementers within a period of 6 months from the adoption of the National Program (25).The BAE started with the preparation of educational materials for the proposed health education pilot program (26). The materials are to be presented, additionally elaborated and distributed through a series of seminars with biology and natural sciences teachers from primary schools. Moreover, the BAE's 'meeting of experts' (Zagreb, October 2002), targeting biology teachers from five regional counties, included the discussion about 'the concept, the implementation principles, and the structure of health education in schools'. In summary, biology teachers are willing to participate in health education, provided that additional training in the area of psychology skills and knowledge is assured. The identified obstacles to the quality implementation of health education in school programs include overloaded timetable and the lack of trained (qualified) educators (27).
With regards to the already existing in-service teacher training programs in the educational fields of gender equality and sexual and reproductive health, the Center for Education and Counseling of Women (CESI) and the Forum for Freedom in Education (FFE) present the examples of 'best practices' coming from the non-governmental sector.
FFE is a NGO, a member of European Forum for Freedom in Education, Germany, founded in Croatia in 1992 with the principal objective of learning about, introducing, and encouraging the implementation of the EU educational standards in Croatian educational system. In 2001 FFE has started again (28) with the implementation of the educational program for teachers - 'Through Education to Health' - that addresses five integrated health aspects: healthy nutrition, smoking prevention, prevention of misusage of alcohol and other drugs, SE and AIDS prevention. The program is founded on the premise of one's own responsibility for one's own health, and primarily targets 10-18 years old children. FFE's approach to health is a positive one, and based on the holistic concept of health. Moreover, it promotes interactive teaching methods and is directed to the development of self-esteem, tolerance and sensitivity for others, as well as to the strengthening of individual decision-making skills. The program is implemented through two 2-day educational seminars for teachers, accompanied with five educational manuals, including 'Human Sexuality' and 'AIDS Education'. The 'AIDS Education' (Flaherty-Zonis, 2001a) manual is pragmatic and positive in its approach: it promotes responsible sexual behavior as 'the prerequisite for a successful sexual life' and focuses on strengthening young people's self-esteem, integrity, and decision-making skills. It includes a section with basic facts about HIV/AIDS, a short knowledge test, and a series of HIV/AIDS related educational units presented together with methodical instructions and concrete guidelines for starting and leading discussions. Finding answers through talks with young people is recommended working method, and the educator's role is described in terms of providing the essential information and facilitating students' discussions. The 'Human Sexuality' (Flaherty-Zonis, 2001b) manual is a more comprehensive one, and besides the fundamental facts on human sexuality (anatomy and reproduction, STIs and contraception) also addresses the issues of self-esteem, individual integrity, responsibility, love and sex, gender roles, and sexual harassment and violence. It incorporates all three aspects that characterize effective SE programs: providing reliable information, developing social skills (communication, negotiation, and decision-making skills), and clarifying attitudes and values. Clear methodical directions give support to active pupils' participation in the educational process that approaches sexuality as a positive and integrated aspect of human life.
The other organization active in the field of in-service teacher training is CESI, a women's NGO, established in 1997, with the objective to actively promote the values of gender equality and tolerance, and contribute to the advancement of women's status and to the building of civil society in Croatia. CESI's 'Building Gender Awareness' program, started in 1999, primarily focuses on young people and in its approach successfully integrates research, education, publishing, and public policy advocacy (29). One of the program's current projects (2003-2004) is 'GenderNet', the European Commission funded educational, capacity-building and media project with the overall objective to integrate the values of gender equality, tolerance, and respect for diversities in schoolwork (30). The project's main activity is development, implementation and evaluation of the 'Gender Awareness' pilot program, an educational intervention for secondary school students, comprising 10 one-class period lessons focusing on gender equality issues. The program's contents include: sex and gender; gender roles and identities; gender, society and culture (with a special emphasis on media influence); and gender (in)equality. In addressing topics such as gender stereotypes and prejudices, sexism, and gender-based violence, this training curriculum combines various interactive teaching methods, and employs adolescent perspective and experiences. A teaching manual is also provided (Hodžic, Bijelic & Cesar, 2000). Besides raising students' gender awareness, the program's objectives are also directed to the development and strengthening of young people's communication and negotiation skills (active listening, assertiveness). The cross-curricular integration of the program's themes is indicated for following school subjects: Croatian language and literature, history, ethics, sociology and psychology. The implementation procedure entails an advanced capacity-building and program-development seminar for 20 teachers who have already participated in CESI's previous trainings in gender awareness and interactive teaching methodology (2001-2002), and who will be putting this educational program to practice with 600 young people in 10 secondary schools in Croatia. A systematic evaluation and monitoring will be conducted in a co-operation with the Center for Educational Research and Development (CERD) using a questionnaire survey ('pre-test, post-test, control group design') to research the impact of the educational program on students' knowledge, attitudes and behavior in relation to gender equality (identities, roles, relations), while the quality of the implementation procedure will be assessed through interviews with principle teachers and students, and a follow-up evaluation seminar for teachers. The planned outcomes of this comprehensive project include a booklet providing a blueprint and recommendations for implementation procedure, educational videotape, as well as the second edition of the educational manual.
The co-operation between CESI and CERD can help that in-service teacher trainings provided by NGOs achieve wider recognition, which was also one of the points raised in the Final Conclusions to the International Conference on Education held in Zagreb in May 2002 (Sahlberg, 2002). CERD is an autonomous, policy-orientated expert institution created in 2000, as the result of the agreement between the Government of Croatia and OSI Croatia, in line with the support of OSI to the Croatia's reform mechanism 'Strategy for the 21st Century' in general, and in the sphere of education in particular. The mission of the CERD is 'to initiate, facilitate, and inform on, policy analysis, development, planning, assessment, evaluation and implementation for educational reform in Croatia'. One of the CERD's current projects (31), supported by the Ministry of Science and Technology (MoST), the MoES and OSI Croatia, is 'Evaluation of Syllabi and Development of Curriculum Model for Compulsory Education in Croatia' (2002-2004). The project's overall objective is to develop an analytical basis for the curricular changes, and its results are expected to serve policy makers (MoES) in decision-making on the implementation of the national curriculum reform.
However, at the moment (March 2003) it is not decided what should be the model
of compulsory school education to coordinate with the development of curriculum
structure, as well as what additional changes would be involved in the whole
educational reform. The current developments in relation to the educational
reform indicate that 'the emerging needs' were not sufficiently addressed during
the drafting procedures, as it was suggested in the above-mentioned conference
conclusions (Sahlberg, 2002) (32).
The existing proposal for the reform of educational system (***, 2002i), after
being accepted by the Croatian Government in November 2002, was rejected by
the Parliament in February 2003. This debatable document is the result of two
years work of the MoES's Council of Experts and the Education Working Group
of the Government's Central Project Council of the Strategy for Croatia in the
21st Century. Both expert bodies produced their own drafts that were harmonized
into the final proposal in October 2002. However, it should be noted that the
principal researcher on the Government's project declined further participation,
after findings from a preliminary comparative analysis (***, 2002j) showed a
groundlessness and doubtfulness of the MoES's proposal, which in its foundations
entails prolonging of compulsory education to nine years, and replacing the
present '4+4' model with the new '3+3+3' standard. This was the most criticized
part of the proposed reform during an intensive public debate that followed
the adoption of the MoES's final draft by the Government
(33). In all critical assessments - from school
union's reactions and the initiative of academics, to the rejection by the Parliamentary
Committee for Education and the final parliamentary decision - the Government's
proposal was reviewed as unacceptable on the basis of its primary focus on structural
and organizational changes of the educational system rather than on the quality
of education itself (34).
In addition, it was pointed out that there are no adequate school's capacities
for such large structural interventions, which would also require additional
financial investments. The suggested alternatives include minimizing organizational
changes - keeping the existing model of eight years (4+4) of primary school,
but extending the compulsory education to include the first year of the present
secondary education - and directing the financial and human resource potentials
towards teachers in order to increase the quality of education, and to develop,
both teachers' and students', creative capacities. Although the consensus about
the need for changes was achieved, it is still not clear how radical and how
prompt these modifications would be. Moreover, it should be taken into account
that the current Minister of Education and Sport will probably not extend his
mandate after the upcoming elections (probably in (late) autumn 2003) due to
a series of recent turbulences in Croatian educational system, including the
case of a HIV-positive girl who was two months isolated from her peers in the
first grade (35), the case
of Roma children segregation, as well as the (unsuccessful) strike organized
by the Union of Croatian Teachers.
Nevertheless, CERD is continuing with the project to develop a curriculum model
for compulsory education based on the adequate needs assessment and the comparative
content analysis of existing Croatian curricula and syllabi, and selected European
cases, including the analysis of their national framework curricula. As the
project's final output should also incorporate the appropriate model for school-based
SE, the findings from this research (IPF) will be included in its drafting process.
The additional, informal support to this part of the CERD's project is provided
by the group of 15 experts (36) (sociologists,
psychologists, medical doctors, educators) joined around the 'Initiative for
the implementation of school-based sexuality education' started in May 2002.
The Initiative resulted in broadening of the network of governmental institutions
(37) and NGOs, scholars,
educators and policy makers dealing with gender equality, sexuality and curriculum
development in Croatia, as well as articulating and setting up a preliminary
agenda for the implementation procedure for the integration of SE program in
both primary and secondary school curricula. My intention is to employ the Initiative's
network and its expert resources for the dissemination and discussion of IPF
research findings and policy recommendations.
This section describes the status and position of gender equality education and SE in Bosnia and Herzegovina (B&H), Serbia and Slovenia. This overview is partly based on my short study visits to Sarajevo, Belgrade and Ljubljana during May 2002, and partly on reviewing relevant documents. It addresses existing legislative (if available), institutions and organizations (governmental, NGOs, and international) involved in SE and/or gender education, as well as their programs and activities. In addition, the list of contacted resource persons and organizations is provided.
Due to decentralization processes started after 'Dayton Agreement', at present there is not the 'clear' picture of educational system in B&H. There are 13 Ministries of Education (2 entity (Republika Srpska (RS) and Federation), 10 cantonal Ministries, and Brcko district), and 4 levels of educational governance (state (B&H), entity (RS and Federation), canton (in Federation only), and municipalities). Primary schools are under municipal control, and secondary schools are under municipal and cantonal control (***, 2001h). Because the system is so fragmented and legal issues are rather confusing, it is difficult to speak about general curriculum or standards in the context of B&H education. The only new subject integrated in the primary and secondary school curricula is 'civic/social education', but without specified gender equality components. However, some of the required legal mechanisms are already pointed out in the 'Bill on Equality and Equity Between the Sexes in B&H' (May 2002): 'Entitled authorities, educational institutions and other legal parties will ensure that plans, programs, and methods are provided to establish educational system, which will guarantee the elimination of stereotypic programs that result in discrimination and inequality of sexes. Contents that promote equality of the sexes are the integral part of the curricula at all educational levels.'
Moreover, some contributions to the promotion of gender equality in the educational sector are already present. The pilot project 'Promoting Gender Concept in Secondary Education' is an action research project conducted by the Forum of Women in B&H Federation. The aim of the project is to introduce the basic notions of gender equality concept to both students and teachers in six secondary schools and to explore their opinions regarding various aspects of gender relations using a short survey. Based on the analysis of the results, the Action Plan for Educational Sector will be drafted. Preliminary suggestions emphasize a need for the gender analysis of current textbooks; the lack of relevant research and databases; a need for teacher training, as well as a very general recommendation for 'initiating and integrating gender equality education in school programs' (***, 2001i). The other project, a booklet 'Gender Equality in Sociology and Philosophy', gives an example of how some educational contents included in secondary school curricula for sociology and philosophy could be discussed applying gender perspective. In a sociology part, for each of the presented educational themes (division of labor, demographics-population policy, social stratification-access to and control over resources, social roles-family, social movements, politics, and tradition and socialization), there is a theoretical section, as well as additional questions for discussion and other suggestions for group activities. The issues selected form philosophy curriculum and elaborated using gender analysis include: distributive justice, prejudices, stereotypes, discrimination, and injustice (Pavlovic & Vukovic, 2001).
Both projects were funded through 'Gender Equity and Equality Program in B&H', a long-term (2001 - 2005), joint project of the Ministries of Foreign Affairs of Finland and B&H. This project, aiming at the development of gender mainstreaming as a strategy, and the development of techniques and tools for gender equality in the B&H context, is being implemented by the Independent Bureau for Humanitarian Issues (IBHI). This branch of international organization is present in B&H from 1995, and, among other activities, works on gender mainstreaming in both governmental and non-governmental sector, through local capacity building, policy analysis, research and development, and various trainings. IBHI also serves as the Executive Agency for Gender Centers, the governments' expert bodies on the entity level, with mandate to improve women's legal rights, prepare laws and policies, and to ensure equal benefits for both women and men in the development process. Gender Centers, in turn, work in co-ordination with the Gender Equality Parliamentary Commissions, set up in order to ensure gender screening of draft laws submitted to the Parliaments.The establishment of these mechanisms, as well as the fact that there are all together 80 government officials at the state and entity levels - so-called 'Gender Focal Persons' - nominated by different Ministries and responsible for improving gender equity and equality in laws and policies, show a rather strong and developed institutional frame. A good co-operation with the non-governmental sector and the media was additionally emphasized by some of my informants. On the other hand, the obstacles to more quality and efficient implementation of gender equality standards in B&H in general, and in the educational system in particular (as perceived by some of my contacts) include: the 'top-bottom' approach to the appointment of 'Gender Focal Persons' ('these people are not from the movement'); the lack of practice-orientated research; the lack of relevant educational manuals; and a need for more educational programs and activities at the 'grassroots' level (38).
At present there are no SE programs as a part of school curricula in B&H;
some relevant contents are included in biology class or fragmentally elaborated
during student community classes. According to the UNDP report on youth in B&H,
90 % of young people think that there is a need to establish 'counseling centers
for sex education' (***, 2000e). Results from the survey, on which the UNDP
report (another IBHI project) is based on, also show that 50% of young people
in B&H do not use contraceptives and that only 15 % approves homosexual
communities. In addition, the report includes - as a contribution to some future
national youth policy - recommendations that within the area of 'Sexuality and
Youth' suggest following activities: 'to implement programs focused on increasing
the awareness of potentially risky sexual behavior; to provide young people
with accurate information on family planning and STIs through media and education;
to organize public debates on integration of SE in secondary schools, based
on the best practices of western countries; to start public discussions on the
rights of young homosexual people in B&H.'
One of the current projects aiming at the development of sexual health educational
program for youth is 'Balkan project', run by 'XY - Association for Sexual and
Reproductive Health', a local NGO. This project is a part of the regional project
'Promoting Sexual and Reproductive Health Services and Human Rights for Youth
and Adolescents in the Balkans' (July 2001 - December 2003), coordinated by
IPPF EN. This larger project promotes co-operation between the Family Planning
Associations of Albania, Bulgaria, and Romania, and their partner organizations
in B&H, Croatia, Kosova, Macedonia, and Serbia and Montenegro. The goal
of the B&H project is to implement sexual health program for young people
through a series of activities with relevant stakeholders. The project activities
include peer-education training and workshops on sexual and reproductive health
and family planning in secondary schools.
During this study visit in Sarajevo, my activities included contacts and meetings with the following key-informants and resource persons:
* Samra Filipovic-Hadžiabdic, the Gender Center of the Federation of Bosnia
and Herzegovina
* Lejla Somun, the Independent Bureau for Humanitarian Issues (IBHI)
* Poonam Thapa, IPPF EN
* Emina Kupusija and Tijana Medvedec, XY - Association for Sexual and Reproductive
Health
* Nada Ler - Šofranic, the Women's Network Program, Open Society Fund B&H
* Jan Z. Kulenovic, the Youth Information Agency B&H
* Jelena Kuzmanovic, the Joint Youth Program in B&H
* Amra Pandžo ?uric, the Center for Gender Research, International Forum Bosnia
* Slavica Juka, the Faculty of Pedagogy Mostar
Following the changes from October 2000, the current educational system in Serbia is in a transition period, as well as the relevant legislative (***, 2001j). Recently, the support for educational reform is provided by the Open Society Fund, by signing the protocol on a long-term cooperation with the Ministry of Education and Sport (MoES) in May 2002. In Serbia, comprehensive SE is not a part of the curriculum. Some relevant SE contents are present as a part of biology classes, or in the form of expert's guest lectures, mostly due to an individual teacher's initiative. In 1998 the National Family Planning Center started with the project of establishing Counseling Centers for Adolescents' Reproductive Health at the level of primary health care and within school clinics. Later additionally supported by UNICEF, the Counseling Centers provide individual consultations, diagnostics and primary care for reproductive health, as well as educational group work with both girls and boys. During 1999 the MoES was giving support to 'Youth education for human relations and family planning', a program largely framed by population and demographic policies, and based on the traditional understandings of gender, family and reproduction.Recent research on adolescent reproductive and sexual health indicates a high prevalence of RSB, a low awareness of STIs and contraceptives, a decline of average age at first intercourse, and the growing number of STIs, unwanted pregnancies, and abortions (Pešic et al, 2000; Brankovic, 2002). A need for school-based SE and peer education programs is emphasized as a part of the recommendations regarding CEDAW's Article 12 'Reproductive health and access to health care' of the (Brankovic, 2002). In the area of health care, one of the suggested measures is to develop programs that are focused not only on providing accurate information, but also on changing young people's attitudes and behaviors (Pešic et al, 2000).
With reference to gender equality, there are no systematic education guidelines
addressing this issue in schoolwork in Serbia. However, the notion of gender
equality is a part of the curriculum for 'Education for democratic citizenship'
(EDC), a new subject, still not fully integrated in the educational system.
In addition, teachers of EDC were, together with Serbian language teachers,
a key target group in the pilot project for school teachers education on gender
equality (described below). The lessons learned from this project outline future
work possibilities considering the integration of gender issues into the educational
system (Milenkovic et al, 2002).
As a part of my study visit to Belgrade, I was invited by the Institute for
Educational Research to give a short lecture on the issue of gender equality
and sexuality education. The lecture was held at the Institute and included
presentations of CESI's 'Building Gender Awareness' program and my IPF project.
The discussion that followed provided information on the current situation of
the educational system in Serbia, and on existing NGO programs in the field
of education on gender equality and/or sexuality. This was also an opportunity
for the exchange of information and publications with the present NGO representatives.
The article 'HIV epidemics Changed Europe's Curricula: Sexuality Education in
Croatia too' reporting on the event, was published in the daily newspaper 'Politika'.
The following part lists my contacts and resource persons, together with the short description of their relevant activities.
Biljana Brankovic and Ana Popovicki, CARE International Yugoslavia. This international organization, in the period from April to October 2002, conducted and evaluated the pilot project 'Basic gender awareness for primary and secondary school teachers in Serbia', funded by Canadian International Development Agency (CIDA). The primary goal of this project, targeting 200 teachers in 20 primary and secondary schools in Belgrade, was to develop and implement a model of training for teachers on the topics of sex/gender difference, gender stereotyping, and the social construction of gender roles, as well as to organize local, school actions around the issues of gender equality and in that way to start changes in the educational system. Evaluation findings indicate that the project made 'the first step' in this direction, and established an excellent co-operation with the MoES, which strongly supports cross-curricular implementation of gender awareness program. However, for the reasons of sustainability and cultural sensitivity, it is recommended that future implementation agencies should be local NGOs with support from international funding (Milenkovic et al, 2002). In addition, a regional collaboration was developed with CESI.
Aleksandar Weisner and Maja Gargenta, The School of Alternative Pedagogy, Pancevo. This is a NGO that works on the long-term strategic development of educational theory and practice. In 1997, they designed, implemented, and evaluated an educational model for training of primary school teachers in the area of SE. The outcome of the project is a comprehensive manual - 'It's Easy: Workshops on Sexuality Education Issues' (***, 1997b) - which includes a short theoretical section, a detailed methodological framework and the guidelines for facilitating workshops, and the extensive list of educational activities. This handbook is intended for educators working with 6 - 14 years old children, and covers the wide spectrum of SE topics, such as reproductive anatomy and physiology, puberty, assertiveness, masturbation, contraception, STIs (including HIV/AIDS), abortion, and gender roles. The implementation of this educational program is being negotiated with the local authorities.
Marija Rakovic, Youth Information Center. This NGO started with the project 'SRCE - Sexuality, Reproduction, Contraception, and Education', as a part of the regional project 'Promoting Sexual and Reproductive Health Services and Human Rights for Youth and Adolescents in the Balkans', coordinated by IPPF EN. The main objective of the project is to implement various educational, informational and communicational programs on sexual and reproductive health and rights for young people. The project should be realized through intensive work with relevant stakeholders, including marginalized and socially excluded groups of young people, all relevant NGOs and educators, family planning associations, media, and government's institutions in the sectors of health, education, and youth and social work.
Biljana Maletin and Tanja Ignjatovic, Voice of Difference-Group for Promotion of Women's Political Rights. Their activities, among others, include drafting laws, conducting research and advocating for gender equality policies, as well as organizing educational programs on gender equality for both NGOs and the institutional sector.
Tamara Milanov, Postpesimists Belgrade. A NGO established in 1997, works with young people in the areas of human rights, conflict-resolution, and interethnic communication. They organized a couple of trainings of trainers on gender relations for young people, activists, and educators from Serbia and Montenegro.
Suncica Vucaj, Center for Girls and SOS Telephone. A NGO established in 1994, works primarily with girls and young women aged 12 - 22. One of their educational programs for adolescent girls - 'Partnership relations' - includes a series of participative workshops on topics such as gender relations, feelings, love, violence in partnerships, sexuality, choice and responsibility, assertiveness, self-respect, and tolerance for differences.
Viktorija Cucic, Yugoslav Association Against AIDS (JAZAS). A NGO established in 1994, works primarily in the area of AIDS prevention through, among others, educational programs (including peer-educators training) in primary and secondary schools. Their activities were supported by the former Ministry of Youth and Sport, but recently their educational programs are sporadic, often with not enough funds.
Aleksandra Petrovic, the Institute for Educational Research. As a part of their research activities, the Institute conducts the annual comparison of girls' and boys' school achievements.
The systematic and legislative educational changes in Slovenia, started in 1992, include the intensive reform of curriculum contents (1996 - 1999) based on the principles identified in 'White Paper on Education in the Republic of Slovenia' (1995). One of the main goals stated in this programmatic document is 'to educate for mutual tolerance, raise the awareness of the equality of rights for men and women, respect for human diversity and mutual co-operation, respect for children's and human rights and fundamental freedoms, and foster equal opportunities for both sexes and thereby the opportunity to live in a democratic society' (***, 2001k). These proclaimed educational aims were included in guidelines for programmatic and curricular changes in relation to gender equality perspective. The specific curricular commissions were required to:
'Systematically incorporate the contents and topics relating to the differences between the sexes in the subject area (special attention had to be paid to the history curriculum and the issue of the absence of women from the history of mankind and from the teaching of history); draft suitable recommendations for the writing of textbooks, manuals, and didactic tools from the point of view of content, language, illustration, exercise, etc. (e.g., ensure equal representation of male and female identification figures); organize, in accordance with didactic recommendations, regular discussion groups and instruction, also in single sex groups, promote writing about the topic of gender roles and stereotypes, sexual harassment, violence, etc.; provide systematic information for parents and the public and alert them to the issue of gender-specific education' (***, 2001h).
A following review offers an example of how some of these educational goals and recommendations were realized in a couple of concrete curricula and syllabi.
The primary schools' curriculum for 'Citizenship education and ethics' (CEE), in its elective part, offers the topic of 'relations between the sexes' (***, 1999e). In the CEE's syllabus of obligatory themes for 7th grade, there are no explicitly stated educational goals, contents, or knowledge requirements that would answer to the concept of gender equality. However, topics important for gender equality education could be identified in some of the proposed themes and operational goals. The teaching plan for 'family' theme embraces following topics: different family types; cultural and historical differences; marriage and divorce; family roles and relations; family (in)equality; privacy and personal integrity; family and sexual violence; tolerance and responsibility. All of these issues should be additionally analyzed and discussed applying gender perspective, and relating relevant concepts to students' experiences. In addition, a teaching plan for educational theme 'ideals and authorities' also opens up possibilities to emphasize the gender dimension of the suggested contents. For example, educational goals in relation to adolescence, peer-groups, and peer-pressures, should involve raising students' awareness of existing gender double standards in different social roles, expectations, and behavioral models for girls and boys. Moreover, applying gender analysis within 'media and information' theme should provide students with some important insights in regards to role models and stereotypes presented in contemporary pop-culture. The gender equality approach should be also integrated within educational theme 'the question of democracy' (in the syllabus for 8th grade) that contains issues such as political participation, decision-making processes, human rights, and civil society. Additional strategy in advocating for the implementation of gender equality relevant contents should be to frame the issue within the discourse of human rights and/or within various anti-discrimination discourses. At the next educational level, the draft sociology curriculum for gymnasiums, as a part of educational theme 'social differences and inequalities' includes the topic of 'sex (gender) and sex difference' (***, 1998b). Proposed educational contents are: the notion of sex/gender; sex and culture (the anthropology of sexes); gender and education, social construction of gender hierarchy, reproduction or change of gender relations; different theories on sex/gender and sex difference; gender and politics, religion, class; women and men today.
One of the focuses of the Slovenian curricular reform during the Nineties was the area of health care (***, 2001k). A special curricular commission was established in order to formulate a proposal for 'Health Education in the Primary School Curriculum' (***, 1999f). The suggested objectives for 'education for healthy sexual life' - stated as one of the components of this proposal - include: to inform students about sexual customs in different time periods and different cultures and in that way to provide the basis for the respect of differences; to increase knowledge; to attain correct use of received information; to inform one's own decision-making (the right to decide about one's own body); to encourage responsible behavior; to develop positive attitudes and values about sexuality (decreasing guilt, fear, misuse, accusations); to inform communication about sexuality issues; and to develop the sense of self-respect and the respect for the others. Following educational contents are proposed: human relationships; growing up; family planning; sexual relations; different types of sexual behavior; risky sexual behavior; STIs; problems in partnership relations; making one's own decisions about one's own body; and the issue of professional help. Each of these themes is further developed through specific topics. In addition, the list of recommended literature is provided. In secondary schools, health education is one of the compulsory optional subjects for gymnasiums, but planned for not more than 15 hours during all four years. The syllabus for health education consists of following educational contents: health concepts; youth and health; life styles, life conditions and culture; health situation in Slovenia; and health care (***, 1998c). Educational theme 'life styles, life conditions and culture' involves teaching about topics such as sexuality and interpersonal relations, family planning, pregnancy and birth, sexual abuse, sexual harassment, pornography, STIs and protection, and sexual orientation. According to my contacts, some of the reasons for the identified lack of systematic quality in the implementation process of these contents are: overloaded timetables; insufficient training of teachers; undeveloped interdisciplinary approach; and the lack of better cooperation between the Ministry of Education and the Ministry of Health.
Besides health education some SE contents are integrated in biology classes.
As stated in 'Biology Curriculum for Primary Schools', in the syllabus for 9th
grade (age of 14!), as a part of educational topic 'genital organs and reproduction'
students are expected to learn about following issues: genital organs, reproductive
process, STIs, contraception, family planning, and relations between sexes (***,
1998d). In the gymnasiums' curriculum for the same subject, as a part of educational
module 'human biology, human evolution, and human genetics', relevant contents
are presented in almost the same order and scope as in the primary schools'
curriculum, the only addition being the topic of puberty (***, 1998e). The didactical
instructions for biology teachers recommend that special attention should be
paid to the context of health education, because of a cross-curricular coordination
between these two subject areas.
During this study visit in Ljubljana, my activities included meetings with the following key-informants and resource persons:
* Terrice Bassler, Open Society Education Programs - South East Europe (OSEP-SEE)
* Fani Ceh, the National Education Institute
* Milica Antic-Gaber, the Faculty of Philosophy
* Tanja Rener, the Faculty of Social Sciences
* Metka Mencin-Ceplak, the Faculty of Social Sciences
* Majda Hrženjak, the Peace Institute
* Roman Kuhar, the Peace Institute
* Katja Zabukovec-Kerin, the Association for Non-violent Communication
This section presents Swedish and Dutch experiences and social practices in the implementation of school-based SE. These two cases were selected based on a long tradition (Sweden) and the efficiency of programs (the Netherlands). In both countries SE is successfully integrated in public schools' curriculum and a need for incorporating gender equality perspective is acknowledged and addressed. Data used for the discussion of these cases was collected from various sources, mostly during my 10-day research visit to Sweden and the Netherlands in September 2002. In addition to insights from briefings with the representatives of relevant national organizations and institutions, additional information was gathered from Internet websites, literature, reports and leaflets. The term 'best practices' in the context of this analysis refers to the effectiveness and sustainability of assessed programs, projects, policies and/or legislations, as well as to the relevance of these practices as experiences from which useful lessons for future actions can be learned. This means stating not only strengths and 'keys to success' that can be built on or adopted, but also recognizing weaknesses and failures that can be avoided or overcome. Each case study shortly describes major trends in developing, implementing and evaluating SE programs in school setting, addresses a wider social and policy context, especially public health and health education issues, and discusses country-specific strategies, challenges and achievements in the field of school-based SE.
In Swedish society, a positive social approach to sexuality is prominent in conceding the adolescents' claim for sexual pleasure without the feelings of shame, guilt, or fear, and in respecting young people's rights to free access to information on the prevention of STIs and unwanted pregnancy. This notion is evident in the long history of school-based SE that is, in the national curriculum, labeled as 'Education on sexuality and personal relationships'. The aims, contents and methods of schoolwork on sexuality and sexual health have been changing during the last 50 years, continuously affected by the course of public debate on sexual matters. When in 1956 SE in schools was made compulsory, Sweden became the first country to mandate the provision of this school subject. In that time, goals were set in terms of eliminating negative outcomes that could be caused by ignorance or social prejudices concerning body and sexuality. Schools were expected to provide teaching primarily in the area of physiology, reproduction and contraceptives (Lennerhed, 2000; Meredith 1989).
During the next decades, the transparency and systematic quality of developmental procedures, as well as the permanent scientific elaborations and evaluations of the national program, have resulted in one of the most comprehensive manuals on the implementation of SE in schools - 'Education in Personal Relationships' - published by the National Board of Education in 1977. This extensive teaching-guide, based on 10 years of research and investigation, involves the argumentation of the fundamental principles and objectives of SE as consonant with the underlying social values of equality, tolerance and the right to personal integrity. This approach to SE departs from ethical pluralism, respecting different moral and value systems of particular ethnical, religious and sexual minorities, while, at the same time, argues for the above-mentioned fundamental, 'common', social values. In teaching practice, among other school tasks, this means advocating for gender equality, promoting tolerance to different sexual choices, and addressing the issue of sexual violence (Meredith, 1989). The manual also includes detailed methodological instructions, together with relevant information and facts about (adolescent) sexuality, as well as teaching strategies for addressing value-sensitive issues such as homosexuality, abortion, and masturbation. Educational methods and contents are adapted to pupils' age/developmental stage, and whereas a dialogue is one of the recommended teaching methods, a strong emphasis is also put on the importance of transmitting the factual knowledge. In general, the manual from 1977 holds a positive attitude to sexuality, which is presented as the integral part of human life, linking identity and society.
In the next period, along with the changes of relevant policies, educational focus in the area of sexuality and personal relationships kept shifting from the affirmation of sexuality to the prevention of STIs, from the emphasis on sexist language and sexual violence to the detected lack of gender equality perspective. This last concern was given particular attention in the quality assessment of SE implementation in schools, carried out by the National Agency for Education in 1999. A total of 80 schools were inspected regarding teaching in 'Sexuality and personal relationships' as one of the school health-work themes (39), intended to be implemented as interdisciplinary areas of knowledge and integrated in other subjects' teaching (Nilsson & Norgen 2001; Nilsson & Sandstrom 2001). Reforms of the Swedish educational system during the Nineties were characterized by the move from a centralized system with detailed regulations to a system where schools are directed through goals and results. The new national curricula (1994 and 1995) lay down the educational system's basic values and overall tasks, and by stating 'the goals to strive towards' provided a framework (40) for the teaching of various subjects and knowledge areas, including the aspects of health education (Garcia-Sanchez et al, 2002; Centerwall, 2000a; Lennerhed, 2000). The only direct reference to sexuality and personal relationships, to be found in the Swedish national curricula (41), is in the context of the principal teacher's duty for ensuring that education in this area is implemented as the cross-subject field of knowledge (Centerwall, 2000a Nilsson & Norgen 2001; Nilsson & Sandstrom 2001). This indicates that the various aspects of sexuality (social, emotional, ethical, psychological, anthropological) need to be presented, and that teaching in this area should be integrated into school subjects such as biology, psychology, civic education, Swedish language, religion and social science (42). Moreover, a promotional approach, stipulated in curriculum as the general point of departure for teaching certain subjects, requires that education on sexuality and personal relationships should find ways to address the positive aspects of sexual relations (pleasure, love, self-esteem, friendship), not only to highlight possible negative outcomes like STIs, unwanted pregnancies and violence.
Without the curriculum-specified teaching goals or a syllabus (43) at the national level, the quality and the extent of SE provision are determined by each school's priorities. The very broad descriptions in the national curriculum, and the decentralized educational system provide an opportunity for a particular school to formulate objectives and develop SE programs that cater the best to the requirements and needs of their pupils. On the other hand, the lack of more explicitly defined concept of sexuality and personal relationships, as well as the lack of clear directions in assigning the responsibility for teaching on this theme could, in some school environments, present obstacles to the effective cross-curricular implementation of SE, as in accordance with the goals expressed in the national curriculum. With the objective to support interdisciplinary approach to school health-work, and to assist teachers in the implementation of the particular aspects of healthcare and education, Sweden's National Agency for Education has developed and published a series of references materials concerning various health-related issues, and focusing on pupils' perspective (Nilsson & Norgen 2001). A body of reference material intended for use in sexuality and personal relationships education, which was commissioned by the Swedish government to replace the manual from 1977, was published in 1995 as 'Love! You can really feel it, you know: Talking about Sexuality and Personal Relationships in School', and two years later was awarded as the best SE program by the World Association for Sexology (Centerwall, 2000a). This 'collection of facts and opinions' gives a clear youth perspective by using examples from adolescent life and emphasizes the importance of dialogue and discussion, reflection and argumentation, as a means of teaching and acquiring knowledge (44). In relation to its contents, the reference material discusses the role of a teacher as a guide; addresses issues often regarded as sensitive-to-teach (homosexuality (45), masturbation, abortion, pornography, sexual violence); provides different accounts of young people's psychosexual development; gives the most recent research insights and statistics concerning adolescent sexuality; and presents educational methods that highlight communication and conversation as basic tools for work in the area of sexuality and personal relations.
Learning perspective ('reflection or information') was one of the criteria used to evaluate schoolwork in the area of sexuality and personal relations (46) in the already mentioned 1999 quality assessment (Nilsson & Norgen 2001; Nilsson & Sandstrom 2001). The other perspectives that served as instruments to assess the quality of teaching were 'gender equality', 'risk/promotion', and 'pupil/adult' perspectives, to which findings (on goals, the head teacher's responsibility for cross-curricular themes, content, work methods, school environment) were compared. The report indicates that the quality of SE provision varies not only between, but also within schools. The cross-subject implementation of these issues proved to be difficult in the schools without formulated written goals at the local level, and in the environments where principal teachers do not actively direct teaching. Another conclusion from the assessment concerns difficulties in providing a balance between the risk, and the promotion perspective. It is important to note that in the cases where the emphasis in teaching was put on the biological and physiological aspects of sexuality (47), educational discourse was dominated by the risk perspective, highlighting potential negative outcomes. Moreover, the report points that education strategies in those cases tend to be orientated more towards the transmitting of factual knowledge and 'informing' pupils (48). On the other hand, the good examples of SE lessons are characterized by using pupils' perspective and experiences as the starting point, as well as by giving young people opportunities for discussion and reflection, and by employing guided dialogue as a general way of working. Likewise, successful SE classes create affirmative atmosphere in which the positive aspects of sexuality are promoted, and adolescents' self-esteem is supported (Centerwall, 2000a; Nilsson & Norgen 2001; Nilsson & Sandstrom 2001).
The quality assessment of the gender equality component in SE school practices departures from the premise that all schoolwork on sexuality focuses not just on 'young people' or 'pupils', but significantly positions children and adolescents as 'boys and girls', as 'young women and young men', the members of a particular social and cultural gender system. The report argues that while there is a need to present more explicit and transparent links between sexuality and identity, at the same time, to over-emphasize gender differences could result in reproduction of stereotypes regarding 'male' and 'female' sexuality. The other concern was raised in relation to a tendency that SE lessons are being delivered more in line with girls' needs and requirements, whereas frequently neglecting the specificity of boys' psychosexual development. This notion goes hand in hand with schools focusing their support networks on female adolescents, who are often perceived as 'the victims of aggressive perpetrators' - their male peers - who mostly lack counseling services that would be suited to their needs for honest, personal, and concrete advice (49). In addition, the quality assessment of working methods stresses that teaching in single-sex groups, without providing the opportunity for a dialogue between girls and boys, contributes to the hardening of gender stereotypes, which often result from the lack of understanding and insights about the other gender's point of view. The collected findings from the inspection were distributed to all head teachers nationwide, with the objective to facilitate further developments in schools' health work in general, and in the area of sexuality and personal relationships in particular (Centerwall, 2000b; Nilsson & Norgen 2001; Nilsson & Sandstrom 2001).
In Sweden, school-based SE is also addressed through the National Action Plan for Public Health and the National Policy for Prevention of HIV/STIs (1995) developed by the National Institute of Public Health. These documents additionally underline the promotional perspective in schoolwork on (sexual) health, and emphasize a communicative approach that aims to stimulate reflection and discussions around issues such as body, sex, identity, self-esteem, and contraceptives. Sexual health is defined in positive terms as 'sexual enjoyment and emotional togetherness', and as 'safe sex-life without STIs and unwanted pregnancies', and in that way incorporates both the promotional and the preventive approach. Moreover, these documents state that all health promotion and prevention efforts should also consider wider aspects of sexuality and relationships, and should include gender equality perspective as well (Garcia-Sanchez et al, 2002; Nilsson & Norgen, 2001).The effectiveness of Swedish approach to work on young people's health is also the result of a developed collaboration between educational and health authorities and organizations at the national, regional, and local level. The 'Health-promoting school' project (50), initiated by WHO in 1995, has been elaborated and managed by the National Institute of Public Health, and today includes a network of 600 schools. Today, there are also around 200 Youth Counseling Centers, established through youth policy programs, and serving as 'easily accessible preventive community resources'. These 'forums' - where support, advice and help for both 'body and soul' are offered to young people free of charge - are functioning as divided responsibility of the County Councils and the municipalities/rural districts. The work at the Centers consists of primary and secondary preventive care, individual consultations, free distribution of condoms, examination and early treatment, and outward activities, such as lectures and group discussions with youth and parents. Another important part of their exterior work is an active participation in school-based education on interpersonal relationships and human sexuality, with the objective to influence schools to further develop and expand their SE programs (51) (Garcia-Sanchez et al, 2002).
LAFA (the Stockholm County Aids Prevention Center) is a unit within the Stockholm County Council's public health department. The implementation of this preventive health program, targeting youth, men who have sex with men, immigrants and refugees, is facilitated in a close co-operation with schools, youth clubs, and youth clinics. Besides its main task - the prevention of HIV and other STIs, and unwanted pregnancies - LAFA also carries out its own research in the field of sexuality and personal relationships, and acts as a methodology and knowledge resource center to promote sexual well-being through safer sex and wider awareness of sexual matters. Services offered by LAFA include educational courses and trainings for teachers, head teachers, school nurses, and social workers; counseling, monitoring and support; information center with statistics, reports, and documentations; methodology material 'Main Thread'; youth magazine on HIV, sexual health and SE; and free condoms (Garcia-Sanchez et al, 2002).
The leading organization in Sweden in the area of sexual and reproductive health and rights is the Swedish Association for Sex Education (RFSU), founded in 1933, when its first program task was focused on introducing SE in schools starting at the age of seven in the first grade. For the past seventy years RFSU has been promoting programs for sexual and reproductive health and rights, organizing clinics, providing counseling, selling condoms, and successfully fulfilling its main objectives: access to contraceptives and counseling services; safe and legal abortion; and SE and family planning as the specific human right. In addition, RFSU actively advocates the implementation of the Cairo Platform of Action; has developed the model of institutional collaboration and multi-sectoral approach that resulted in many legislative changes; offers technical assistance regarding sexuality and SE in Sweden and internationally; and produces material that illustrates the Swedish experiences and the Swedish model of working with sexual and reproductive health and rights (Garcia-Sanchez et al, 2002; Lennerhed, 2000).
In summary, the Swedish approach to school-based SE is pragmatic, taking girls and boys and their needs as the point of departure, with the primary goal of supporting and helping young people in their psychosexual development. The educator's role is to present different value perspectives and to facilitate group discussions, while adolescents themselves make conclusions and acquire knowledge through dialogue and reflection. The basic concept underlying Swedish SE is that promoting positive perspective on sexuality gives rise to strengthened self-esteem and greater capacity to have control and make decisions about one's own sexual life, which in turn assists to prevent unplanned pregnancies, abortions, and STIs. The efficiency of Swedish SE results from a successful integration in the educational system and a close co-operation with the health sector, as well as from the approach that takes into account the social reality of young people's sexuality.
Dutch school-based SE programs play a prominent role in the country's successful efforts in health education and the prevention of unwanted pregnancies, HIV and STIs. SE became an obligatory part of schools' curricula in 1993 and sexuality related questions were added to national exams (Berne & Huberman, 1999). In almost all secondary schools and in around a half of the primary schools, SE topics are integrated into many subjects such as biology, health care, social sciences, and religion courses (52). The selection of a specific program to be implemented in a particular school environment is allocated to local authorities. This agrees with the current tendencies in Dutch education policy that underline individual choice, and the freedom of schools to develop their own policies. (Buijs et al, 2002).
The growth of SE practices in the Netherlands can be traced through three successive groups of educational approaches and programs developed to reduce adolescent's risk behavior that may lead to HIV infection, other STIs, and unwanted pregnancies. In the middle of the Eighties, school-based risk-reducing educational programs were founded on the assumption that the increase in young people's knowledge about HIV/AIDS will result in the lessening of their risk-taking sexual behavior. These programs were quite short (one or two one-class period lessons), designed without a formal conceptualization and needs assessment, and primarily focused on transferring information. The next generation of risk-reduction programs was developed to include - besides necessary, but insufficient transmitting of knowledge - clarifying of values and attitudes, raising awareness of social norms and influences, and improving assertiveness, as well as communication and decision-making skills. With regards to working methods, these educational interventions use group activities, exercises, role-plays, videotapes, games and other tools for facilitating interactive and participatory learning (Schaalma et al, 1996).
In the beginning of the Nineties, the third group of SE programs started to appear, characterized by a systematic developmental process. This kind of a planned approach to the elaboration of (sexual) health education programs initially entails a problem analysis and definition, followed by a needs assessment to identify determinants that underlie the specified problem-causing behavior. In the next phase, based on the research insights on behavioral determinants, educational goals need to be formulated, and then translated into concrete educational activities and materials. The articulation of learning objectives and teaching strategies employs multiple scientific theories related to changing behavior through education, such as social cognitive theory ('modeling'), and various theories on communication, attitudes and group process. A key element in the whole developmental process and the actual implementation of the program involves a close co-operation with members of a target group (adolescents and teachers), as well as with the representatives of the educational system (local school authorities) (53). Another important aspect of this systematic approach is the appropriate evaluation of the implemented program, the assessment of the measures taken with regards to the effectiveness of the educational intervention on the identified behavioral determinants and the problem-producing behavior (Schaalma & Kok, 1995; Schaalma et al, 1996).
The excellent example of the teaching program developed, implemented, and evaluated according to the systematic approach described above is 'Long Live Love!' (LLL), an AIDS/STI education program for use in Dutch secondary schools. The first version of LLL was designed in 1993, and today it is the most commonly utilized methodology for SE in schools throughout the Netherlands (54). This interactive educational program, primarily focusing on the promotion of using condoms consistently, is the joint project of several organizations and institutions working in the fields of sexuality, education, and health. The Department of Health Education at the University of Maastricht conducted a preliminary research on the determinants of (risky) sexual behavior among Dutch adolescents, as well as the assessment of teachers' needs and abilities. The Dutch Center for Health Promotion and Health Education (DCH) (55) translated the research findings into teaching methods and outlined the lesson plan. The Netherlands Foundation for STI Control and Prevention (SSB) (56) developed the educational material, and implemented and evaluated the program. The overall objective of this school-based teacher-delivered prevention program is to support adolescents to develop healthy, safe, responsible and positive attitudes towards sexuality, and to strengthen their skills in communication and negotiation about safe sex. The LLL educational package consists of a manual for teachers, and a booklet (information presented as role-model stories in teen magazine) and a videotape (also based on the teaching principle of 'social modeling') for students (Garcia-Sanchez et al, 2002; Schaalma & Kok, 1995; Schaalma et al, 1996).
Based on the findings from the systematic evaluation (57) of the 1993 version, as well as on the recent research knowledge and insights on sexuality and STI prevention, the new LLL material was designed, implemented, and evaluated again in the period from 1999 to 2002. The new LLL version additionally addresses pregnancy prevention, incorporates gender equality perspective, and focuses on multicultural diversity of the Dutch society. The revised program involves six one-class period lessons (58), worked-out and described in terms of objectives, methods, and materials, and included in the teacher's manual (59). The manual also provides background information on adolescent (risk) sexual behavior, (un)safe sex, and support services; discusses the rationale for the whole LLL program; and specifies the learning outcomes in the areas of knowledge, attitudes, risk perception, social norms and influences, and communication and negotiation skills (Garcia-Sanchez et al, 2002). The whole 3-year project combined the improvement of the revised LLL version with the development of an implementation strategy and the research on the effectiveness of the implementation procedure (at the municipal and teacher level) and the effectiveness of the educational program at the student level. The project's realization was facilitated by the inter-sectoral co-operation between the SSB, the NIGZ (60), the Rutgers-NISSO Group (61), the TNO-Prevention and Health (62), and the Netherlands Association for Community Health Services (63). The implementation process entailed the initial training of regional health workers/educators at municipal health services (GGDs) that have functioned as 'linking agencies'. The health educators, in turn, trained recruited teachers, and together with them worked on the implementation plan for a particular secondary school. The teachers' trainings focused on strengthening their motivation and skills, and addressed practical issues concerning educational activities and materials. A monitoring strategy was developed to provide possibilities for continuous meetings and check-ups between teachers and regional health workers. Preceded by a small-scale pretest, 180 teachers put the new version of LLL to practice in 90 secondary schools, in 46 regions throughout the Netherlands. The implementation was accompanied by 'GENESIS' (Gender, Ethnicity, and Sexuality in Sex Education), a systematic evaluation project with the objective of measuring the impact of LLL educational component on pupils' attitudes and practices towards sexuality and safer sex, and especially focusing on gender roles and identities, and intercultural relations (64) (Garcia-Sanchez et al, 2002).
With regards to public health issues and health education, SE was identified as one of the pressing issues (together with bullying, social skills, smoking, alcohol and drugs) related to health promotion in Dutch schools. This is one of the findings from the assessment of 200 schools concerning their activities, needs, and priorities in the area of school health policy. The investigation was conducted as a part of the project 'Developing a national action plan for a school policy on health', started in 2000, aiming to co-ordinate current projects in schools' health promotion, strengthen a co-operation between the health and education sector, and generate prospects for new school-based health promotion initiatives and programs. The project's findings point to differences between health organizations and schools in their views, interests, and concerns in the field of health promotion and health education in schools. The project's recommendations include promoting collaboration between these two sectors at all levels, focusing on schools (tailoring support to each school's needs) and regional organizations that should assist them in health promotion (Buijs et al, 2002).
The development of life-skills programs is one of the current initiatives in Dutch schoolwork on health promotion. Life-skills approach in health education is based on various theoretical perspectives, which justify the development of crucial life skills that promote healthy development and minimize harm and risk. Skills development, informational content, and interactive teaching methodologies are the key-elements of any life-skills program. With reference to SE programs, research supports the development of social skills (communication, assertiveness, peer-refusal, and negotiation), as findings indicate that young people's shortage in these skills is significantly correlated to the negative outcomes of adolescent sexual activity, such as unwanted pregnancy and STIs (Cohen & Burger, 2000; Aldinger et al, 2001; Lottes, 2002). Moreover, in the educational area of sexual and reproductive health and interpersonal relationships, life-skills development can be applied to many informational contents, like friendship and dating, social influences (including the media), information on contraception, gender stereotypes, gender (in)equality, as well as to seeking help and locating services.
In conclusion, contemporary Dutch SE incorporates a positive, comprehensive approach to sexuality and health, and is successfully integrated in schoolwork. SE programs are pragmatic, systematically developed on the basis of research findings and needs assessments, and designed using scientific educational and behavioral theories. In teaching, this means focusing on the prevention of negative outcomes by supporting and empowering young people to develop and enjoy healthy and safe sexuality. Likewise, educators emphasize a personal responsibility in sexual decision-making that is based on individual and informed choices, as well as the respect for one's own and others' sexual and reproductive health and rights. In a classroom, educational practices are directed to the development and strengthening of social skills, especially communication and negotiation skills, and towards an open discussion about sexual issues that reflect adolescents' interests and needs. Moreover, a strong public support to sexual health education is reinforced by continuous mass media campaigns focused on promoting safe sex and condom use (Berne & Huberman, 1999; Lottes, 2002; Schaalma et al, 1991). The Dutch experience shows that the combination of qualitative and comprehensive SE and confidential, affordable, and accessible services provided by numerous government-funded centers for sexual and reproductive health, results in positive epidemiological facts, including the low rates of unplanned adolescent pregnancy and abortions, as well as the high frequency of contraception use (65).
My initial intention for employing Focus Group Discussions (FGDs), as an exploratory qualitative investigation, was to provide young people with an opportunity to discuss an educational program on sexuality and gender equality in relation to their own needs and concerns. However, during the course of research, I decided to reformulate the conception of FGDs, and to include, besides pupils, also teachers, as another key users and beneficiaries of schools' educational programs. Moreover, I decided to redirect discussions' guidelines towards the issue of school-based SE in Croatia in general, and to address the gender equality perspective as one of the cross-curricular components of efficient schoolwork on sexuality and health. My decision was made in the view of the early stage of the development of school-based SE in Croatia, as well as to adjust to the activity plan of the broader processes of drafting curriculum reform at the national level, in which this (IPF) project is involved. Additional conceptual suggestions were provided at expert consultations (66). The FGDs' topic guide and related questions were developed to reflect major critical points from the literature (*** 1997c; ***, 1997d; ***, 2002k; Carrera & Ingham, 1997; Csincsak et al, 1994; Lawrence, Kanabus & Regis, 2000; Oost van et al, 1994), and to include the specificities of the Croatian context.
Participants were recruited from four secondary schools in Zagreb, utilizing established networks of pupils and teachers who have participated in CESI's educational programs. There were eight teacher participants (all female), two of them working as school pedagogues, and the other six as subject teachers (biology, teaching methods, pediatrics, ethics, Croatian language and literature, English language) in three secondary schools (Administrative, Civil Airforces, Midwives). Seven pupils participated (six girls and one boy), aged between 14 and 18 years, and attending two different secondary schools (Civil Airforces and Nursing). Separate sessions were organized for the teachers (November 12th 2002) and for the students (November 15th 2002), both at the CESI premises in Zagreb. The FGDs lasted between an hour and 15 minutes (teachers) and an hour and a half (adolescents), and were facilitated by Nataša Bijelic (CESI) (67) and myself. The discussions were tape-recorded and then transcribed. The analysis of textual material was directed by the interaction of questions serving as guidelines for the discussions, and the particular issues raised by the participants themselves. The following part, based on the major themes identified, summarizes findings from the FGDs with both teachers and students.
All of the participants, students and teachers alike, agreed that there is a strong need (68) for SE programs in Croatian schools, and that school-based SE should be mandatory and regulated at the national level. The teachers were uniform in their opinion that SE contents should be implemented across the curriculum, integrated in teaching subjects such as biology and student community class (69), and additionally organized in the form of 'projects and seminars'. Moreover, many teachers highlighted a need for applying interactive teaching methods ('workshops') within SE lessons, as well as a need for a closer co-operation between school personnel (e.g. a school psychologist/pedagogue and class-teachers). Students, on the other hand, differed in their opinions on the issue of SE implementation. Whereas some of them tended to see SE in school as a separately time-tabled subject ('but without marks'), the others suggested that sexuality issues should be addressed within various school-subjects such as biology, psychology, and Croatian language and literature, but a problem is that some of secondary schools' curricula (some vocational and art-schools) do not include many of these subjects. The adolescent participants did not support the idea of student community class as the proper timetable niche for SE, adding that these classes are often used for other purposes, mostly as a substitute for the lessons missed. However, the students, same as the teachers, additionally emphasized a need for interactive learning methods ('It should be more like a conversation, with everyone participating'). The both groups of participants also agreed that SE should be implemented already in the primary schools' curriculum, and adjusted accordingly to major developmental stages of pupils. One suggestion was that in lower grades the educational focus should be more on relationships, and then to gradually introduce sexuality issues in order to achieve a comprehensive and systematic coverage of all SE contents.
With reference to the objectives of SE, teachers deliberations offer a wide-ranging account: to improve young people's self-esteem and personal integrity; to develop respect and tolerance for different sexual identities; to provide basic knowledge of reproductive system; to strengthen communication skills; to address the issues of sexual and gender roles and identities; and to support positive attitudes to sexuality. On the other hand, the students in their answers to the same question often referred to the contents rather than to the goals of SE. Nevertheless, their inputs paint the vivid picture of adolescents' concerns and needs when it comes to sexuality: STI's (occurrence, symptoms, avoidance, testing); contraception; the first experience of sexual intercourse; pressures ('everybody is doing it'); fears; unwanted pregnancy; going to gynecologist; masturbation; 'about sexual intercourse as something natural and normal'; sexual orientation; sexual violence; love relations; communication; and emotions. With regards to this last issue, young women added that it is necessary that SE classes also address emotions, as 'girls often don't know the difference between physical attraction and being in love' and 'young men are often 'closed' and don't discuss their own emotions'. While all of the teachers and all of the young women agreed that there is no need for single-sex groups, the only male participant pointed that, concerning the issue of masturbation, it could be better to have discussion first in single-sex groups, and then in a joint girls-and-boys session.
In discussions about who should be teaching SE, the teacher participants suggested that these educators, primarily, should be motivated and trustworthy individuals who are comfortable with discussing sexuality issues with young people. However, they also indicated that sexuality educators should also have sufficient expert knowledge and developed facilitation skills, indicating a need for additional teachers' education in the knowledge area of sexuality and personal relationships, as well as a need for training programs focusing on interactive teaching methods. The teachers also indicated that well prepared and compiled educational materials (manuals, references, handbooks) could additionally motivate the potential practitioners of school-based SE. On the same issue, the adolescents proposed that various experts from the outside of school environment (medical doctors, gynecologists, psychologists) should be invited to conduct SE classes. Young people argued that it is easier for them to confide in someone from the outside, someone whom they do not encounter every day. In that way they feel more comfortable to ask about things that they would be embarrassed to ask their class-teacher, or a school pedagogue/psychologists. Their accounts emphasize youth's need for confident, reliable, and pragmatic support and advice on sexual matters.
The participants, depending on their age, differently perceived parents' role in the implementation of school-based SE. The adolescents indicated that SE classes should not be conditioned by parents' consent, as 'there are some very conservative parents who don't discuss that subject with their children', and 'probably would not allow that their children discuss it in school'. They also stressed that 'parents don't realize that sexuality is a really important issue for young people'. On the other hand, the teachers suggested that 'SE program should be accompanied with workshops and support groups for parents', and that 'if SE would be regulated at the national level, then parents' consent is not necessary'. Likewise, generational differences were notable in the discussions on the role of religious institutions in the development and implementation of SE in Croatian schools. Young participants pointed out that 'sexuality isn't a matter of church' and argued that 'these /sexuality issues/ are our problems, and we have to talk about them', and that 'we know that religion tells us one thing, but real life is something else'. On the other side, teachers remarked that it is necessary to involve the representatives of church in the process of drafting SE school-programs, as 'every confrontation with the church in a country where 95% of its population self-identify as Catholics is not effective'. Their recommendations include 'seeking liberal people within the Catholic church', and 'starting to create a dialogue with them first'. They also suggested that it is needed to 'think politically' and to keep in mind that 'some religious (Catholic) interest groups could have a certain influence on the Ministry of Education' and that 'entering into conflict with the Church could significantly reduce the odds of SE implementation in schools'.
The teacher participants indicated two possible directions for future actions in the area of school-based SE: to intensify lobbying for a consensus at the national level and then to develop SE projects in a co-operation with the MoES; and/or to continue former work of spreading and coordinating the network of motivated individuals. One of the teachers stressed that any future initiative should also involve organizations and institution from other sectors, for example public health (Children's Hospital Zagreb) and NGOs (CESI), as well as various experts. The adolescents, from their perspective, added that there is a need for peer-education programs, and that young people should have an opportunity to suggest the themes for particular SE classes.
While it is evident that no general conclusions can be stated on the basis of such a small sample, both the students' and the teachers' contributions, each from their perspective, additionally stress some of the major points and considerations that need to be addressed in any future policy development and/or curriculum experimentation (small-scale programs with evaluation) in the area of school-based SE.
The research project "Urgently Claiming the Future: Focus on Gender for Safer Sexual Relationships" (2001-2002) was carried out by CESI and supported through the WHO's 'Social Science Research Initiative on Adolescent Sexual and Reproductive Health'. This study of young people's perceptions and attitudes to gender and sexuality, and the ways in which 'being a boy' or 'being a girl' shapes and influences one's sexual identity and practices, including RSB, is the first gender-focused scientific investigation of adolescent sexuality in the Croatian context (Hodžic & Bijelic, 2003). It is largely built upon the 'Living for Tomorrow' (LfT) questionnaire, 'a cross-cultural research and education tool' (Lewis, 2001; Lewis & Clift, 2001), developed as a part of the project 'Living for Tomorrow: Youth, Sexual Health and the Cultural Landscapes of Gender and Sexuality in Nordic/Baltic/N.W. Russian Times of Transition: An HIV/AIDS Era Initiative' (1998-2000) (70), funded by the Nordic Institute for Women's Studies and Gender Research (NIKK), Oslo (71). The CESI's research design includes a qualitative phase (6 FGDs); a survey, using self-completed questionnaires, of 995 adolescents (472 females and 523 males), aged 16-17 and drawn from grammar, technical, and industrial and craft schools in four big Croatian cities (Split, Rijeka, Osijek, and Zagreb); and the presentation of the findings at participatory workshops with young people to explore the meaning and implications of the results for them.
The overall findings point to significant gender disparities with regards to sexual experience and its acceptability, motives for sex, peer culture, and ability to negotiate (safe) sex. Moreover, the research results call attention to the active role that traditional terms and structures of gender inequality (reproduced by both young men and young women while negotiating and engaging in sexual practices) have in affecting and reinforcing RSB. Adolescents' attitudes and beliefs about social positioning of women and men in the Republic of Croatia mainly reflect traditional divisions of gender roles embedded in inequalities. In addition, young people recognize that most media images present women and men in stereotypical gender roles, in an over-sexualized, and unrealistic manner. The gender double standards often contribute to misconceptions and the lack of understanding when communicating about sex, especially concerning contraception, as both girls and boys face obstacles in negotiating sex. With reference to young people's attitudes to the importance of different aspects of sexual relations, CESI's results show that young men tend to emphasize the physical aspects of a sexual relation, whereas for young women, the emotional and/or relationship qualities of sex are stated as more important. One half of the boys and one third of the girls from the sample reported experiencing sexual intercourse.
All of these findings should be seriously taken into consideration by the developers of future educational program on sexual and reproductive health to be implemented in primary and secondary schools in Croatia. More specifically, these results should inform the ways in which SE program addresses gender norms and behaviors, and direct the educational process to raise awareness among youth about the ways in which gendered attitudes and expectations affect RSB, but also to stress young people's ability to protect themselves from unsafe sex. This means recognizing and acknowledging that young women and young men ascribe diverse perceptions, expectations, priorities and meanings to 'male' and 'female' sexuality. However, gender-sensitive SE program should also include the analytical observation of existing social traditions and media representations of gender differences and inequalities. In other words, there is a need for a programmatic orientation (72) towards rethinking of traditional stereotypes and prejudices about women and men (active in gender double standards on sexuality) that support sexual vulnerability of girls and certain risk behaviors of boys, and in that way have a direct influence on young people's (sexual and reproductive) health. Furthermore, educational programs on sexual health should provide a possibility for an open discussion between young men and women, encourage visualization of the other gender's perspective, and strengthen communication skills in order to facilitate better understandings between girls and boys. Moreover, the results of the CESI's research indicate that SE programs for boys should additionally develop the expression and articulation of emotions ('emotional literacy'), whereas for girls, it is needed to design educational activities orientated to strengthen assertive behaviors, and to support clear and confident expression of one's own needs and wants in relation to sexuality. In addition, information on sexual health, safe sex, and sexual risks should be more transparently linked to a critical perspective on dominant social norms and media images, which significantly form young people's perceptions about what 'women' and 'men' are, and how they should behave in (hetero)sexual relations. To make it more concrete, it is important to explain the proper way to use a condom, but it is also vital to question the reactions of a peer-group to a 16-year old girl carrying a condom, as well as to address possible gender-based obstacles to condom use. The integration of gender-focused research and gender-sensitive educational activities in the area of adolescent sexuality should be one of the key strategies for the successful promotion of sexual health.
* Rationale: Today, sexual well-being of Croatian youth is put at risk by the spread of STI's (Chlamidya and HPV), the inconsistent use of condoms, and the unequal gender distribution of sexual rights and responsibilities. Moreover, psychosexual development of Croatian adolescents takes place within the society characterized by confronting and often gender-discriminative sexual values, and messages coming form the media and the Catholic Church. In addition, the concerns of (gender-based) sexual violence, and homophobic attitudes and violent reactions demand an urgent spread of sexual literacy of the (young) population at large. Still, there are no visible efforts and initiatives coming from the national level to improve sexual health of young women and men by employing gender-sensitive educational programs within schools.
* Basic Principles: The program's underlying values are linked to adolescents' sexual and reproductive health rights, and ethical principles that emphasize personal freedom and integrity, tolerance, respect, cooperation, responsibility, and gender equality. The program is developed on the basis of reviewed international achievements and best 'practices' in the field of (school-based) sexual health education, utilizing theoretical models of behavioral change ('health belief model', 'social learning theory', 'theory of reasoned action'), as well as taking into account local research insights on gender-based norms and stereotypes that can lead to increased sexual health risks. Central teaching principles are active participation and social modeling.
* Aims: To attain and maintain young people's capacity and freedom to express their sexuality in a positive manner, and to enjoy relationships based on mutual respect and responsibility, without discrimination, harassment, and manipulation, and free of any abuse; to promote safer and responsible sexual behavior and practices by providing the needed knowledge, resources and skills; to support young people's psychosexual development and to ensure that they have the ability to accept and respect their own and others' sexuality, as well as the capacity for establishing caring, supportive, non-coercive, and mutually pleasurable and satisfying intimate and sexual relationships.
* Objectives: To enable responsible decision-making about one's sexuality; to promote and strengthen pupils' self-esteem, as well as their self-confidence and self-efficacy regarding condom use and the refusal of unprotected sex; to promote and to establish pupils' positive attitudes to sexuality in general, and positive norms towards safer sex and condom use in particular; to develop and enhance pupils' practical skills in personal relationships, namely communication, assertiveness, active listening, expressing and discussing emotions, problem-solving, peer-refusal, and negotiation and decision-making about safer sex practices and condom use; to provide a clear understanding on the concept of 'gender', and to explore the influence of gender stereotypes on adolescent sexuality and sexual health in general, and the impact of unequal gender power relations on condom use and safer sex behavior especially; to develop pupils' critical awareness of messages about gender, appearance (body image), and sexuality within the media and elsewhere (family, school, peer groups); to clarify values, challenge gender norms, and examine gender double standards regarding adolescent sexual experience and its acceptability, motives for sex, peer culture, and the ability to negotiate safer sex practices and condom use; to foster the development of gender roles and identities that promote respectful, responsible and equitable (sexual and personal) relationships; to create an learning environment where pupils could ask questions and discuss sexual matters without embarrassment in order to explore and assess their sexual values and attitudes, and in that way develop their own, autonomous and informed insights in the matters of sexuality.
* Target Group: School-going adolescents in the key-stage 3 of compulsory education (grades 7 - 9, age range 12(13)-14(15)).
* Developmental Messages: Sexuality, and sexual feelings and desires are a natural and healthy part of life. The sexual response system differs from the reproductive system. Love is not the same as sexual involvement or attraction. Loving relationships of many types are important throughout life. Sexual relationships can be more fulfilling in a loving relationship. Dating enables people to experience and learn about other people, about companionship and intimacy, about romantic and sexual feelings and expressions, and about what it is to be in a loving relationship. People's image of their bodies affects feelings and behaviors. Physical appearance is only one factor that attracts one person to another. The size and shape of one's penis, or vagina, or breasts do not affect reproductive ability or the ability to be a sexual partner. The media, including pornography, usually do not portray sexuality realistically, and often present an unrealistic image of what it means to be female or male, and how men and women behave in loving and sexual relationships. Talking openly about sexuality enhances relationships. Gender norms and stereotypes (about communication (on sexual matters)) could present barriers to the effective sharing of information, feelings and attitudes. Some people display gender double standards with regard to sexual practices and behaviors. Gender role stereotypes are harmful to both men and women, and accepting them can limit one's life. Assertiveness means communicating one's feelings and needs, while respecting the right of others. Being assertive in sexual situations may be difficult. Young people who date need to learn to negotiate decisions about sexual behavior and limits. Values guide a person's behavior, and influence one's decision-making. Being responsible in making decisions about sexuality is important as those decisions usually affect other people too. Sexual intercourse is not a way to achieve adulthood. A person has the right to refuse any sexual behavior. Being sexual with another person usually involves many different sexual behaviors (kissing, touching, caressing, massaging ...), not only oral, vaginal, or anal intercourse. Sexual fantasies are common, and many of them involve behaviors not actually acted upon in real life. Masturbation is one way of expressing one's sexuality, and also may be an important part of a couple's sexual relationship. Individuals are responsible for their own sexual pleasure. Many pleasurable sexual behaviors (including the use of sex toys), which do not involve exposure to semen, vaginal fluids, or blood, do not put a person at risk of STIs/HIV or unintended pregnancy. Contraception enables people to have sexual intercourse and avoid an unwanted pregnancy. Talking to one's partner about using contraception is important. When a (young) woman becomes pregnant and chooses not to have a child, she has the option of having a legal abortion. Having an abortion rarely interferes with a woman's ability to become pregnant or give birth in future. Abortion is not a method of contraception. Proper use of condoms, as individual preventive behavior, can help to prevent both pregnancy and STIs, including HIV infection. People can find creative and sensual ways of integrating condom use into their sexual relationship. The only sure way to know if someone is infected with STI/HIV is from medical testing. (Compiled on the basis of 'Guidelines for Comprehensive Sexuality Education: Kindergarten - 12th Grade /Second Edition/' (SIECUS, 1996).).
* Main Themes and Educational Topics: Interpersonal Relationships (attraction, emotions, sexual identity and orientation, friendship, (falling in) love, dating, breaking up); Sexual Intimacy and Sexual Behavior (sexual fantasies, feelings, and desires, sexual arousal and response (sexual pleasure, orgasm), kissing, masturbation, abstinence, foreplay, first sexual intercourse); Social Influence (gender (sex/gender difference, gender roles and identities, gender stereotypes, norms and double standards), media (pornography), peer groups, body image); Personal Skills (values, communication, active listening, assertiveness, emotional literacy, negotiation, decision-making, problem-solving, peer-refusal, correct condom use); Sexual Health (STIs/HIV prevention, contraception, abortion, sexual violence (date-rape), seeking help and locating services).
* Duration: 12 one-class periods (six 90-minutes units) per school year.
* Implementation in School: As an 'elective module' (or a 'special' Health education course) during a two months period (suggested pace: one educational unit (90 minutes) per week).
* Working Methods: Interactive and participatory teaching techniques including role-plays, skill practice, small groups, games, brainstorms, quizzes, value continuum, and case studies, and aiming to provide pupils with an opportunity to practice skills and discuss situation that they find significant and realistic. Whereas the program is designed to be implemented with mixed-sex groups, work on some issues (e.g. masturbation) could require a more flexible and supportive response, a combination of single sex (initiating discussion) and mixed groups.
* Training of Teachers: 3-4 day training on gender-awareness, sexual health issues, and interactive learning methods. (The existing resources and capacities within non-governmental sector should be utilized (CESI and FFE), as well as the network of peer-educators (Children Hospital Zagreb). The future program for continuous education of sexual health educators needs to be developed and implemented in a co-operation with reproductive health counseling centers within the healthcare system at the county level.).
* Materials and Resources: Teacher manuals: 'Sex and Gender Under Magnifying Glass' (CESI, 2000), 'AIDS Education' and 'Human Sexuality' (FFE, 2001). Peer-education manual: 'MEMOAIDS: Youth Educating Youth About AIDS' (Children Hospital Zagreb, 2000). Adolescent-friendly booklet: 'You Have the Right to Know: Sexuality and Reproductive Health from A to Z' (CESI, 2002). Internet website: 'SEZAM: Sexuality Education For Youth (URL: http://www.sezam-hr.net). Additional readings: 'Teenagers' Sexuality' (Profil International, 2002), 'Sex: How? Why? What?: The Teenager's Guide' (Sysprint, 2002), 'This Needs to be Known!: Answers to Sensitive Questions for Girls and Boys from 13 to 17 Years' (Mozaik knjiga, 2002). (An ad-hoc commission, consisting of the program development team, the authors of the existing SE resources, and the representatives of young people, should design a specific program material.).
* Cross-Curricular Links: Clear guidelines need to be developed to ensure that the issues of personal responsibility, assertiveness, decision-making, and self-esteem are continuously addressed in prospective health education during the whole compulsory schooling. In addition, it is needed to develop precise knowledge standards for relevant educational contents included in the subjects of natural science and society (grades 1-6) and biology (grades 7-8), in order to make certain that accurate information about sexuality is provided. This means supplying young people with basic, scientifically proven, and intelligible facts on human growth and development, puberty, human reproduction, anatomy, physiology, pregnancy, childbirth, sexual identity and orientation, contraception, abortion, and STIs including HIV/AIDS. (In this way, and respecting the principle of vertical and spiral curriculum programming, pupils should acquire the needed knowledge base that is not provided by this program. However, the program should involve a short knowledge 'test' focusing on basic facts regarding the issues of STIs/HIV, the efficiency of particular prevention method, as well as contraception.) On the other hand, a strong gender educational component of this sexual health program should be adequately supported throughout the national curriculum, and in the accordance with the directives of the National Policy for the Promotion of Gender Equality. Furthermore, the program's specific objectives are closely linked to the overall goals of compulsory education such as the promotion of pupils' self-confidence and self-esteem, and the development of their communication and problem-solving skills, and their capacities for tolerance, cooperation, and other aspects of social competence.
* Sensitive Issues: The value-laden issues such as homosexuality and abortion should be addressed having in mind that some pupils might have been raised in rather strong religious teaching and tradition of Catholicism that does not fully accept human sexuality and struggle with many issues related to reproduction. In spite of that, relevant policy and educational guidelines should assure that homophobic attitudes do not go unchallenged, and that abortion is seen in the context of women's rights to exercise control over their own bodies. Moreover, educators should take into account that while one's religious values can play an important role in sexual decision-making, inner-conflicts relating to religious values may also arise during adolescent psychosexual development. On the other hand, it is also true that some (young) people believe that some religious views are not personally relevant. In addition, adequate school and healthcare networks should be established to provide support and assistance in case there are young people who wish to talk about their specific sexual-related problems (e.g. sexual identity/orientation, sexual abuse) outside of classroom discussions.
* Learning Outcomes/Attainment Targets: After participating in the program pupils will: develop positive values and attitudes towards sexuality that will guide their decisions and behavior; recognize the complexity of social, cultural, and moral issues surrounding sexual matters, and be able to form a view of their own; develop skills to communicate effectively; be able to develop and manage satisfactory interpersonal relationships; understand the concept of 'gender', recognize gender stereotypes, and identify aspects of these stereotypes that are related to sexuality and sexual health; develop a critical awareness of messages about gender, appearance, relationships, and sexuality within the media and elsewhere; consider the importance of respecting difference in relation to gender and sexuality; develop skills in order to resist peer pressure and gender stereotyping; develop skills in order to avoid being pressurized into having unwanted or unprotected sex; explore reasons for having sex; understand that sex involves emotions, and should involve a sense of respect for one's own and other's bodies, feelings, decisions, and rights; consider the benefits of sexual behavior within a committed relationship; understand the reasons for having protected sex and be able to make informed and responsible decisions; have sufficient information and skills to protect themselves and, if they have one, their partner, from unintended and unwanted conceptions, and STIs, including HIV.
* Monitoring and Evaluation/Quality Assessment: The implementation of the program will be monitored by means of structured teacher self-reports. The efficacy of the implementation procedure will be assessed at the school level, through structured interviews and/or focus group discussions and/or a questionnaire targeting teachers, pupils, and principal teachers. The effectiveness of the educational component of the program will be measured at the pupil level using a quasi-experimental 'pre-test, post-test, control group' research design. The output indicators to be researched include knowledge (about STIs, prevention methods, contraception), attitudes (towards consistent condom use and the refusal of unprotected sex), risk appraisal, social influence (gender norms and stereotypes, peer culture norms), intentions and self-efficacy (regarding consistent condom use and the refusal of unprotected sex). Having in mind the age range of the target group, the program's impact on pupils' sexual behavior should be assessed as a part of longitudinal trails. (While this program is framed within the context of starting relationships and the first intercourse, a similar educational model for senior secondary school students should be developed with focus on promoting consistent condom use in the context of steady relationships, and refusing unprotected sex in casual encounters.)
Whereas a major part of the contemporary international research and analysis in the field of school-based SE focuses on the consequences - effects and impacts - of one or another implemented SE program, this study is placed at 'the starting point', and should be reviewed as a reference frame for the carrying out of 'SE project' in Croatian schools. By providing a substantial account of international evidence and experiences, as well as an outline of regional perspective and a detailed analysis of the current national situation regarding SE, this research aims to contribute to the starting public debate about an appropriate SE program to be implemented within the formal educational system in the Republic of Croatia.
At the level of global policy development and expertise in the area of sexual and reproductive health and rights, a clear consensus exists, and a strong message is given through international documents and treaties, that school-based SE is no longer an option to be debated, but rather 'one of the best investments a society can make' in promoting, attaining and maintaining sexual health of its (young) people. While it is true that, in general, the primary sexual socialization takes place within a family environment, it is also factual that many (Croatian) parents are reluctant to discuss sexuality with their children. Whether because of the sensitive nature of the subject, or whether for reasons of being more and more absent from home, parents often do not sufficiently fulfill their role of basic sex educators (73). Accordingly, schooling (compulsory education in particular) has emerged as a major opening for the systematic support of young people's psychosexual development. An adequate assistance to youth's progress to sexually healthy adulthood involves not only giving accurate information about this multi-dimensional component of human life. It should also approach young people's affective domain and provide them with opportunities to explore their sexual attitudes, and develop their own values and insights concerning sexuality, identity, relationships, and intimacy. Besides this 'facts and reflection' perspective, any aspiring SE program should - as its developmental axis - incorporate adolescents' point of view, as well as the principles of health promotion and gender equality. Furthermore, comprehensive SE entails helping young people to develop interpersonal skills, including communication, assertiveness, negotiation, and decision-making, as the necessities for pleasurable, safe, and responsible sexual relationships.
The collected and reviewed international evidence shows that young people who are satisfactorily informed about sexual matters behave in a more protective and responsible way, and are less likely to be exposed to sexual risks than their sexually-ignorant peers. In spite of these proven insights, there are still wide disagreements - at the individual country/cultural level - about the objectives and contents (74) of school-based SE, and even the rejections of comprehensive SE programs on the grounds of 'family morals' and/or 'religious values' (75). Fortunately, there is a significant number of scientifically evaluated SE 'success stories' in general, and their school-based versions in particular (Scandinavian countries, and the Netherlands, to name the European best 'practices'), to provide common - and universally agreed upon - essential components of the successful SE that should form the foundation of any future programs. However, any further country-specific program and curriculum developments should be culturally sensitive and appropriate, and should incorporate a given social context of (adolescents') sexual behavior and practices.
With reference to the Republic of Croatia, this implies taking into consideration a fact that the traditional notions of gender and sexuality, as a part-and-parcel of the general Catholic moralistic backdrop, are still active in the formation of young people's beliefs and values about women, men, and sexual relationships. On the other hand, the snapshot of the sexual reality of Croatian adolescents shows that every third secondary school student is sexually experienced, and that not more than half of them use condoms (inconsistently), regardless of current negative epidemiological tendencies and the spread of 'new STIs', such as Chlamydia and Humane Papillae Virus (HPV). In relation to the social context of adolescent sexuality, this picture further reveals the reflection of wider gender-based structures and relations of inequality that - reproduced through socialization, the media, and peer-culture norms, and embodied in gender double standards - often present obstacles to efficient communication, and responsible decision-making about safer sexual behavior and practices. In addition, we must not overlook homophobic, and even violent reactions towards different sexual preferences that also constitute a part of the social milieu in which the psychosexual growth and development of Croatian young men and women takes place. A need for systematic and nation-wide response to the current state of sexual health should be evident, but it is also additionally affirmed and demonstrated in the course of this research, through insights from FGDs with pupils and teachers, as well as in findings from the CESI's research on the gender dimension of adolescents' sexual attitudes and behavior.
Having in mind that in most countries in the region (systematic and comprehensive) SE is not integrated in schoolwork, I hope that this study - especially its comparative perspective on region-specific obstacles, as well as common recommendations for the successful development and implementation of SE in schools - will be of interest to a wider, regional, policy and expert audience in the areas of school education, adolescent sexuality, and the promotion of sexual and reproductive rights and heath, and gender equality as well. Whereas country-specific observations are presented in the sections on Croatian situation and a regional perspective, general suggestions that can be applied to all regional countries included in this research (B&H, Croatia, Serbia, Slovenia) refer to: applying a promotional approach in work on (adolescents') sexual health; taking into account existing SE resources and initiatives coming from the non-governmental sector; improving a collaboration between public health and school education sectors at all levels, including the Ministries in the context of curriculum development; and assuring young people's participation in the program development, as well as the involvement of teachers, local communities, religious groups, and other relevant stakeholders.
On the other hand, 'the lessons learned' from the case studies of Swedish and Dutch school-based SE practices and experiences, offer valuable guidelines for (Croatian) program developers and policy makers. In the scenario where SE provision is regulated by the 'common' social values and educational goals of the national framework curriculum, and SE is implemented in schools as a cross-curricular subject area, it is crucial to provide precise and explicit guidelines regarding principal teacher's responsibility in this matter. Moreover, it is vital to formulate a specific SE policy at the level of each school in order to ensure that positive, systematic and comprehensive approach to sexuality is provided, and not only that its biological aspects and risks are addressed. As it was the case in almost half of the recently inspected Swedish compulsory schools, despite their nearly 50 years of practice in SE. This reaffirms that the permanent evaluation and improvement of curriculum, teaching and learning materials, and didactic instructions for educators is a necessity for any school-based SE. The systematic quality assessment of implemented programs is characteristic for the contemporary SE in Dutch schools. Whereas SE became an obligatory part of schools' curricula only ten years ago, its confirmed efficiency results from the successful implementation of programs grounded in theory and research, which integrate prevention lessons within more comprehensive sexuality curriculum, and are tailored to the needs of a particular (secondary) school. Therefore, it is not sufficient that, to be effective, school-based SE should be mandated at the national level, and included in the curriculum as an interdisciplinary knowledge area, but it should also involve an additional sexual health program, focused on concerns specific to a given social/cultural context and/or target group. In that way, systematic and comprehensive cross-curricular schoolwork on sexuality issues would be reinforced and focused through the program that is adopted to local concerns, and which promotes the aspects of sexual health that are detected as priorities for that particular society.
In relation to Croatian SE prospects, and in the light of approaching curricular, and broader educational changes at the national level, it seems it is the right time to push forward the initiative for a school-based (experimental) program, and to place SE on the agenda of both relevant sectors: education and public health. On the basis of the research conducted, and in order to promote sexual health of Croatian youth, following programmatic measures are recommended:
* Complete and finalize the experimental program on sexual health, using the
draft proposal provided as a part of this study, and utilizing expert resources
and capacities within the established 'Initiative for the Implementation of
School-Based Sexuality Education'.
* Implement and evaluate the experimental program using a 'pretest-and-posttest-control-group'
design (in 10-15 primary 'experimental' schools, with the corresponding number
of 'control' schools, selected using 'stratified random sample').
* Simultaneously develop national guidelines for comprehensive SE as a part
of the project 'Evaluation of Syllabi and Development of Curriculum Model for
Compulsory Education in Croatia' conducted by CERD.
* Ensure that the national guidelines include all following components:
o value framework (consider the fundamental values of the Croatian society
such as personal freedom and integrity, democracy, and human rights);
o educational approaches (refer to interdisciplinarity, 'facts and reflection',
'individualization' and 'normalization', health promotion, gender equality,
and young people's perspective);
o goals (link the promotion of sexual health to the overall aims of the Croatian
schooling);
o objectives (address the spheres of knowledge, values, attitudes, and skills);
o description of key-concepts (include the notions of sexuality, sexual health,
relationships, identity and gender);
o overview of contents (indicate main themes and topics correspondingly to main
developmental stages, and respect the principle of vertical and spiral curriculum
programming );
o cross-curricular organization and implementation (identify teaching subjects
that incorporate SE contents, assign responsibility for managing the interdisciplinary
provision of SE at the school level, and provide implementation directions that
are explicit, meaningful, and relevant);
o teaching methods (focus on (small group) discussions, skill practice, role-play,
case studies, and other interactive activities, as well as on the issue of mixed
and single sex groups);
o educational materials (provide the overview of recommended and available resources);
o sensitive issues (give specific advice on the teaching of homosexuality, abortion
and sexual violence);
o monitoring and review arrangements (emphasize the importance of ongoing needs
assessments and evaluations, and propose useful tools);
o in-service teacher training (suggest a model for permanent in-service teacher
training in sexual health, gender sensitivity, and interactive teaching methods);
o working with parents (explain the level of their information and involvement);
o specific matters (discuss the issues of individual advice, confidentiality,
and the legal situation);
o example of a SE policy statement to be developed at the school level (stress
a need for formulated and written-down distinct goals, work schedules, and teaching
assignments within each school).
* Make certain that curricula for both primary and secondary school subjects
identified as containing SE contents include learning outcomes that refer directly
to the objectives stated in the national guidelines.
* Assure that the provision of SE course or sexual health program is mandated
as a part of all secondary school curricula.
* Develop a framework for a national sexual health strategy.
* Improve multi-sectoral collaboration on sexual health issues between schools,
NGOs, and public health centers at the local level, and with youth counseling
centers within the healthcare system at the county level.
While it is true that it would require at least the formal support of the MoES to realize the proposed actions, it is also evident that most Croatian young people, teachers and educators, as well as many NGOs, scholars, and experts (including a few governmental representatives) working in the area of sexual health (education) encourage the insertion of SE in school curricula. This research study and a related policy paper intend to further galvanize existing capacities (primarily the already-mentioned Initiative), and to provide justification, and assist in lobbying for the funds needed (76) to start with the implementation and evaluation of the pilot program, and the development of the national guidelines. Moreover, it is considered necessary to develop a national sexual health strategy that would proclaim the essentiality of sexual well-being for one's overall health, and affirm the measures needed to supply young people with sexual literacy as a precondition for pleasurable, safe, and happy sexual life.
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