A Situation Analysis of the Education Sector Response to HIV, Drugs and Sexual Health in Brunei Darussalam, Indonesia, Malaysia, the Philippines and Timor-Leste

"In order to provide an enabling environment for preventing HIV and drug abuse, it is important to have an educated population, one that does not hold misconceptions or is discriminatory towards PLHIV [people living with HIV] and key affected populations. This is where education can play an important complementary role with health sector interventions."

This research is a synthesis of situation-response analyses (SRA) on the education sector response to HIV, drugs, and sexual health undertaken in five countries: Brunei Darussalam (2012), Indonesia (2010), Malaysia (2012), the Philippines (2012), and Timor-Leste (2012). It is written for the United Nations Educational, Scientific and Cultural Organization (UNESCO) Jakarta.

The objectives of this synthesis report are to:

• "Provide an overview of the current state of HIV and AIDS, drugs and sexual health activities in the education sector in the five countries;
• Identify the policies, programmes and resources for HIV and AIDS, drugs and sexual health education that are missing or weak in the education sector;
• Provide evidence-based information for future education sector HIV and AIDS, drugs and sexual health education planning and prioritisation; and
• Make recommendations on where to properly allocate resources to support the missing or weak responses.

…The factors that provide an agenda for strengthening HIV, sexual health and drugs education, include the following:

• Presence of stigma and discrimination;
• Limited access to information and services for young people, especially females;
• School dropout;
• Gender-based violence;
• Early initiation of injecting drug use:
• Access to pornography online;
• Family problems;
• Early initiation in sex work (especially in the Philippines);
• Lower levels of HIV knowledge in rural areas;
• Prevalence of misconceptions about HIV and AIDS;
• Low levels of comprehensive HIV knowledge among young people; and
• Changes in culture and sexuality and increasing sexual activity among young people."

Data on young people and their sexuality is limited, though rates of sexually transmitted infections (STIs) are rising, indicating more risk-taking behaviours and a need for further study in each country. Participation in secondary education and religious affiliation rates are high in most countries, but declining in some of the population.

Each country has a focus on HIV prevention directed towards key affected groups, but the education sector has not been prioritised for a role in prevention. To strengthen the education sector responses, the following areas need attention:

• Policy and Strategy - "No country has a time-bound and costed sector-specific strategy for developing HIV and drugs education or school health."
• Managing the Response - "Policies require implementation arrangements, including dissemination mechanisms, in order to be effective. This can require the establishment of specific institutional capacity to take this forward or adding the responsibility to existing arrangements. In large education systems, it is important to decentralise implementation to provincial or state levels. In all education systems, it is important to build implementation capacity in the school itself and in the community."
• The Curriculum - All 5 countries call for curriculum integration of HIV education, but "curricular content on HIV tends to be superficial," including textbook inaccuracies and insufficient attention to prevention methods such as condoms. "It was found that HIV, sexual and reproductive health, and drug abuse are subjects of interest to students in Indonesia and Malaysia. However, many students are not satisfied with what they learn from textbooks and they look for further information in popular media or cyberspace without supervision."
• Co-Curricular Activities - "All five countries have some co- or extra-curricular activities that may be supported by NGOs [non-governmental organisations] or CBOs [community-based organisations] in some schools, which include HIV, sexual health and drugs education. There is a lack of data on the coverage of these programmes. These appear to be important in that they allow for a more participatory student-centred form of learning experience."
• Teacher Training and Classroom Practice - "The five countries have generally not developed specific teacher training curricula and materials for teachers in pre- service training for HIV, drugs and sexuality education." Training was found to be in-service or ad hoc training among a limited number of teachers.
• Supervision and Support - Little professional supervision and support was found for teachers.
• Learning Outcomes - There is a data gap, though some assessments are being done.
• Monitoring and Evaluation - "No country has put in place a specific M&E framework for HIV, drugs and sexual health education."

The research concludes by recommending that each of these areas be strengthened. In particular, curriculum strengthen must start with review: "Review current curricula in the light of the Interagency Task Team (IATT) criteria for effective curriculum-based HIV programmes, EDUCAIDS and UNESCO sexuality guidelines."