PhD Defense Anna Ninsiima "Context Matters: Assessing the Environment for Sexuality Education to Deliver ‘Healthy’ Outcomes for Adolescents in Uganda"

This study explores the environment for sexuality education and the degree to which it does, or does not, deliver positive outcomes for adolescents in Uganda. A substantial proportion of the world’s young people - 59 percent live in sub-Saharan Africa (WHO 2017). It is these adolescents who will determine the nature of the social fabric, and levels of economic productivity, in the coming decades. However, adolescents are confronted with life-threatening health risks related to unwanted pregnancies, sexually transmitted diseases, and HIV. Development agencies have identified Comprehensive Sexuality Education (CSE) as a solution to adolescents’ sexual ill health. They have argued that CSE provides adolescents with the information necessary to make safe and informed choices about their sexual health, and that this may reduce early pregnancies, early marriages, gender inequalities, as well as HIV and STIs. To what degree are the context-specific realities in Uganda supportive or, or inconsistent with, CSE?


The study argues that policies need to support sexuality education, and that adolescents should enjoy the freedom to do what they aspire to do free from coercion.  However, this study adds a qualifier - strengthening institutions for service delivery is crucial. Sexuality education cannot be a ‘successful island’ in an environment with weak education and health systems. 


Inspired by the capability theory of justice and institutional policy framework analysis, this study shifts the analysis away from the individual to the interaction between different levels of the macro and micro aspects of adolescent sexual health in order to understand the vulnerabilities, political and socio-economic lives of the Ugandan adolescents. The study argues that neglecting a multitude of environmental conditions including the economic and cultural dimensions of adolescent’s lives, appears to be based on Western ideas of individual agency, and may turn out to be unresponsive to the country-specific power relations at play. An enabling environment using multi component approaches appears to be a necessary precondition for CSE to gain traction among the adolescents.


VUB, Promotiezaal
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