Evolution and Resistance to Sexuality Education in Mexico.

BACKGROUND: Since the 1930s, Mexico has made substantial progress in providing adolescents with sexuality education through an evolving national school-based program. As part of a broader effort to document strategies to build support for and deal with resistance to sexuality education, this analysis uses a historical lens to answer 2 key questions: (1) How has the nature of sexuality education in Mexico evolved from the 1930s to the 2010s? (2) How have the drivers, responses, support, and resistance to sexuality education impacted Mexico's experience implementing and sustaining school-based sexuality education? METHODS: The analysis was informed by a review of peer-reviewed and gray literature as well as the personal experience and documents of one of the authors, who has played a central role in Mexico's sexuality education effort for 50 years. The findings were organized according to 4 time periods-the 1930s, the 1970s, the 1990s, and the first 2 decades of the 21st century-that emerged during the analysis as distinct periods with regard to the social and political context of school-based sexuality education. Within each of these time periods, the following 4 thematic aspects were assessed: drivers, responses, support, and resistance, with a particular focus on the rationales and strategies of resistance over time.Findings: This analysis identified determined support for school-based sexuality education in the 4 historical time periods from a range of governmental and nongovernmental stakeholders. However, opposition to sexuality education also steadily rose in the time period considered, with a growing range of more organized and well-financed actors. The Mexican government's commitment to delivering school-based sexuality education has driven its inclusion in public schools, along with expansion of its curricula from primarily biological content to a more comprehensive approach. CONCLUSION: Mexico's experience with sexuality education can inform other countries' efforts to consider the drivers, responses, support, and resistance that may be present in their own contexts. This type of analysis can contribute to strategic, well-informed, and well-conceived programmatic design and implementation to build support for sexuality education and deal with resistance.

Building Support for Adolescent Sexuality and Reproductive Health Education and Responding to Resistance in Conservative Contexts: Cases From Pakistan.

BACKGROUND: Despite international recommendations and supportive evidence, there are few examples of scaled-up and sustained programs to provide adolescents with sexuality education. Moreover, despite acknowledgment that building community support and responding to resistance are key challenges, there is a lack of detailed discussion on specific programmatic strategies to address these issues. OBJECTIVES: This article reviews the work of 2 organizations-Aahung and Rutgers Pakistan-that are successfully implementing large-scale sexuality education programs in Pakistan, collectively reaching more than 500,000 students. This review aims to answer the following questions: (1) How did Aahung and Rutgers Pakistan work to understand Pakistani society and culture and shape their programs to build community support? (2) How did Aahung and Rutgers Pakistan overcome resistance to their efforts? METHODS: We reviewed program documents and publications, synthesized key themes, identified questions of interest, and engaged key informants from Aahung and Rutgers Pakistan's leadership. RESULTS: The success of Aahung and Rutgers Pakistan was grounded in their readiness to understand the nuanced context within the communities, collaborate with groups of stakeholders-including parents, school officials, religious leaders, media personnel, and adolescents themselves-to ensure support, and stand up to forces of resistance to pursue their goals. Specific strategies included working with communities to select content, tactfully selecting and framing issues with careful consideration for sensitivities, engaging adolescents' influencers, strengthening media presence, showcasing school programs to increase understanding and transparency, and choosing opportune times to introduce messages. CONCLUSION: The successful strategies used by Aahung and Rutgers Pakistan to promote adolescent sexual and reproductive health through sexuality education can inform programs worldwide. Additionally, the programmatic weaknesses identified can guide future planning and action by Aahung and Rutgers Pakistan. We call on other programs to continue sharing challenges, specifically related to resistance, with sexuality education programs in order to develop a toolbox of additional strategies for community uptake.