CSE Report. 2016

Comprehensive Sexuality
Education (CSE)
for Out of School
Youth in Zambia:
Training of Trainers Report

03 CSE TOT REPORT 2016
Maria Bakaroudis,
UNFPA ESARO CSE Specialist, and the chief
facilitator, welcomes participants
AFRICA (ESA) COMMITMENT AND MANUAL
OVERVIEW
Introduction
UNFPA ESARO Regional Youth Programme,Safeguard
Young People (SYP), aims to improve the sexual and
reproductive health status and reduce HIV infections
among young people aged 10 to 24 in eight Southern
African countries by the end of 2019. There has been
renewed political commitment in many countries in the
region including in Zambia, to integrate HIV Prevention
and Sexual and Reproductive Health and Rights
(SRHR), with a special focus on scaling up
Comprehensive Sexuality Education (CSE) and youth-
friendly SRH services through the ESA Ministerial
Commitment and its accountability framework to
which this programme responds. Noteworthy strides
have been made in institutionalizing CSE in the formal
education sector through national curriculum
revisions and capacity building of teachers through
standardized pre and in-service teacher trainings.
However, to reach the masses of diverse young people
in the region who are not in school, UNFPA has
recognized the need to focus on delivering CSE to them
through out of school CSE programming and support
materials that are in line with international
standards. Zambia, being the first country in the
region to adapt CSE materials locally, proceeded to
host a Training of Trainers (TOT) on the Comprehensive
Sexuality Education Manual for Out of School Youth,
the overall objective of which was to develop the
capacity of experienced sexuality education trainers
to train others in the use of the manual. The TOT
included session on training and facilitation,
demonstrations of the sessions in the Facilitator's
Manual as well as practice teaching in line with
Zambia's National Framework on CSE for Out of School
Young People.
Training Welcome and Overview and Participants
Introduction
Maria Bakaroudis, UNFPA ESARO CSE Specialist, and
the chief facilitator, welcomed participants and
provided an overview of the training. Participants'
INTRO TO CSE, EASTERN AND SOUTHERN Introduction was facilitated by Lucy Bwalya of
SAFAIDS.
Developing GroundRules and Pre-test
The following ground rules were developed and agreed
byall participants:
· Bepunctual
· Consistent and active participation byall
· Respect others opinions and behave like “good
adolescents”
The facilitator, Andrea Irvin, administered a pre-test
to measure participants' knowledge and
understanding priorto thetraining.
Introto CSE,ESACommitmentand Manual Overview:
Comprehensive Sexuality Education (CSE) was
formerly known as Family Life Education (FLE),
Population Education or Life Skills. Frameworks like
the ESA Commitment on CSE and YFS (2013) inform
the delivery of CSE in the region. Maria Bakaroudis,
UNFPA CSE Specialist, defined CSE as “ curriculum-
based education that approaches sexuality and
relationships with information that is: gender and
rights-based, age-appropriate, culturally relevant,
scientifically accurate,realistic and non-judgmental”.
Her presentation debunked myths like CSE promotes
sexual minorities (homosexuality, transgender, etc.),
CSE disregards abstinence as an option, and it
perpetuatesmyths aboutcondoms.
CSE: what it is and what it is not!

Who Am I
She emphasized that among other myths, CSE does
not involve teaching young people how to have sex or
take away their innocence. On the other hand, some
benefits of CSE include reduced in misinformation
and increased correct knowledge about sexuality,
relationships and HIV, delayed sexual debut and
clarified and strengthened health promoting values
and attitudes. She mentioned that CSE can reduce
young people's vulnerabilities by building knowledge
and skills that enable them to reduce sexual risk
behaviours and have healthier relationships.
Participants expressed appreciation for the lesson
and the CSE approach as a whole. However, it was felt
that there was a struggle to communicate CSE to
community members because of the “Christian
values” most Zambians professed. Participants were
eager to know whether there was a code of ethics to
guide CSE trainers – “how would one stay
professional and/or articulate different values to
help deliver CSE without struggling to project our own
values”? An example of a Pastor's wife teaching the
benefits of masturbation as part of CSE in her
workplace and discouraging thepractice of it at
church highlighted the aforementioned conflict.
Andrea suggested that, CSE aims to help young
people figure out what their own values are amid the
conflicting values they have already been exposed to.
So CSE trainers should not impose or even discuss
their own values when conducting CSE. That
approach will prove helpful in delivering CSE
information and services.
Whoam I? Understanding Values
In small groups, participants discussed: What 5
things are important in your life? Responses included
- family, shelter, religion, good health and
intimacy/sexual relations. Participants mentioned
that family and friends, society, tradition and
culture, role models and religion influence values when
asked whom/what influences values. It was further
agreed that, from socializing to making important life
decisions, values influence one's behaviour to a great
degree.
LearningDomains and Circles of Sexuality
The A.B.C.'s of learning stand for Affective,
Behavioural and Cognitive. These are the 3 learning
domains. Affective is about values and attitudes and
is subjective. Behavioural domain is about actions
and skill-building. To develop skills, learners need step
by step instructions, practice, and then feedback.
Cognitive domain is about facts and knowledge - it is
objective. Participants were given different domain
contents to discuss and group according the
domains. Under affective domain, bias, emotion, and
feelings were some of the contents. Under
behavioural domain, abilities, technology skills, and
people skills were identified. Cognitive domain
included statistics and data. The facilitator asked
participants to give an example of a relationship skill.
The act of negotiating sex was one of the points
identified. “Communication, though, is the number
onerelationship skill,” shereaffirmed.
A second exercise called 'He and She' was handed to
participants to discuss in groups. Given different
scenarios: (1) what decisions about the use of
protection will a couple make and why? Which
statements they make would most impact their
behaviours?; and what domain was each statement in
and which domain had the most influence on what
they did? Participants mostly agreed that the couple
would probably use the pill. Responses to the other
two questions showed that affective domain was the
most dominant domain in the example. It therefore,
should be emphasised when facilitating CSE to young
people.
Influences on MyValues
Participants were asked to give an outline of what
values they learnt from their families, religion, culture
and peers pertaining to alcohol, sex and gender.
Somelearntfromtheirfamilies that “alcohol was

okay for adults but not for children” while a few
others learnt that “they could drink but responsibly”.
Three of the forty plus participants - one Baptist,
another of the United Church of Zambia faith and a
Rastafarian all had one common value learnt from
their religions – “Alcohol intake is forbidden.” In
relation to sex, some values learnt from peers
included: “practice makes perfect” and “when you
have a wet dream you are ready for sex.” Most
participants said they were not directly taught
about sex at home. Throughout the lesson emphasis
was placed on the fact that, after all the different
influences are encountered, the onus is on the
individual to make the final decision about their own
values.
What do my Values tell meto do?
This session involved looking into detail at the
relationship between values and behaviours.
Participants analysed a case study of Meri, a 19 year
old girl from a poor Christian family who had a boyfriend
she loved, who wanted to have sex with her.
Participants were to identify what values Meri
portrayed in her predicament. Meri's story ended with
her agreeing to her boyfriend's request for sex but only
if he used a condom. Subsequently, it was generally
understood that Meri had two key values. Firstly, she
wanted to wait until she was married to have sex
(influenced by her Christian family and faith).
Secondly, although she decided to have sex eventually,
she would not compromise on using a condom
(influenced byherknowledge).
International Values and Human Rights
Participants were tasked to develop role plays in
groups illustrating a specific human right given them.
Others were to figure out what right they thought was
being dramatized. Rights to feel safe, and to have a
healthy life were some of the rights role-played. The
right to control your body sketch performed in sign
language depicted a man trying to initiate intercourse
Circles ofSexuality
Changes DuringAdolescence
Body Talk
Female Reproductive System
with his wife who was tired and unwilling to engage in
the act. The moral here was that each person's body
belongs to them and no one can force them to do to
their body what they do not want to do. It was noted
that rights come with responsibilities. The
responsibilities for all are to learn about their rights,
and torespectand protectourownand othersrights.
The facilitator advised that this session was not in the
manual. She requested participants to advise her
later if they felt it needed to be added based on their
evaluation. Skin hunger was defined as the desire to be
touched in a healthy way. Sexual orientation was
explained as the sex to whom you are physically and
romantically attracted. These clarifications were
some of the few participants envisioned would be
queriedbyyoung peopleduring theirfield work.
Participants were asked to discuss the physical,
emotional and social changes in males and females
during adolescence. They were to identify which
changes were common for everyone and which differ by
sex. They were also to identify ways to cope with
feelings during adolescence. Participant admitted
that adults needed to be more understanding of the
changes in an adolescent's body. Generally, it was
understood that girls start puberty earlier than boys.
Social and emotional changes (e.g. moods changing
quickly, developing own values, starting to feel sexual
attraction, etc.)arethesame forgirls and boys.
Participants wrote on flipchart paper all names and
nicknames they had for the male and female sexual
organs and for sexual intercourse. This activity had
majority of participants laughing at their discoveries.
Dundumwezi, one of the many slang words written in
reference to the male sexual organs, however,
appeared to offend some participants whereas 'ka
tournament' describing sexual intercourse filled the
conference room with laughter. This session further
servedas an energizerforthenextsession.
Diagrams of the inner and outer female reproductive
organs were put up. Participants took turns to stick
the names of different parts on the diagrams and
explained their various functions. Participants learnt
that some females have hymens, and some don't.
Therefore, hymen examination cannot be used as an
accurate test forvirginity in females.
“Weareall bornsexual people!”
One of the Participant during plenary session

Understanding
Menstruation
Male
Reproductive
System
responded jovially.
The discussion
The facilitator
indicated that,
in teaching this
topic, a lot of
misinformation
a n d
misconceptions
usually went
unchecked in
c l a s s . A
c o m m o n
misinformation
is that most
cycles are 28 days long. Cycles vary greatly between
women and within an individual from month to month.
Some mentioned by the participants include the
misconception that everything a menstruating woman
touches is unclean is still entertained in different rural
parts of Africa.
Some of the myths and traditional beliefs shared were
as follows:
· When you are menstruating, you can't go to
church during prayer sessions because the
pastor will lose his power;and
· Don't go close to a baby or you will infect it with
Tuberculosis orHIV.
As a facilitator, one was to give objective information
to young people to help them make good decisions
about their health. Period pains arise out of the
contraction of the uterus muscles during
menstruation. For adolescents, the message should
be that there are no “safe days” when it comes to
pregnancy or STIs and HIV. Discussions should be
more about the safety of female youth from STI's and
otherrelatedissues.
After putting up
diagrams of male
r e p r o d u c t i v e
o r g a n s o n
flipcharts, he
asked, “What do
you see?” “Sir, I
see an instrument
o f p o w e r , ” a
p a r t i c i p a n t
stressed the necessity for foreplay before sexual
intercourse as a means of lubricating the vagina and
protecting the penis from cuts and bruises it would
otherwisesustain.
SourcesofSexual Learning
The facilitator defined sex as the biology of being male
or female. Nonetheless, the word sex is used in daily
language to refer to sexual intercourse. Young people
learn about sex through school, pornography, parents,
culture and tradition, animals, religion, friends, sexual
partners, internet, social behaviour change
communication materials, trainings, media, laws and
policies, and by themselves. Young people are exposed
to all sources of sexual information whether their
parents teach them or not. The important thing is to
ensure the sources are reliable. The value of this lesson
was to help facilitators know where young people are
learning about sex and to what extent they are
exposed.
Let'sTalk about Sex
Participants wrote down any questions they had
about sex that they wanted answered by the
opposite sex. “What matters most to you in sex,
width or length?” one question addressed to females
read. In reply, ladies said none of those but skill
mattered. “It's not the size of the ship but the
motion in the ocean,” uttered the facilitator.
Another question to females was why they usually
act as though they are not for the idea of sex when
they are asked but actually are. The response was
that it was a cultural thing. However, participants
said this belief that girls saying “no” but mean “yes”
was a promoter of rape. Young people need to be
encouraged to change this mentality. The facilitator
emphasized that even though CSE was not all about
“It's not the size of the ship but the motion in the
ocean”
S1
X8
Let's Talk
About
SEX
daythree
Because of
Culture,
Religious Belief,
Attitudes. etc

sex, questions and answers like the ones asked
during the session were some of the things that
young people wanted to know about
Whatis Power?
The facilitator asked participants to list words
and expressions that meant “power.” 'Boma ni
Boma', authority, influence, and boss, were
presented. In the lesson it was established thatHuman Sexual Responses
power could be used positively and negatively.Continuing on the topic of sex, the facilitator
Positive uses of power include it bringing aboutcautioned that this topic was not recommended for
desire to change. Negative uses of power includeyounger adolescents. She gave an outline of the
using it to take advantage of others or tohuman sexual response cycle using a diagram to
oppress and create conflict with others. After a shortshow the following: Desire, Excitement, Plateau,
task, the types of power listed were as follows: Power:Orgasm and Resolution. She explained that
within, to, with, and over. Participants recommendedExcitement, Orgasm and Resolution were the most
that the CSE manual be translated into localprevalent features of the cycle. Participants'
languages to help out of school youth understand theinterpretation of the various elements included
essentials better.excitement = penis erects; orgasm = ejaculation; and
resolution = pass out for males.
Power&Privilege
Participants were asked to mention groupings of
people with more and less power in the community.This session was a follow-up on the last two. The
Men, parents, and employers were listed as havingfacts presented here were meant to help young
people clear up some myths and misconceptions
they might have. Key points highlighted were that:
masturbation is not physically harmful; not all
women experience pain or bleeding on their sexual
debut; and according to research, 70% to 75% of
women do not have orgasms from vaginal intercourse
alone.
Coping with Attraction
A case study about a 14 year old girl named Betty
and a 15year old boy named Thulani, getting
emotionally attached and longing to be romantically
involved, was distributed. Four groups discussed the
questions and provided some suggested answers:
more power. Women, children, employees, were listed as
having less power. How do parents, among the group
with more power, act towards children? They are
sometimes harsh and bossy and exhibit a 'I know it all'
mentality.
ExperiencingPowerImbalance
Twenty volunteers assisted with a demonstration. The
purpose of this exercise was to show participants the
effects of having a power imbalance in a community or
society. It was discovered that those in power fear
losing power, as is the case with boys and girls in
different situations. Trainers were encouraged to
promote power with or working together as a solution
toachieving greaterthings.
Sexand Gender,What's theDifference?
Sex and gender are sometimes used interchangeably
buttheymeantwodifferentthings.
What is happening to At this age both
Betty and Thulani? Thulani and Betty were
experiencing hormonal
changes, are sexually
excited and can’t
understand their
bodies.
What do you think Betty Betty and Thulani
and Thulani should do involve themselves in
and why? extra curricula
Does this happen in real Yes
life
dayfour

Sex, defined in earlier sessions, is the biology of being Challenging GenderStereotypes
male or female. This is different from gender which is
about how society expects men and women to be and
what it expects them to do. Maria read some
statements and invited participants to distinguish
whether they exemplified sex or gender. Some answers
include:
· Womencannot producesperm.–Sex
· Education is more important for boys than
girls. –Gender
· Boys aregentle,girls arerough. – Gender.
While sex is consistent in all parts of the world, gender
varies by culture and change over time. For example,
there are now female minibus drivers in Lusaka. Not
long ago, this was considered a taboo in the society
ActLike a Lady, ActLikea Man
A fish bowl activity was used in this session. There
were two groups - males and females. One group sat in
the inner circle and discussed the questions asked by
the facilitator while the other was to listen and ask
questions later. What is the most difficult thing about
being a man/woman in Zambia? What beliefs about
men/women make you angry and frustrated? What
accurate information should replace that? What do
you wish the opposite sex understood about you? were
a few of the questions asked. A female participant
shared that for her, being a 25 year old fending for
herself, having no man to look to, and looking likely to
not get married any time soon was the hardest thing
for her. She faces a lot of prejudice daily. Some women
also expressed frustration at the idea that men are
. It allowed to be promiscuous and women not. “A single
was emphasized that there are only three differences woman cannot command respect in society” and the
between men and women - only men can get women belief that “a woman cannot succeed by herself” were
pregnant; only women can get pregnant; and only some of the prejudices noted. Men on the other hand
woman can breastfeed. wanted women to understand that they could be
faithful and would be better communicators if given
support. Men indicated that they need their private
This discussion brought to light society's gender space sometimes. “We are not all the same and we can
norms that push women and men into boxes. When a be more helpful and useful around the house with the
boy or man is told “act like a man”, he is being told to be chores”, some men said. Participants commented
strong, don't cry, be brave, provide for others etc. that these kinds of activities very much need to be
which all confine him into a restrictive box of done in the community, even with adults, to help men
masculinity. When a girl or woman is told “act like a and womento understand eachotherbetter.
lady,” she is being told to be gentle, speak softly, don't
drink, spend more time in the kitchen, submit to your Relationship Rights and Responsibilities
man, don't initiate sex and more. Participants were Relationship rights include the right to ask for what
asked to list the names that the genders are called you need or want and the right to say no without
when they step outside the box, e.g. sissy, slut, feeling guilty (e.g. No, I won't give you my Facebook
stubborn, John solye ubwali (John come eat nshima) to password), the right to be yourself (e.g. you can wear
name a few. Gender boxes are bad for men and women's what you want), and right to be treated with respect
health and impedetheirdevelopment and as an equal in a relationship. It also includes the
right to protect your sexual health. Relationship
responsibilities include respect for your partner's
rights and accepting responsibility for yourself and
your actions. This session re-emphasized the need for
people to know their rights and own their
responsibilities.
.
If I were, I would (Whip)
“If I were a woman, I would want to have thick and curvy hips,”
said a male participant. This warm up activity was done to get
participants to start thinking about gender issues by asking
them to consider what they like about being a member of their
own sex and what they would do if they were the opposite sex
and why.
“The Ministry of Health is looking to scale up the CSE
programme from Lusaka to all 10 provinces” Dr Tasila Tembo
Peters.
Dr. Tasila Tembo Peters, Deputy Director Health Education,
Ministry of Health said the Ministry was happy to hear about
the proceedings of the TOT. She emphasized that a lot still
needs to be done in the field. “From here and Copperbelt, the
Ministry is looking to scale up CSE to all 10 provinces,” Dr.
Peters encouraged participants to get the most out of the
training and go back to their communities as leaders.
RELATIONSHIPS
LOVE
SEX &
Straight talk on
Check out
TUNEME.ORG
A free interactive mobisite
made for you It’s your life
DREAM, LOVE & LIVE

friendships and allow quick dissemination of
information. They are also cheap and good for social
marketing.
Participants were tasked to analyse different social
media scenarios and write down all the things that
might go wrong in. Group 7's scenario was: a 16 year old
girl takes a nude photo and sends it to her boyfriend.
What could go wrong? Some responses included: In the
event they broke up, the picture could go viral if
uploaded on social media and mishandled or sent to
friends of her boyfriend; it could be used for blackmail;
and possibly cause the boyfriend to think less of her.
Although adolescents have the right to freedom of
expression, this does not mean that they are allowed
to infringe other people's rights. Adolescents need to
exercise extra care in how they relate with others on
social media. Participants proposed the following do's
and don'ts of social media interaction: be friendly to
others; filter your settings and all that comes to yourPeople go into relationships for different reasons. For
account; avoid sharing personal details including lewdsome, to give and receive love, for friendship and for
photos of yourself and others; avoid giving others yourfulfilling sexual desires. The reasons depend on the
password; and don't accept friend requests fromtype of relationship one is in. Elements that make
peopleyou don't know.relationships strong and healthy include compromise,
tolerance, respect for one another and
communication. The opposite of those destroy
Kudakwashe Dube, Adolescent Sexual andrelationships.
Reproductive Health and Youth Officer, UNFPA
Zambia made a short presentation on 'Tune Me'. TheParticipants worked in small groups to discuss
mobisite is an initiative of UNFPA and partners to helpdifferent types of relationships. The types discussed
address challenges faced by adolescents especially onwere peers, work colleagues, community, family and
sexual and reproductive health issues. The interactiveromantic or sexual relationships. Common positive
site enables young people to access accuratequalities by participants included effective
information on sex, love, relationships and more. “Sincecommunication, trustand respect.
we launched Tune Me in October 2015, we have had
more than 8,000 youth who have accessed the site.
When asked about the
social media platforms they
u s e d , p a r t i c i p a n t s
indicated Facebook, Viber,
Instagram, and WhatsApp.
Potential negative impacts
of social media on youth
include: social media
anxiety, revenge porn, loss
of time, and development of
anti-social behaviours.
Participants expressed
concern that social media
are destroying the culture
of reading and writing and
have led to the development
of false images/identities
(catfishing) among youth.
On the positive side,
however, they help maintain
'TUNEME'presentation
Social Media Safety
Building Healthy RelationshipsDayFive

was played. According to Mr. Dube, efforts are being skill. Participants discussed what gets in the way of
made for Zambia to promote utilisation of the site good communication and what helps communication.
countrywide and ensure that access is still free to end Misinformation and dishonesty were identified as
users. He encouraged CSE trainers to introduce Tune causes of misunderstandings. Effective
Metoall theirtrainees and youth. communication was said tostrengthena relationship.
The facilitator transitioned to this session byOne decision adolescents often have to make are to
conducting a communications exercise. He whispered awhether to wait to have sex or to engage in sex at the
message into a participant's ear to be passed on totime. An exercise in two groups engaged participants
the end of the line. The same message was whisperedin discussing why young people would make each choice.
down two lines. It was noted that, by the end of the line,Participants were asked to evaluate the reasons and
both groups had distorted the message. This exerciseto decide if they were not very good, fairly good or
was meant to show that when information travelsextremely good reasons. The group discussing why
through numerous people, it eventually becomesyoung people decide to wait cited: cultural and religious
distorted and to highlight the need for two-wayexpectations, psychological maturity, and to avoid
communication. The facilitator highlighted the need forpregnancy and STIs as some of their answers. All
participants to be active listeners if they wanted tothese reasons were considered to be extremely good.
growand strengthenrelationships.On reasons to have sex, the group listed “peer
pressure; to keep relationships; to explore; and to
express love” as some of the common reasons. They
were all considered to be extremely good. In summary,
to help young people, participants understood that
they should guide young people to bring out common
reasons why those that are engaging in sex are doing
it, and why othersarenot.
The types of pressure that people feel were explained
and explored including examples of internal and
external (explicit) pressure and of threats, arguments
and insults were discussed. The ways a young person
could deal with such pressure were also discussed - i.e.
they could negotiate, delay, say no and/or leave.
Negotiating can work in instances where a partner is
calm and able to understand and discuss rationally.
Role plays were done to assist participants practice
dealing with pressure.
Participants were given examples of partner's
behaviours and asked, if that happened, whether they
would do nothing, discuss the behaviour and try to
change it or end the relationship. Disrespect, violence
and controlling behaviours were cited as warning signs
that a relationship is not healthy. However, it was
noted that sometimes, people don't end unhealthy
relationships because they tell themselves that the
problems are not serious, make excuses for their
partner,orblamethemselves.
Communication was defined as the sending and
receiving of information. The session focussed on
communication as the most important relationship
AreYouListening?Weighing theOptions
Don'tPressureMe
WhenWould YouEnd it?
Whatis Communication?

Speaking ForYourself?
Non-verbal Communication
Discussing Behavioural Domains and Teaching Skills
into parts. The role of the facilitator is to
Participants were advised to focus on demonstrate, give the steps to the skill,, help
communication in their relationships. When couples learnerstopracticeand give themfeedback.
have conflicts, some argue, some fight, some walk
away and others keep silent. The facilitator said,
“During arguments, using I-statements removes Non-verbal communication is communication that
blame from the other person, diminishing the 'fire' a involves no words but rather body language and
heated argument would otherwise bring.” An example actions. Body language constitutes 55% of
was: “When I came home yesterday and found your communication while words and voice quality
clothes on the floor and on the chair in our room, I felt constitute 7% and 38% respectively. To
frustrated. I need to be able to sit at the desk and demonstrate the point, the facilitator uttered
study. Would you be willing to either put your clothes different sentences such as, “Okay now listen to me!”
away or leave them only on your bed so that they are in two different tones of voice, for example, in
not in my way?” Participants were guided through a authoritative and hushed tones. The participants
worksheetonhowtoconstructI-statements. explained what the differences in mean were. This
highlighted that tone and emphasis on certain words
and phrases, among other things changes the
The facilitator highlighted what domains the meaning of one statement. To show body language,
previous session addressed. “The session before, four volunteers' demonstrated different actions and
was mostly in the behavioural domain but had some participants were to explain what the non-verbal
aspects of affective and cognitive domains,” she actions meant. The volunteers raised a thumb in a
said. This was because a demonstration was done clenched fist, for example. Participants said this
while participants observed to give the knowledge signified “am with you” or “good!” On the contrary,
needed about what I-statements are (cognitive another participant said in some other parts of the
domain); and participants were allowed to practice world, it meant one wanted to have sexual
(behavioural domain). Participants gave feedback to intercoursewith theotherperson.
further develop the skills being taught. More
practice will lead to mastery. If the skill is difficult for
learnerstograsp, thefacilitator needstobreakit
Daysix

HowPregnancyHappens
Decision Making aboutPregnancyOptions
PracticeFacilitation Instructions and Assignments
The facilitator instructed participants to close their
eyes and visualize their hopes and dreams for the
future. She asked them to imagine those plans
disrupted now, for females, by a pregnancy and, for
male, by a girlfriend who is pregnant. Participants
then discussed the repercussions of the pregnancy.
Ten participants put the steps of the process of how
pregnancy happens in order. They then discussed
when in the process, emergency contraception could
be used. The use of emergency contraception pills
raised a lot of discussions. It was opined that taking
emergency contraception prevents ovulation. A
participant bemoaned the hostility some health
centres display when youth try to get contraceptives
or access sexual and reproductive health services. In
defence, a participant from one youth friendly centre
said the attitude of staff at most youth centres is
slowly changing.
Throwing up, nausea, weird cravings, urinating at
short intervals, being very moody and wanting to
sleep, were noted as some signs of pregnancy. When
adolescents get pregnant, some of the pressures
they face include taking care of the child and being
forced to marry. A scenario of Sonja and Yousef, 16
year olds who had unprotected sex was discussed.
Sonja was now pregnant. Participants were asked
what they would do if they were in Sonja's shoes.
Some participants said they would keep the
pregnancy because of the re-entry policy in the
education sector. Some proposed abortion. It was
noted that Zambian laws allowed for termination of
pregnancy under social economic or medical reasons.
Three doctors have to give consent to this unless it's
an emergency, in which case, only one doctor can
authorize thetermination.
A good training of trainers (TOT) must incorporate a
lot of practice. Participants were put into groups,
given specific topics and tasked to demonstrate
that they could deliver a CSE lesson from the manual
while correctlyfollowing thelesson plan.
TheLearningCycle and theLesson Plan
PreventingPregnancy
Discussing Contraception
The facilitator outlined the learning cycle, which
provides a structure for planning interactive
lessons, starting with experience (activity),
processing, generalizing, and applying. Next she
asked participants to give examples of what
happens during the different stages of the
cycle. She stressed that a facilitator is a guide
leading participants through each of the
stages. Trainers must go through all the
stages because, if not, they run the risk of their
students drawing wrong conclusions or
eventually learning nothing. She also noted that
applying may not happen in every lesson but the 3
stages beforethat should not beskipped.
Participants suggested methods for preventing
pregnancy. These included condoms, contraceptive
pills, withdrawal, abstinence, vasectomy, calendar
method, spermicides, diaphragm, loop or IUD, and
natural methods. A debate about whether wearing
beads on the waist and sterilization were prevention
methods ensued. It was concluded that both were
not measures to prevent pregnancy. The proper use
of male and female condoms was demonstrated at
this point. It was noted that Ministries of Education
do not allow such demonstrations to be done in their
schools. However, demonstrations like these could be
done forout of school youth.
Four sketches were performed by participants. These
showed the different situations in which the
participants needed to discuss contraception with a
parent or a partner. One play, in particular, had a
focus on a couple discussing using condoms for
protectionagainst pregnancy, STIs and HIV.
D E L I V E R I N G
W H E R E E V E R Y P R E G N A N C Y I S
E V E R Y C H I L D B I R T H I S
AND EVERY YOUNG PERSON’S POTENTIAL IS
a w o r l d
W A N T E D
S A F E
fulfilled.
dayseven

Myths and Facts about STI
ToKnoworNottoKnowYourHIV Status?
HowMuchDoYouKnowAboutHIV?
answered. “How long can one have HIV before one has
A music video called Private Party by SYP artists was full-blown AIDS?” asked another. The response given
screened. The song pointed out the importance of to him was, “it depends on when the person is
condom use and exposed some facts and myths diagnosed, and other factors, however, and it is
about STIs. Following this, a true or false exercise was usually a periodofabout5to 15years”.
conducted in which the facilitator read some
statements and participants had to say whether
they thought the statement was true or false. It was “How do we know our HIV status?” the facilitator
noted that STIs caused by bacteria are curable but asked. “We do a blood test to check if HIV is present”,
those caused by viruses can only be managed. One of a participant answered. People who are negative need
the statements read: “You won't get an STI if you only to go for another test after at least 3 months
have oral sex. This was agreed to be false. One cannot because they could be in the window period, it was
exclude sex and STIs if talking about issues to do with advised. The window period is the period between
sexuality to young people because the two are infection with HIV up to the time when the HIV test
intertwined. can detect HIV antibodies in the person's blood. Pre
and post counselling are done before and after HIV
testing. Participants did an activity in which they
rotated among sheets of paper answering questions
about getting tested, such as If you are HIV negative
and you know it? How will you feel? What will you do?
And what will happen? The conclusion is that in every
situation, whether you are positive or negative, it is
bettertogettested.
Participants in four groups undertook a quiz on HIV.
The true or false statements were on myths and
facts about HIV. Some statements read: A person
can get HIV from a mosquito that bit someone with
HIV before. Semen, pre-ejaculate, vaginal fluids, blood
and breast milk are the 5 body fluids through which
HIV can be transmitted. Participants played a game
in which they had to answer such true or false
questions.
HowHIV Makes YouSick
Participants' role played “how HIV attacks the body”.
After the drama, the facilitator asked participants
what they learnt from it. The key lessons drawn
included: HIV takes the CD4 cell captive and uses it to
manufacture HIV; HIV weakens the immune system,
allowing opportunistic diseases infect the person. “It
is believed that there are people who do not have
receptors for HIV, they can carry the virus but cannot
get sick”, a participant stated. “There are some
people without the receptors to which HIV attaches
itself. Such people are very rare”, another participant
Messages fromHIV Positive Youths (AndreaIrvin)
The facilitator requested participants to turn
to page 98 of their workbooks to read some
messages from youth living with HIV. A story
about Max, a 13 year old boy generated
emotions among a considerable number of
participants. Max said it hurt him when he heard
people say, “AIDS is a killer” especially
considering that not all people get infected with
HIV through sexual intercourse. Max was born
with it. The facilitator encouraged all trainers to
incorporate stories like those in the workbook
and others from their communities to generate
conversations with the youth they are training.
Get
Test

Understanding and Challenging Stigma
Participants were asked to stand alone at a different
place in the room and “Focus on one event that
happened that made you feel isolated and rejected”.
After some minutes, participants were asked to
volunteer to share their stories. A participant
explained that the ill treatment she received from her
husband's relatives when she had miscarriages made
her feel neglected and rejected. Stigma, defined as
placing a negative tag on oneself or another, makes it
difficult for the stigmatized to live in the society.
People living with HIV are stigmatized by being called
names like kanayaka (He/she is lit), or A toping'a
(He/sheis on pills).
Discussion of Teaching in theAffectiveDomain?
“The lesson before was not only looking at stigma
people living with HIV experience but also how
homeless youth, gay, lesbian transgender young
people, young people who drink or use drugs andEveryone infected should behave responsibly by
those that fall pregnant are stigmatized,” thedisclosing their status to their partners. Fear of
facilitator stated. The purpose of this lesson was torejection is the major reason why most people don't
review the affective domain by reflecting on thedisclose their status to their partners. The
session before - Understanding and Challengingresponsibility of knowing your status to lies on both
Stigma. She noted that when dealing with youngparties. Each partner should take keen interest in
people who are enduring stigma, we need to be awaresafeguarding his/her health and asking their partner
that it can be very devastating and they could beabout their status too. It was felt that importance
contemplating suicide, so it is important to supportshould be placed on acquisition of skills and attitude
and help them. The facilitator advised that whenchange so people take more responsibility in knowing
people grow up in a society that stigmatizes certaintheirstatus and disclosing it totheirpartners.
groups, they will absorb those attitudes, whether
they like it or not. We should not deny it; our only
choice is to recognize it and fight it. People are
Anti-Retroviral drugs (ARV's) are medicines used to
sometimes discriminated based on racism, religious
treat or manage HIV. Antiretroviral Therapy is a
bias, tribalism, sexism etc. It was suggested that
combination of drugs prescribed by a doctor to
participants can lobby for favourable laws to protect
manage HIV. The facilitator emphasized that
the interests of those stigmatized and
adherence to treatment could allow a person living
discriminated against in society.
with HIV to lead a long and healthy life. Poor
adherence has negative side effects such as
increased CD4 count and resistance to the ARVs so
that they do notworkanymore.
Participants read to real life stories about young
people living with HIV. Patience's story was about a
young woman who was very sick but didn't want to get
tested due to her fear of stigma and how she got her
life back after finding out that she had HIV. Sunday's
story is one of a young girl who was born with HIV, her
experiences of discrimination and acceptance and
how she copes. A number of lessons were drawn from
the cases. It was noted that being HIV positive is not
the end of the world, it is manageable. Further, people
living with HIV should not be discriminated against
and rathershould tobetreatedlike everyoneelse.
TreatmentforHIV
Positively Alive
Dayeight
Telling Our Partners
WhatWould YouDo?
The 'What Would You Do' exercise helped participants
appreciate attitudes of people towards illness and
examine why people are not changing their behaviour
to protect themselves from HIV. It involved different
scenarios read out and performed by participants.
To start with participants were told to “Walk around
the room, pretend to know each other and interact…
However, try to protect your health and avoid
getting sick.” They were then told “here is a new
serious illness that has been discovered that is
passed from one to another by shaking hands”. They
were given several different messages about how the
new disease is transmitted and at the end
discussed how they changed their behaviour with
each announcement and why. The link was then made
toprotectingourselves fromHIV.

daynine
The MCP Handshake
Do Ask, Do Tell
A demonstration was conducted on how multiple
concurrent partnerships (MCPs) could spread HIV.
Discussions revealed that some young people had
anal sex to preserve vaginal virginity. There is also
the growing trend of people engaging in oral and
anal sex with young women, believing it is safer.
These are no safer than vaginal sex.
This session was designed to teach participants
how to answer questions from participants.
Difficulties faced when answering questions
included: not knowing the answer; giving wrong
answers or information; not knowing how to answer;
answering with own values; and inappropriate
questions. A guideline for answering participants'
questions was handed out. The guidelines included
questions to ask yourself such as - could it be
interpreted in more than one way and is there a
question behind the question? If a trainer is not
sure what a question means, they should rephrase
it and ask the participants to help them clarify.
Trainers should make sure their answers are non-
judgmental but sensitive to the varied feelings,
experiences, and backgrounds of participants.
Simulations exercises were conducted
by participants over the
next two days of the ToT. Participants
were to demonstrate their
underst anding of the
various topics and their
ability to deliver them to
young people. Groups of
partici pants facilitated
sessions to other
participants, who tried to act as if
they were young people being
trained in CSE. These practical
sessions were filmed and later viewed
and discussed by participants.
Gershom began by defining what multiple
partnerships are. Shortly, Kizito energized
participants in readiness for a music video, Jack
and Jill by KrTC, a SYP artist. The video showed a
guy having multiple partners. Discussions on what
participants observed and learnt from the video
ensued. After their presentation, the team was
commended for: using an informative music video,
sticking to the script, their energy and
organization, and repeating statements
contributed by one participant to benefit another.
To improve, they need to keep to time and avoid
irrelevant things (e.g. the homework, which they did
not eventually give and high-fiving participants).
They seemed to change some processes by turning
what was to be a plenary session into small group
work. A facilitator reminded participants that their
task was to deliver the sessions in the manual as
written.
The question “Who do young women/men have sex
with and why?” was thrown out to participants.
Responses included: young men and women have sex
with older partners (blessers or sugar mummies
and daddies) for material benefits and sexual
experience and sometimes for emotional
attachment. Some young people have sex with sex
workers, same sex fellows and animals. Overall, it
was understood that the older the partner, the
riskier the relationship for the young partner. The
team was advised to refrain from giving their
audience their backs. They should be more audible
and show better class control. It was observed
that they were too laid back and forgot to clarify a
question asked by a participant in their class. The
facilitators however said this group did fairly well in
their presentation.
SIMULATION EXERCISES FOR TRAINERS
Multiple Partnerships
Older Partners, What's the Risk?

WhatDifferenceDoesa DrinkMake? Setting Goals
“A friend of mine had a drink and had sex with one The mock class was split into groups to discuss what
of the nicest girls on campus. The next day he was will delay adolescents from achieving their goals.
bragging to us about his escapade while doing his Pregnancy, illness, and death of parents were among
laundry. When he decided to wash the trouser he the reasons given. During feedback one facilitator
wore the previous night, he discovered his condoms was cited for using complex words and phrases while
were still intact”. This was a scenario shared with another did not give clear instructions to the class
nor control of the class. They did not give
participants a take home message either. They were,
however,commendedfordoing a fairly pleasant job.
Overcoming Barrierstocondom use
A sketch was performed by the group portraying two
of young people who had planned to have sex on their
3 month anniversary date. The boy proposed to do it
without a condom but the girl shuddered at the
prospect of getting pregnant and contracting STIs.
When the day finally came, the girl stormed out of the
room because her boyfriend refused to use a condom.
The group then demonstrated the proper use of
condoms. It was agreed that trainers should be
realistic about how adolescents thought about sex
because the greater need lay in teaching them about
protection and not trying to get them to stop having
sex. The feedback from other participants to the
group was generally good. They were all applauded
participants. When people take alcohol or drugs, even though all four showed minor hiccups during
they get excited, feel sad or lazy, eat more, feel theirsession.
sexy, become violent, and most of all have impaired
judgement. This means, alcohol and drugs influence Reducing theRisk
people's behaviour. Drinking alcohol can bring a lot
The facilitator selected a small number of
of risks, including having unprotected sex, enduring
participants to form a small group and asked the
embarrassing moments and even death. It is risky
audience to define what 'reducing the risk' meant.
to have sex when intoxicated. Not drinking is the
The small group was asked to think of some
safest option for young people. The team was cited
behaviour that would either be complete protection,
for using big words and not introducing themselves
some protection and no protection
as facilitators. A member did not wrap up the
session on condoms and ignored other participants
when they raised their hands.
Exploring Outercourse
Participants were split into groups to list and
categorize different types of sexual behaviours.
During the exercise, there arose an exciting
discussion about whether breast sex and thigh sex
are safe. Some felt it was safe, some felt it wasn't.
Many forms of safer sex were listed. “Does being a
giver or receiver of oral sex change the levels of risk?”
a facilitator asked. It was disclosed that
outercourse is a safe way of expressing oneself
sexually and getting pleasure. During the feedback
session, the team admitted that this was a difficult
topic to facilitate. They were commended for trying
their best to do justice to the topic. Consequently,
she clarified that people around the world have
different understandings of what virginity and
abstinence are. She said the notion that one who
masturbates cannot performin bedis a myth.

against HIV. A debate about whether condom use “keep” “stop” and “change”. Participants then
discussed if they would keep, stop or change variouswas complete protection or some protection ensued.
traditional practices. Whilst discussing theSummary points of the lesson included - abstinence
traditional practice of initiation, participants agreedis complete protection; minimize the number of
that some aspects should be changed. Participantspartners you have; and alcohol/drug abuse can
agreed too to help give information and teachincrease the risk of contracting HIV/STIs. The
facilitator was commended for his enthusiasm and
skill in interacting with participants. However, he
forgot to stress important points. His lesson also
dragged on for long and delivered parts of the topic
incorrectly.
“What do you understand by a want and need?” the
facilitator asked. Participants noted that, a want is
something you desire but can do without and a need
is something you cannot do without. Cultural norms
were defined as “things a society, family and
community expect one to do and behave a certain
way”. Some cultural norms that make discussing sex
difficult were listed. These included - age of the
person; young girls being admonished from
discussing pregnancy with their mothers; and gender
stereotypes. A co-facilitator then led the session on
i-statements. Their evaluation after the
traditional leaders about the consequences ofpresentation highlighted that a member was
practicing harmful practices. The feedback showedcaptivating and interactive but dragged the lesson
that the team's presentation was good. They,while the other facilitator seemed nervous; got easily
however, forgot to drive the salient points of thedistracted; was not interactive enough and was too
lesson homeslow.
.
Sexual and GenderBased Violence
Participants were given a worksheet and asked toThe facilitator helped participants define marriage
identify which definitions matched the sexual andas the union of two people. A story of a young girl
gender based violence terms given. Issues that camenamed Agness was told to participants for
up included: inappropriately touching children, anydiscussions. Agness married a strange man because
sex with children under 16, even those who appear toshe was forced to by her parents and she wanted to
have given have consented, is considered to be rapebe respectful to them. Participants discussed that,
for they are not considered to be mature enough tothe consequences of child marriage include - Gender
understand the consequences or give consent; andBased Violence (GBV); emotional stress;
most rape cases are committed by men on women. Acontraction of HIV and STIs which result in children
key point was that - rape is often perpetrated bybecoming orphans; having shuttered dreams;
someone the victim knows. The following sentenceenduring poverty; losing their identity and
was read out for discussion: 'Young Zambian mensubsequently dying. Reviews of their session showed
learn violence, Young Zambian women learn to acceptthat they forgot to do a number of tasks but
it'. Several participants reacted with displeasure togenerally delivered well.
this. They said, however, that it depicted a harsh
reality. Others felt the statement was wrong
because culturally, men were taught to protect theirThe class listed the following traditional practices:
families and communities. The team wastraditional ceremonies, polygamy, wife inheritance,
congratulated for their sound articulation of theand lobola. Distinct harmful traditional practices
topic but they were encouraged to further clarifythat were discussed in detail were female genital
definitions and give clear directions to the class onmutilation, virginity testing, not discussing sex, and
what they expectedto bedone.separating one from their family. A group activity
had three participants holding signs that read
Asking forWhatYouWant&Need
Child Marriage
Traditional Practices

CSE Report. 2016

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CSE Report. 2016