Purpose: This study examines key factors that facilitated and hindered creating an enabling environment for the implementation of SEmangaT duniA RemajA/Teen's Aspirations (SETARA), a comprehensive sexuality education (CSE) intervention in schools across three sites in Indonesia.

Methods: Data were collected through interviews with teachers, program implementers, and government officials; a review of program documents and monitoring and evaluation data; and a qualitative evaluation with SETARA students.

Results: One of the most important factors for creating an enabling environment for CSE relates to how well the program is introduced to government officials for approval. Findings showed that the relationship between the implementing organization and city government officials was important for obtaining approval, support, and formal agreements on collaboration. Framing the curriculum within local policies and priorities made it easier to communicate to schools, community, and parents. Buy-in from school principals was important for creating a supportive environment. Complexity of the materials, lack of time to prepare and implement sessions, and teacher-level factors such as pedagogical skills and misaligned values remain key challenges despite trainings.

Discussion: The study suggests that it is possible to implement and create political support for CSE in conservative contexts, especially with a good introduction of the program. Potential solutions for implementation and scaling barriers may lie in the digitalization of the intervention and of capacity strengthening and technical support for teacher. More research is needed to investigate which content and exercises can effectively be delivered digitally and which should best be delivered by teachers to maintain the effect of breaching the taboo around sexuality.

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http://dx.doi.org/10.1016/j.jadohealth.2022.07.016DOI Listing

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