STAKEHOLDERS’ ASSESSMENT OF THE NEED FOR SEXUAL HEALTH EDUCATION AMONG ADOLESCENTS IN SAUDI ARABIA: AN EXPLORATORY STUDY

Abstract

Sex education has been shown to improve the sexual health outcomes of adolescents, yet many countries still lack the provision of formal sex education programmes. In Saudi Arabia, although having a large adolescent population, no formal sexual education programme exists in the country. Some information is provided within the national curricula, mainly through the subjects of Science and Islamic Jurisprudence. The aim of this thesis is to assess the need for sex education for adolescents in Saudi Arabia, and possible provision for such a programme, in addition to the obstacles and facilitators for implementation from the perspective of stakeholders. A qualitative approach was applied using in-depth semi-structured interviews with 28 stakeholders from four different stakeholder groups: policy-making agencies and officials; social and healthcare providers; teachers and other school staff; and religious scholars. The findings of this research revealed a unanimous agreement on the need for sex education. Opinions varied regarding adopting a science-based approach vs a religion based one. Both approaches were drawn on as non-conflicting sources to guide a feasible, appropriate programme in the country. Opinions varied on the required areas to cover including harm reduction strategies. Various public health terminology were conceptualized differently than their international definitions. Harm was perceived as not limited to physical harm but encompassed spiritual and social harms as well. Ambiguity was not only adopted during expressing opinions but also suggested as a strategy for packaging otherwise sensitive information which differs than international guidelines that recommend clear messaging tactics in these programmes. The need for sex education was not presented as a preventative measure exclusively against physical disease, rather it was needed to ensure happy marital relationships and to preserve the family unit. Obstacles and facilitators for implementation were mostly related to the local Saudi context, specifically the structural factors related to the 10 education and public health infrastructure, as well as the fast pace social and political changes occurring in the country. Sex education has been shown to improve the sexual health outcomes of adolescents, yet many countries still lack the provision of formal sex education programmes. In Saudi Arabia, although having a large adolescent population, no formal sexual education programme exists in the country. Some information is provided within the national curricula, mainly through the subjects of Science and Islamic Jurisprudence. The aim of this thesis is to assess the need for sex education for adolescents in Saudi Arabia, and possible provision for such a programme, in addition to the obstacles and facilitators for implementation from the perspective of stakeholders. A qualitative approach was applied using in-depth semi-structured interviews with 28 stakeholders from four different stakeholder groups: policy-making agencies and officials; social and healthcare providers; teachers and other school staff; and religious scholars. The findings of this research revealed a unanimous agreement on the need for sex education. Opinions varied regarding adopting a science-based approach vs a religion based one. Both approaches were drawn on as non-conflicting sources to guide a feasible, appropriate programme in the country. Opinions varied on the required areas to cover including harm reduction strategies. Various public health terminology were conceptualized differently than their international definitions. Harm was perceived as not limited to physical harm but encompassed spiritual and social harms as well. Ambiguity was not only adopted during expressing opinions but also suggested as a strategy for packaging otherwise sensitive information which differs than inter