Education For Health and Well-Being:: Unesco Strategy On
Education For Health and Well-Being:: Unesco Strategy On
                          November 2016
Published in 2016 by the United Nations Educational, Scientific and Cultural Organization, 7, place de Fontenoy, 75352 Paris 07 SP, France
© UNESCO 2016
This publication is available in Open Access under the Attribution-ShareAlike 3.0 IGO (CC-BY-SA 3.0 IGO) license (http://creativecommons.org/licenses/by-
sa/3.0/igo/). By using the content of this publication, the users accept to be bound by the terms of use of the UNESCO Open Access Repository
(http://www.unesco.org/open-access/terms-use-ccbysa-en).
The designations employed and the presentation of material throughout this publication do not imply the expression of any opinion whatsoever on the
part of UNESCO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or
boundaries.
The ideas and opinions expressed in this publication are those of the authors; they are not necessarily those of UNESCO and do not commit the
Organization.
Cover photos:
© Jayakumar/Shutterstock.com;
© Karpova/Shutterstock.com;
© Monkey Business Images/Shutterstock.com;
© Anca Dumitrache/Shutterstock.com;
© Maridav/Shutterstock.com;
© wavebreakmedia/Shutterstock.com;
© BestPhotoStudio/Shutterstock.com
Inside photos:
p. 6 © Rawpixel.com/Shutterstock.com;
p. 8 © R.M. Nunes/Shutterstock.com;
p. 13  © Riccardo Mayer/Shutterstock.com;
p. 15  © DGLimages/Shutterstock.com;
p. 19  © Asier Romero/Shutterstock.com
Printed in France
CONTENTS
Acronyms 	                                                     4
Foreword 	                                                     5
1 INTRODUCTION AND BACKGROUND 	                                6
2 GOAL AND STRATEGI C PRIORITIES	                              8
3 IMPLEMENTING THE STRATEGY	                                  15
Annex 1:
How UNESCO’s strategy will contribute to the Sustainable
Development Goals and UNAIDS targets	                         20
Annex 2:
Comprehensive sexuality education – life skills, sexual and
reproductive health and HIV-related content	                  23
                                                                   3
    ACRONYMS
    AIDS	     Acquired Immune Deficiency Syndrome
UN United Nations
4
FOREWORD
This new strategy articulates UNESCO’s commitment         We will seek to ensure that all young people
to promoting better health and well-being for             develop the knowledge, attitudes, values and skills
all children and young people and to supporting           they need to protect themselves from HIV and to
UNESCO’s Education Sector contribution to ending          establish healthy and respectful relationships. We
AIDS as a public health threat by 2030.                   will support countries to strengthen the role of
                                                          national education sectors in promoting awareness
The strategy updates and expands previous UNESCO          of HIV testing and treatment and in preventing
strategies and responds to recent developments in         early and unintended pregnancy. We will also step
the global education, HIV and health agendas. It is       up efforts to eliminate school-related violence and
aligned with, and will contribute to, achievement of      bullying, including gender-based violence, to prevent
the Sustainable Development Goals – in particular         discrimination, and to support schools to promote
those related to education, health and gender equality    healthy lifestyles. These priorities are consistent
– and the targets in the new UNAIDS 2016-2021             with UNESCO’s commitment to advancing human
Strategy. It reflects growing international recognition   rights, gender equality and social justice.
of the inter-relationship between education and
health, and the high priority that UNESCO continues       The result of an extensive consultation process,
to give to strengthening the response to HIV and          this strategy provides the overarching framework
AIDS.                                                     for concerted action by UNESCO and its partners
                                                          at global, regional and country levels during 2016-
The strategy builds on UNESCO’s longstanding              2021. Implementation of the strategy will be led by
experience of supporting national education sector        UNESCO’s Section for Health and Education, which
responses to HIV, and promoting comprehensive             works with UNESCO’s other sectors, institutes,
sexuality education. It reflects UNESCO’s work in         regional bureaux and field offices. We will continue
promoting safe and inclusive learning environments,       to mobilise resources through our regular budget
and its commitment to strengthening the links             and extra-budgetary sources, including UNAIDS and
between education and health, which necessitates a        the private sector, and to work in partnership with
more comprehensive approach to school health and          national governments, other UN agencies, donors,
coordinated action across sectors.                        civil society organizations, professional associations,
To promote better health and well-being for all           academic and training institutions, organizations and
children and young people, UNESCO will structure          networks of young people, faith-based, community
its work around two strategic priorities – ensuring       and parents’ organizations, the private sector and
that all children and young people benefit from good      the media.
quality, comprehensive sexuality education that
includes HIV education, and ensuring that all children
and young people have access to safe, inclusive,
health-promoting learning environments.
UNESCO
                                                                                                                    5
       1            INTRODUCTION
                    AND BACKGROUND
    This document is the new UNESCO Strategy                Section 3 outlines how UNESCO will implement the
    on Education for Better Health and Well-Being:          strategy.
    Contributing to the Sustainable Development Goals.
    The new strategy:                                       The strategy builds on UNESCO’s longstanding
                                                            commitment to strengthening the links between
     Updates previous UNESCO strategies and               education and health. This reflects international
       provides the overarching framework for concerted     commitments set out in the 1986 Ottawa Charter for
       action by UNESCO and its partners at global,         Health Promotion, the 2000 Dakar World Education
       regional and country levels during 2016-2021.        Forum Framework for Action and, more recently, the
     Builds on UNESCO’s work on HIV and on                2015 Incheon Declaration, Education 2030: Towards
       promoting comprehensive sexuality education          inclusive and equitable quality education and lifelong
       and safe and inclusive learning environments,        learning for all.
       and places more emphasis on the role of schools
                                                            It also reflects growing international recognition
       in promoting health.
                                                            of the inter-relationship between education and
     Reflects recent developments in the global           health, which necessitates a more comprehensive
       education, HIV and health agendas and is aligned     approach to school health and coordinated action
       with the new UNAIDS 2016-2021 Strategy and           across sectors. The Global Education First Initiative1
       the Sustainable Development Goals, in particular     identifies health as one of the core outcomes of
       SDG3 Health, SDG4 Education and SDG5 Gender          good quality education and the Incheon Declaration2
       Equality.                                            states that quality education ‘develops the skills,
                                                            values and attitudes that enable citizens to lead
    This section summarises the background and context
    for the strategy; Section 2 provides an overview of
    the strategy’s goal, priorities and key outcomes; and   1	http://globaleducationfirst.org
                                                            2	 Education 2030: Towards inclusive and equitable quality education and
                                                               lifelong learning for all, 2015.
6
healthy and fulfilled lives, make informed decisions,                           contribute to achievement of the targets in the new
and respond to local and global challenges’. There                              UNAIDS Strategy 2016-2021 (see Annex 1).
is good evidence that education is strongly linked
to health outcomes and to determinants of health                                Finally, the new strategy reflects increased
such as health behaviours, risk contexts and use of                             awareness of the importance of investing in
preventive services.3 Effective skills-based education                          adolescents6. Adolescence is a critical stage in life,
creates awareness of the risks of unprotected sex                               for education, health, and physical, emotional and
and substance use, encourages the adoption of                                   psychological development.7 It is also a time when
healthier behaviours, and develops attitudes and                                young people may start to engage in behaviours
values that support human rights and gender equality.                           that can adversely affect their health and education.
Health is equally fundamental to education. Healthy                             HIV, suicide and violence are among the five leading
and happy learners learn better, while poor health                              causes of death among adolescent boys and girls.8
can have a detrimental effect on school attendance                              Adolescence ‘represents an opportunity to influence
and academic performance.                                                       key decision-making processes such as the timing
                                                                                of sexual debut and parenthood, the onset or
In addition, it reflects growing recognition of the                             avoidance of risky and addictive behaviours as well
impact that the school environment has on learning.                             as the acquisition of life skills’.9 In the 2016-2030
Schools that are safe and inclusive for all children                            Global Health Strategy for Women’s, Children’s and
and young people are essential for effective learning                           Adolescents’ Health, the UN Secretary-General
and the strategy builds on UNESCO’s efforts to                                  states that ‘by helping adolescents to realise their
ensure that schools are free from fear, harm and                                rights to health, well-being, education and full and
discrimination.                                                                 equal participation in society, we are equipping them
                                                                                to attain their full potential as adults’. Investing in the
The strategy will contribute to achieving the objectives                        education and health of children and adolescents is
of UNESCO’s Education Strategy 2014-20214, in                                   also essential to realise the potential benefits of the
particular ‘promoting health through education’,                                ‘demographic dividend’.10
which commits UNESCO to ‘strengthen support
for Member States to deliver health education that
contributes to healthy lifestyles and gender equality
through safe and equitable learning environments
that promote overall well-being, good quality
education and learning outcomes for all’. It will also
contribute to UNESCO’s Medium Term Strategy5 and
Member States’ achievement of the Sustainable
Development Goals (see Annex 1).
                                                                                                                                                                       7
       2             GOAL AND STRATEGI C
                     PRIORITIES
    UNESCO’s Goal
    UNESCO’s goal is to support the contribution of           health education, safe learning environments and
    national education sectors to ending AIDS and             links to health services.11
    promoting better health and well-being for all children
    and young people. This, in turn, will contribute to       The strategic priorities are inter-dependent and
    achievement of the Sustainable Development Goals,         mutually reinforcing. For example, comprehensive
    particularly those related to education, health and       sexuality education that promotes respect for
    gender equality.                                          others and positive attitudes towards diversity is
                                                              critical to a safe, inclusive and non-discriminatory
    To achieve this goal, UNESCO has identified two           learning environment. Safe and inclusive learning
    strategic priorities:                                     environments are critical to support healthier
                                                              choices about sexual and reproductive health
     To ensure that all children and young people           and relationships. Effective education to promote
       benefit from good quality, comprehensive               better health can build on lessons learned from
       sexuality education that includes HIV education        comprehensive sexuality and HIV education. A
     To ensure that all children and young people           school environment that promotes good nutrition,
       have access to safe, inclusive, health-promoting       provides opportunities for physical activity and has
       learning environments                                  safe and sanitary facilities is essential to reinforce
                                                              education about health.
    These strategic priorities are an integral part of
    a comprehensive school health approach that
    encompasses policy and systems, skills-based
                                                              11	   This reflects the integrated approach set out in the Focusing Resources on
                                                                    Effective School Health (FRESH) framework.
8
The strategic priorities are also grounded in human                                young people who have substance use problems or
rights and gender equality principles, which will inform                           who have experienced violence, including bullying,
all actions taken within the framework of this strategy.                           is also essential to reinforce the efforts of national
                                                                                   education sectors to promote safe, healthy and
Access to services is a cross-cutting issue.                                       inclusive learning environments. Depending on the
Comprehensive sexuality education must be                                          context, school health services may have a role to
complemented by access to sexual and reproductive                                  play, for example, in ensuring access to condoms,
health (SRH) services so that young people can take                                family planning and counselling.
steps to prevent unintended pregnancy, protect
themselves from HIV and other sexually transmitted                                 The context and rationale for the two strategic
infections, find out their HIV status and receive HIV                              priorities are discussed in more detail below.
treatment. Access to services, such as support for
Strategic priority 1:
All children and young people benefit from good quality
comprehensive sexuality education
Key outcomes for UNESCO include:                                                   Despite clear and compelling evidence of these
                                                                                   benefits, many children and young people are not
 Preventing HIV and other sexually transmitted                                   realising access to good quality comprehensive
   infections                                                                      sexuality education. To address this, and for the reasons
 Promoting awareness of HIV testing, knowing                                     discussed below, there is a need to both expand the
   one’s status, and HIV treatment                                                 coverage and improve the quality of comprehensive
 Strengthening puberty education                                                 sexuality education. In addition, comprehensive
 Preventing early and unintended pregnancy                                       sexuality education must better address the needs of
                                                                                   all children and young people, including those living
 Developing attitudes, values and skills for healthy
                                                                                   with HIV, those who are most vulnerable, those who
   and respectful relationships
                                                                                   may not be in school, and those who do not conform
Comprehensive sexuality education12, of which HIV                                  to gender norms.
is a core component, is central to achieving these
                                                                                   The HIV epidemic is not over and young people
key outcomes. It is a critical intervention in efforts
                                                                                   remain disproportionately at risk. Those aged 15-24
to end AIDS as a public health threat and to enable
                                                                                   years account for 16 per cent of the global population,
young people to reduce their risk of HIV infection.
                                                                                   but represent 34 per cent of those aged 15-49 years
It is also a critical intervention for promoting SRH,
                                                                                   acquiring HIV each year. Young women in sub-Saharan
gender equality and healthy relationships, all of which
                                                                                   Africa are especially at risk. In 2015, there were an
can positively affect education and health outcomes.
                                                                                   estimated 250,000 new HIV infections worldwide
Good quality school-based comprehensive sexuality                                  among adolescents aged 15-19 years, with adolescent
education13 increases correct knowledge, promotes                                  girls accounting for 65 per cent of new infections
positive attitudes and values, and develops skills                                 among this age group. AIDS is the leading cause of
to make informed choices. These in turn have                                       death in adolescents aged 10-19 years in sub-Saharan
demonstrated sexual and reproductive health                                        Africa and the second leading cause of death among
benefits that include delaying sexual debut, reducing                              adolescents globally.
the number of sexual partners, and reducing
                                                                                   Knowledge is a prerequisite for healthy behaviours but
unprotected sex, unintended pregnancy, HIV and
                                                                                   many young people are still poorly informed about HIV.
other sexually transmitted infections.
                                                                                   Country data reported to UNAIDS shows that fewer than
                                                                                   40 per cent of young people have a basic understanding
                                                                                   of HIV and fewer still have accurate knowledge about
                                                                                   how to prevent infection. Effective school-based HIV
12	 Comprehensive sexuality education is defined as an age-appropriate,
    culturally relevant and gender transformative approach to teaching about       education offers a significant opportunity to provide
    sex and relationships that provides scientifically accurate, realistic, non-   children and young people with the knowledge and
    judgmental information and provides opportunities to explore values and
    attitudes and to build decision-making, communication and risk-reduction       skills they need to protect themselves and others
    skills. See International Technical Guidance on Sexuality Education,
    UNESCO, 2009.
                                                                                   from infection. It can also ensure that that they are
13	 UNESCO has identified essential and desirable topics to be covered by          aware of developments in HIV prevention, such as
    comprehensive sexuality education (see Annex 2).
                                                                                                                                               9
     combination prevention,14 and specific interventions,                              Puberty can be a challenging time for young people,
     such as treatment as prevention, PrEP15 and voluntary                              especially if they are not well prepared or supported.
     male medical circumcision. Children and young people                               Awareness and understanding of the changes that take
     outside of school can be reached with non-formal                                   place during puberty is often limited. Many girls know
     education.                                                                         nothing about menstruation until they experience it
                                                                                        and, in many cultures, information provided is selective
     Almost 50 per cent of people living with HIV globally                              or based on taboos and myths. Many boys also lack
     – 17.1 million of 36.9 million16 – do not know that they                           accurate information about menstruation, which
     have the virus and consequently are not benefiting from                            can result in lack of empathy for, and harassment of,
     treatment. Treatment is critical as it enables people with                         girls.17 In response, UNESCO has produced normative
     HIV to live longer, healthier and more productive lives                            guidance on puberty education and menstrual hygiene
     and, by reducing viral load, helps to prevent onward                               management18 and will support national education
     transmission of HIV. Education – formal, informal and                              sectors to integrate this within the framework of
     non-formal – can play an important role by ensuring that                           comprehensive sexuality education.
     all children and young people understand the benefits
     of testing, develop treatment literacy and have the                                Many young people also lack basic knowledge about
     skills required to access services if they need them.                              pregnancy and do not have the information and skills
                                                                                        required to access family planning services and use
                                                                                        contraceptives. The State of World Population Report
           Promoting HIV testing                                                        2013, which focused on adolescent pregnancy,
           and treatment literacy                                                       highlights sexuality education and access to services as
                                                                                        two key interventions to reduce early and unintended
           UNESCO is supporting efforts to increase uptake
                                                                                        pregnancy.19
           of HIV testing and ensure that all young people are
           aware of the benefits of early initiation of treatment.                      Comprehensive sexuality education is essential to
           For example, in Eastern Europe and Central Asia,                             enable children and young people to develop accurate
           UNESCO has worked with partners on a regional                                and age-appropriate knowledge, attitudes and skills
           HIV testing campaign targeting young people and                              related to these issues and, ideally, it should start
           adults and, in Eastern and Southern Africa, UNESCO                           before they reach puberty and become sexually active.
           had led efforts in ten countries to build the capacity                       Comprehensive sexuality education can also develop
           of teachers and peer-to-peer educators to promote                            positive values including respect for human rights,
           treatment literacy through the Adolescent Treatment                          gender equality and diversity and develop the attitudes
           Literacy Toolkit.                                                            and skills that contribute to safe, healthy, positive
                                                                                        relationships.
     Review of experience since publication of the
                                                                                        There is growing demand from young people
     International Technical Guidance on Sexuality Education
                                                                                        themselves for good quality comprehensive sexuality
     in 2009 has also identified the need to pay more
                                                                                        education, for example, the 2011 Mali Call to Action, 2012
     attention to sexual and reproductive health issues such
                                                                                        Bali Global Youth Forum and the 2013 UNECE Regional
     as puberty and menstruation, early and unintended
                                                                                        Youth Conference Istanbul Call to Action, which called
     pregnancy and family planning.
                                                                                        for evidence-based comprehensive sexuality education
     Sexual and reproductive health has a direct impact on                              to be prioritised as ‘an efficient and effective method of
     the education and future prospects of young people.                                empowering us to make informed choices about our
     For example, early and unintended pregnancy increases                              sexual lives, practice life skills and explore attitudes and
     the risk of absenteeism, poor academic attainment                                  values’. More recently, the Youth Statement on the 2030
     and early drop out from school for girls and also has                              Agenda for Sustainable Development highlighted the
     educational implications for young fathers. The risk of                            importance of young people’s sexual and reproductive
     complications and death is also higher among younger                               health and rights. Many parents and communities
     mothers; in low and middle-income countries the risk                               are also actively supportive of provision of education
     of maternal death for mothers under the age of 15 is                               about sexuality in schools, because of concerns
     double that of older mothers.                                                      about adolescent pregnancy, sexual violence and the
                                                                                        conflicting messages that young people receive from
     14	 Combination HIV prevention includes primary prevention and prevention          society and the media.
         of onward HIV transmission; it involves a combination of biomedical,
         behavioural and structural interventions tailored to the epidemic context
         and people’s situation, risk and choices.                                      17	 See fact sheet on men and boys www.menstrualhygieneday.org
     15	 Pre-exposure prophylaxis: The use of medication used to treat HIV              18	 Puberty Education and Menstrual Hygiene Management. Good Policy and
         (antiretroviral drugs) to reduce the risk of becoming infected; among people       Practice in Health Education, Booklet 9. UNESCO, 2014.
         who are HIV negative and at high risk of HIV infection.                        19	 Motherhood in childhood: Facing the challenge of adolescent pregnancy.
     16	 UNAIDS. AIDS by the numbers 2015.                                                  The State of World Population, UNFPA, 2013.
10
There has been considerable progress with                   government commitment, there is still a gap between
implementation of comprehensive sexuality education         policy and practice, and that school curricula and the
in recent years. UNESCO support, together with that of      skills of educators need to be strengthened.
other partners, has made an important contribution to
building commitment and many countries have taken           Ensuring that comprehensive curricula and teaching
steps to integrate comprehensive sexuality education        and learning materials are developed, that sexuality
into teacher training and school curricula.                 education is allocated adequate time in the school
                                                            timetable and that teachers are trained and supported
                                                            to deliver it, will be critical. More attention must be
   Increased commitment to                                  paid to ensuring that pre-service and in-service training
   comprehensive sexuality education in                     provides teachers with the requisite knowledge
   East and Southern Africa                                 and skills, to assessing how they are delivering
                                                            comprehensive sexuality education, to addressing
   Extensive engagement with policy-makers in East          the reasons for poor delivery, and building teachers’
   and Southern Africa resulted in the 2013 Ministerial     capacity.
   Commitment, Young People Today: Time to Act Now,
   which was endorsed by Ministers of Education             In some contexts, a selective approach to sexuality
   and Health from 21 countries in the region and           education is taken that avoids more sensitive or
   aims to ensure that all children and young people        challenging topics. In such contexts, the national
   have access to high quality, comprehensive life          education sector needs to engage with parents,
   skills-based HIV and sexuality education and to          politicians, community and religious leaders to ensure
   appropriate youth-friendly health services. Ministries   that they understand the benefits of comprehensive
   of education and health in the region have made joint    sexuality education and address misconceptions
   commitments to reducing HIV infections, reducing         about its consequences.
   adolescent pregnancy, and preventing gender-             National education sectors also need to take
   based violence and child marriage. Joint work plans      advantage of the opportunities presented by
   have been developed by a number of countries and         information and communication technologies to
   21 countries have incorporated comprehensive             expand and strengthen comprehensive sexuality
   sexuality education content into school curricula.       education. Technology can facilitate new ways of
   UNESCO efforts to strengthen sexual and                  teaching and learning and some countries are already
   reproductive health and HIV prevention through           implementing internet-based sexuality education
   promoting comprehensive sexuality education have         courses for educators and learners. This approach
   reached more than 34,000 schools, 80,000 teachers        can support educational efforts to reach children and
   and 4 million learners in the region. In addition,       young people in non-formal settings.
   UNESCO has, together with partners, commissioned
   various studies to inform the achievement of the         Finally, it is important to recognise that national
   Commitment targets focusing on school-related            education sectors alone cannot improve young
   gender-based violence, early and unintended              people’s sexual and reproductive health. Education
   pregnancy, laws concerning adolescent sexual and         must be complemented by access to youth-friendly,
   reproductive health, and comprehensive sexuality         non-judgmental,      confidential health   services
   education in teacher training, as well as developing a   that can provide appropriate advice, care and
   community engagement strategy that targets young         commodities, including free or affordable condoms
   people and parent-teacher associations.                  and contraceptives. Collaboration between the
                                                            education and health sectors is therefore essential.
                                                            Working together, these two sectors ‘have enormous
Despite this, much more needs to be done to                 potential to promote the good health and well-being
improve the coverage and quality of comprehensive           of all individuals and communities and to prevent
sexuality education, if all young people are to develop     early and unintended pregnancy, transmission of
the knowledge and skills they need. Challenges to           HIV and other sexually transmitted infections and
be addressed include lack of appropriate national           to facilitate access to care and support particularly
education sector policies, failure to implement             for adolescents and young people living with HIV
comprehensive sexuality education at scale and lack         or heightened vulnerability to sexually transmitted
of support for education managers and teachers,             infections including HIV’.20
resulting in inadequacies in the quality and delivery
of comprehensive sexuality education. For example,
a 2015 review of the status of comprehensive
                                                            20	 East and Southern Africa Ministerial Commitment, Young People Today: Time
sexuality education in 48 countries found that, despite         to Act Now, 2013.
                                                                                                                                            11
     Strategic priority 2:
     All children and young people have access to safe, inclusive,
     health-promoting learning environments
     Key outcomes for UNESCO include:                                                    impact on learning and psychological well-being.
                                                                                         Teachers as well as learners are affected by violence
      Eliminating school-related violence and bullying                                 and discrimination in schools, and ensuring that
        including school-related gender-based violence                                   the school environment is safe and enabling for all
      Preventing health- and gender-related discrimination                             is integral to ensuring a good quality education for
        towards learners and educators                                                   learners.
      Increasing awareness of the importance of good
                                                                                         Learners affected by school-related gender-based
        nutrition and quality physical education
                                                                                         violence may avoid classes, participate less in
      Preventing use of harmful substances                                             class or find it difficult to concentrate, or drop out
     Violence in educational settings is a problem in all                                from school altogether. Concerns about sexual
     countries. One estimate suggests that, globally, 246                                harassment in and around school are often cited by
     million children and adolescents experience some                                    parents as a reason for not sending girls to school.
     form of gender-based violence in and around school                                  School-related gender-based violence also increases
     every year.21 Although in many contexts girls are                                   the risk of unintended pregnancy and other sexual
     more likely to experience gender-based violence,                                    and reproductive health problems, and affects girls’
     the United Nations World Report on Violence against                                 physical, psychological and social well-being, all of
     Children in 2006 showed that bullying particularly                                  which can have a detrimental effect on education
     affects learners who are perceived not to conform                                   outcomes.
     to prevailing sexual and gender norms. A recent                                     Bullying, which is a specific form of violence, can
     UNESCO report showed that students considered to                                    also result in reduced school attendance, early drop
     be gender non-conforming experienced significantly                                  out from school and poorer academic performance
     higher levels of school violence and bullying.22                                    and achievement. It increases the risk of depression,
     Discrimination towards children and young people in                                 anxiety, loss of confidence, reduced self-esteem,
     school, as well as towards teachers, based on gender                                psychological stress and social isolation, which
     norms, ethnicity, disability, social or economic status                             has a negative impact on educational outcomes.
     among other issues, is also a significant problem                                   There is also evidence that young people who have
     in many contexts. Despite efforts to promote a                                      experienced bullying at school may be more likely
     supportive legal and policy environment for people                                  to abuse alcohol and drugs and engage in high-risk
     living with HIV, stigma and discrimination continue                                 sexual behaviour.
     to affect learners and educators living with HIV.                                   National education sectors need to adopt and
     Children and young people from marginalised or key                                  implement measures to prevent and address
     populations also experience discrimination in some                                  violence and discrimination, because of their impact
     educational settings.                                                               on education, health and well-being and because
     Schools that are not safe or inclusive violate the                                  they stop children and young people from achieving
     right to education, which is enshrined in the United                                their potential.
     Nations Convention on the Rights of the Child, and                                  Schools also act as an important socialising
     contravene the Convention against Discrimination in                                 mechanism and school-based education is a core
     Education, which aims to eliminate discrimination                                   component of a comprehensive response to gender-
     and promote the adoption of measures that ensure                                    based violence and discrimination in educational
     equality of opportunity and treatment.                                              settings. School-based education, in particular
     Violence in and around schools, including bullying,                                 comprehensive sexuality education, can challenge
     abuse and sexual harassment, also undermines                                        harmful norms and foster attitudes and values that
     learning and has adverse physical and mental health                                 promote respect for diversity, human rights and
     consequences. Discrimination also has a negative                                    gender equality. More specifically, there is clear
                                                                                         evidence that comprehensive sexuality education
                                                                                         reduces stigma and discrimination towards people
     21	 A girl’s right to learn without fear: Working to end gender-based violence at
         school. Plan International UK, 2013.
                                                                                         living with HIV.
     22	 Out in the Open: Education sector responses to violence based on sexual
         orientation or gender identity/expression. UNESCO, Paris, 2016.
12
                                                                            Ensuring that these commitments are translated
     Preventing HIV-related stigma and                                      into policy and practice will be critical in the coming
     discrimination                                                         years. Strengthening links between national
                                                                            education sectors and other sectors is essential, so
     UNESCO supports a range of actions to prevent                          that schools can refer children and young people to
     HIV-related stigma and discrimination in                               appropriate services.
     educational settings. In Eastern Europe and
     Central Asia, where an estimated 150,000 children
     and adolescents are living with, or affected by,                          Taking action to eliminate school-
     HIV, UNESCO has produced a series of short                                related gender-based violence
     videos featuring people living with HIV talking
                                                                               The Global Working Group to End School-Related
     about their lives and experiences, including young
                                                                               Gender-Based Violence, which was established
     learners describing the impact of discrimination
                                                                               in 2014, is co-hosted by UNESCO and the United
     and rejection by fellow learners at school.
                                                                               Nations Girls’ Education Initiative (UNGEI).
     UNESCO has also supported a consultation on                               The Working Group comprises 30 international
     adolescents living with HIV in the Asia-Pacific,                          agencies, donors and civil society organizations.
     with the Asia Pacific Network of People Living with                       With the Working Group, UNESCO commissioned
     HIV, UNICEF and Treat Asia, at which young people                         the first global review of policies and practice
     highlighted the need for school policies to address                       in school-related gender-based violence, a
     stigma and discrimination.                                                discussion paper, a policy paper and a regional
                                                                               review in the Asia Pacific.
There is growing support for action to eliminate                               UNESCO has supported action at regional and
school-related gender-based violence. In 2015, 58                              national level including working with UNGEI and
countries signed up to the first ever UN resolution                            the UNiTE campaign to mobilise policy-makers
on school-related gender-based violence, Learning                              and young people in the Asia-Pacific region,
without Fear. Advocacy by the Global Working                                   training teachers and school administrators in
Group to End School-Related Gender-Based Violence                              the Asia-Pacific and West and Central Africa
(see Box below) also resulted in the inclusion                                 regions, and conducting studies of school-related
of a commitment to eliminating gender-based                                    gender-based violence in Indonesia, Thailand and
discrimination and violence in schools in the Incheon                          Vietnam. UNESCO’s institutes, IIEP and IBE, have
Declaration, which was endorsed by Member States                               also developed practical tools and resources to
at the World Education Forum in 2015.23                                        promote safety, resilience and social cohesion in
                                                                               educational settings.
23	 Education 2030: Towards inclusive and equitable quality education and
    lifelong learning for all, 2015.
                                                                                                                                      13
     National education sectors also need to respond to                             specifically, use of alcohol can increase the risk of
     the changing global burden of disease. In much of                              unsafe sex and sexual violence, and injecting drugs
     the world, non-communicable diseases are now the                               increases the risk of HIV and hepatitis. Schools can
     main cause of illness and death. Around 80 per cent                            contribute to prevention of substance use, through
     of deaths from non-communicable diseases are due                               skills-based education that targets learners before
     to cardiovascular disease, cancer, chronic respiratory                         adolescence. In some contexts, national education
     disease or diabetes. These diseases share four risk                            sectors also play an important role in provision of
     factors: unhealthy diet, physical inactivity, tobacco                          information about harm reduction for children and
     use and harmful use of alcohol.                                                young people who are using substances.
     The WHO Global Strategy on Diet, Physical Activity                             Safe and inclusive facilities are important for the
     and Health recommends to Member States that                                    health of learners in general but are especially
     school policies and programmes should support the                              important for girls once they reach puberty. Globally,
     adoption of healthy diets and physical activity through                        one in four girls reports that they do not feel safe
     nutrition education, school feeding programmes,                                in school toilets or latrines and UNESCO’s recent
     inclusive physical education and creating a supportive                         policy and evidence work on menstrual hygiene
     environment. National education sectors can also                               management has also shown that lack of toilets,
     promote good nutrition and physical activity through                           water supplies and soap, disposal facilities and
     strengthening school links with nutrition, youth,                              privacy can contribute to absenteeism and drop out
     sports and other relevant programmes and with                                  among girls once they start menstruation.
     communities.
14
    3          IMPLEMENTING
               THE STRATEGY
Implementation of the strategy will build on            Based on its mandate and comparative advantage,
UNESCO’s guiding principles (see following page) and    UNESCO will focus primarily on support for
its longstanding work on promoting comprehensive        interventions in formal educational settings, but
sexuality education, safe and inclusive schools and     will also contribute to the actions of other partners
school health through a range of global, regional and   intended to improve health through non-formal and
national initiatives. It will also build on UNESCO’s    informal education. UNESCO will give priority to
track record in HIV, as the lead UN agency on support   supporting national education sectors to ensure that
to countries to scale-up responses by national          all children and young people have the opportunity to
education sectors, including HIV prevention with        develop the knowledge, attitudes and skills needed
young people in educational settings.                   for healthy lives and relationships in the context of a
                                                        supportive learning environment.
                                                                                                                  15
        UNESCO’s guiding principles
         Human rights – UNESCO is guided by international human rights principles, conventions and standards.
           UNESCO takes a human rights-based approach in all its actions that emphasises equality, non-discrimination
           and respect for diversity, participation and accountability.
         Gender – UNESCO supports gender-transformative programming that advances gender equality and respect
           for diversity, and addresses gender roles, cultural norms and power structures that increase young people’s
           vulnerability and adversely affect their health and education outcomes and well-being.
         Country ownership – UNESCO is committed to the principles of national ownership, harmonisation and
           alignment in line with the Paris Declaration on Aid Effectiveness, and will continue to align its actions with
           national priorities, plans and processes.
         Evidence – UNESCO supports approaches that are scientifically accurate and grounded in evidence and will
           support countries to implement evidence-informed education responses that contribute to better health and
           education outcomes and improved well-being.
         Participation of young people – UNESCO targets actions to meet the needs of children, adolescents and young
           people and works with youth networks and organizations and initiatives that promote their involvement in
           shaping the policies and programmes that affect their lives.
16
Partnerships
Partnerships with a range of actors will be central       and country levels to deliver results and respond to
to implementing the strategy. UNESCO is also              country needs and priorities. At country level, UN
committed to building bridges between civil society,      Joint Teams will remain an important mechanism
in particular youth and gender equality networks,         for joint advocacy and action on issues such as
governments, donors and UN organizations.                 comprehensive sexuality education, access to sexual
                                                          and reproductive health services and school-related
Partnerships with national governments, in particular     gender-based violence as well as wider school health
strong and well-established relationships with            promotion.
education ministries, remain at the core of UNESCO’s
work. UNESCO will also continue to work with its          Partnerships with other UN agencies will be
many other partners, which include UN agencies,           strengthened, to take forward global, regional and
donors, civil society organizations, professional         national action and support collaboration between
associations, academic and training institutions,         the national education sectors and other sectors at
organizations and networks of young people, faith-        country level. For example, UNESCO will build on
based, community and parents’ organizations, the          joint work with UNFPA on comprehensive sexuality
private sector and the media.                             education, with ILO on teacher training and safe and
                                                          inclusive schools and with UNICEF, UNFPA, UNDP
While national education sectors have a key role          and UN Women on prevention of school-related
to play, they cannot address HIV, sexual and              gender-based violence. UNESCO will also work with
reproductive health and other issues that affect the      WHO and UNODC on prevention of use of harmful
health of children and young people alone. Action by      substances among young people, WHO and UNICEF
other sectors is needed to address structural factors,    on school health and with WHO on how national
to ensure that children and young people have access      education sectors can help to prevent and minimise
to appropriate, quality and affordable services, and to   the impact of emerging health issues and disease
promote a supportive environment outside of school.       outbreaks such as the Zika virus. Opportunities to
UNESCO will therefore promote national education          strengthen collaboration with UNICEF on school
sector links and collaboration with other sectors         water and sanitation and with WFP on school
including health, youth, child protection, social         nutrition will also be explored.
protection, justice, water and sanitation. In addition,
UNESCO will support enhanced collaboration within         UNESCO will continue to work in partnership
education ministries, departments and institutions,       with other UN agencies, donors and civil society
for example, between those working on teacher             organizations through global platforms, such as
training, curriculum development and school health.       Every Woman Every Child, which aims to ensure
                                                          the Global Strategy for Women’s, Children’s and
UNESCO will sustain and strengthen partnerships           Adolescents’ Health is implemented, and inter-
with donors, who have provided vital support for          agency mechanisms, such as the Inter-Agency
its work on HIV, comprehensive sexuality education        Task Team on Education and School Health that is
and school-related gender-based violence that this        convened by UNESCO, and the FRESH partnership.
strategy will build on.
                                                          Other partnerships, with teachers’ associations,
UNESCO will continue to work on HIV with the              training institutions, parents, communities and civil
UNAIDS Secretariat and other UNAIDS’ co-sponsors,         society organizations such as youth networks and
guided by the Division of Labour, which describes         faith-based organizations, will also be strengthened.
how the Joint Programme acts collectively at global
                                                                                                                  17
     Key areas of action
     UNESCO actions will be tailored to regional and                            non-communicable diseases28 and obesity, but
     country priorities and respond to emerging needs                           also encourages the development of well-rounded
     over the coming years. The following outlines broad                        children and adolescents who will be more likely to
     areas of action, based on UNESCO’s core functions,                         regularly participate in physical activity and adopt
     with indicative examples of activities.                                    healthy habits throughout their lives.
18
Knowledge generation and sharing                        Evaluation framework and development of indicators
                                                        for inclusion in Education Management Information
UNESCO supports research and action to improve          Systems; and support education ministries to monitor
knowledge and strengthen the evidence base and          their contribution to achieving the SDG targets.
promotes sharing of information, expert opinion
and experience, including through south-south
cooperation mechanisms.                                 Convening and coordination
For example, UNESCO will: continue to document          UNESCO brings together partners to coordinate
and disseminate knowledge and evidence through          action at global and country level, promotes
its Good Policy and Practice series; and generate       coordination between sector ministries and
evidence to inform national education sector action.    between government and non-government actors,
                                                        and supports networking between initiatives with
                                                        common agendas.
Monitoring and evaluation
                                                        For example, UNESCO will: facilitate collaboration
UNESCO supports the generation of strategic             and joint action between education and health
information, monitoring and evaluation of global,       ministries and support education ministries to build
regional and country progress and the impact of         alliances with other sectors; bring together ministries
national education sector responses.                    of education to review progress and plan action,
                                                        focusing in the short-term on national education
For example, UNESCO will: strengthen global and         sector responses to bullying and to substance
national monitoring and evaluation of the coverage,     use; continue to co-host the Global Working Group
quality and impact of comprehensive sexuality           to End School-Related Gender-Based Violence;
education; build the capacity of national Education     and support national education sectors to engage
Management Information Systems for collection and       parents, communities, young people, faith-based
analysis of data on skills-based sexuality education;   organizations and the media in policy dialogue.
build on work to date on the global Monitoring and
                                                                                                                  19
     ANNEX 1:
     HOW UNESCO’S STRATEGY WILL
     CONTRIBUTE TO THE SUSTAINABLE
     DEVELOPMENT GOALS AND UNAIDS
     TARGETS
          NO                ZERO                   GOOD HEALTH             QUALITY               GENDER                 CLEAN WATER
          POVERTY           HUNGER                 AND WELL-BEING          EDUCATION             EQUALITY               AND SANITATION
          AFFORDABLE AND    DECENT WORK AND       INDUSTRY, INNOVATION     REDUCED               SUSTAINABLE CITIES     RESPONSIBLE
          CLEAN ENERGY      ECONOMIC GROWTH       AND INFRASTRUCTURE       INEQUALITIES          AND COMMUNITIES        CONSUMPTION
                                                                                                                        AND PRODUCTION
     HEALTH AND EDUCATION         SELECTED HEALTH AND EDUCATION SDG                EXAMPLES OF UNESCO STRATEGY’S
     SDGS                         TARGETS                                          CONTRIBUTION
                                  4.1 Ensure all girls and boys complete            Addressing factors that contribute to school
      GOAL 4:
                                  primary and secondary education                     dropout and gender disparities in education
      Ensure inclusive
                                  4.5. Eliminate gender disparities in education      e.g. early and unintended pregnancy,
      and equitable
                                  and ensure equal access…                            school-related gender-based violence
      quality education
                                  4.7 Ensure all learners acquire the               Eliminating bullying and discrimination in
                                  knowledge and skills needed…to promote              school settings
                                  … human rights, gender equality, peace and
                                  non-violence
                                  4a…provide safe, non-violent, inclusive and
                                  effective learning environments
20
The UNESCO strategy will also contribute to the achievement of other key SDGs, especially those related to
gender equality, poverty, hunger, peaceful and just societies (see below).
                             Education plays a key role in reducing gender inequalities, through equipping girls with
  GOAL 5:
                               knowledge and skills that empower them in their communities and relationships and improve
  Gender
                               their future employment prospects and income, and engagement with boys
  equality and
  empowerment of             Education can promote attitudes and values that support gender equality and tackle harmful
  girls and women              gender norms
                             Education can develop the attitudes, values and skills required for peaceful, tolerant and
  GOAL 16:
                               inclusive societies
  Peaceful and
  inclusive societies        Safe and supportive learning environments that are free from violence and discrimination
                               provide a model for later life and instil respect for rights, diversity and equality
                                                                                                                                   21
     UNESCO’s strategy is also closely aligned with the UNAIDS 2016-2021 strategy On the Fast-Track to End AIDS,
     and its vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNESCO’s work
     on education and HIV, in particular its strategic priorities of increasing access to good quality comprehensive
     sexuality education and making education safe and inclusive, will contribute to the ‘three zeros’ and to the
     following specific UNAIDS targets.
                                                                                                Comprehensive
                                                                                             sexuality education to
                          UNAIDS Target 3:
                                                                                            develop the knowledge,
                        90% of young people are                                               attitudes, skills and
                       empowered with the skills,                                           competencies required
                      knowledge and capability to                                              for HIV prevention
                      protect themselves from HIV
                                                                    Comprehensive sexuality
                                                                 education is a core element of
                                                                combination prevention and can
                                                                provide the knowledge and skills
                                                              and ensure linkages to enable young
                                                                people to access prevention and
                 UNAIDS Target 4:                                sexual and reproductive health
               90% of women and men,                                        services
             especially young people, have
              access to HIV combination                                                           Support for
             prevention and SRH services                                                      national education
                                                                                             sectors to eliminate
                                                                                          HIV-related discrimination
                                                                                            towards learners and
                                                                                             educators in school
                                                                                                   settings
                                                                        Comprehensive
                        UNAIDS Target 8:                              sexuality education
                                                                  addresses gender inequality
                      90% of people living with,
                                                                    and power relations and
                      at risk of and affected by,
                                                                promotes healthy gender norms;
                     HIV report no discrimination,
                                                                 Support for national education
                    especially in health, education
                                                                  sectors to eliminate school-
                       and workplace settings
                                                                     related gender-based
                                                                            violence
22
ANNEX 2:
COMPREHENS IVE SEXUALITY
EDUCATION – LIFE SKILLS, SEXUAL
AND REPRODUCTIVE HEALTH AND
HIV-RELATED CONTENT
Source: Emerging evidence, lessons and practice in comprehensive sexuality education: A global review, UNESCO, 2015.
                                                                                                                                             23
                               Education
                               Sector
           United Nations
Educational, Scientific and
    Cultural Organization
                             This strategy builds on UNESCO’s longstanding commitment to strengthen the links between
                             education and health, reflecting international recognition that a more comprehensive
                             approach to school health and coordinated action across sectors is needed. As stated
                             in the 2015 Incheon Declaration, education develops the skills, values and attitudes that
                             enable citizens to lead healthy and fulfilled lives, make informed decisions, and respond
                             to local and global challenges.
                             It updates previous UNESCO strategies and expands on UNESCO’s work on HIV and
                             on promoting comprehensive sexuality education and safe and inclusive learning
                             environments, placing more emphasis on the role of schools in promoting health. More
                             specifically, it reflects recent developments in the global education, HIV and health
                             agendas, and is aligned with the new UNAIDS 2016-2021 Strategy and the Sustainable
                             Development Goals, in particular SDG 3 Health, SDG 4 Education and SDG 5 Gender
                             Equality.
                             For more information on UNESCO’s work on health and education, visit the website:
                             http://en.unesco.org/themes/health-education
                                                                                                                         Sustainable
                                                                                                                         Development
                                                                                                                         Goals