Digital sexuality education during Covid-19

Covid-19 has challenged the delivery of face-to-face Comprehensive Sexuality Education (CSE) worldwide. The closure of schools and limitations to be in groups have pushed organizations to find alternative ways to provide CSE. Dance4Life and its franchisees promptly responded to the challenge: we adapted the Journey4Life to a digital version. This article summarizes the results from the needs assessment and the outcomes of first impact evaluations of this digital version. In 2021 we plan to pilot and evaluate a final digital Journey4Life, and work towards a blended version combining face-to-face and digital sessions to empower young people to live healthy lives.

Urgent need to digitalize the Journey4Life
Since the Covid-19 outbreak, Dance4Life established a Creative Crisis Response task force to gather best practices from the innovative ideas by franchisees to mitigate the effects of Covid-19. During the first webinar, franchisees from China, Kenya and Russia presented online activities started to respond to the stay-home measures. Most participants reacted expressing the need to develop digital tools and strategies to engage young people online, getting inspiration from the face-to-face Journey4Life. Independently, some franchisees experimented activities and sessions inspired by the Journey4Life on different platforms, with positive results in terms of appreciation from the participants. Lessons learned were shared in the second webinar, leading to a strong consensus on starting a more structured design process of digitalization of the Journey4Life.

Needs assessment conducted among young people
In July 2020 eight Dance4Life franchisees conducted a rapid needs assessment among young people to investigate their interest in attending CSE online sessions, what type of content they wanted to be covered and which technological channel they preferred to use. A total of 1091 young people participated to the needs assessment. In Kenya and in Kazakhstan, Kyrgyzstan, Russia and Ukraine the majority of respondents were 16-19 year olds; in Ghana and Pakistan the majority of respondents were 20-24 year olds. A balanced sample was reached in Indonesia, where 32.9% of young people were 12-14 year old, 31.4% were 16-19 year olds and 35.7% were 20-24 year olds. Across all countries the majority were girls, with Ghana also reporting young people identifying their gender as “other” (15%).

Interest in online CSE and use of online channels
The majority of respondents expressed an interest in online CSE sessions and, stated they could easily access to internet through their phones or computers. When investigating their current use of internet in accessing CSE information, findings showed that in Indonesia, Kazakhstan, Kyrgyzstan, Pakistan and Ukraine, the majority of respondents did not search for this type of information, while in Ghana, Kenya, and Russia they did. In order to understand which online channel was more appropriate for the delivery of the digital Journey4Life, young people were asked about their preferred online channel for the sessions. Channels as WhatsApp and Telegram were mostly chosen. Zoom was chosen as second choice by Indonesian respondents, while Instagram was chosen by young people in Kazakhstan, Kyrgyzstan and Ukraine as second choice, and in Russia as third choice.

Preferred content of the sessions
The questionnaire also explored young people’s priorities in terms of content to be covered by the digital Journey4Life. The main challenges regarding sexual and reproductive health and rights (SRHR) identified by young people were the three main challenges Dance4Life wants to decrease: HIV, adolescent pregnancy and gender-based violence (GBV). When asked about priority topics for the sessions, many topics mentioned were in line with ones addressed by CSE programs, such as: communication within relationships; relationship with parents; gender equality; puberty and physical changes; saying “no” to violence and unwanted sex; bullying and violence; pregnancy and childbirth; SRHR; contraceptive methods; sexual behaviours. However other topics were sort of influenced by the current Covid-19 times and sounded like a request to the CSE sector to also address important, but still not often included, challenges faced by young people: mental health and SRHR, and Covid-19 and SRHR.

Development of the digital Journey4Life
Based on the needs assessment, Dance4Life developed a Theory of Change for the digital Journey4Life and a measurement framework with outcomes indicators. The main difference between the face-to-face Journey4Life and the digital version is that the face-to-face Journey4Life is delivered through creative facilitation and experiential learning, with a focus on building socio-emotional learning (SEL) competencies. Although Dance4Life maintained interactivity in the online experience, more time is needed to be able to adapt the experiential learning approach and present the SEL competencies.

Although the Covid-19 outbreak still allows community and advocacy activities, young people’s access to SRHR services has significantly been reduced

Step 1 Designing the digital sessions
Dance4Life believes in the power of co-creation: designing products and services in co-creation with partners and users. The digitalisation of the Journey4Life consisted of experimentation, testing and adaptation in which Dance4Life involved program staff, Trainers4Life, peer facilitators and young people at every stage of its development. Based on the insights, the use of technological channels that young people know well, use daily and can easily access became a priority. The final choice on which technological channel to use, was based on both the needs assessment and feasibility from the franchisees’ side. Where connection is not strong and widely available (Ghana, Kenya and Pakistan) the technology chosen is instant messenger (WhatsApp), useful for text messaging, use of emoji’s and GIFs, sharing photos, videos, files and links; voice recording. The franchisees from China, Indonesia, Kazakhstan, Kyrgyzstan, Russia and Ukraine opted for video conferencing (Zoom,Tengxun) sessions and combine them with instant messaging (WeChat, Telegram).

Step 2 Implementation and safeguarding
After contextualization and translation of the digital Journey4Life, peer facilitators were trained by the Trainers4Life to deliver the sessions to young people. Being autonomous actors, the franchisees implemented the digital Journey4Life in different ways and at different points in time. At present, some of them already finished implementation, others are still in the planning phase and Kenya could not implement.

An important aspect of delivering CSE in digital spaces has been the safeguarding of young people who participate in the sessions. Deliberate efforts were made to provide safety, such as:

  • Agreeing and sticking to group rules that ensure safe space, respect of confidentiality and privacy of the members of the group
  • Allowing young people to opt out from sharing information and choosing what they feel comfortable to share
  • Deploying role of safe guardian to be present in the group (or their contact details to be shared) as a point for referral in case of an incident, and making sure that reporting procedures are clear and defined for the safe guardian and the franchisees.

Step 3 Evaluation of the digital Journey4Life
An evaluation has been planned across countries involved in the prototype of the digital Journey4Life. For this, a pre-post Currently evaluations have been conducted in Kazakhstan and Indonesia (in October 2020), but are taking place or are planned also in the other countries. Since the questionnaire are contextualized, findings cannot be compared across countries. Only statistically significant results are reported.

Evaluation in Kazakhstan
Increased knowledge
After exposure to the digital Journey4Life a higher percentage of young people acknowledge that :

  • HIV is transmitted from an HIV-positive mother to her child during pregnancy, childbirth and breastfeeding” (90% at endline – 60% at baseline)
  • Antiretroviral therapy does not completely removes HIV from the body” (78% at endline – 66% at baseline)
  • Antiretroviral therapy suppresses the virus and allows the body to restore the immune system” (83% at endline – 59% at baseline)

Also, more young people know which health services to visit if they “need to get tested or treated for STIs” (84% at endline compared to 66% at baseline) or if “they need to get tested for HIV” (92% at endline  – 74% at baseline).

Higher level of confidence
After exposure to the digital Journey4Life more young people show confidence to “discuss pregnancy, HIV/STIs, gender-based violence issues with their sexual partners” (97% at endline – 88% at baseline)

Changed gender equal attitudes
After exposure to the digital Journey4Life, a higher percentage of people disagree with the following statements:

  • Girls should be cleaner and tidier than boys” (79% at endline – 57% at baseline)
  • Boys should always defend themselves, even if it means a fight” (41% at endline – 26% at baseline)
  • Protection from unwanted pregnancy is the responsibility of girls only” (83% at endline – 61% at baseline)

Evaluation in Indonesia
Increased confidence
On a scale from 1 (I totally can’t do that) to 5 (I totally can do that) the average score for confidence among participants increased from 2.65 points to 3.29 in relation to the statement: “If someone wants to have sexual intimacy with me, I feel able to either say yes or no (depending on what I want)”.

Changed gender equal attitudes
On a 4-point scale (1= I strongly disagree – 4= I strongly agree), the average score for gender equal attitudes in relation to the item “boys should help with chores in the household” increased from 3.05 to 3.38.

Socio-emotional learning competencies
When young people were asked to think about the type of advice, on a scale from 1 (very unlikely) to 5 (very likely), they would give to a friend “finding hard to bring up the issue of condom use with his/her partner”, self-awareness and social-awareness both increased from 3 to 3.53, and from 3.23 and 3.78 respectively.

Mixed online experiences
The majority (93%) of respondents found the peer facilitators easy to reach for questions and 95% agreed that peer facilitators were able to create a comfortable atmosphere among participants during online sessions. Respondents did not have difficulties in using Zoom and WhatsApp: 88% reported easy access and use and no difficulties to open  educational materials used during the sessions. 70% reported convenient access to technical assistant. At contrary, online interaction was not easy for everyone. Also the length of the sessions was described as too long for 35% of respondents. Favorite topics mentioned by the respondents were: reflection on personal boundaries; body changes during puberty; gender equality; relationships; and general SRHR. Less attractive topics addressed were: contraception; pregnancy; STIs.

Overall, 93% would repeat the experience and 86% would recommend the digital Journey4Life to their friends.

Summary of findings

  • The majority of participants are from urban areas, which makes easier for them to access online content. In the future it is important to find ways to reach out also the most marginalized young people living in rural areas with limited availability of technology.
  • Overall, evaluations in Kazakhstan and Indonesia show that the digital Journey4Life contributes to some changes in knowledge, confidence, gender equal attitudes and socio emotional learning. Greater benefit of the digital Journey4Life appear to be on gender equality, in line with findings from the pilot of the face-to-face Journey4Life. This finding shows the potential of digital CSE to increase gender equality, something that needs to be further explored.
  • Some changes in socio-emotional learning competencies are also visible, and offer an additional outcome of digital CSE to be investigated in the future. However, changes still remain limited.
  • No changes in behaviours were detected. Restricted access to SRHR services and to physical relationships due to Covid-19 might have contributed to this result. An option – also useful after the pandemic- is to develop new behavioural indicators based on how sexuality takes place digitally.
  • There is a need to guarantee better safeguard of young people accessing digital CSE, and to make interaction more comfortable ensuring that information about privacy and confidentiality are shared with participants. Hopefully benefits of digital CSE can be added to ones of face-to-face CSE in a near future.

Covid-19 has required organizations to find alternative ways to deliver CSE. Dance4Life and its franchisees have responded proactively adapting the CSE component of the Empowerment Model – the face-face sexuality education curriculum Journey4Life – to the digital environment. Building on the available evidence, sessions have been co-created with young people, while the content and way of delivery have been based on needs assessment conducted in eight countries. Aware of the importance to offer insights to the CSE community, Dance4Life conducted pre-post evaluations of the prototype of the digital Journey4Life.

Dance4Life is planning to integrate all findings from the evaluations of this prototype into a final version of the digital Journey4Life, to pilot and evaluate in 2021. It also plans to work on a blended version combining face-to-face and digital sessions to empower young people to have healthy lives.

Here is the full report of the research findings, including the methodology chapter.