Qualitative Researcher, Gender and Adolescence: Global Evidence (GAGE), ODI, London, UK. Correspondence:
Research Associate, Oxford Department of International Development, University of Oxford, Oxford, UK.
Sex Reprod Health Matters. 2023 Dec;31(2):2195140. doi: 10.1080/26410397.2023.2195140.
Comprehensive sexuality education (CSE) seeks to improve young people's knowledge, attitudes and practices in relation to sexual and reproductive health, sexual and social relationships, and dignity and rights. In Ethiopia, young people with disabilities and young women involved in sex work are particularly vulnerable to sexual violence and poor sexual health, yet face stigma and accessibility challenges that continue to exclude them from information, support and services. Because they are often out of school, these groups are also often excluded from programmes that are largely delivered in school settings. This paper explores the challenges faced by these groups of young people in accessing inclusive and age-appropriate sexual and reproductive health knowledge and services in the Ethiopian context and the implications for delivering CSE. The research included literature review, mapping analysis and interviews with young people from those two groups and with service providers and programme implementers. Our findings indicate that young people with disabilities and young women involved in sex work face myriad barriers to accessing information and services that support positive and healthy sexuality, relationships and rights. However, changes over the past decade to national and regional governance structures and a political environment in which CSE has become increasingly contested have generated siloed approaches to the provision of sexual and reproductive health information and services, and poor linkages to complementary services including violence prevention and social protection. It is vital that efforts to implement comprehensive sexuality education are informed by these challenges in the wider policy environment.
全面性教育（CSE）旨在提高年轻人在性健康和生殖健康、性和社会关系以及尊严和权利方面的知识、态度和实践。在埃塞俄比亚，残疾青年和从事性工作的青年女性特别容易遭受性暴力和性健康不良的影响，但他们面临着耻辱和难以获得信息、支持和服务的挑战，这使他们继续被排除在信息、支持和服务之外。由于他们经常失学，这些群体也经常被排除在主要在学校环境中提供的方案之外。本文探讨了这些青年群体在埃塞俄比亚背景下获取包容性和适合年龄的性健康和生殖健康知识和服务所面临的挑战，以及提供 CSE 的影响。研究包括文献综述、绘图分析以及对这两个群体的年轻人、服务提供者和方案执行者的采访。我们的研究结果表明，残疾青年和从事性工作的青年女性在获取支持积极和健康的性行为、关系和权利的信息和服务方面面临着诸多障碍。然而，过去十年中，国家和区域治理结构的变化以及 CSE 日益受到争议的政治环境导致了提供性健康和生殖健康信息和服务的孤立方法，以及与包括预防暴力和社会保护在内的补充服务之间缺乏联系。在更广泛的政策环境中，了解这些挑战对于实施全面性教育的努力至关重要。
