UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Sexuality education within high school curriculum in Uganda : exploring teachers’ perceptions of contextual… Tushabomwe, Annette 2014

Your browser doesn't seem to have a PDF viewer, please download the PDF to view this item.

Item Metadata


24-ubc_2015_february_tushabomwe_annette.pdf [ 555.49kB ]
JSON: 24-1.0165559.json
JSON-LD: 24-1.0165559-ld.json
RDF/XML (Pretty): 24-1.0165559-rdf.xml
RDF/JSON: 24-1.0165559-rdf.json
Turtle: 24-1.0165559-turtle.txt
N-Triples: 24-1.0165559-rdf-ntriples.txt
Original Record: 24-1.0165559-source.json
Full Text

Full Text

SEXUALITY EDUCATION WITHIN HIGH SCHOOL CURRICULUM IN UGANDA: EXPLORING TEACHERS’ PERCEPTIONS OF CONTEXTUAL INFLUENCES ON CLASSROOM DISCOURSES    by  ANNETTE TUSHABOMWE B.Sc., Makerere University, 2000  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF  MASTER OF ARTS in The Faculty of Graduate and Postdoctoral Studies (Science Education)  THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver)   November 2014  © Annette Tushabomwe, 2014 Abstract This case study investigated teachers’ perceptions of contextual influences on their instruction and student engagement on sexuality discourses within four selected schools in Kampala, Uganda. The question that guided the study was: What and how are the contextual factors as perceived by health education teachers in Uganda influencing classroom discourses on sexuality? The research is grounded within two relevant theoretical frameworks; constructivism and the conceptual change theory (CCT). Constructivism acknowledges that individuals have preconceived notions rooted in their social, cultural and historical backgrounds, and CCT enables teachers to develop strategies that allow learners opportunities to reexamine their preconceptions about phenomena with a view of aligning them with canonical science. Through a narrative methodological approach, teachers narrated their stories based on their lived classroom experiences. Data sources included researcher’s field notes, e-mail correspondences, semi-structured questionnaires, and audio recordings of the teachers’ narratives. The data corpus was analyzed following intense dialogic analysis procedures, which encompassed elements of thematic and structural analytical methods as well as other broad interpretive dimensions such as how talk among speakers is dialogically produced. The findings revealed that while there is some form of sexuality education in schools and while teachers are very enthusiastic about its implementation, it is largely constrained by a plethora of contextual factors.  Four themes that best addressed the inquiry were identified: 1) Dilemmas around navigating conflicting social stances; 2) Competing dichotomies with regards to adolescent sex health provision; 3) Teachers’ inadequate training to play the envisioned roles as sexuality educators; and 4) Relegation of Sex Health Education (SHE) to extracurricular status undermines ii  its value and potential. The teachers therefore have a steep task to continue searching for appropriate pedagogical approaches to diffuse these dilemmas. This thesis provides a nuanced approach to understanding the practical realities and complexities involved in designing a framework for SHE delivery in schools, and also suggests various approaches teachers can employ to bring about meaningful learning.       iii  Preface This thesis is an original intellectual product of the author, Annette Tushabomwe. Two bodies approved conducting this research and made it official ─ the UBC Behavioural Ethics Review Board under #: H13-00285 and the Uganda National Council for Science and Technology, under registration #: SS 2993   iv  Table of Contents Abstract .......................................................................................................................................... ii Preface ......................................................................................................................................... iv Table of Contents ...........................................................................................................................v List of Tables .............................................................................................................................. viii List of Figures ............................................................................................................................... ix List of Abbreviations .....................................................................................................................x Acknowledgement ........................................................................................................................ xi Dedication ................................................................................................................................... xiii  Chapter 1: Background to the Research Study ..........................................................................1 1.1 Problem statement and its educational significance ....................................................... 2 1.2 Study context: Purpose and research questions .............................................................. 4 1.3 Sexuality within the Ugandan context ............................................................................ 5 1.3.1 History of sexual instruction ....................................................................................... 5 1.3.2 Sex health education in schools .................................................................................. 6 1.3.3 General trend of SHE efforts in Uganda ..................................................................... 6 1.4 Researcher background ................................................................................................... 7 1.5 Thesis contribution.......................................................................................................... 8 1.6 Overview of the thesis .................................................................................................... 9 1.7 Theoretical framework and literature review ................................................................ 10 1.7.1 Constructivism .......................................................................................................... 13 1.7.2 The conceptual change theory .................................................................................. 15 1.7.3 Adolescent SHE provision and access in secondary schools.................................... 16 Adolescent SHE provision ................................................................................ 16 School as a hub for SHE ................................................................................... 17 Understanding adolescent behaviour ................................................................ 19 1.7.4 Perceptions of teachers and students on SHE provided in schools ........................... 20 General perceptions around sex health education ............................................. 21 Perceptions around the nature of the current sex education ............................. 22 1.7.5 Summary of perceptions on adolescent SHE provision and access in schools ......... 24 1.7.6 Significance of constructivism, CCM and perceptions in science teaching and learning ..................................................................................................................... 25 1.7.7 Self-reflexive praxis as a tool for conceptual change ............................................... 27 1.7.8 Summary of the chapter ............................................................................................ 29  Chapter 2: Methodology and Research Design .........................................................................30 2.1 Rationale for narrative inquiry ...................................................................................... 30 2.2 Research context and participants ................................................................................. 31 v  2.2.1 Sampling and choice of participants ......................................................................... 32 2.3 Interview process and data collection ........................................................................... 33 2.3.1 Interviews .................................................................................................................. 33 2.3.2 Transcription ............................................................................................................. 35 2.3.3 Data analysis ............................................................................................................. 36 2.3.4 Presentation of results ............................................................................................... 38 2.4 Validity of the study...................................................................................................... 38 2.5 Limitations .................................................................................................................... 43 2.6 Summary of the chapter ................................................................................................ 44  Chapter 3: Data Analysis, Findings and Interpretation...........................................................46 3.1 Teachers’ biographies and schools’ demographics ....................................................... 46 3.2 Emergent themes from the inquiry ............................................................................... 50 3.2.1 Dilemmas around navigating conflicting social stances ........................................... 50 The clash between religious leanings and SHE ................................................ 51 Managing interactions between acceptable cultural norms and adolescent-formulated cultural norms” ............................................................................... 53 The influence of media and technology on students from high social economic backgrounds ...................................................................................................... 56 Summary of the theme: Conflicting social stances ........................................... 61 3.2.2 Competing dichotomies with regards to adolescent sex health education ................ 61 Condom use versus abstinence ......................................................................... 62 African culture versus Western influence ......................................................... 68 Summary of the theme: Competing dichotomies with regards to adolescent sex health education ................................................................................................ 71 3.2.3 Teacher’s inadequate training to play the envisioned role of sexuality educators ... 71 Training around collaboration with parents ...................................................... 72 Training around working with adolescents ....................................................... 74 Summary of theme: Teachers’ preparedness to handle sexuality discourses ... 76 3.2.4 Relegation of sexual health education to extracurricular status undermines its value and potential .............................................................................................................. 77 3.3 Conclusion of chapter three .......................................................................................... 80  Chapter 4: Discussion of Results ................................................................................................82 4.1 The efficacy of sex health education in schools ........................................................... 83 4.2 Effectiveness of the current SHE framework at meeting adolescents’ needs ............... 84 4.2.1 A critical look at the teachers’ role in fueling distrust from their students ............... 88 Controversy around sex and condom use ......................................................... 90 Dilemmas around dressing and hygiene ........................................................... 95 4.2.2 Beyond teachers’ instruction and the school perimeters........................................... 97 vi  Chapter 5: Conclusions, Implications and Recommendations ..............................................100 5.1 Implications................................................................................................................. 102 5.1.1 Implications for sex health education ..................................................................... 102 The teacher ...................................................................................................... 103 The approach ................................................................................................... 104 5.1.2 Implications for sex health education curriculum design ....................................... 106 Critical consideration of context ..................................................................... 106 Sex health education curriculum as a tool to dispel the dichotomies ............. 107 Consideration of all social economic backgrounds on sexuality .................... 107 5.1.3 Implications for policy ............................................................................................ 108 The need for clear policies around sexuality discourses ................................. 108 Teachers should be given autonomy over their practice ................................. 109 Gender particularly problematizing marginalization of girls .......................... 109 5.2 Recommendations ....................................................................................................... 111 5.2.1 Sensitization of the population about the relationship between comprehensive SHE and promiscuity ....................................................................................................... 112 5.2.2 Inclusion of SHE education within the formal curriculum ..................................... 112 5.2.3 Suggestions for further research ............................................................................. 113  References ...................................................................................................................................115  Appendices ..................................................................................................................................129   vii  List of Tables Table 1. Demographics of the research participants and the respective schools .......................... 32 Table 2. Phases of thematic analysis............................................................................................. 37 viii  List of Figures  Figure 1. Transcription key ........................................................................................................... 36   ix  List of Abbreviations ABC Abstinence, Be Faithful and Use Condoms AIDS  Acquired Immune Deficiency Syndrome  CCM  Conceptual Change Model CCT Conceptual Change Theory CRE  HIV Christian Religious Education  Human Immunodeficiency Virus  NAEA National Abstinence Education Association PIASCY Presidential Initiative on AIDS Strategy for Communication to Youth SHE Sex Health Education STDs Sexually Transmitted Diseases STIs Sexually Transmitted Infections UNAIDS Joint United Nations Programme on HIV/AIDS. UNESCO  United Nations Educational, Scientific and Cultural Organization UNFPA United Nations Fund for Population Activities WHO World Health Organization     x  Acknowledgement I am thankful to God who has blessed me with an abundance of life, filled with good health, without which this thesis would be none existent. I am grateful to the amazing team of professors, for the way they have enriched my experiences at UBC and made them memorable. I am forever indebted to my supervisor, Dr. Samson Nashon, not only were you a supervisor, who helped me conceptualize and refine the study- but you also took on the role of a dad, guiding me and paying close attention to my various needs as a student. Thank you.  To the rest of the committee members, thank you for taking time to read and critique this study. Dr. Sandra Scott, I could not have done this without your motherly care and your professional critique. I also owe great thanks to the faculty for of education and the Faculty of Graduate studies for providing me with the financial support, both during the entire course of the program and for travelling to Uganda to conduct the research.  Special thanks to my different colleagues whose commitment, insights, and knowledge made this project possible. The teachers I interviewed in Uganda, thank you for sharing your time, your expertise with me, and for particularly challenging me to reconsider my preconceived notions about the discourse. I am forever grateful to the friendships I have made during the course of my study. To my friends and colleagues, Ozlem and Robyn, thanks for the countless hours you took to proof read and provide provoking questions and critic in this thesis and the entire course. To the Sakuhuni and Diana families, for the immense support particularly for providing alternative homes for our children. Sister Elizabeth, thank you for your unwavering support. To all my countless friends around the world, thank you for being my inspiration.  My big family in Uganda, I could have never done this without your support! To my parents, thanks for giving me the sharp brains and for providing for me in every aspect you could xi  afford. To my siblings and your families, thank you for the joys and laughters we share. Juliet, you have always been there for us, providing for us, thank you. To my husband’s family, dad and mom, sisters and brothers, thank you. To uncle Fred and your family, your acts of kindness will forever be remembered. To my white Ugandan family, the Westerman’s, thank you for the timely financial support. You are all cherished.   Finally, to my Vancouver family, I extend my eternal appreciation to you all. To my sweet bundles of Joy; Shawn, Asher, and Jesse, I could never ask for better bunnies.  Although I took time from you, you never complained. Instead, you rewarded me with hugs, giggles and smiles, which I so much needed to endure the hardships. I love you to the moon. To my dear husband, Esau, you should be awarded a degree of masters of Science Education. Thank you for making it possible for me to undertake this venture that has forever changed both our lives.  Through your meticulous critical eye, you read and critiqued every piece of work I did, thank you. The way you managed to juggle family life, provide the needed financial stability, share responsibilities, and yet your own plate was full as you hassled with your PhD, make you one unmatched human being. For that, you are my “superman”. To my two beautiful sisters (whom I never met until I came Vancouver) Jalia and Gertrude, no words can express how grateful I am for your support. Not many people have seen me cry, but when the course became overwhelming, you were there proving your shoulders, and the cherished sisterly hugs. Jalia, right from the beginning, you encouraged me, motivated me, walked every step with me, believed in me, guided me through the entire application process, and for that I am eternally grateful. Gertrude, you are that sister, who was there, every time I needed a sister hug, and provided me that “big” sister advice and counsel as a “ssenga”. Big thanks to you and your family. e xii  Dedication This thesis is dedicated to the two most beautiful and important women in my life: To the loving memory of our daughter, Audrey Ttendo Ahuhaire Arinaitwe. Thank you for always reminding me to live as if there is no tomorrow, and yet to embrace the unknown mystery of the future.  and  To my mom, Beatrice N. Nyakayumbu. I can never find words to express how thankful I am that you are my mother. Though you did not have much of an education yourself, through thick and thin, you strove to educate us all.  xiii  Chapter 1: Background to the Research Study Sexuality has long been associated with controversy and there seems to be unending debates among parents, teachers, and health practitioners pertaining to the provision of sexuality education in schools (Cavanagh, 2011; Lesko, 2010; WHO, 2011). This study adopts definitions of sexuality and sexuality education from WHO and UNESCO respectively.  Sexuality1 is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.” It is  “…. influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors. (WHO, 2006, p.5).  For the purposes of this study sexuality education is defined as an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgemental information. Sexuality education provides opportunities to explore one’s own values and attitudes and to build decision-making, communication and risk reduction skills about many aspects of sexuality (UNESCO, 2009).  In many communities in Uganda, for example, religious and cultural norms have for a long time stifled open and frank discussions around sexuality and in fact, any discourses related to this matter are considered taboo and immoral (Muhanguzi, 2011; Muyinda, Nakuya, Whitworth, & Pool, 2004). These complexities and ambiguities are further fueled by the diverse perceptions and preconceived notions that individuals hold on how to navigate the discourse. While there are many players involved, including parents, teachers, students, policy makers, 1 For this study, the terms sex, sexual, sexuality, sex health, sexual health, and sex health education are used interchangeably. The discussions are ultimately tailored to fit the Ugandan context where the research was carried out.    1                                                   curriculum designers, religious bodies and many more, this thesis focuses on the teachers, who are the key implementers of this form of education within secondary schools in Uganda. 1.1 Problem statement and its educational significance It is now a widely acknowledged view that individuals approach a teaching and learning environment with their perceptions of what it means to teach and learn, and that these preconceived notions influence teaching and learning in profound ways (Ausubel, 1963; Driver, Asoko, Leach, Mortimer, & Scott, 1994; Nashon, 2013). In Uganda for example, numerous studies have elucidated the influence of individual perceptions on sexuality and the provision of adolescent sex health education, although this extant literature largely concentrates on the social and economic impacts of HIV/AIDS. Of the few studies that have not concentrated solely on HIV/AIDS, a scarcity of research has investigated teachers’ perceptions of Sex Health Education (SHE) on their instruction and student engagement within the Ugandan context. Although the available literature is undeniably invaluable in articulating the challenges encountered, in most cases, such an exclusion underplays the fact that understanding teachers’ perceptions is critical to arriving at workable mitigation and intervention strategies. This is because teachers are the frontline implementers of this form of education in schools. Historically, teachers have held a passive voice in the whirlwind of educational research and theory (Gitlin et al., 1992), and often times they have been reduced to the “status of high-level technicians carrying out dictates and objectives decided by experts far removed from the realities of classroom life” (Giroux, 1988, p. 121). Moreover, literature reveals that most models used in Uganda, such as The World Starts With Me (Rijsdijk et al., 2011), do not fully address the specific cultural contexts of the schools in which they are implemented.  Yet, to be effective, a discourse such as sexuality must be context based and culture sensitive (UNESCO, 2010; 2  WHO, 2011) which can be achieved by involving the teachers who are central to the discipline. Furthermore, existing research has frequently employed structured interviews. Ultimately, the voices of teachers are lost due to the tendency to position them as objects of study who simply answer pre-determined questions (Connelly & Clandinin, 1990).  It is this void, the missing voice of the teacher, which compelled me to investigate teachers’ perceptions of the contextual influences on instruction and student engagement. My study employed narrative methodology with the aim to provide secondary school sexual health education teachers in Uganda with a voice. A voice which according to Biley and Holloway (2011) “encompasses the spoken word, the written text, and other types of expression” (p. 972). Through this approach, teachers narrated their stories based on their lived classroom experiences. This study is very timely since questions are now being raised about Uganda’s strategy for spearheading the fight against the spread of HIV/AIDS. The fact that the HIV/AIDS occurrence rates have steadily increased from 6.4% in 2006 to 7.2% in 2012 (UNAIDS, 2012), and that risky sexual behaviours and negative sexual health outcomes among youths are becoming more prevalent (Kagolo & Alinda, 2012; UBOS, 2007, 2012) makes this research timely. A report by the Population Reference Bureau (PRB, 2012) using data from the 2005 – 2012 Uganda Demographic Health Surveys highlighted the magnitude of the problem. The report showed that adolescents are sexually active at a young age, and that early childbearing and child marriage in adolescents were some of the areas that needed urgent attention.  Given that sex health education teachers are the primary sources of information for youths in schools, it was important to investigate their perceptions of the contextual influences on their instruction and student engagement. This research serves as a case study (Riessman, 2008) for wider questions pertaining to adolescent sex health education provision in schools in 3  Uganda. Invariably, the questions raised here and the solutions proposed (although they might differ contextually) largely remain relevant to the way adolescent sex health education is considered in Uganda and elsewhere. 1.2 Study context: Purpose and research questions This study took place in four high socio economic schools in Kampala, Uganda. All the schools received government aid, and students resided at the schools. Based on Uganda’s National Examination grading system, the participating schools were among the best in the country. A total of six teachers who engaged with the discipline of sex health education in varying capacities were interviewed. Details of the teachers’ biographies, school demographics, and criteria behind their selection are discussed in section 3.1.  This study specifically investigated teachers’ perceptions of contextual influences on sexuality discourses and how these perceptions influence their instruction and student engagement. To do so, the study was guided by the following research question: What and how are the contextual factors as perceived by health education teachers in Uganda influencing classroom discourses on sexuality? Specifically, three sub-questions guided the study:  1) What contextual factors do health education teachers in Uganda perceive as influencing sexuality discourses within the secondary school curriculum?  2) In what ways do teachers perceive these contextual factors influencing classroom sexuality discourses?  3) How do teachers perceive sexuality discourses within the curriculum implicating student’s sexual behaviour after their engagement? 4  1.3 Sexuality within the Ugandan context   1.3.1 History of sexual instruction In East African countries, matters of sexual instruction were traditionally “in the hands of “grannies”2 who imparted practical knowledge of sexual practices, family responsibilities, and domestic skills in the cultural experience of visiting the forest” (Kilbride & Kilbride, 1990, p. 174). In many Ugandan communities, informal sessions were delivered to girls by older women (often maternal aunts) commonly known as Ssengas, and to boys by uncles commonly known as Kojas (Kiapi-Iwa & Hart, 2004; Muyinda et al., 2004). These sessions were often held in the private spheres of homes. Marriages were prearranged by parents and modern courtship practices such as the betrothed couple getting acquainted with each other, was unknown. In fact, sexual purity before marriage was expected from youths, particularly girls, and those who were not faced harsh punishments, including death. Over time, with modern practices, globalization, commercialization of the Ssenga institution, and the erosion of the traditional family unit, many traditional belief systems were condemned by various activists (Kilbride & Kilbride, 1990). Ultimately, most of the traditions outlined above have been abandoned although clear alternative avenues to teach sexuality matters and model behaviour have not been offered. This could possibly explain why the HIV/AIDS pandemic affected Uganda so adversely in the early 1980’s (Serwadda et al., 1985) which caused all concerned bodies, including governments to reconsider the way sexuality was viewed. The strategies that were being employed, for example openly discussing sexuality matters, were characterized as taboo and immoral and could not tackle the scourge of the pandemic. As part of the solution to the crisis, the government of Uganda 2 Grannies in this context refers to more knowledgeable members of the society in sexual matters, including aunties, uncles and other friends.  5                                                   mandated that the discourse be openly discussed in public spheres such as open rallies and that reproductive health and HIV/AIDS be introduced in the formal education in order to reach out to the youths (Opio et al., 2008). This strategy was largely responsible for the dramatic reduction in HIV/AIDS incidence rates in the 1990’s (UNAIDS, 2004).  1.3.2 Sex health education in schools As discussed in the above section, the AIDS pandemic altered the way sex education was viewed and provided in many areas of Uganda, including schools. An HIV/AIDS education control program was set up in 1987 (Hooper, 1990) and subsequently, in 2002, the President of Uganda mandated that sex health education be included within the school curriculum under the Presidential Initiative on AIDS Strategy for Communication to Youth [PIASY] (Mudege & Undie, 2009; Ndawula & Nakawuki, 2010). Today, selected sex health topics are incorporated into subjects such as biology, religious studies, and in other extracurricular activities (Mirembe, 2002). The framework mainly employed is ABC (Abstinence, Be Faithful, and Use Condoms), although abstinence until marriage is the main approach emphasized for youth. Even then, stakeholders still struggle with their perceptions around the appropriate sex health education for youth. Some, including teachers, still hold the view that the “less they [students] know, the better” (Cohen & Tate, 2006). Therefore, since studies show that individuals hold varying views around various phenomena, and that these views affect teaching and learning (Ausubel, 1963; Bodner, 1986; Driver et al., 1994), it was pertinent to investigate teachers’ perceptions since they are key implementers of sex health programs in schools. 1.3.3 General trend of SHE efforts in Uganda When the campaigns against HIV/AIDS started around 1987, Uganda experienced a drastic decline in the HIV prevalence rates from a steep 30% to 6.2 % in 2005 (Slutkin et al., 6  2006). In fact, Uganda was lauded as one of the few African countries to have successfully found a working framework, which could potentially be implemented in other countries (UNAIDS, 1998). This decline in the prevalence rates of HIV/AIDS was mainly attributed to the multi-sectoral education approach, an aggressive integrated intervention strategy that brought everyone on board (religious leaders, politicians, the government, medical experts among others) to confront the scourge (Allen & Heald, 2004).   Today, the prevalence rates of HIV/AIDS stand at 7.2 % (UNAIDS, 2012), higher than the 2005 rate! Several theories have been advanced to explain this increasing trend including involvement in unsafe sexual behaviours. For instance, the recent Uganda AIDS Indicator Survey 2011 indicate that almost three quarters of Ugandan teenagers aged between 15 and 19 years are engaging in higher risk sex with minimal condom use (Kagolo & Alinda, 2012). The situation is even more alarming in slum areas as revealed in a study conducted between March and April 2014 by Uganda Youth Development Link (UYDL). This study indicated that most youths do not use condoms during their first sexual encounter hence the prevalence rate in this cohort (10.3%) is much higher than the average prevalence rate of 7.2% (Agaba, 2014). The fact that youths are sexually active and still engage in risky sexual behaviours despite the different approaches employed calls for an analysis of the factors leading to such risky behaviours with the aim of reversing trends.  1.4 Researcher background I conducted this research as both an “insider” and an “outsider”. As Aoki (1993) states, in this research, I see with double vision. As a student and later as a science educator in Uganda, I experienced firsthand the uncertainties surrounding sexual health education and how they can result in negative sexual health outcomes particularly among the girls. I have served in many 7  schools in different capacities including being a housemistress, a biology teacher, and a senior woman teacher. In these roles, I observed the challenges and struggles teachers encounter in their efforts to provide adequate sex health education to adolescents. Recently, as an intern from UBC, I volunteered with TASO (The Aids Support Organization), one of the leading grass-root organizations spearheading the fight against HIV/AIDS in Uganda. This experience further enhanced my understanding of sexuality within the Ugandan context and the various compounding factors. Conversely, living and studying in Canada has also shaped the way I view sexuality as a health education topic. Particularly, my work with Battered Women Services, an organization that fights violence against women, enabled me to acquire different perspectives through which I view sexuality in relationships. These experiences position me as an outsider to the Ugandan context.  I was aware that with this background I could impact the research.  I therefore took the position of a naïve inquirer (Biley & Holloway, 2011; Morrow, 2005) where my main goal was to listen and give the participants the opportunity to tell their stories without interrupting. In addition, I was self-reflexive through the entire process, constantly interrogating my internal conversations, opinions, and how I might possibly impact the research (Kerby, 1991; Tracy, 2010).  1.5 Thesis contribution Although this was a case study and generalizability may not be claimed from the results due to several compounding factors such as the small number of participants and the multiple possibilities of constructing and representing different stories (Fraser, 2004), the detailed narratives provide critical context baseline knowledge upon which further inquiry can be built. As Riessman (2008) asserts, “Cases can uncover social practices that are taken for granted……., 8  “close in” on everyday situations and test how something occurs in social life. The advantage here is depth rather than breadth.….. (the little things”)”. (p. 194) This research therefore provides an in-depth understanding of the socio-cultural construction of sexuality through analysis within the specific cultural context of Uganda and a particular group: teachers. Such an inquiry is important when exploring avenues of positively influencing sexual behaviour of youths in secondary schools. By analyzing these narratives, this thesis provides a nuanced approach to understanding the practical realities and complexities involved in designing a framework for SHE delivery. Ultimately, the importance of this thesis extends beyond teachers’ perceptions and lends itself well to the analysis of sexuality discourses in Uganda and elsewhere. This research explored the limits of sexuality education, and how these limits enable us as educators to understand some of the problems faced by the sexuality discourse worldwide. In addition, this research elucidated some of the strengths of the current sexual health education offered in schools from which educators can draw to make and propose informed solutions to counteract the negative sexual health outcomes. Therefore, this thesis contributes an important perspective to the growing body of knowledge on sexuality education.  1.6 Overview of the thesis The thesis has five chapters. Chapter 1 provides the background to the study and establishes the theoretical base for analyzing issues raised. Social constructivism, the principal theory guiding the thesis is discussed. This theory is pertinent to a discourse such as sexuality since it emphasizes that individuals approach the learning environment with their preconceived notions, and that this prior knowledge influences the teaching and learning process (Ausubel, 1963; Kelly, 1955; Mathews, 1994). Furthermore, social constructivism showcases that learning is influenced by the social and cultural environments in which an individual resides, which are 9  key tenets of sexuality. Conceptual change theory, which is useful in interrogating what causes learners to reconsider and transform preconceived notions that are inconsistent with the widely acceptable ones, is also discussed. The complementarity of these two theories guides the analysis in the thesis. Several studies around SHE provision in Uganda and elsewhere are discussed.   Chapter 2 is the methodology chapter and provides a detailed description of the proceedings of the study, clearly explicating why and how certain procedures and decisions were adopted over the others. Ethical clearance procedures, site of the study, and methods of data collection are discussed. This leads to Chapter 3, which presents the results of the study. Specifically, results are presented as four main themes which best address the research question: What and how are the contextual factors as perceived by sex health education teachers in Uganda influencing classroom discourses on sexuality. Chapter 4 critically analyzes teachers’ narratives through the lens of science teaching, specifically scrutinizing and articulating what it means for teachers to teach sexuality and how various contextual factors enrich or undermine the discourse. Finally, because this thesis has the potential to bring a fresh perspective to the discourse, Chapter 5 focuses on the implications for theory, curriculum, and research. The chapter further delves in recommendations for the way forward, and proposes changes to the ways teachers handle the discourse of SHE in schools. The final chapter ends with a conclusion which raises one main question for future inquiry: “What will it take for SHE to be streamlined?” 1.7 Theoretical framework and literature review This study was about the very complex issue of adolescent sexuality. It specifically investigated teachers’ perceptions, which are also varied and complex. Therefore, in this chapter I attempt to establish a theoretical framework that speaks to a complex issue, SHE, by representing the diverse needs of many stakeholders. The framework serves three main purposes: 10  1.  To establish an epistemological background in which the research was framed; 2. To justify theoretical support for the study, problematizing the hegemony that has historically constrained the SHE discourse, and; 3. To construct a possible framework for sex health education in secondary schools in Uganda.  Constructivism was chosen as the main theory upon which the study was framed. This theory was selected because of the emphasis on the effects of individual, social, cultural and historical backgrounds on teaching and learning (Ausubel, 1963; Bodner, 1986; Driver et al., 1994; Kelly, 1955; Mathews, 1994). Driver et al. assert that teachers often bring their prior conceptions about teaching to learning situations, and these do influence the way teachers interact within the classroom. Nashon (2013) further contends that teachers’ prior perceptions of what it means to teach quite often interfere with their teaching and calls upon science teachers to “always seek awareness of how students’ learning can influence them to be innovative about strategies that can influence their effective teaching” (p. 227). This is not a simple task and authors like Claxton (1993) point to the deeper challenges faced by school teachers and allude to the belief that their role to prepare young people for the world, regardless of their academic abilities, can be daunting.  Because literature about children’s learning posits that learning occurs only when newly acquired information is tied to previously gained understanding (Driver et al., 1994; Johnson & Gott, 1996; Henson, 2010), a theory which considers teachers’ and students’ prior experiences was deemed invaluable. Mathews (1994) contends that such a theory should steer “a path between teacher-dominated instruction, the traditional didactic model of education, and the student-led discovery learning, the progressive model of education” (p. 147). Moreover, for a 11  concept such as sexuality, where individuals’ worldviews depend on their cultural, historical, and social contexts, a theory such as constructivism provides an appropriate framework for teachers to understand how to deal with the preconceived notions and ultimately initiate students into the discipline’s (science’s) subculture.   Constructivism is complemented by the conceptual change theory (Posner, Strike, Hewson, & Gertzog, 1982) as this theory provides insight into how to devise strategies to manage dilemmas encountered during teaching and learning. Because one of the aims of teaching science is to offer learners experiences where previously gained understandings are weighed against canonical ones (Aikenhead, 1996; Hodson & Hodson, 1998b), the Conceptual Change Model (CCM) was deemed appropriate and complementary to the constructivist perspective. The CCM enables teachers to develop a conscious understanding of what it entails to bring about change in behaviour; a fact which is usually underplayed during instruction. This is particularly important with the realization that there are often discrepancies between students’ constructed frames of reference and the teachers’ intended frames (Johnson & Gott, 1996). Thus there is the need to seek models such as the CCM to address the underlying causes of such discrepancies.   In the subsequent sections therefore, a detailed discussion of constructivism and the Conceptual Change Model will be provided. Specifically, studies around worldviews, particularly how teachers and students come to know what they know and the effects of this prior knowledge on teaching and learning in the context of sexuality and adolescent health will be drawn upon. Implications for curriculum design and instruction will be also be discussed. 12  1.7.1  Constructivism Constructivism as a learning theory refers to the psychological (cognitive) processes and structures at the individual level that influence the way knowledge is constructed within the individual’s social, cultural, and historical contexts (Bodner, 1986; Driver, 1983; Johnson & Gott, 1996; Kelly, 1955; Mathews, 1994). In other words, the constructivist theory views learning to be constructed by individuals depending on their cognitive processes, their worldviews, and the ways they perceive various phenomena. This study mainly hinges upon Piaget’s and Vygotsky’s understanding of constructivism as discussed in Mathews (1994). Piaget based his theories primarily on cognitive abilities which stressed the biological and psychological mechanisms found in the individual learner that influence the way they learn. Piaget’s cognitive constructivism is objective in nature and assumes some bottom-line realities such as existing cognitive processes upon which the individual constructs knowledge (Phillips, 1995).  Vygotsky’s (1978; 1986) social constructivism focuses more on the social nature of learning, and the manner in which human beings construct and internalize knowledge. Vygotsky specifically stresses the importance of language as a prerequisite for cognitive construction as he argues that the human mind is influenced by social, cultural, and historical environments, and that knowledge is socially constructed and mediated. Vygotsky claims that there is an intimate relationship between human beings and their environment, and this relationship is central to the manner in which knowledge is both transferred and constructed. Learning is considered to be a social construction of knowledge where individuals engage in a dialogue about shared problems where more skilled members of a culture initiate less experienced ones into the shared culture (Driver et al., 1994).  13  Johnson (2003) ties together Piaget’s and Vygotsky’s constructivism and emphasizes that knowledge is constructed by drawing upon earlier experiences as the foundation within an interactive and interdependent environment which results in growth of the individual and social environment. Similar to Vygotsky, Johnson argues that an individual's interaction within a social milieu transforms both the individual and the milieu. Yet, this depends on the individual’s cognitive abilities. This assertion is consistent with Piaget’s emphasis on cognitive abilities.  In light of this, although Piaget focused more on cognitive abilities and Vygotsky concentrated primarily on the social context and the involvement of more experienced members of a culture, both theorists have influenced the teaching and learning of science. Indeed, given the overwhelming literature in support of the belief that children have cognitive structures upon which they construct knowledge (Bodner, 1986; Driver et al., 1994; Mathews, 1994) and that learning is a social process where children are acculturated through effective, meaningful, and systematized instruction (Ausubel, 1963; Nashon & Anderson, 2012), the constructivist theory was found to be unparalleled as a foundational theory for this study. Moreover, due to the “social” nature of sexuality, social constructivism underscores the role of various social factors and group collaboration in the construction of knowledge which are vital for the discourse. In the next section, the Conceptual Change Theory (CCT) will be discussed. As presented in the above section, learners possess cognitive frameworks upon which they actively construct new knowledge. Therefore, a theory such as CCT provides an understanding of these conceptions and merits discussion. Such a discussion is useful in comparing the learners’ conceptions with canonically correct ones and devising instructional strategies to enable them to reconstruct conceptions that might be inconsistent with widely accepted worldviews. 14  1.7.2 The conceptual change theory Conceptual Change Model has been proposed in science education literature as a viable teaching learning tool (Posner et al., 1982; Thorley & Stofflet, 1996) that can enable teachers plan instruction for meaningful learning that ensures “students … master … scientific concepts and principles which are … useful to every individual living in modern society” (Sequeira & Leite, 1991, p. 45). As discussed in the preceding section, constructivism acknowledges that individuals have prior experiences which they bring to the learning environment, and because some of this prior knowledge is often at variance with canonically-correct scientific ideas, which some authors have referred to as misconceptions or alternative frameworks (Clement, 1993; Driver & Erickson, 1983), the CCM enables learners to abandon or evaluate these un-canonical ideas in favour of canonically correct ones.   The Conceptual Change Theory evolved to address dilemmas involving learning theories emanating from Piaget's theory of cognitive development and from the Alternative Conceptual Frameworks (ACF) (Stinner & Williams, 1993), among others. According to Stinner and Williams, Piaget’s claim that students fail to comprehend concepts due to undeveloped cognitive structures, and the ACF’s assertion that learners abandon misconceptions if they are led to confront them and reconstruct their own knowledge are insufficient. These assertions are attested to in the science education literature, especially considering the complexities of attempting to bring about conceptual change with the nuance that teaching and learning are not synonymous. Teachers can teach and teach really well but that does not necessarily mean that students learn what they have been taught (Herron & Eubanks, 1996). It is against this background that the model has been revised and explained in various ways by different authors of which Posner et 15  al.’s model (1982) is part. Posner et al.’s model (1982) presents four main prerequisites which must be fulfilled before accommodating new ideas:  1. Dissatisfaction with existing concepts must be present (cognitive dissonance),  2. A new conception must be intelligible, 3. A new conception must appear initially plausible, and 4. A new concept should suggest the possibility of a fruitful program (p. 14).  According to this model, students become dissatisfied with their prior knowledge (cognitive dissonance) because a new concept provides alternatives which are more viable in explaining the scientific concept (intelligibility). In turn, the alternative concept must fit with the prior conceptions for the student to find them reasonable (plausible). Lastly, the new concept must be meaningful for the learner and should be seen to solve future problems and open up new areas of inquiry (fruitfulness). The model acknowledges that oftentimes, learners resist the desired change and hold on to their preconceived notions. Therefore, this calls for negotiations especially around socio-cultural conceptions during the teaching and learning process to enhance the conceptual change. Insights into this model therefore provided a framework for analyzing how students can be led to reconsider their frames of reference in favour of meaningful ones.  In the next section, literature around adolescent health provision and access and the various contextual influences which affect the discourse will be provided.  1.7.3 Adolescent SHE provision and access in secondary schools Adolescent SHE provision Research around adolescent sex health provision and sexuality in general is reported in the literature (Blake, Ledsky, Goodenow, & O'Donnell, 2001; Cavanagh, 2011; Levesque, 2003; 16  UNAIDS, 2004; UNESCO, 2010; WHO, 2011). Generally, these studies depict an overwhelming support for the importance of school-based sexuality education in assisting students to develop attitudes, knowledge and behaviours critical for the prevention of negative sexual health outcomes. A growing list of studies (Naidoo, Wills, & Royal College of Nursing, 1998; Phillips & Martinez, 2010; Rijsdijk et al., 2011) allude to the position that school based sex health education provision encourages young people to adopt healthy life styles at an early age which then prepares them for opportunities, responsibilities, and adult life experiences. However, to be effective, sex health education must be age-appropriate, scientifically accurate, culturally sensitive, and locally-adaptable (UNESCO, 2010). Moreover, programs should be geared towards harnessing social skills that protect youth from negative sexual health outcomes (WHO, 2011).  In Uganda, Rijsdijk et al. (2011) carried out a multilevel evaluation study to assess the efficacy of World Starts With Me (WSWM), a computer based comprehensive sex education offered by various clubs in some secondary schools, on the socio-cognitive determinants of safe sex behaviour among youths. The study revealed significant positive effects of sex education particularly for those schools which modified the program to suit their specific contexts. Sex health education is therefore viewed as an important aspect of adolescent education. School as a hub for SHE Regarding secondary school as a hub for SHE, several authors argued that indeed, school is the appropriate setting for sex health education for a number of reasons. Purpel and Ryan (1976) argued that it is inconceivable for schools to take a child for such a significant period of time in their life span and not focus on their moral lives. In Uganda, with the introduction of universal secondary education, a large population of adolescents attend secondary schools for a 17  considerable number of years. Moreover, most are boarding schools, which implies that students reside there for about nine out of 12 months of the year. These schools become a “long term home” for the students. Furthermore, the literature reveals that most parents in general do not discuss sexual matters with their children (Diiorio, Pluhar, & Belcher, 2003) making the school environment, with its teachers, an ideal place for delivering properly planned programmes. However, despite the strong support for sex health education in secondary schools, two debates have emerged around the kind of SHE that is appropriate for adolescents. The options are: those in favour of abstinence only (Kay & Ashley, 2008; Hymowitz, 2003; Kirby, 2002; NAEA, 2013; Rector, 2002) and those in support of comprehensive sex health education (Center for Advancing Health, 2007; Morin, Collins, Alagiri, & Summers, 2002; Stanger-Hall & Hall, 2011). Those in support of abstinence-only maintain that abstinence is the only sure way of preventing the negative sexual health outcomes and assert that teaching practices such as condom use promotes premature sexual activity. Proponents of comprehensive education assert that abstinence-only programs have historically failed to protect the youth and argue that these programmes are very risky, and it is delusional to imagine that adolescents can abstain. In fact, Stanger-Hall and Hall (2011) contend that in the United States of America the increasing emphasis on abstinence education is positively correlated with high teenage pregnancy rates. They pose the following profound question, which is relevant for research in adolescent sex health education: “If teens don’t learn about human reproduction, including safe sexual health practices to prevent unintended pregnancies and STDs, and how to plan their reproductive adult life in school, then when should they learn it, and from whom?” (p. 10).  The controversy and discomfort associated with the adolescent sex health education, that is what to teach, to what age 18  group, and in what detail, is real (Buston, Wight, & Scott, 2001;Crooks & Baur, 1983; Lesko, 2010). The result is that most health educators are confused about how to manage discourse.  In the next section of this chapter, I will focus on literature aimed at understanding adolescents. Although adolescents were not the primary subjects of my study, they are accorded diligent attention in this literature review because of their role in shaping teacher instruction and secondary school education. Understanding adolescent behaviour Because my study investigated secondary school teachers’ perceptions on sexuality discourse, literature on adolescents, who are the primary beneficiaries, was deemed necessary. As I alluded to in section 1.8, teachers are called upon to pay attention to students’ learning to devise effective pedagogical methodologies (Nashon, 2013). These can be provided by understanding adolescent behaviour which assists educators in discovering different factors and typical adolescence stages that influence teaching and learning. Fontana (1995) argues that this understanding of adolescent development is invaluable in helping professionals become effective communicators with young people. Adolescents3 are young people who are in the 12-24 years age bracket (Siegel, 2013), an unpleasant time for this age group because of the many physical, intellectual, psychosocial, and emotional changes they experience (Meece, 1997). While in this age bracket, many youths engage in risky, socially disruptive, and health-endangering behaviour (Steinberg, 2004). Siegel argues that at this age, most youth attain puberty, and their sexual desire begins to manifest, although they experience confusion regarding sexual relationships. In agreement with constructivist approaches, adolescent behaviour does not develop in a vacuum. 3  In this study the terms adolescents, youths, young people, teenagers are used interchangeably to denote secondary school students. 19                                                   Rather it is a result of the cultural and social environment within which an individual resides (Meece, 1997). Meece argues that adolescent sexuality is influenced by taboos, cultural beliefs, religious backgrounds, and other kinds of social norms. Several strategies such as Santrock’s (2001) theory have been advanced around teaching adolescents. Santrock asserts that when provided with clear rules to guide them, and when rewarded for complying with the rules, adolescents are more likely to exhibit morally acceptable behaviour. However, Hall (1904) argues that adolescence is a period of “storm and stress”, characterised by conflict and confusion, hence the need for the adults involved to be cognizant of these facts and handle them appropriately.  The next section deals with perceptions of adolescents and sexual health educators, around sex health education provided in schools. Although teachers were the primary focus of this study, literature on other sex health educators’ perspectives such as nurses and doctors has been included. These professionals can influence teacher instruction since they also provide sex education in secondary schools.  1.7.4  Perceptions of teachers and students on SHE provided in schools Understanding people’s perceptions is key to studying various social phenomena since they reveal what is on their conscious and subconscious minds, which in turn determines their actions as individuals, communities, and societies (Gibson, 1979). This understanding provided an interpretive lens for the results of this study by revealing how teachers and students perceive the education provided in schools within their social contexts. This sub section is divided into two main categories: 1) general perceptions around sex health education; and 2) perceptions around the current sex education provided in schools. 20 General perceptions around sex health education In schools, teachers’ and students’ perceptions reveal prominent factors, which influence the way they interact with the discourse. Hinde (2004) argues that “Just as water surrounds and envelopes fish, shaping their perspectives and determining their courses of action, culture evolves and surrounds teachers forming their perspectives and influencing their decisions and actions” (p.1). As elucidated in this excerpt, studies around teachers’ perceptions on sex health education provide insights into the various contextual factors such as the culture of the school which includes social norms and religious beliefs among other facets, which determine how teachers interact with the discourse. Conversely, these factors illuminate how adolescents engage with the material, thus providing an interpretive framework for the study.  Generally, because of the positive sexual health outcomes associated with sex heath education, teachers in their role as the primary custodians in secondary schools are very enthusiastic about delivering this education (Connell, Turner, & Mason, 1985; Levenson-Gingiss & Hamilton, 1989). However, their enthusiasm is often tempered by various factors particularly a lack of support from senior management (Buston et al., 2001). Teachers’ enthusiasm seems to align with their professional identity and their commitment to having “some kind of positive influence on students’ academic, social, and economic development” (Lasky, 2005 p. 906). These views originate primarily from their training, teaching experiences and expectations from the community.  Conversely, literature around students’ perceptions generally depicts that they hold various myths around SHE discourse, and that many lack trust in the teachers and the sex education provided (Kiapi-Iwa & Hart, 2004; Mutonyi, Nashon, & Nielsen, 2010). Instead, students tend to be biased towards peer-led interventions, which according to Siegel (2013) is a 21  normal phenomenon as adolescents tend to trust one another more than adults because of their shared experiences. However, Kim and Free (2008) assert that peer-led interventions do not necessarily improve sexual health outcomes among youths unless facilitated by an adult. This statement aligns with Vygotsky’s assertion that the presence of an adult is essential to the process of enculturation (Driver et al., 1994). Perceptions around the nature of the current sex education  Several studies have been conducted to assess perspectives around different aspects of SHE. For example, Kiapi-Iwa and Hart’s (2004) qualitative study investigated perceptions of healthcare providers and adolescents about access to sex and reproductive health services in the Adjumani district, Uganda. The participants included eleven students attending secondary schools in the district, two medical doctors with at least two years’ experience, one nurse assistant working in one of the doctors’ clinics, two traditional healers, and two pharmacy shop attendants. The authors revealed a number of findings which are interesting as well as disturbing. Although young people had knowledge of and treatment for STDs, some of them were not fully informed, and some of the myths they spoke about were reported to be perpetuated by teachers, parents, and health providers. Furthermore, students reported that most of the sexual health educators were rude and harsh, and they provided conflicting views around various phenomena. The study also alluded to the gendered nature of sexuality discourses, particularly around girls’ vulnerability. Those who became pregnant were expelled from schools. Hence most girls flocked to health care providers seeking an abortion; although, they were always denied this option.  Several other studies pointed to the gendered nature of sexuality education where girls tend to be marginalized (Burns, 2002; Muhanguzi, 2011). In this case study, Burns argues that although teachers and health care providers are aware of the sexuality challenges that girls face, 22  strategies which they endorse to protect them, such as isolation, abstinence, and avoiding romantic love affairs are ineffective, leaving the girls more vulnerable. Burns argues that instead, emphasis should be placed on problematizing the “Unquestioned male sexuality” (p. 84) that condones boy’s sexuality as an initiation into manhood and on equipping girls with skills and accurate scientific knowledge about their sexuality.  Regarding perceptions around teachers training requirements in sexuality education, Eisenberg, Madsen, Oliphant, Sieving, and Resnick (2010) carried out a qualitative study  to assess sexuality educators’ in Minnesota (USA) perceptions of their preparedness to handle the discourse in today’s challenges. Forty-one sexuality educators with one to 30 years of teaching experience were sampled. Of these, thirty-one were classroom teachers while ten were community based. The sexual health education programs under which they trained varied from single sessions to semester long courses. Teachers had numerous suggestions regarding ways in which their training could have better prepared them to teach sexuality education. They cited challenges such as lack of strategies of working with culturally diverse students and dealing with contentious issues. Specifically, teachers stated that they were unprepared for their first year of teaching especially on how to handle controversy, which is a key characteristic of sexuality education. Buston et al. (2002) also allude to the importance of teacher training at the outset in order to boost beginning teachers’ self-confidence around challenging concepts.   Yet, another important aspect was to consider how students who have experienced this education perceived it and how their views compared with those of the teachers’ who delivered the education. To understand this aspect, a study by Phillips and Martinez (2010) was drawn upon. Study respondents were former beneficiaries of the comprehensive Sexual and Reproductive Health (SRH) education provided within publicly funded Catholic and secular 23  Canadian schools. Thirty-one young adults, aged 18-24 years, 31 teachers, and 14 health partners were included in the study. Teachers and students had conflicting views about the SHE provided. Although the students agreed with the teachers on the major themes promoted in class, such as topics to cover and methodological approaches, they asserted that the model left much to be desired. For instance, students stated that they were mainly encouraged to abstain from sexual activity, and that sex was presented as an inherently negative and risky activity. Instead, students recommended a more sex-positive education. 1.7.5 Summary of perceptions on adolescent SHE provision and access in schools The studies reviewed above have a direct bearing on the study which focused on teachers’ perceptions of contextual influences on sexuality discourses. Due to the finding that “teacher change can be mediated through student learning” (Nashon, 2013 p. 227), and because teachers’ perceptions of their obligation as teachers have strong influences on their pedagogical practices (Beijaard, Verloop, & Vermunt, 2000), understanding these two phenomena, as has been attempted in the preceding sections, provided a strong foundation for interpreting the research data. Students’ and teachers’ perceptions of sexual health education provided, the ecology of the classroom, the school culture and their own lived experiences, which have been elucidated above, all influence the ways in which teachers handle the concept and how adolescents engage during instruction. As Hodson (1998) argues, students’ perceptions generally influence how they learn and what they choose to learn. This nuance therefore provides teachers with insights on how to go about teaching and engaging these students. The next section focuses on literature around employing constructivist approaches within sexuality discourses in order to understand various perceptions held by teachers and students and how this brings about conceptual change.  24  1.7.6 Significance of constructivism, CCM and perceptions in science teaching and learning  As discussed in section 1.8.1, the constructivist theory is instrumental to the teaching of science because without understanding students’ and teachers’ frameworks, how they are constructed, and how these experiences influence teaching and learning, bringing about conceptual change becomes an extremely complex process. Two main themes, which are influential to the current study, emerged from the literature on constructivist theory. The first is the importance of eliciting learners’ existing cognitive frameworks in understanding new knowledge (Johnson & Gott, 1996). In this aspect, the teacher’s role is to provide physical experiences which encourage reflection (Driver et al., 1994), a strategy which enables students to not just accumulate information (Hewson, Beeth, & Thorley, 1998) but to make sense of the new knowledge using their prior experiences and then ultimately to make their own conclusions. The teacher needs to have a strong scientific background around the phenomenon they are teaching (Harding & Hare 2000) to create the dissonance required for students to become dissatisfied with their ideas and come to assimilate the new ideas (Posner et al, 1982). Through a constructivist approach, the teacher is able to elicit students’ worldviews by asking questions rooted in science and then ascertain the source of those views and how long these ideas have been held, and how committed the students are to their knowledge (Cobern, 1996). With this understanding in place, the teacher can then design effective pedagogical approaches.  The second theme is the theory that knowledge is socially constructed rather than an individual activity (Vygotsky, 1978). Hence there is the need to enhance social harmony and employ scaffolding strategies (Hodson & Hodson, 1998) to aid the learning process. Henson (2010) stresses the importance of forming small-groups where students are given assignments, 25  and each member helps all other group members. In these groups, students are able to have a dialogue which enables them to find meaning in what they learn as they build a shared narrative (Lodge, 2005). Anderson, Thomas and Nashon, (2009) argue that the teacher’s role is to mediate these groups and encourage debate among learners on contentious issues which enables learners to build a culture of science, a culture that proceeds on the basis of conjecture and debate between colleagues. Similarly, Hewson et al. (1998) contends that the teacher’s critical role is to monitor classroom activities and decide if, when, and how to intervene. For a long time, many scholars have shunned science methodological approaches and argue that science is not made accessible to learners, and it is presented to students as a consensus theory of works where it “is tacitly always linked with accepted standards of validity” (Apple, 1990, p. 88-89). Apple charges that this positivist stance ignores students’ worldviews and reduces them to passive observers. Yet, according to the social constructivist theory, students appreciate scientific phenomena when they are given a chance to question the new knowledge with the intent to relate it to their preconceptions (Cakir, 2008). This can be achieved through the use of models such as the CCM. The conceptual change model’s major foundation is that effective teaching ought to consider the ways in which students learn, the critical role their prior knowledge plays (Hewson et al, 1998), and “to consider learning, not purely as an accumulation of bits of information, but as an active, interactive, connective process”(p. 199). Teachers are to ascertain students’ worldviews and challenge them to come to their own realization that some of those ideas which are at odds with widely accepted ones need to be abandoned.  Research has been conducted around perceptions and the influence of prior knowledge on learning science as noted in Section 1.8.1. Mutonyi’s (2005) study on the influence of students’ prior knowledge on HIV/AIDS learning during biology lessons provides insight on how to 26  mediate learning. Although this study was about HIV/AIDS, the emergent findings can be juxtaposed to the concept under study since the issues are influenced by more or less the same factors. In Mutonyi’s study, a total of 160 senior three (grade 9) students, aged 15-17 years were interviewed. Mutonyi discovered that some students remained with their views regardless of what they were taught about the science of the disease and condom use. In fact, over 50 % of the students believed that HIV/AIDS was a curse from God and they did not advocate for condom use. Mutonyi’s study is particularly important since it reveals that abandoning preconceived ideas is not as easy as portrayed in most models. In fact, students used canonically correct information to reinforce their preconceptions but not to change them. As a result, science educators are cognizant of the fact that prior beliefs can sometimes remain resilient, and that students employ them in different contexts. As discussed above, this nuance has challenged them to implement various strategies to harness the CCM in bringing about conceptual change (Aikenhead, 1996; Cobern, 1996; Nielsen & Nashon, 2007). For the current study, considering its nature, a self-reflexive praxis could be employed to enhance the conceptual change process.  In the next section therefore, existing literature around implications of reflexive practice will be explored. Specific attention will be placed on the efficacy of reflective practice on teachers’ choices in designing classroom activities and mediating instruction and its influence on student engagement.  1.7.7 Self-reflexive praxis as a tool for conceptual change In this thesis, self-reflexivity “refers to the conscious turning of the individual toward himself, simultaneously being the observing subject and the observed object, a process that includes both self-knowledge and self-monitoring” (Pagis, 2009, p. 266). Pagis argues that self-27  reflexivity studies require that individuals research themselves as human beings, and explain who they are, why they choose to do what they do while espousing their various assumptions and biases. In this aspect, the teacher becomes a “reflexive practitioner” (Pedretti, 1996, p. 307) who constantly reflects on his/her pedagogy looking for possibilities to improve practice. A self-reflexive teacher acknowledges that individuals possess their own background experiences which form certain beliefs, assumptions, knowledge, attitudes, and values which they bring to the teaching environment. In turn, these individuals are confronted by realities within the social and cultural context in which they operate (Pitsoe & Maila, 2011). For a concept such as sexuality, critical reflection provides teachers with opportunities to uncover the interrelatedness of the various socio-cultural beliefs which affect the discourse on sex education and provide ways to deconstruct those practices that constrain the teaching and learning process. Lasky (2005) argues that it is particularly important for teachers to question the beliefs around the right ways to be a teacher, problematizing their “unwillingness to change their identity” (p. 913) even when other factors challenge them to change.  One potential way to enhance self-reflexivity is discussed in studies on metacognition. Metacognition refers to the higher order cognitive processes that involve thinking about one’s own thinking and taking active control over those cognitive processes that are engaged in learning (Anderson & Nashon, 2007; Flavell, 1979; Livingstone, 1997; Sternberg, 1998; Thomas, Anderson & Nashon, 2008; Yuruk, Ozdemir, & Beeth, 2003). Sternberg (1998) specifically posits that “knowledge about one’s knowledge”, that there is something they do not know, which he refers to as “higher- order knowledge” (p. 129) is developed through metacognition, and that such knowledge is very important in motivating people to learn. Metacognition enables learners to reflect on their own learning and teachers to reflect on their 28  own pedagogy. This reflective praxis enhances teaching and learning. Therefore, studies such as those by Livingstone (1997) and Flavell (1979) which provide teachers with an understanding on how to be more aware of their metacognitive processes were reviewed to provide insights into the current study. According to Flavell, metacognition largely depends on processes like planning, evaluating, monitoring, and problem-solving. Therefore, when teachers are involved in these activities, they become more aware of the instruction process and are able to devise ways on how to regulate students’ learning processes.  1.7.8 Summary of the chapter This chapter explored the following four main facets: 1) justification of the constructivist theory in studying sexuality discourses; 2) the role of the Conceptual Change Model in facilitating change (learning); 3) perceptions around adolescent sex health provision and access; and 4) using a self-reflective pedagogy to enhance teaching and learning.  Generally, the literature review has emphasized the importance of grounding pedagogy in the social and cultural contexts as a significant step in addressing the controversies surrounding the SHE discourse. Furthermore, there is a deficiency in literature around teachers’ perceptions of contextual influences on sexuality discourses particularly in Uganda, and yet, as the primary implementers of this curriculum, they play an important role in shaping sexuality discourses and influencing students’ learning. The need to pay attention to teachers’ voices and to equip them with models to manage the discourse, which is undeniably complex and fragile, was clearly articulated. This literature review therefore provided a backbone for the study and framed its direction. The next chapter focuses on the methodological framework in which data for this thesis were collected and analyzed. 29  Chapter 2: Methodology and Research Design As discussed in Chapter 1, this study’s theoretical groundwork operates within a postmodern paradigm rooted within social constructivist epistemology. This paradigm recognizes the significance of socio-cultural backgrounds, prior knowledge among other facets on learning, and emphasizes the understanding that what individuals know has a profound influence on the way they learn (Ausubel, 1968; Bodner, 1986; Kelly, 1955). Teachers, students, the researcher, and all other stakeholders perceive their own truths around the concept of sexuality depending on their individual prior experiences, social contexts, and cognitive abilities. The methodological approaches employed were deemed appropriate for unveiling the underlying understandings by addressing the question: What and how are the contextual factors as perceived by sex health education teachers in Uganda influencing classroom discourses on sexuality?  In an attempt to answer the question, the study employed a collaborative narrative inquiry approach where the interviewer and interviewees become active participants who jointly construct meaning through storytelling (Clandinin & Connelly, 2000) as they draw upon from their prior knowledge. This approach challenges interviewers to relinquish control and ask simple unstructured open-ended questions to elicit responses that reveal what the interviewees truly believe (Riesman, 2008). As Connelly and Clandinin (1990) contend, “what emerges from this mutual relationship are new stories of teachers and learners as curriculum makers, stories that hold new possibilities for both researchers and teachers and for those who read their stories” (p. 12). 2.1 Rationale for narrative inquiry  Narrative inquiry was chosen because the research question above required elicitation of the teachers’ inner reality of their lived experiences (Connelly & Clandinin, 1990; Lieblich, 30  Tuval-Mashiach, & Zibler, 1998; Polkinghorne, 1988). Moreover, stories and ‘wise sayings’ with hidden meanings were common cultural tools which were traditionally employed by Elders to teach different phenomena such as moral behaviour to young people (Silver, 2001). Considering that discussions on matters of sexuality are culturally frowned upon, talking about it directly through answering a set of questions would pose challenges. On the contrary, telling stories would encourage individuals to share their experiences more freely. Narrative inquiry therefore was deemed appropriate for a discourse such as sexuality. The narratives conveyed an in-depth and multifaceted understanding of teachers’ experiences and perceptions of the contextual influences around sexuality discourses, and how the connectedness of these facets shape classroom instruction. Drawing from our cognitive processes and prior experiences, we (the teachers and the researcher) engaged in conversations around sexuality. The themes presented in the next chapter are a result of those interactions. 2.2 Research context and participants This study was conducted in Uganda between June and August 2013.  Uganda was chosen mainly because I, the researcher, am familiar with the culture and hold reflections as an insider who attained her education there and also taught in various schools for over seven years. In particular, I am familiar with the local language which is a critical facet in understanding any given society (Burr, 1995). Although the interviews were to be conducted in English, understanding the local language became an important asset since discussions about taboo topics such as sexuality are usually held in local dialects.  A total of six teachers, who are identified by the pseudonyms of Olga, Molly, Jolly, Beatrice, Paula and Gorretti, from four different schools participated in this research. Paula and Beatrice were from a Mixed Boarding and Day School (MBD); Jolly and Molly were from a 31  Girls’ Boarding Only School (GBO); Gorretti was from a Mixed Boarding Only School (MBO) while Olga was from a Boys Boarding Only School (BBO). Pseudonyms were used to maintain privacy and ensure confidentiality. Details of the teachers’ biographies, demographics of the schools, and selection criteria are presented in Section 3.1. Table 1 presents a professional summary of the participating teachers.  Table 1. Demographics of the research participants and the respective schools Participant Main Subject Capacity Years Teaching SHE Type of School Religious Affiliation of School Jolly Agriculture Senior woman >11 GBO Christian (Anglican) Molly Biology Housemistress >11 GBO Christian (Anglican) Paula CRE Health Patron 5–10 MBD Christian (Anglican) Beatrice Geography Senior woman 5–10 MBD Christian (Anglican) Gorretti  Chemistry Senior woman 2–4 MBO Muslim (non-sectarian) Olga Biology Senior woman >11 BBO Christian  (Catholic)  2.2.1 Sampling and choice of participants  A visit was made to Uganda to conduct interviews from April to July 2013. Snowball sampling, a technique in which initial research actors are identified, who in turn suggest other potential actors from their social networks (Thompson, 2002), was employed. The secondary schools in Kampala were identified through friends, the researchers’ own contacts, and selection was based on their status and academic performance4 history (Talemwa & Mwesigye, 2010). 4 In Uganda, these are schools which are historically known to excel in national exams 32                                                   Once the selection of schools was narrowed, the researcher identified teachers who taught sexuality in those respective schools by randomly asking friends contacted through social media and individuals who had any information about the schools. The teachers’ telephone contacts were secured. I then called the teachers, briefed them about the details of the research proceedings, and discussed what was required of them in terms of time commitment, details about recording the interviews, how data were to be used, the honorarium to acknowledge participation, withdrawal from the study, among other related issues. After each telephone conversation, I also e-mailed the study details. The participants were given a maximum of one week to decide whether they would participate in the research.  All the teachers contacted agreed to take part in the study. Signed consent forms were collected before each interview. Jolly and Molly requested that physical copies be left at their school, and I delivered them one week prior to their interviews. For every interview, I brought extra copies of the interview script as a precautionary measure in the event that the teachers had not printed them, or they had misplaced them. Of all the teachers, Olga was not able to make it to the physical interview. Her input was invaluable since she was the “female” in the all-boys school so replacing her was not feasible. She therefore completed the interview script,  and emailed the documents to me; then I telephoned  her  to clarify some of the points.  2.3 Interview process and data collection 2.3.1 Interviews I administered a specially designed open-ended scripted interview (Connelly & Clandinin, 1990) to allow for flexibility and consistency (Appendix C). Furthermore, as Clandinin (2007) contends, the use of open-ended qualitative interviews enhances close “attention to teachers’ practical knowledge and to the ways they use imagery and metaphor to 33  express that knowledge and make sense of their work” (p. 360). The interview questions revolved around the overall opinions teachers had about the contextual influences on sexuality discourses, and how those factors influenced their instruction and student engagement.  The interviews took place on the respective school premises. Molly was interviewed from the veranda of her home (she resides at school) while Jolly chose a vacant classroom. Both premises were ideal for the interview since there was privacy and no interruptions. Similarly, Beatrice and Paula also chose a classroom; although they insisted to be interviewed together. For Gorretti, my efforts to convince her to find a private place were fruitless, so we held our meeting outside in the school compound. Moreover, the interview took place during recess with the occasional interruptions by the students who wanted to consult with their teacher on various academic issues.  Nonetheless, the salient points were made.  Triangulation was achieved by discretely interviewing teachers who handled sexuality discourses in different schools and employing multiple data collection methods, including an open-ended interview, e-mail correspondences, audio recordings, and journal notations (Patton, 2002). All interview data were audio recorded, and I maintained a journal throughout the interviews, where I recorded my internal conversations and personal reactions to the narratives. To elicit rich and coherent narratives, probes were employed with the intent to either redirect the conversation or to bring out salient points which might have been ignored.  Interview sessions were characterized by interludes of silence. One could probably speculate that the teachers were critically thinking about the irresolvable controversies surrounding the SHE discourse. In the researcher’s view, the teachers displayed a genuine desire to provide children with the best sex health education they could possibly give to enable them (students) to avoid the negative sex health outcomes.   34  2.3.2 Transcription The data were then transcribed following recommendations by Lapadat and Lindsay (1999) which emphasize paying close attention to the details to enhance the interpretive thinking needed to make sense of the stories. These authors assert that “... it is not just the transcription product—those verbatim words written down—that is important; it is also the process that is valuable” (p. 82). Therefore, the researcher employed Riessman’s (2008) co-construction procedures where the roles played by both the researcher and the participants were highlighted. This procedure takes into account that personal narratives are socially and dialogically constructed. Care was taken to ensure that the actual interview, and the stories were kept intact and to elucidate how the researcher and interviewees co-constructed the narrative and meaning (Mishler, 1991). To homogenize the transcripts, the researcher compared the audio recordings with the notes recorded in the journal for any disparities which needed to be merged. In addition, different utterances, both verbal and non-verbal were all included in the script using various transcription symbols. Based on Jefferson’s (1985) procedure, a transcription key to guide the study was formulated (Figure 1)         35  Transcription                                                  Symbol • Emphasis/ stressed words                           bold  • Pause                                                           p, ≤ 3 sec; P  ≥  • Phonetic sounds                                        Uhms, uhh, Aha, mm-hmm, uh-huh • Expression                                                (type of expression)  • Interviewer interrupting                             (green) • Overlapping phrase                                    {talk here} • Raising tone softly                                       ↑  • Lowering tone softly                                    ↓ • Interviewer                                                    I • Narrator                                                         N • Abrupt stop                                                     -  • Inability to hear transcript                           [ ] • Exactly that                                                    ! • Sex Health Education                               SHE  Figure 1. Transcription key  2.3.3 Data analysis As discussed in Chapter 1, the theoretical framework and interpretive skills employed to analyze the data were informed by several studies (Ausubel, 1963; Bodner, 1986; Driver et al., 1994; Kelly, 1955; Mathews, 1994; Posner et al., 1982; Thorley & Stofflett, 1996; Vygotsky, 1978, 1986). This process was mainly aimed at uncovering teachers’ perceptions of contextual influences on sexuality discourses. The study employed Riessman’s (2008) dialogic analysis procedure which encompasses elements of thematic and structural analytical methods as well as other broad interpretive dimensions such as how talk among speakers is dialogically produced. According to Riessman, dialogic analysis “…requires close reading of contexts, including the investigator, setting, and social circumstances”, with the belief that “Stories don’t fall from the sky” (p. 105). In other words, this procedure was geared at elucidating the role played by the both the researcher and participants in constructing knowledge within their given contexts.  36  This analysis was informed by Braun and Clarke’s (2006) detailed and straightforward systematic guide. Specifically, Braun and Clarke provide six phases of a good thematic analysis (p. 36) presented in Table 2. During the data analysis phase, codes related to contextual factors influencing sex health education were identified from the transcript. To identify the codes, the researcher listened to the audio several times, read and re-read the data corpus to make sense of the teachers’ stories in relation to the research question. The codes were then merged to generate initial themes. These themes were then cyclically reviewed, named, and refined to generate final themes which would best represent teachers’ perceptions of contextual influences on sexuality discourses. These themes are presented in the next chapter.  Table 2. Phases of thematic analysis Phase Description of the process 1. Familiarising yourself with our data: Transcribing data (if necessary), reading and re-reading the data, noting down initial ideas. 2. Generating initial codes: Coding interesting features of the data in a systematic fashion across the entire data set, collating data relevant to each code. 3. Searching for themes: Collating codes into potential themes, gathering all data relevant to each potential theme. 4. Reviewing themes: Checking that the themes work in relation to the coded extracts (Level 1) and the entire data set (Level 2), generating a thematic map of the analysis. 5. Defining and naming themes Ongoing analysis to refine the specifics of each theme, and the overall story the analysis tells. 6. Producing the report: Final analysis: selection of vivid, compelling extract examples, final analysis of selected extracts, relating back of the analysis to the research question and literature, producing a scholarly report of the analysis.  37  2.3.4 Presentation of results In this thesis, care was taken to reflect the teachers’ narratives clearly elucidating how they participated in the research. Individual excerpts are therefore blended to give each participant a voice, revealing how each teacher participated in constructing knowledge—a concept referred as relational knowing (Gunzenhauser, 2006). Gunzenhauser asserts that relational learning advocates for multivoicedness of players involved in the research and guards against “demonizing certain participants” (p. 642) by ensuring that narratives of all participants are featured within the report. The draft of the results transcript was shared with the respective participants via email correspondence to ensure final consent on accuracy of the interview. The transcript was then analyzed to elucidate in what ways the findings addressed the research question and how they could be used as a basis for recommendations and implications for further research.  2.4 Validity of the study A fundamental question directed to many investigators conducting qualitative studies is why research findings of an inquiry, particularly those produced by a lone field-worker should be believed and trusted (Denzin & Lincoln, 2005; Lincoln & Guba, 1985). Several scholars have urged all researchers, particularly those employing narrative inquiry to acknowledge the complexities and ambiguities associated with this methodological approach (Riessman, 2008; Tracy, 2010; Yardley, 2000). Riessman asserts that “… narrative is not simply a factual report of events, but instead one articulation told from a point of view that seeks to persuade others to see the events in a similar way” (p. 187). This section therefore elucidates how various decisions and procedures in this study were geared towards enhancing the quality of the findings, with the cognizance that good qualitative research is like a crystal with many facets (Ellingson, 2008).  38  The term credibility represents what would otherwise be termed as validity in quantitative research since in such studies, validity mainly relies on tenets such as truths, generalizability, and reliability which “are elusive qualities” (Locke, Silverman, & Spirduso , 2010 p. 85) and difficult to determine in qualitative studies. Credibility is defined as “the trustworthiness, verisimilitude, and plausibility of the research findings” (Tracy, 2010, p 842). These terms are used interchangeably in this thesis. As Tracy (2010) explains, the terms denote that the research was conducted in an authentic way and that fairness, honesty, genuineness and transparency were highly deliberated upon during research proceedings.  Several criteria are suggested to assess value in qualitative research. Tracy (2010), for instance presents eight key quality markers required for excellence in qualitative research which she refers to as the “Eight ‘Big-Tent’ Criteria for Excellent Research”. This study draws on four of the eight facets from Tracy’s model.  These are: 1) Significant contribution; 2) Meaningful coherence; 3) Ethical; and 4) Rich Rigor. These markers are achieved in this study through various strategies as explicated below. (1) Significant Contribution: For a study to be found trustworthy, it must become a basis for others’ work, and the “truth test” should occur “cumulatively in the development of knowledge”—a phenomenon Reissman (2008) terms “Pragmatic Usefulness” (p. 193). Specifically, a study should problematize the moral, practical, theoretical, and heuristic stances held by societies (Tracy, 2010) and cultivate a culture of exercising human judgment when dealing with various issues (Schwandt, 1996). Like most other credible studies, this thesis presents a combination of these aforementioned components. Firstly, universal truths and the homogenization of adolescent sex education provision are contested by providing alternate ways to consider the discourse. Secondly, questions (although these questions are in themselves 39  complex and not easy to answer) are raised that challenge stakeholders to re-think about the ways sex health education is provided. In the process, this study has challenged educators to do more research and find more ways of addressing the ambiguities surrounding the discourse. Lastly, this study provided suggestions for policy makers, curriculum designers and teachers basing on theoretical foundations deemed ideal for the discourse. These recommendations are grounded in teachers’ lived experiences and have challenged some of the underlying assumptions about delivery of sex health education within the Ugandan context.   (2) Meaningful coherence: This criterion deliberates on how research findings fit with and against existing theories and research. In other words, “the way different parts of the interpretation create a complete and meaningful picture” (Lieblich et al., 1998, p. 173.), “making sense analytically of both convergence and divergence” (Riessman, 2008, p 191). This study clearly articulated the problem statement, the theoretical foundations and the methodological epistemologies that were intended to be employed at the outset. At the end of the study, various contextual factors which influenced the discourse have been elucidated. Also, how the stated theories, CCM and constructivist approaches, can be employed to enhance the discourse. Overall, the researcher believes that the research achieved the stated purposes and has addressed the question: “What and how are the contextual factors as perceived by sex health education teachers in Uganda influencing classroom discourses on sexuality?  (3) Ethical: The last criterion chosen to enhance trustworthiness of this thesis addresses ethical considerations. For research to be considered credible, it must pay close attention to procedural, situational, cultural specific and relational ethics among others (Tracy, 2010), with an aim of promoting social justice (Chase, 2005). Several strategies were undertaken to ensure that ethical procedures were adhered to hence enhancing the trustworthiness of the study. For 40  instance, the researcher secured ethical clearance from Behavioural Ethics Review Board (BREB), (a body which accords ethical clearance to conduct research for UBC students. In Uganda, ethical clearance was obtained from the Uganda National Council for Science and Technology (UNCST), the body responsible for approving research in Uganda. Hence the research was approved by these two official bodies. (4) Rich Rigor: This marker refers to “The comprehensiveness of evidence” (Lieblich et al., 1998 p. 173) and challenges researchers to explain the multiple ways and the details of the procedures followed when conducting a study. Details on theory, data management, study context, sampling procedures, analysis process, among others, greatly enhance the credibility of a study (Weick, 2007). Rigorous procedures invite readers to “witness the storytelling event”, since ‘I was there’ is not sufficient for many audiences” (Reissman, 2008 .p. 191). Ultimately, this enhances persuasiveness which promotes trustworthiness. This thesis therefore not only provides a factual account but also the precise details and “thick descriptions”, that is, the cultural structures, meanings, and interpretations (Geertz, 1973) of what transpired during the entire process. Among others, the rationale for the participants and sample, the interviews (lengths and breadth), the questions asked, the probes employed, details of data analysis procedures, how the data were coded and transformed into a report, details of the theoretical framework are all provided. Furthermore, in line with this study’s constructivist framework which “values multiple realities that people have in their minds as a way of acquiring valid and reliable information” (Golafshani, 2003, p. 8), multiple methods of searching or gathering data (interviews, audio recordings, open-ended questionnaires, field notes, email correspondences) were employed. In addition, multiple data sources enhanced triangulation (Bloor, 2001), which is a critical criterion when judging credibility of a report. Furthermore, verbatim quotations were 41  also incorporated to engender teachers’ voices and further strengthen persuasiveness. However, as Riessman contends, “Verbatim quotations without context can be deceptive” (p. 191). Therefore, the study was grounded within a particular context as elucidated by the theoretical framework, relevant literature, sociocultural setting, and participants’ perspectives (Yardley, 2000). It is worth noting that although case-centered studies cannot be generalized, such rigorous procedures can translate generalizability into transferability (Peshkin, 1985). Peshkin argued that:  When I disclose what I have seen, my results invite other researchers to look where I did and see what I saw. My ideas are candidates for others to entertain, not necessarily as truth, let alone Truth, but as positions about the nature and meaning of a phenomenon that may fit their sensibility and shape their thinking about their own inquiries (p. 280).  Therefore, stakeholders who read this report ought to find issues which resonate with them. I believe that readers of this report will find it credible and find ways of applying it in their own contexts.  Perhaps most importantly was how I, the researcher conducted the research. As several authors suggest, I  was constantly self-reflexive, critically assessing how her own biases could interfere with the research (Biley & Holloway, 2011). For example, I kept a field journal where I recorded my internal reactions. I also constantly checked with the participants and assessed their reactions to ensure that the interviews were being conducted in an ethical manner. Once the report was completed, the analysis chapter was sent to each participant to encourage member reflections (Tracy, 2010) and to ensure that the findings were a true reflection of their 42  experiences. All the documents were coded and pseudonyms were used to ensure confidentiality as discussed in Section 3.1  2.5 Limitations As anticipated, my position as an insider/outsider affected the research in distinct ways. It was clear that some teachers were not sure whether I “belonged to them” or whether my ways of thinking had been biased by Western influences. I was honest with them about my intentions, explicitly stating why it was important for them to share their lived experiences without fear of being judged. Although most teachers seemed to be uncomfortable at the onset, these feelings seemed to wane as the interviews progressed. Conversely, my birth and upbringing in Uganda meant that my personal experiences informed my understanding of the issue under investigation as well as the intricacies of the socio-cultural factors. Therefore, efforts were made to refrain from speaking on participants’ behalf to ensure that a conducive environment was created to allow the teachers to articulate their views.  Secondly, although I believed that I was familiar with the Ugandan culture, I eventually realized that to a great extent, my understanding was limited. I was not familiar with some of the metaphors and phrases used by the participants from cultural backgrounds with which I was unfamiliar. With this realization, I kept asking questions for clarity during the interviews; a position of a naïve inquirer (Biley & Holloway, 2011; Morrow, 2005). Ironically, when I began the data analysis phase, I realized that I was still naïve about various meanings. As a result, I kept in touch with the teachers using email and the telephone to seek clarification.  Finally, with narrative based studies, the small number of participants interviewed and the individual stories told limit generalizability of the findings within scholarly communities. This is especially true since there is a danger of interpretations being imposed on the data by the 43  researcher (Bell, 2002). To overcome this challenge, the report provides detailed information about the research proceedings, the methodologies employed, how interpretations were drawn, and avails the teachers’ narratives in form of verbatim extracts (Reissman, 2008) among other precautions. As discussed in Section 2.4, although this process does not signify that the results can be generalized, it provides the necessary details required for readers to transfer findings to their own situations if they deem them trustworthy. Transferability in this context refers to a scenario “when readers feel as though the story of the research overlaps with their own situation, and they intuitively transfer the research to their own action” (Tracy, 2010, p 845). Ultimately, the decision is left with the readers of the report. 2.6 Summary of the chapter This chapter presented the research procedures including recruitment of participants, data collection and transcription, data analysis, credibility issues, and limitations of the study. The investigation throughout this research focused on three sub questions: 1. What contextual factors influence sexuality discourses within the secondary school curriculum in Uganda?  2. How do these contextual factors influence teachers’ instruction during sexuality discourses? 3. What perceptions do teachers have around the effect of contextual factors on student engagement? All the procedures employed including interviews, narrative methodology, semi-structured questionnaires, validity criteria were those deemed most appropriate for investigating the three sub-questions. Most importantly, throughout the study the researcher was critical and conscious of her presence and how that could affect the dialogue with the teachers during the 44  interviews. All these considerations ensured a smooth course for this study. In the next chapter, the results of this study will be presented.  45  Chapter 3: Data Analysis, Findings and Interpretation Until this point, this thesis has focused on the theoretical and methodological groundwork in which the study operates. This chapter now reverts to presenting the findings of the inquiry: What and how are the contextual factors as perceived by sex health education teachers in Uganda influencing classroom discourses on sexuality? The findings have been summarized and presented as four distinct themes. These themes emerged based on how best they addressed the research question. As a caveat, although the findings are presented as distinct themes, it is imperative to note that these themes are inextricably intertwined, each infinitely bound to and interweaved with the other within the discourse. This distinction has been done solely for the purpose of elucidating the phenomenon that was investigated. For every narrative research, Connelly and Clandinin (1990) stress the importance of situating it within a specific context of time and place. In agreement with this notion, I provide a brief biography of the participants and the nature of their respective schools. To maintain the confidentiality protocol, the schools are identified by their nature and the teachers are given pseudonyms.  3.1 Teachers’ biographies and schools’ demographics A total of six teachers were interviewed which is in alignment with recommendations regarding the recommended number of interviewees in narrative research (Clandinin &, Connelly, 2000). It was important that every teacher’s voice be heard in order to provide a glimpse of their lived experiences. As Pinnegar and Daynes (2007) contend, “The turn from numbers to words is not a rejection of numbers but a recognition that in translating experience to numeric codes, researchers lose the nuances of experience and relationship in a particular setting that are of interest to those examining human experience” (p. 15). Therefore, six teachers was a 46  reasonable number and a small enough group to ensure that every one’s voice was heard and yet large enough to bring diversity.   The participating teachers were from four of the best5 government aided schools in Kampala, Uganda. Since sex health education is an emerging concept in Uganda, it made sense to choose well established schools with the underlying belief that such schools strive to implement what is recommended within the curriculum. The data would in turn be a fair representation of how sexuality is generally perceived in schools. In addition, efforts were made to select schools that represented the major religious affiliations, Christian and Muslim, in order to analyze how religious affilation affects the discourse since Uganda is primarily a religious country (Pew Research Center, 2012). To that end, three Christian founded schools, two Anglican and one Catholic, were chosen while the fourth school was Muslim affiliated.  Although my intention was to interview teachers from six different schools, I realized that teachers from the same school who handled sexuality in different ways, for example a biology teacher and Christian Religious Education (CRE) teacher from the same school, would add a different perspectives to the findings. Such a perspective would be of particular interest when considering the specialty of teachers who should handle the sexuality concept in schools. Therefore, four teachers were from two schools, two from each school, while the remaining teachers were from two separate schools. These teachers were actively involved in many programs in their respective schools and much could be written about them. However, the vignettes below focus solely on their responsibilities which relate to sexuality.   5Best in this context refers to schools which usually appear among the best ten in national examinations, and those which best implement curriculum recommendations from the Ministry of Education and Sports. These schools also usually belong to high socio-economic class. 47                                                    Paula and Beatrice were from a Mixed Boarding and Day School (MBD); Jolly and Molly were from a Girls’ Boarding Only School (GBO); Gorretti was from a Mixed Boarding Only School (MBO); and Olga was from a Boys Boarding Only School (BBO). All the participants were women for the following two reasons: I) they were readily accessible in these schools and  II)  it seems they are the ones mostly proactive in sex health education provision.   My efforts to find a male teacher active in the field were fruitless even when I went to a BBO. It was actually very surprising to find a senior woman6 in this boys’ only school, where one would expect a senior man teacher. The MBD school also had a senior man teacher (who seemed to be active in the provision of sex health education) but I was unable to reach him.   GBO is a Christian founded school, one of the oldest and most prestigious schools in the country. Jolly and Molly were interviewed here. Molly is over 40 years old, and she has taught biology for over eleven years. Molly is also a housemistress who supervises and takes care of the girls in their dormitories. Jolly on the other hand teaches agriculture and also works as the senior woman and class teacher. Both teachers are staunch conservative Christians, and they beamed with excitement as they talked about Christ and what He can do in people’s lives. Jolly occasionally talked about her own children, and she related sex health education to her real life experiences as a mother.  Paula and Beatrice are from a MBD school, which is also a Christian founded school although the teachers did not seem to be as conservative as those from the GBO. Paula and 6 A senior man or senior woman is a teacher whose responsibility is to advise students on issues pertaining to their lives such as sexual and reproductive health. This teacher may not necessarily be senior in age but must be knowledgeable in that field to be able to engage students on related issues.   48                                                   Beatrice were interviewed together since my efforts to separate them were ineffectual. They insisted that because they design their programs as a team, I must interview them together. Paula, who is also a trained counselor and patron of the health club is over 40 years of age and teaches CRE. Both teachers are on the gender desk7. Beatrice is the senior woman teacher and teaches geography and Luganda, one of the local languages. During the interviews, they would occasionally disagree on a few points, but it was evident that they had a very good working relationship. Being mothers themselves, they were passionate about the concept of sexuality and helping young people get through the challenges of life. Of the four schools I visited, in comparison to the other three schools, the MBD had a well-organized program that dealt with challenges around sexuality.  Gorretti, the teacher from a MBO, teaches chemistry, and is also the senior woman teacher. She is in her mid-thirties and has been involved in sex health education for two to four years. MBO is a Muslim school, and it was evident that religious principles were emphasized. In fact, the day I went to interview the teachers, I was prevented from entering the school premises because I was deemed to be indecently dressed according to the school’s dress code (I was dressed in trousers and these, together with short skirts/dresses are considered indecent. I was allowed in after I completely covered myself with a piece of cloth). Gorretti was enthusiastic about her work as a senior woman teacher, but at the same time she seemed to be overwhelmed with other responsibilities in comparison to all the other teachers.   The final teacher, Olga was from a BBO, also a Christian founded Catholic school. Olga, a biology and senior woman teacher is between 40 and 50 years, and has taught sexuality 7Gender desk, is weekly program designed by the teachers to handle topics geared at helping young people to go through the challenges of life. 49                                                   education for over ten years. She is confident of what she does and refers to herself as a “kafulu” in sexuality matters, which means an expert. She is also confident that students approve of her work. The summary of the teachers’ demographics and their respective schools is presented in Section 2.2 (Table 2). The next section reverts to the emergent themes presented through a lens of teachers’ perceptions of the various contextual influences.  3.2 Emergent themes from the inquiry   Four main themes that best reveal teachers’ perceptions of contextual influences on SHE were identified: 1. Dilemmas around navigating conflicting social stances  2. Competing dichotomies with regards to adolescent sex health provision  3. Teachers’ inadequate training to play the envisioned roles as sexuality educators  4. Relegation of SHE to extracurricular status undermines its value and potential.  The main thread which cuts across all the four themes is the complexity around the provision of sexuality education to young people in schools. The constant forces, both visible and invisible, which surround sexuality in the African culture, coupled with the fluidity of the concept itself leave most teachers paralyzed and unsure of what to teach. Under each theme, teachers’ views are conveyed through excerpts to bring out their voices on the various phenomena. Occasionally, fragments are presented one after the other to establish a rhythmic dialogue, which seemed to characterize the data, even for those interviews done separately and from completely different individuals and places.  3.2.1 Dilemmas around navigating conflicting social stances This theme is consistent with the notion that individuals are not “tabula rasa”, that is, they do not enter a learning environment as empty vessels. Rather, they bring with them who 50  they are and what has molded them over the years. As teachers enter the sexuality discourse, they have their established stances which have been solidified over time due to interactions within their social milieu. At the same time sexuality does not appear in a vacuum, rather, it is in constant interaction with the norms and beliefs a society holds, which may not necessarily be in agreement with the teachers’ stances. These implicit beliefs, as Claxton (2001) contends, more than anything influence the way people perceive different phenomena. Navigating this thin line presents a battle for teachers as they strive to deliver an appropriate sex education to counteract the negative sexual health outcomes among adolescents.  Teachers, in this study, considered acculturation of students into society’s practices and values as one of their main roles. This was mainly reflected through the topics they considered appropriate for SHE which include contraception, sexual orientations, hygiene, morals, abstinence, preparing individuals for marriage, relating with opposite sex, and sexual abuse, among others. The method of delivery and content largely revolved around teachers’ social stances and the various salient factors from the periphery which surround sexuality.  Three of the salient factors: 1) religion; 2) culture; and 3) media and technology are discussed under this theme because their influence on sexuality discourses in this inquiry was unmistakable as unraveled in the teachers’ stories. Therefore, the section that follows explores the dissonance between social stances and these three salient factors on teacher instruction and student engagement. The clash between religious leanings and SHE  The schools linked to this research are built upon a religious foundation, and each school has religious values that model its culture. While the core beliefs across religions seemed to be consistent, it was also evident that different religions interpreted the subject of sexuality in 51  varying ways. This became particularly complicated when it directly influenced classroom instruction. For instance, one teacher’s irony in MBO, a Muslim school, was how to traverse values taught at the mosque with her classroom sexuality discourse. Gorretti highlighted how the differential treatment accorded to students in a mosque based on their sex goes further to affect their engagement in classroom discourses—including sexuality. This narrative explains what happens at the mosque and how she saw this phenomenon affect students:  … you find it like that because in mosques, they don't mix; because they don't want them to get so close together, it goes even in class... you find there is a clear demarcation between boys and girls. [laughter... ] It is not necessary because they do not become free with one another, so when one gets a chance, she feels she wants to exploit. If they were free, they would be used to one another, treating each other like brother and sister; there would be no mystery.... and even though you try to talk to them, that does not help because once they go to the mosque, they tell them different things.  Gorretti further expounded on the issue stating that this demarcation in the mosque aims at reducing proximity, which in a way relates to promiscuity. She had reservations about this particular religious norm as shown in the excerpt above. Her argument was that once these students are given a chance to be together, especially on Saturday movie nights, when it is dark, they tend to use every opportunity to “experiment”. Gorretti seemed to imply that with this kind of training, the students will not only relate proximity with the opposite sex to promiscuity, but they will always be curious and try to experiment at every opportune time. Gorretti’s belief is that such restrictions do not work since adolescence is a stage when students want to prove the many ‘whys’ in their lives.  52   This thesis, particularly the discussion in Chapters 4 and 5 raises critical questions about the role of religion in sexuality education and provokes stakeholders to reject or at least feel uncomfortable about the manner in which religion is used to legitimize certain values at the expense of providing adequate scientifically proven facts to the students. Managing interactions between acceptable cultural norms and adolescent-formulated cultural norms”  Closely affiliated with religion is culture. The cultural norms, meanings and traditions held around sexuality gave a fundamental background to the framework employed by the teachers. This is in-line with Claxton’s (2001) stance that learning is influenced by the often unconscious cultural beliefs and values held in a society. Without a doubt, teachers’ pressing concerns were deeply rooted in cultural traditions that influenced their instruction in distinct ways. The issues under contention oscillated along a continuum from minor8 factors such as dressing and decency; conducting oneself with the opposite sex; to the more significant9 ones such as virginity, abortion and sexual orientation. An example of espousing such cultural norms is Jolly’s concern with the way girls dress and the consequences of this dressing: As we go in for these morning meetings, as the class teachers; these are things we talk about like you girls, how are handling yourselves? Like the HAC's [grade 11 and 12 students], they have gotten into the habit of trimming their skirts and they become so tight and you ask, how are you going to sit in the lab[oratory], now you are going to open your legs and the skirt will go up and there is this male teacher... you know—of course 8 Although minor and significant are relative, minor ones, are those where consequences are indirectly related to the negative sexual health outcomes and primarily depend on different cultural contexts. 9 Significant factors are salient factors whose consequences directly impact the lives of students. 53                                                   you say it jokingly, not so formally—but you know the message is going across—you know the hips have widened, why do you go into tight clothing?  While Jolly’s school takes a more liberal approach, some schools take it further and create   rules to emphasize decency10. The teachers believed that such rules yielded positive results in reducing the negative sexual health outcomes as portrayed by Gorretti’s excerpt below: We used to have short skirts; they have been turned into long ones—this term…. It [engaging in sex] has reduced now because of the long skirts, [hmm…laughter.... ] by the time you open the skirt, and it goes down….. [nodes in approval].  This wave around dressing is not only an issue in schools but rather a concern of the wider society. It is an issue that was legislated in the Anti-Pornography law recently passed by Uganda’s parliament. This law, which was spearheaded by Simon Lokodo, the Minister of Ethics and Integrity, and assented to by the President, outlaws mini-skirts with offenders facing years in prison or paying hefty sums of money. Minister Lokodo explained the “provocative” dressing that the law bans in the nation’s leading paper: “Any attire which exposes intimate parts of the human body, especially areas that are of erotic function, are outlawed. Anything above the knee is outlawed. If a woman wears a miniskirt, we will arrest her”. (Kamukama, 2013)  This law has raised heated debates with those in favour arguing that it was a move that infringes on human freedoms. Particularly the feminists came out strongly arguing that this is yet another tool to infringe upon women rights. Amidst all this ambiguity, teachers are expected to negotiate these tensions as they handle the discourse, but this is by no means an easy task.  10 Decency is still relative but for this thesis, the teachers’ focus was around short skirts, trousers and tight clothing. 54                                                   Ironically, as teachers form their beliefs based on their cultural backgrounds, so have students. Teachers feel that students have their own “adolescent-cultural norms” which they do not easily give up despite the teachers’ efforts. This confirms Claxton’s assertion that such unconscious beliefs and values affect teaching and learning in profound ways. What confounds the situation further is that most of the students keep their beliefs to themselves or share them with their peers as opposed to teachers. Jolly articulates this phenomenon in the fragment below: … some of these girls not being open because from their family background, the concept of open communication with adults has not been inculcated into them—because even with the parents at home, they don’t have that VERY open communication. So you coming in as a third party, it may not be very easy, as I said, sometimes you might identify that someone has a problem but however many people you try to use, you never get to the bottom of it. The above narrative expresses teachers’ frustration of knowing that students have a problem and yet they cannot help because the students do not want to disclose the issue. Molly relayed a story of a young girl at their school who is believed to have died from complications related to an abortion because she did not want to disclose the issue. The teachers are also aware that students do not necessarily agree with what they are taught, even those ideas which seem obvious to the teachers. They have their “culture” which seems to be at odds with the school’s or even that of the general society. Jolly continues to expound upon her predicament as she ponders students’ behaviours:  55  then there is a component to deal with cultural norms, and in a school like this, we are from different cultural backgrounds— and I think you have heard in Rukuyi11 where they don’t handle sanitary towels at all. Can you believe even here, there are people who throw them around? They just go to the bathroom and put it on a rover somewhere up there when there is an incinerator around. The school has tried to put proper disposal mechanisms—a bucket in the bathroom, and then I think they have a duty rota, and sometimes they do not end up there and I think that has to do with the cultural norms.  For Molly, it seems clear that proper disposal of sanitary towels, particularly when “disposal mechanisms” are in place, should not be an area of concern, thus, the “Can you believe question” in her narrative above. She is however confronted with the reality when she finds used sanitary towels thrown all over the place. This implies that “adolescent culture” might not realize or even find it problematic to throw around sanitary pads. Moreover, historically, in most Rukuyi tribes, during menstruation, girls would go to the bush or a secluded place and dig holes where they would sit and drip their blood which might imply that they are not accustomed to using sanitary towels. For these teachers, it is this clash between their social stances and the students’ own stances which they must constantly navigate. The teachers’ struggles revolve around how to devise appropriate pedagogical methodologies to deal with these various social as well as cultural stances. The influence of media and technology on students from high social economic backgrounds There is an intimate relationship between socio-economic status and lifestyles (Jones, 2008; Neema et al., 2006). For instance, the fact that the socio-economic background of students 11  Rukuyi  is a pseudonym assigned to this particular tribe for confidentiality purposes. 56                                                   in a way determines the schools they attend and the amount of disposable money they have is not new to someone who is familiar with the education system in Uganda. However, little attention has been paid to the manner in which high socio-economic status affects adolescents in sexuality matters in Uganda. With the exception of a few critics (BioMed Central/BMC Public Health, 2008; Isiugo-Abanihe & Kola Oyediran, 2004; Wepukhulu et al., 2012), many researchers have mainly concentrated on the effects of low social-economic status on adolescent sexuality at the expense of the other factors. This study has elucidated on this often ignored phenomenon as revealed below. First, media and technology have been stressed by the teachers in this study as the biggest setback undermining sexuality discourses in schools of high socio economic status. As stated in Section 2.2, schools of students of high socio-economic status were chosen.  In these schools, challenges characteristic of schools from low socio-economic background such as poverty were of less concern to the teachers. This however does not mean that these teachers did not have to deal with sexuality related matters.  These teachers were acutely aware that being in a high socio economic class could be a double-edged sword. The participating teachers reported that students from high socio economic backgrounds can easily access media and technology either from their homes or the schools they attend. All the teachers interviewed explicitly stated that the interference from these two sources was profoundly regrettable. They argued that because of constant exposure to media and technology, students encounter multi-world experiences at a rate much higher than that of students from low socio-economic backgrounds. Media bombards these students with information, most of which is considered by the teachers to be inappropriate for their age. Understandably, money is not an issue as these students can afford to buy all kinds of magazines, watch any movies, go dancing in 57  night clubs, and can generally do whatever they want. It even gets worse in cases where these schools are located in cities as illustrated in the following narratives:  Jolly claimed: I wouldn't say that in this school the financial aspect really plays a good part and the average people here can afford to have proper sanitation; but as an interference on the other hand, we have the media if I may call it that. I don’t know if the Internet is part of media, because as you try to inculcate these values, they are busy getting other things from elsewhere; we try so much to block, some of these avenues, but haaaa, adolescents  are very tricky, somehow they get there; and even the public media, there are those songs which come on the radio; have you heard the song emesse12? heheheheee[laughter] and it was on like a week or two before the girls came in but you would just say emesse in class and everybody would yell and go into that song. Of course it comes in the figures of speech but they are talking about sex—the woman waking up the husband to go into sex You know, someone’s mind is already there ... Paula said:  - anyway, ours is a town school, peculiar from other schools, when they go home, the internet cafes are open, sometimes vehicles pass here with very loud music—stupid music [laughter]. The other day on Saturday there was a bell lager day—stupid songs playing out loud, a town school has its own challenges and the way we handle our children is always different from children from rural schools. For us we have to do a lot; a little bit more. 12Emesse literally refers to mice, but this is used figuratively to refer to sex. 58                                                   Gorretti wrote:  Our media has gone wild, they show things to these children which are not necessary; even on these televisions where they used to have nice plays which could limit up to the case, you can find people showing even the ‘other part’; by the way, it has spoilt children, the movies they watch, … they put a movie/soap which has all sorts of things and for them they are inquisitive, they want to explore. At least, if they edited their movies, the media has done a lot in spoiling our children … you find that Tuesday, children buy Bukkedde because it has ssenga13 and then they buy red pepper to read hyena14, you find a student in class when he has cut very many of these papers from those newspapers, he makes a full book of those concepts, he puts one here, patches another there, I have very many which I confiscate. From the above narratives, the various ways in which media and technology constrain teachers can be deduced. Moreover, adolescents are a peculiarly unpredictable cohort that seeks sexually charged content meant for adults. The songs (emesse) which excite them, the stories they look for in newspapers, hyena and ssenga, the movies they watch, and the content they search for on the Internet all revolve around sex. For town schools, the situation is even more revealing because of their location where Internet cafes, bars, cinema and disco halls surround the schools.   Teachers employ several strategies such as blocking the avenues and confiscating newspaper excerpts as explicated in the above narratives. However, these strategies, though useful, have not been very successful given the fact that teenagers are a very cunning group. The 13Ssenga refers to aunt, but this is a section in the local luganda newspaper which focuses on love sex and marriage.  14Hyena is the English version of ssenga, published in the Red Pepper, a newspaper mainly focussing on sexually charged content.  59                                                   teachers, particularly those from schools located in towns, are confronted with these questions: “How can you block avenues when there is sexual music playing in the school’s backyard? How can you possibly block sexual content when Internet cafes are everywhere? How about the fact that students have their own phones, which are connected to the Internet? By themselves, these questions are complex and do not ellicit easy answers. Furthermore, the teachers realize that students tend to get addicted and “keep going back to the source” and yet they [teachers] vehemently disapprove of most of the information that students consume. The tensions that result from negotiating such terrains between information from the media and teachers’ stances around the kind of information students should access is revealed in Gorretti’s narrative below:  … and because they are experiencing their body changes, they have the media, which motivates them otherwise, then they go astray, because you are telling someone—you expect to get wet dreams but when you do, don't think that you are mad or you should not get somebody to" sleep on", it is normal—you are going through the normal stages of life—but some body, because they would have watched something else, they go in for it. In frustration, teachers contemplated involving the government to regulate the media as revealed in their narratives. Although that seems plausible, so far, it has not been feasible as because controversies still exist around what is considered appropriate. Although the Ugandan government recently enacted the anti-pornography law, that in itself is not a guarantee that it will be enforced as many other Ugandan laws only appear on paper and are seldom enforced. The teachers clearly did not have a solution for how to deal with information from the media. They had so many “how to” questions regarding teaching appropriate sex health education to students amidst contrasting media messages. Perhaps, if teachers could answer some of these questions, 60  then, they would be closer to the solution. These “how to” questions, albeit very complicated, must be answered. Summary of the theme: Conflicting social stances In concluding this theme, it is vital to stress that religious beliefs, cultural norms, and media and technology profoundly influence the way sex heath education is delivered in Ugandan secondary schools as I have argued throughout the theme. The teachers must constantly negotiate who they are due to their social stances, their beliefs and the competing expectations placed upon them by the aforementioned factors. What is even more distressing for the teachers is how to navigate the fact that students have their own social stances around various phenomena and they tend to stick to them regardless of the teachers’ efforts. Some of the information that the students consume, particularly from media and technology is not accurate and conflicts with the religious  and cultural facts teachers try to instill in students. The interconnections among these various phenomena are so powerful causing constant anxiety in teachers as they struggle to navigate them as revealed in their narratives. This leads to the second theme, which deals with the emergent dichotomies primarily originating from teachers’ personal social stances. 3.2.2 Competing dichotomies with regards to adolescent sex health education This theme focuses on the competing dichotomies which were very contentious and raised heated debates as they arose from the teachers’ stories. A number of dichotomies were identified but only two will be featured here: Condom use versus abstinence and African culture versus Western influence. This is mainly because these two dyads were noticeably conspicuous among the rest in the narratives. This section now reverts to each of them.  61 Condom use versus abstinence Clear dichotomies emerge around these two methods of preventing negative sexual health outcomes, with such strong convictions, which are difficult to ignore. For schools in Uganda, as discussed earlier in the literature review, the proposed working framework for sex health education is ABC: Abstinence, Being Faithful, and Condom use (The United States President’s Emergency Plan for Aids Relief [PEPFAR], 2004). The three concepts however carry different weights: Greater emphasis is placed on Abstinence (A) its advantages and why it is the most, if not the only relevant method. Being Faithful (B) is merely alluded to with the argument that schools are not there to “groom couples”. Condom use (C), on the flip side is detested by the key stakeholders particularly parents and teachers yet it is hard to ignore when dealing with sexuality. All the teachers interviewed were against C in favour of A and they shared Paula’s belief which is succinctly espoused in the narrative below:  Now, condom use is not an intervention in Ugandan schools, basically we don't provide condoms, it is not an intervention. However, in A’ level [grade 11 and 12.] in paper IV, we teach about family planning methods, information is provided, advantages and disadvantages, but it is not an intervention in schools and we don't provide them in schools; it is for the marrieds—we are very careful to mention that, because what family are you planning if you are a student? We quickly add that these methods are for the marrieds,[laughter] ... now being faithful still is preparation for future use, abstinence basically is the best intervention in schools in Uganda. Teachers’ reasons for not embracing condom use as an intervention are multifaceted. They are pivoted on four main factors: i) beliefs emanating from various factors within their social milieu; ii) the perceived nature of condoms and their usage; iii) biology around maturation 62  of children; and iv) expectations from the larger community. Although the role of other factors cannot be underplayed, there is irrefutable evidence that teachers detested condom use mainly because of their cultural and religious beliefs. Most teachers believe that sex is sacred and should be reserved for the marital bed. Since time immemorial, a successful person was expected to study, complete university, find a job and then officially enter the marriage institution, moreover as a virgin. When children drop out of school, particularly due to pregnancy or other sex related consequences, they are regarded as failures, and this does not reflect well on their teachers and parents. The teachers were therefore proactive in promoting A as opposed to C, since condom use, particularly among young people, bares negative connotations relating to immorality. These dichotomies emerge as teachers are constantly interrupted by forces that encourage condom use as illustrated in Molly’s and Paula’s narratives respectively:  Molly:  I like abstinence—I don’t like condom use; involving in sexual activities is not only the matter of the body … but also their minds, they get distracted from reading their books; encouraging them to get married in future is the best…. . Abstinence is a Christian value and teenagers are encouraged to have it and exercise it. Paula: … emphasis should be on abstinence, you can relate it to religious values; bring in the cultural implications—although they are dying down. Here in Buganda for example, it was quite an excellent thing to get married when you were a virgin ... and then the goat comes and everybody knows—wow; that one at least the goat came [laughter]. From the above narratives, it is evident that teachers believe that abstinence can be achieved, especially when religious and cultural values are emphasized.  The second factor revolves around the nature of condoms as perceived by teachers, coupled with the fact that students lack adequate knowledge of how to handle them. Teachers 63  argue that condoms are weak and ineffective and can burst anytime making the children even more vulnerable. Even worse, the circumstances under which students have sex are not conducive making it almost impossible for them to use these condoms correctly. Molly and Gorretti express their discomfort and fears in the narratives below: Molly:  I suggest that people should not encourage them [students] to use condoms because you find them being advised that if you can’t abstain, go ahead and use a condom; we should encourage them to have self-control, and these sexual activities are done when they are hidden; parents in Uganda don’t approve sexual activity among their children like elsewhere, and these condoms normally do not work; they won’t use them properly. Gorretti: I don’t encourage the students to use condoms and even to be given condoms because when they are going to have sex, they  don’t have time, they are doing it stealthily, as if they are cheating; so somebody may not use it in the appropriate way it’s supposed to be used,  then the way they store them; because the boy will put it in a wallet, puts it on the body, sits on it, by the time  they are going to use it, it is already spoilt, me I don’t encourage condoms in schools, you would rather tell them to abstain. For Gorretti, her stance around condom use and abstinence is very clear. Regardless of the fact that some of her students engage in sex, she maintains her opinion just like many other teachers. This was revealed when she was probed further as she narrates below: Hmm, they [students] are very active... hmmm, there I don’t have a clear solution but with the issue of condoms, the way I have seen them [students] using them I don’t recommend them, me I don’t encourage condoms in schools, you would rather tell them to abstain. 64  Whether these claims about the condoms are true or false, all the teachers had their reservations around their usage, including the science (biology, chemistry and agriculture) teachers. They all unanimously supported the notion that condoms are ineffective and should therefore not be encouraged in schools.  The third factor is rooted in teachers’ beliefs that biologically, students are not mature enough to get involved in sexual activities with or without condoms. This leaves them with no choice but to preach abstinence. Most of their narratives uncover this underlying fear. They argue that sex does not only involve the body, but the mind and emotions and this interferes with students’ education. These teachers were also well equipped with explanations and facts to discredit condoms and early sexual intercourse. Paula’s narrative highlights one of them:  Like this question of I don't know whether it is also related to sex but this issue of fistula—fistula is a disease, caused by early relationship [sexual intercourse] then somebody gets pregnant, then during the process of delivering, the uterus might break... and at the end of the day, somebody just susuz15 anytime, there is no control and maybe because the bladder is affected. Whether Paula’s facts are scientifically proven or not, teachers found it very helpful to have such facts to back their stances, especially when they had real examples of individuals who suffered those conditions. Such real life examples would enable students to grasp the concepts better and take the message about abstinence seriously. Finally, expectations from the wider community particularly parents and students largely fuel the debates around condom use and abstinence. From the teachers’ analysis, students and 15Susu, is a Luganda word which refers to urinating. 65                                                   parents express diverging views on these dyads. The fragments below from Molly and Gorretti respectively, reveal how students interact with these phenomena and how teachers respond. Molly claimed, “Students really like it when they are given ABC's; sometimes they capitalize on the condom use; but as mature people, we are supposed to guide them on which one works best.”  Gorretti wrote:  But because of having a mixed environment here, students involve themselves in such[sex]—either willingly or unwillingly; because even at times you find used condoms; you usually find them on the HAC [grade 11 and 12 ] block, we find used condoms there and you ask yourself—where do they come from? Who has used them? These narratives highlight students’ stances while elucidating teachers’ pedagogical approaches as they handle the discourse. However, it is a fact that not all students abstain regardless of the abstinence approach being emphasized. Evidence that students are sexually active unfolds through the above excerpts and the interest in condom use is undeniable. What is not clear though is whether those who are sexually active are the ones “capitalizing” on the C or whether students, sexually active or not, would like information about condom use. It is clear from the teachers’ narratives that some students want to capitalize on condom use. Teachers are therefore expected to take extra precaution while dealing with the discourse in topics such as reproduction in biology and sex and marriage in Christian Religious Education (CRE). Teachers are not expected to use condoms as teaching aids since that would cause unnecessary commotion. But perhaps, most importantly, teachers must stress the fact that condom use is not meant for these students but for the future. Molly exposes this reality,   “in fact here in Uganda, if they got you with these condoms in schools, it can be very bad. So it is done in secrecy because parents don’t want their children to be involved and the teachers don’t 66  want.”  Beatrice adds, “Every Wednesday; a senior woman teacher offers a talk around sexuality; sometimes guests are invited; they talk about condoms; advantages—but quickly add that those are for marrieds.”  When Beatrice was further probed about condom use and using them as teaching aids in schools, she sounded very offended and was not amused judging from her raised tone in the response:“What are you saying↑? What are you driving at, eeh?... I don’t even think that you would derive anything from that lesson—you would cause unnecessary commotion.” The majority of parents are in favour of abstinence as revealed in the aforementioned sections. Meeting the expectations of these parents who advocate for abstinence was not a problem since abstinence is the main message promoted. The most pressing dilemma for the teachers was how to meet the needs of the minority of parents who felt that comprehensive knowledge about condom use as an intervention should be given to students. Teachers reported that some parents came to terms with the reality that their children were sexually active, and they tried to employ several strategies to ensure their children become knowledgeable about condom use. One of the strategies parents employed was to ask teachers to provide information about condom use given their [parents’] culture of not openly discussing sexuality with their children. Olga narrates her discussion with a parent around the issue: …  a mother  approached me and said me I am a born again Christian—she said, fine we are born again but some of our children are sincerely sexually active, what can you do as school to tell them about condoms ... In such scenarios, teachers had several ways of addressing the issue without jeopardizing their jobs or conflicting with other stakeholders. Teachers generally invite healthcare professionals or resource persons from organizations dealing with health related issues such as HIV/AIDS. These 67  professionals teach about condom use in relation to these health-related concerns. In this case, the teachers felt that the students obtain the knowledge without openly promoting condoms as an intervention.  Some other parents take up the matter in their own hands and avail condoms to their children although such a move is by minority and seems to be condemned as well as raises contention according to Jolly:  I hear most parents especially those with boys pack condoms for their boys especially those in secondary schools; but ehh, my God!, how do you talk about condoms at this stage?; like ‘well, I know once in a while you may be tempted, so have this—just in case’—Allah! [deep sigh] ... I think emphasis should be on abstinence. In conclusion, vigorous debates continue to hover around condom use and abstinence. Clearly, the majority of the teachers and parents want to promote abstinence. Even with the realization that children are sexually active, and that some actually do use condoms, abstinence is still the recommended method. This dichotomy remains a complicated paradox and continues to pull teachers in multiple directions. African culture versus Western influence “Again it is that western culture which is bringing problems to us”–Beatrice Another distinct dichotomy revolves around the African culture and the Western influence. Teachers in this study expressed concern around the erosion of their cherished African cultural values by Western influences. The African culture seems to be distinctly different from the Western culture in many ways particularly with regard to the emphasis on morals and religious values. It is evidently more desirable than the western culture, which seems to be more 68  liberal and condones certain traits that supposedly encourage immoral behaviour as Paula narrates:  … . many young people in Uganda really take up the western influences because they think those people are better than we are…. You see the western culture, I don’t know but they don’t seem to be so strict on people abstaining—some young people here also would like that ... Molly could not agree more:  The Western culture is really influencing them [students] and that’s a challenge; uhh.. I think our culture was safe—a culture without hugging, people there hug and kiss freely and sometimes the outcomes are not good. As explicated in these narratives, teachers voiced that students actually want to identify more with the young people in cultures other than in their own cultures. This obsession with the Western culture is of great concern to the teachers and is indeed difficult to ignore. Students are consistently exposed to this culture through media and technology. As explained in Section, they can easily afford access because of their socio-economic status. It is worth noting here that media and technology are by no means undesirable innovations, the problem is the kind of information students opt for, as Beatrice laments: … and here, haha.... through technology─net, you see these expensive phones are dangerous, they get information from there; and the problem they will go for the wrong information. Well, there is also good information [laughter...]but you know adolescents, they are partly children, sometimes they are children, sometimes they behave like adults, they are in between, they need a lot of guidance and follow up. 69  The teachers recognize some of the benefits of using media and technology as highlighted by Beatrice. In fact, almost all the teachers echoed the need to increase the use of these innovations while teaching sexuality. However, Beatrice’s narrative conveys tensions felt within herself as she ponders upon how to provide the “right guidance” to students so that they ignore the “detrimental information” from Western culture. This dichotomy between Western influences and the African cultural values is further confounded by the beliefs that the students have formed about their teachers. What is particularly perplexing is that students consider their teachers to be old fashioned as Jolly reveals below. How, then can teachers provide proper guidance when students feel there is a better source and up-to-date information about sexuality? This dissonance is clearly expounded upon by Jolly as she narrates some of the perceptions students have about teachers:  … that woman is so old fashioned, these are modern times, things have changed, we are the dot.com era. That is what everybody is telling them anyway—so they think whatever we did is archaic, in fact, that it is us who should change and do things the way we see them being done... on the Internet/TV or wherever. This excerpt uncovers the most pressing challenge faced by teachers as they strive to provide sex health education which is distrust. Because students do not trust their teachers to provide them with up-to-date information, they explore and learn from their counterparts in the Western culture. The irony though is that teachers consider themselves to have a rich experience and even think that they know what is good for the students. They [teachers] therefore continue to grapple with how to deal with this dissonance especially when students keep going back to their preferred source. 70 Summary of the theme: Competing dichotomies with regards to adolescent sex health education This theme has explored the effect of two competing dyads; condom use versus abstinence and African culture versus Western culture on sexuality discourses. The analysis shows diverging and conflicting views around the various dyads. The analysis also reveals how teachers are pulled in multiple directions as a result of these diverging views. For condom use and abstinence, it is clear that the latter is the most preferred method particularly by teachers and parents. Yet, the influence of condoms cannot be ignored since some students are actually using them. Considering the other dyad of African culture versus Western influence, teachers and students have explicit stances. Teachers aim to promote the former while students prefer the latter. Students consider Western culture to be ideal given the generation in which they are living. Solutions around these dichotomies are ambiguous, and teachers continue to wrestle with how to navigate them. In the next section, the third theme that deals with how teachers are prepared to deal with these ambiguities is discussed.  3.2.3 Teacher’s inadequate training to play the envisioned role of sexuality educators All the teachers who participated in this study unanimously stated that they needed training on how to handle Sex Health Education. The need was felt even stronger given the fact that they were dealing with  adolescents which is a complicated group. According to Helleve et al. (2009), training is the most critical facet for the successful implementation of sex health education. If teachers are trained, they will be competent at handling concepts related to sexuality. The teachers in the study were very enthusiastic about teaching sexuality and had the desire to help students avoid the negative sexual health outcomes. However, most of them felt incompetent. Their desire to be trained is expressed in Paula’s and Molly’s excerpts: 71  Paula:  … then we teachers need to be trained; I don’t really remember when we were last trained to handle this health education—when we had a major training; it must have been some time back because nowadays people think that these students know.  Molly: We should bring in real people, who have the facts, really, because even some of us, some of our facts may be distorted here and there. Moreover, there is no standardized pedagogical approach on how to deliver sex health education. Occasionally, teachers attend training workshops but they seemed to suggest that those do not occur often enough. The narratives reveal two critical areas where teachers felt they needed training: 1. Collaboration with parents; and 2. Training on how to work with adolescents.  The teachers felt they needed training in these two areas since parents and students are part and parcel of the school as Paula stresses in the excerpt: “… for us in schools, it’s a triangle, with three sides, the teacher (at the school), but there is the parent also and the student”. Training around collaboration with parents Considering parents as the primary custodians of their children, it is important that their voices be clearly heard while handling sex health education. This is clearly stipulated in many SHE guidelines including the Public Health Agency of Canada (2008). Teachers indeed felt that they needed to involve parents and consult with them on various issues. In this teacher-parent collaboration, teachers considered it their duty to educate parents on how to handle sexuality with their children and yet, they themselves felt incompetent as explained in the above section.  Parental involvement was posited as being primarily two-fold; i) as “home teachers” who  continue nurturing children and building on the foundation laid at school and; ii) as program 72  designers and trainers who participate in the design and delivery of SHE in schools. Parental involvement was seen as critically important, particularly in Uganda where many schools are boarding in nature with students spending a reasonable amount of time in a typical school term which is about three months in residence at school and then approximately a month at home for holidays. As revealed by Paula, the teachers felt that it was important for parents to utilize the time that the students spend at home during holidays to continue talking to their children about sexuality: … because for us we may be here, with a boarding child for three months, then we talk and teach and guide! but the one month which she will spend at home without a parent who is present at home, can undo … , I heard the girl's warden telling the parents that please do not undo what we have given these children.   The teachers also understood that it was important that both parties kept each other abreast of what happened at the other end of the spectrum for mutual support and continuity. Paula clearly articulates the teachers’ fear of parents “undoing what they have done” or simply keeping quiet. Therefore, teachers need skills to challenge parents to get involved in the SHE provision for their children amidst the counteracting forces.  This teacher-parental involvement seems to be constrained by various factors. Among these factors, a lack of open communication between children and their parents featured prominently. It was evident from the teachers’ narratives that most parents do not discuss sexual related matters with their children and yet, there are many other sources where the children obtain information. According to the teachers, this lack of communication originates from parents’ strongly held social stances around openly discussing sexuality matters with the children as discussed in Section Paula and Molly express the gravity of the matter in their 73  narratives. Paula claimed, “Parents are not talking, some teachers are not talking—but the bad people are talking into their lives, it’s so unfortunate, the bad ones never get tired, but the good ones are relaxing”.  While Molly said:  Some parents are shy about it therefore some students don’t have the knowledge; it is us teachers who try to provide the knowledge but the parents don’t seem to be telling them enough about their sexuality. Molly clearly articulates the need for training. Her choice of words of “it is us teachers who try” reveals the uncertainties and levels of discomfort about the way they teach. Since SHE is considered a triangle with three sides which includes parents, teachers and students, the teachers cite the need for acquiring skills to challenge parents to do their part. The teachers are aware that getting parents involved is not an easy task. Without this training, the teachers believe they run the risk of conflicting with parents, a scenario that could potentially undermine sex health education in schools. Training around working with adolescents In relation to the training around managing parental partnerships, the teachers also stressed the need for training on how to deal with adolescents. The teachers’ narratives uncovered the discrepancies embodied in the current SHE. These discrepancies could be rooted in the inadequate training provided to the teachers. As revealed by the teachers, students in lower levels (grades 7 and 8) show great enthusiasm and interest in the education provided while that interest seems to wane as they mature. Although the teachers knew that adolescents needed to be treated in a special way, sometimes as adults and on other occasions as children, teachers seemed to be unprepared about how to do it. Molly stipulates the ideal training needed for the teachers: 74  “ ….because they [adolescents] are a unique group so they need a particular kind of sex health education which is suitable for their needs. … they should try to design something suitable for their age group; where research has been done on how to handle; and we teachers should be trained” Obviously, the teachers were acutely aware of the effects of their incompetence on instruction as Molly continues to explain: Some students are disengaged; they don’t participate actively because there is lack of an exhaustive discussion. When students ask you questions and you don’t know most of the things, they will not continue asking. Molly’s frustration resulting from her inability to authentically address student’s concerns was apparent. Although other intricacies such as time constraints come into play, the role teachers’ incompetence plays cannot be understated. The teachers felt that if they were trained on how to manage adolescents, they would clearly know how to encourage student participation even for those topics with which they were not very conversant. In the face of such complexities, teachers have tried to navigate the issue by employing different pedagogical methodologies including using real life experiences as Beatrice explains:  … and on top of that, you give them examples; through real life experiences; you just know somebody who did what and the end result—so real life experiences; even they themselves, they can give you such examples; like from the elder sisters, relatives, etc…. and in that way, also come in to give them more accurate information, you have an avenue of teaching/telling them what is actually expected of them; so that they don't fall in such problems. 75  However, teachers stressed that life experiences must be relevant to the students if they are to bring about the desired results as Jolly emphasizes:   As I said, if you bring in a real life experience examples—like people actually dying, … if you tell them that mad man you see on the street  may not be a good one but if you bring- hmm, what is the name of this singer who died in South Africa, Brenda Fassie ?─it was all over that she died from drugs....., if you bring in a vivid example like that- and those are the people they want to associate with,  at the peak of her career, of course with Michael  Jackson, this is a new generation they may not associate with him. Unfortunately, not all teachers are cognizant of this fact as the narratives reveal. Moreover, if not used effectively, such an approach is likely to cause more harm than good since it requires teachers to involve students in sharing real life examples about themselves. For instance, they must be prepared to handle emotions and feelings of anxiety which arise as a result of talking about such life experiences especially if the experiences are associated with traumatic memories. Through effective training, the teachers felt they could competently deal with the students in these situations. Summary of theme: Teachers’ preparedness to handle sexuality discourses This theme embodies teachers’ standpoints around training in sexuality discourses. The narratives have elucidated their outcry for the need to be carefully prepared if they are to mitigate the negative sexual health outcomes through implementation of SHE. Their voices affirm that most of them are not adequately prepared and this affects their instruction in profound ways. They contend, this training should encompass how to manage a complex issue such as sexuality, dealing with adolescents and collaboration with parents among others. With proper training, teachers felt they would have skills necessary to engage students and collaborate effectively with 76  parents, which to a great extent would lead to successful delivery of SHE. The next theme deals with the current SHE framework in schools and how it shapes the discourse. 3.2.4 Relegation of sexual health education to extracurricular status undermines its value and potential In Ugandan schools, sex education is not included within the main curriculum. Rather, it is proliferated in other subjects and also handled in various clubs as discussed in Chapter 1. Occasionally, “talks” are organized at particular stages of the school term to address certain topics. Sometimes, resource persons are invited to address the issues or the teachers facilitate the talks depending on the envisioned goals. This framework is reflected in all the schools I visited with the exception of MBO that had the “gender desk” to complement this universal framework. Generally, the teachers’ narratives reveal layers of frustration with this framework. They assert that it sabotages effective delivery of SHE since they struggle to ensure that all students access the information. With this approach, the teachers argue that not all the students are members of those particular clubs and yet, sex health education is such a critical component which every student must access at school. Moreover, they contend that most clubs largely concentrate on HIV/AIDS leaving other sexual health concepts such as growth and reproduction on the periphery. Ironically, it is these other neglected concepts that students seem to be more interested in. This assertion is in line with Mutonyi’s (2005) recommendation that HIV/AIDS strategies in Uganda should instead be geared towards addressing sexuality and reproductive health. In addition, inviting resource persons seems to be a problem. The teachers stressed that these visits did not happen often enough and because of the big number of students, they fail to answer all the questions students normally have. Moreover, in the event that a scheduled 77  workshop does not take place, there is a chance that a whole term can elapse without any training because of the already crowded curriculum. Further, teachers expressed concern that some schools may not afford to bring in resource persons due to the associated logistics. Then, sex education is proliferated within the curriculum in some subjects such as CRE and biology. As much as this covers some topics, the teachers felt there was lack of time to exhaust all the topics since they are constrained by an exam driven curriculum. Teachers are assessed on what they deliver in terms of grades and not necessarily on how they have instilled morals. Besides, in biology, the topic of reproduction is normally taught in grade ten when students have already acquired a great deal of information from many other sources and already informed their judgments.  One solution to overcome these challenges was suggested by Jolly from GBO and Olga from BBO. They envisioned a compulsory timetabled SHE specifically designed for the lower grades (7 and 8). During the interviews, Jolly did not want to engage in any conversation before delving into what she did not like about the current sex health education framework in schools. She was given a chance to deliberate over the issue and discuss the matter in whatever order and style with which she felt most comfortable. Jolly’s opening remarks are revealed in the fragment below in which she succinctly articulates her feelings:  I don’t like the fact that it [sex health education] is not time tabled as an important subject on the time table; I think it requires a lot of time considering the number of issues we have to discuss so it should really be part of the curriculum and be time tabled; we are doing it kind of informally; I think that is not fair; and yet it plays a big role in the day to day lives of students. 78  Although this approach was not proposed by all teachers, when I asked for their views around Jolly’s and Olga’s suggestion, they all seemed to agree that it should be part of the curriculum, even the teachers from MBO school, which had a unique framework, including the gender desk. Their argument was that duplication of the system at their school was a problem since many schools are constrained by various factors some of which are discussed in preceding paragraphs of this section. The narrative below is Paula’s response to her fellow colleague Beatrice on the current framework. She erases the fears Beatrice raised around taking such a bold move:   I don't know my colleague but to differ a bit from her, considering that many schools do not handle the issue, I think it should be compulsory and timetabled. We are the makers of the curriculum, we can re-organise ourselves and we see where we can fix it, you know, life is not only about academics, this doctor, or lawyer or pharmacists to become, needs to be guided on the challenges of life. Paula asserts that a timetabled SHE curriculum is necessary to equip students with skills to overcome “the challenges of life” for them to fully succeed in their future professions. From her perspective, she is convinced that SHE should be an integral part of adolescent education which is in line with Jolly’s and Olga’s beliefs. Interestingly, teachers are aware of the dire implications of making SHE compulsory especially on the already crowded curriculum, but they believe that it would be worth the risk. They even had suggestions around managing those challenges as best explained by Jolly:   We know that the curriculum is loaded with so many things…hmm, but in senior 1 and 2 [grade 7 and 8] , it should be a  compulsory subject—at least for two years; because this is the time the children are changing; and they have a lot of issues to deal with and they 79  don't know how to go about them; then maybe later—well, it may not be examinable but like we do CRE, by the end of two years, everyone has a foundation—kind of, then after that, we can go in with what we have at the moment—the informal part. The teachers suggest that a compulsory SHE will be particularly ideal for the young students who are still forming their identities. As explained in Section 1.8.4, teachers believe that one of their main roles as SHE pedagogues is to acculturate children into society’s acceptable norms and beliefs. Teachers therefore consider this stage to be the most ideal for molding students and working with them to equip them with skills on how to overcome the challenges related to sexuality.  3.3 Conclusion of chapter three In this chapter, I have presented the findings of the research undertaken to investigate the question: What and how are the contextual factors as perceived by sex health education teachers in Uganda influencing classroom discourses on sexuality? Six teachers who teach sexuality discourse in different capacities were interviewed. These teachers were selected from well-established schools in Kampala that offered different forms of SHE within their curriculum. A number of research tools including researcher’s field notes, e-mail correspondences, semi-structured questionnaires, and audio recordings were employed. Teachers’ opportunities and the challenges they encountered as they handled sex health education were deduced from their narratives. I have presented teachers’ life experiences, both personal and social, and have elucidated how the resultant stories were constructed dialogically between the researcher (myself) and the teachers (Lather, 2006). Rich excerpts are intentionally displayed to give each teacher a voice.   80  From the findings, it is evident that the SHE provision in secondary schools is surrounded by many inequities. Clearly, sexuality is a multifaceted issue and teachers revealed various layers of nuances and levels of ambivalence with respect to educating adolescents. Perhaps, what is nerve-wracking for the teachers is their lack of freedom to handle the discourse independent of firstly, the social constructs and ideals which they feel obliged to abide by and secondly, their own ideals which in most cases are shaped by cultural and religious norms. In turn, this dilemma is aggravated by lack of a very important facet in their toolkit which is training. Regardless of these setbacks, findings indicate that there is general support for provision of SHE, and teachers are enthusiastic about guiding young people on how to overcome the challenges in life.  Finally, although I have presented teachers’ stories, I am aware that “narrative inquiry remains an unfishable business; researchers step in and out of school settings coming away with stories that are always incomplete and partial” (Clandinin, 2007, p. 375). Therefore, in the next chapter, I will discuss these findings and open up a conversation for continuous engagement with the stories.  81  Chapter 4: Discussion of Results  The bulk of the discussion in the preceding chapters focused primarily on the methodological approaches, theoretical foundations, and the results of the study. This chapter ties the findings together into the theoretical framework of the study, the reviewed literature and the researcher’s personal experiences. In addition, it scrutinizes the teachers’ narratives in relation to the title of this thesis: Sexuality Education within High School Curriculum in Uganda: Exploring Teachers’ Perceptions of Contextual Influences on Classroom Discourses. The discussion is presented through a lens shaped by the teachers’ narratives, the researcher’s own experiences both as a student and as an educator who handled sexuality in various contexts. Through this lens, the researcher explicitly states that the themes that emerged did so simply because of the realities and ideals dictated upon the discourse.  Generally, much of what was revealed through the literature review regarding an effective sex health education framework resonated with the results of this research. To a great extent, the teachers were aware of how to handle the discourse, but in practice, what they delivered was far from ideal because of a multitude of confounding factors. The core of the argument in this discussion therefore revolves around the tangential relationship between two forces, the realities and ideals surrounding the discourse and how they unfold into inextricable factors which dictate the way SHE is delivered in secondary schools.   The discussion  is divided into three parts. The first part focuses on the general view held by teachers and other members from the periphery around SHE provision in schools. The second analyzes the effectiveness of the current SHE at addressing the needs of adolescents. In this section, controversies hovering over the discourse are identified, elucidating how teachers’ pedagogical strategies can at times impede student engagement. The last part highlights  the 82  factors that go beyond school parameters and yet constrain the discourse. Critical questions to enable teachers to scrutinize and rethink their pedagogical practices are raised.  4.1 The efficacy of sex health education in schools The teachers in this study were in full support of SHE, and felt a sense of fulfillment in what they were doing. “As an educator,” Olga narrates with a smile, “I have found it gratifying in that I am able to a make a positive difference in [the] lives of these young men”. Olga’s viewpoint was shared by all the teachers in this research. Generally, they were very enthusiastic about providing SHE, and asserted that it is a critical component of the students’ lives and that it provides a needed foundation for their future careers. Paula argued that unless the children are guided through the challenges of life, they would not be able to achieve their fullest potential. This is consistent with literature around adolescent sex health education. I could not agree more with Paula’s and several other teachers’ assertions. Sex health education should be a critical component of young people’s education. I witnessed firsthand the effects of inadequate sex education on the lives of students, particularly girls. The negative sexual health outcomes can be devastating.  It is in the same vein that the concept of universal access to reproductive health is supported globally. In fact, it is featured in the United Nation’s 2013 millennium development goals report (UN, 2013) as one of the areas which needs great emphasis, particularly in matters of maternal health and HIV/AIDS. These goals cannot be achieved without provision of adequate sex health education particularly to adolescents. As clearly articulated by the United Nations Population Fund (UNFPA, 2013), adolescence brings not only changes to their bodies but also new vulnerabilities to human rights abuses, particularly in the areas of sexuality, marriage, and childbearing.  83  . Teachers are very cognizant of adolescence as a stage when children are changing biologically and if the stage is not handled well, particularly in sexuality matters, the consequences can be adverse. Through their various experiences, they know the dire consequences of inadequate sex health education that negatively affect adolescents emotionally, psychologically, economically, and socially. In addition to these “indirect” consequences, the teachers are aware of direct impacts and consequences that could lead to death such as fistula, HIV/AIDs, and risks related to abortion. With this nuance, the teachers strive to educate students so that they avoid such consequences. The irony though is that this commitment to prevent students from facing these devastating outcomes at times takes precedence over teaching students scientific facts about various sex related phenomena. As a result, this creates conflicts within the discourse as will be discussed throughout this chapter.  4.2 Effectiveness of the current SHE framework at meeting adolescents’ needs Although the teachers acknowledged that there is still much to be done, they believed that they had done a commendable job amidst a myriad of constraints. As revealed through their narratives, it was evident that students, particularly those in lower grades enjoyed the education provided and followed the teachers’ advice. Generally, teachers drew from their stances rooted in societal norms, religious beliefs, personal experiences, and school culture among others to handle the concept. Religious and cultural values are peculiarly highly promoted, and as the narratives revealed, the teachers were always cautious about relating their teachings to these values. Students are constantly urged to avoid “social pressure acts” such as condom use, homosexuality, and abortion. Instead they are asked to focus on abstinence, G(g)odly behaviour, and obedience to the culture.  84  Although one cannot claim with complete certainty that the sexual behaviour of children is solely shaped by the education provided, there is some grain of truth here speaking from my own experiences. I went to Kigezi High School (1991–1997) which is one of the middle class mixed boarding schools in Kabale, Uganda. During my tenure at Kigezi, there was no formal sex education, but the school had a strong Christian foundation upon which behaviour was modeled and molded. Although sex related concepts were incorporated into subjects such as biology and CRE, the main teachings were primarily instilled through the hidden curriculum, that is, “That more obscure, less visible part of the curriculum…─ that which is taught implicitly, rather than explicitly, by the school experience” (Henson, 2010 p. 13). Every morning, the school would start off with the general assembly. It was mandatory to read scripture from the bible with the intent to instill morals in students. On several occasions, conferences would be arranged where locally renowned preachers would be invited to continue with and expand upon biblical teachings. Although some students would “go astray” and fail to follow through, those students who listened, believed, and followed the religious teachings managed to go through high school without any negative sexual health consequences. I could assert with certainty that this model worked for some students, at least during their years in secondary school.  Therefore, it is not surprising that most teachers in this study believed that the education they provided to some extent was successful. In fact, when Paula was questioned as to what she said about changes in the way they provided sex education, she responded, “We design our programs so we like them. We sit as a group/team and decide; so for me, I like all the programs. So we think our programs are successful. I like them↑.” 85  Hence, I suggest that the framework used in schools, although far from being comprehensive as recommended by UNFPA and other United Nations agencies, it did have some positive impact in secondary schools and to argue otherwise would be unproductive. However, we cannot refrain from scrutinizing the framework unless we want to ignore the weaknesses, which were clear from the teachers’ narratives. Indeed, the SHE framework leaves much to be desired. Interestingly, the same contextual factors of African culture, religion, media and technology, and social stances upon which teachers draw to teach sexuality are the very ones that constrain the discourse. This was an issue because as discussed in the literature review, social constructivist theory stresses that science teachers must be well equipped with scientific facts to support their arguments for teaching to be effective. In this study, this notion seemed to not stand true in various scenarios. To confound the situation further, some teachers still considered themselves as sources of knowledge as revealed through Olga’s narrative: As a School Counselor and Biology Teacher I have been able to impart to students sex health related issues so to create awareness and prepare the students for the challenges and situations the students may encounter after completion of high school so as to [nurture] nature future responsible and mature focused adults. Olga’s choice of the word “impart” reveals a multitude of beliefs behind teachers’ instruction. Most teachers were in charge of teaching instead of employing Vygotsky’s scaffolding techniques that included providing sufficient support to stimulate student learning.  The teachers’ narratives prompted me to reminisce about my years as a biology teacher, a senior woman teacher, and as a school matron in one particular Ugandan school. My daily mantra included thinking about how to negotiate ways to deal with sex related concepts. I wondered, should I delve into certain sexuality concepts raised by students? The discomfort I 86  would feel while teaching reproduction in biology was immense. I know with certainty that students sensed my discomfort, although I cannot explicitly state how this affected the teaching and learning process. For now, with the benefit of hindsight and through the teachers’ narratives articulated in this study, I am fearful of the profound effects I could have had on student engagement. It is not surprising that I can relate to a number of issues that the teachers in this study struggle with on a daily basis. These issues manifest simply because of the ideals around the concept in various contexts. When the teachers are faced with the ‘on the ground’ realities of the classroom, even with the best of intentions, they realize that certain ideals become “unrealistic” thus resulting in tensions. Most areas of concern are cultural and context based, and although they might seem easy to navigate for “outsiders”, it is a different experience for the teachers in charge of the discourse. These tensions eventually culminate into a flawed SHE framework which is evidenced through students distrusting their teachers and the education provided as discussed in the ensuing sections.  The gaps identified in the current framework provide an opportunity for teachers to re-examine what they teach and the pedagogical approaches they employ, with the aim of diffusing these tensions. Contrary to Paula’s’ assertion that they are satisfied with the framework at their school, I argue that such an attitude is detrimental because complacency cripples programs. My belief is that even the best programs need improvement to remain relevant. As elucidated in the literature review, there are many setbacks that hinder sex health education, not only in Uganda but elsewhere. These challenges should awaken teachers to engage in self-reflexivity and to critically analyze their pedagogical framework with the intent to find ways to navigate this complex discourse. 87  This critical analysis can be drawn from the social constructivist philosophy of learning (Vygotsky, 1978) and the Conceptual Change Model (Posner et al., 1982). As already discussed in Section 1.8.1, central to the social constructivist theory is the importance of ascertaining existing cognitive frameworks. Without understanding students’ prior experiences, how these are constructed, and how these experiences influence learning, enacting conceptual change becomes an extremely complex process (Driver et al., 1994; Henson, 2010; Johnson & Gott, 1996). This assertion seemed to stand true in this study. From the teachers’ narratives, it was evident that quite often, students retained their preconceived notions regardless of their teachers’ efforts. Unfortunately, as various authors have argued (Clement, 1993; Driver & Erickson, 1983), some of this prior knowledge is inconsistent with canonically-correct scientific ideas around sexuality discourses. In the next section, I attempt to uncover why students would retain their preconceived notions and include a discussion on factors which originate from teachers’ instruction, and those which are inherent in the system.  4.2.1 A critical look at the teachers’ role in fueling distrust from their students From the analysis of teachers’ stories, it is evident that most of the information given to students created some kind of cognitive dissonance which caused them [students] to be dissatisfied with their world views as stipulated in CCM. One issue though, is that the new information did not always seem to provide more viable explanations which resulted in students not trusting their teachers enough to re-evaluate their ideas in favour of the new canonically correct ideas. While the younger students were very interested and very eager to learn, their interest seemed to wane with age. Therefore, it is critical to understand why there is disregard for SHE among the students in higher grades.   88  One possible explanation is that although students hold worldviews resulting from previous experiences, they approach the discourse with an open mind and eagerness to learn. Indeed, the teachers revealed that the young students have very many questions. As they advance in age, they keep getting information from teachers, media, home, and various other sources. A time comes when for every piece of sex health education information they receive; they compare what they have learned to what they already know. Ultimately, they decide that the teachers’ message is not worthy of their trust. As a result, their behaviour remains unchanged or they continue to search for alternative explanations which are more plausible and meaningful to them. Consistent with constructivist approaches, for teachers to effectively teach sex health education, they must ascertain what students already know about the concept. In this study however, most teachers seemed to approach the discourse with their own preconceived notions around the ideal sex education. They seemed to ignore or undermine what students brought to the learning environment. In the end, the students did not trust their teachers and continued to exhibit contrary behaviours, some of which were very risky. For instance, the girls continued to trim their skirts, although teachers promoted long skirts; they remained with their beliefs around hygiene and sanitary disposal against the teachers’ instruction and perhaps, most distinctly, they did not change their behaviour around involvement in early sexual activities. As discussed throughout this thesis, the main message emphasized in secondary schools is abstinence. However, regardless of the efforts, all the teachers interviewed acknowledged that some students were sexually active, and there was evidence of condom use. So why would adolescents engage in risky behaviours regardless of instruction? This seems to contradict with Santrock’s (2001) theory that when adolescents are given clear rules to guide their behaviour, they more likely exhibit morally accepted behaviour. What brings about the deviation?  89  A plausible explanation can be drawn from the way teachers handle the concept although  some of the factors are far beyond the teachers’ control. Critical examination of the strategies employed by the teachers reveals shortcomings that help explain, at least in part, why these initiatives have largely failed to provide adequate education to the students. Unveiling these constraints will provide an opportunity for educators to engage in meaningful conversations with the hope of finding solutions. For instance, many times, teachers give conflicting messages and fail to fully address students’ concerns. In the end, this failure constrains the discourse. To expound on this argument, two main examples will be used to illustrate how various contextual factors led to teachers giving conflicting ideas and how this influenced student engagement. Controversy around sex and condom use In many Ugandan communities, because of various stances rooted in religion, culture, and other social norms, sex, particularly among adolescents is primarily portrayed as an evil and immoral act. In fact, when I was growing up, it was referred to as “ebyabafu” which literally means “things done by the dead.” Ironically, when we turn to science, sex is revealed or understood through a different lens. As Siegel (2013) contends, adolescence is a stage when children become interested in sex, and with their emotions and hormones, they might not find the act as evil and distasteful as portrayed by the teachers. As an educator, I am tempted to ask: what if the teachers stressed that sex, if done correctly and at the right time can be enjoyable? Wouldn’t this be a plausible approach? But because teachers desperately want the students to abstain, they lead the discussion with the negative effects and do not provide the real science and known facts about sex.   90   In the same vein, most teachers tended to overemphasize the negative side of condoms, blurring the science and the known facts around their usage. For instance, some of the main reasons teachers did not want students to use condoms included statements such as “condoms are weak and can burst” and that students do not know how to use them. These assertions have some truth and a large body of research shows that condoms are not 100% effective in preventing pregnancy and other sexually transmitted diseases. For instance, studies by Stoneburner and Low-Beer (2004) and Weller and Davis (2002) show that condoms are typically only 80-90% effective. The teachers however chose to promote the negative side (10-20% failure rate) and neglected the fact that condoms in fact provide up to 90% protection against pregnancy and sexually transmitted diseases if they are used consistently and correctly. Regardless of these facts, teachers’ dislike for condoms is evident and they vehemently condemn their use among adolescents. In the event that students discover such simple truths (which they normally do), this escalates the distrust they have for their teachers.   Jones (2008) argued that the campaign against condom use emerged around 2004 when the President's Emergency Plan for AIDS Relief (PEPFAR) demanded that all beneficiaries promote abstinence only, or else the fund would be withdrawn. According to PEPFAR’s mandate, as stated on their website, unmarried individuals particularly youths should abstain from sexual activity. They should view abstinence as the best and only certain way to protect themselves from exposure to HIV and other sexually transmitted infections (PEPFAR, 2004.). As a result, beneficiaries of this fund, including schools were obliged to start promoting abstinence only. Although this school of thought might be appealing, it cannot offer a convincing explanation for someone who is familiar with sex health education in Ugandan secondary schools. During my years in high school, and later on as a teacher of the same grades, I never 91  witnessed situations where condoms were recommended to adolescents. Although PIASY came out with the ABC model, the emphasis has always been on abstinence for the youth in secondary schools. Mutonyi’s (2005) study on perceptions of biology students in Uganda around HIV/AIDS clearly showed that PIASY’s prevention strategy depended on the age group. Condoms were vigilantly promoted for married couples and for students at higher institutions of learning. The fact that condoms have not historically been recommended for adolescents could possibly account for the high birthrates prevalent among girls aged 15-19 in sub-Saharan Africa as revealed by the UN Millenium Development Goals Report (2013). The report indicates that adolescent girls are deeply condemned for their involvement in sex, much more so than adult women, thus making it difficult for them to seek for help from reproductive health services for fear of this stigma.   Despite the teachers’ message around abstinence and its many advantages, the reality is that students are sexually active. Critical analysis of the history of sexuality discourses in Uganda unravel the evolution of this trend. Because of globalization and “modernity16”, moral values which once held societies together are dying. For instance, in the past, people who upheld culture were rewarded, and those who did not were severely punished. In those days, Santrock’s (2001) theory of individuals exhibiting desirable behaviour because of the reward or punishment associated with certain behaviours was in practice. Specifically, because the punishments were fatal, many people feared going against cultural norms. For instance, in my kikiga culture, up to  the early 1900s, when a girl would become pregnant before marriage, they would be taken to an island, popularly known as the “punishment island” and left there to die or they would be thrown 16  Modernity in the Ugandan context simply means adopting modern/ “up-to-date” customs particularly the Western cultures.  92                                                   over the cliff (Bazanye, n.d.; Briggs, 2013; Otiso, 2006). Similarly, in the kiganda culture, as Jolly explained in her narrative, most girls were motivated to remain virgins because their in-laws would send goats to their parents as tokens of appreciation to the parents for raising these girls very well. Since most of these girls did not want to ridicule their mothers and considering the fact that punishments for “immorality” were fatal, the fear of such consequences was so strong that many young people strove to abstain until marriage. In recent times, certain norms have been challenged and restrictions have lessened.   In addition, globalization has resulted in additional challenges in Uganda. In the past, there was no close proximity between opposite sexes as is in today’s culture. In most Ugandan cultures, marriages were pre-arranged meaning the bride and groom would never cross paths until the wedding night (Otiso, 2006). The children were not in mixed sex boarding schools as in today’s culture where boys and girls are in constant contact. These boy/girl interactions take place amidst their biological body changes and emotions. My argument here is that the school culture has evolved (from single sex schools or no schooling at all to mixed schools) which has created more interactions between boys and girls. However, the education system has not been able to adapt to this evolution, and this has left a gap that can be bridged by creation of a relevant SHE that recognizes such societal changes.  The dilemma I see is that Uganda embraces modern issues through programs that promote children’s rights and freedoms. Yet at the same time, the same government fails to equip students with the skills and information needed to confront moral challenges. No wonder, Molly said that students tend to capitalize on C. Are educators ignoring adolescents’ realities and the challenges associated with this stage of development? How are educators positioned to close this gap? It is distressing that even when the teachers were probed further about what they would 93  do with the reality that students are sexuality active regardless of their teaching, some of them like Gorretti maintained that they would still promote abstinence because they do not endorse condoms.   Ironically, research confirms that a comprehensive sex health education among youths has no correlation with their early involvement in sexual activities (Center for Advancing Health, 2007). There is however overwhelming evidence that adolescents are sexually active regardless of abstinence education (Stanger-Hall & Hall, 2011; Trenholm et al., 2007). As a caveat, I must stress that I neither endorse sexual intercourse among adolescents nor do I encourage condom use. Rather, my argument is reserved for those adolescents who have made up their minds to have sex regardless of the abstinence message. Would they rather engage in sexual activities without protection, or would it be better for them to use a condom that provides them up to 90% protection against pregnancy and STIs? I agree with. Halperin et al.’s (2004, p. 1) argument that “when targeting young people, for those who have not started sexual activity, the first priority should be to encourage abstinence … ”. For those young people who are sexually active, correct and consistent condom use should be supported.  This study revealed that the general approach teachers are employing, of ‘sticking to their stances, regardless of the students’ needs, will continue to escalate the distrust students have in them, making the education unfruitful. In the process, this undermines the conceptual change theory. At this point, the debate should not be about condom use versus abstinence. Rather, we should be asking ourselves how we can equip young people to overcome the challenges of life given the on ground realities. This is by no means a simple task. It is likely that conservative members who try to maintain the school culture as well as other values may not tolerate these stances, but with the teachers’ efforts, they would eventually espouse them.  94 Dilemmas around dressing and hygiene Teachers and students clearly have diverging views around a dress code. The teachers restrict the girls from wearing tight and short clothing as they argue that such styles are sexually alluring to male teachers and distract boys from concentrating on their studies. It is irrefutable that sexuality is highly cultural and depends on different contexts and the worldviews held by communities. For instance, in Uganda, men/boys might actually find it sexually appealing to look at girls’ thighs and legs whereas this might not necessarily be an issue of concern in Western cultures. In fact, the recent anti-pornography law in Uganda (Kamukama, 2013) was enacted partly to stop “indecent” dressing for women implying that “decency” is an area of concern. While this law was enacted, it is clear that students are not about to start dressing the way teachers want them to dress. Girls continue with their “modern” dressing style. In fact, some feminists have argued that such a move is geared at promoting paternalistic tendencies which further constrain girls and fail to underscore the role of men in sexuality discourses.  Similarly, the issue of hygiene, particularly proper disposal of sanitary pads, remains an area of contention. Teachers give clear instructions and even provide proper disposal mechanisms, but some students seem not to be bothered. This behaviour can possibly be explained by the “adolescent-culture” which is influenced from the students’ backgrounds and the information they access from various sources. Historically, in many Ugandan cultures, it was a taboo for males to see used sanitary towels. In fact, girls were told by their ssengas that they would become barren if they exposed their used sanitary towels hence menstruation was taken as a sacred phenomenon, and girls were very diligent about proper disposal. Teachings, which emphasized false negative outcomes, were common in the African culture as the intent was to instill values. Today, with the disintegration of the family unit and ssenga institution, there is 95  probably no one person to instill such values in students. Moreover, students are constantly getting information from science publications, media and technology, peers, and other information sources which might not necessarily stress the importance of certain values. Ultimately, students realize that at times, there is no correlation between some cultural beliefs and the science or information they have. For instance, how could exposure of a used sanitary towel lead to barrenness? In such scenarios, teachers need to employ constructivist approaches and delve into the real-life worldviews the students have around such concepts before attempting to instruct them on what to do. With this approach, teachers can provide a proper scientific explanation to dispel such myths thus making it easier for students to abandon them.  Inarguably, there is a dissonance between science and various values instilled by the teachers. Moreover, adolescents are knowledgeable about the world; they know what happens elsewhere, and they probably see no dire consequences of certain behaviours which teachers strive to instill. Not until teachers are able to explain such discrepancies and give plausible explanations will the students re-evaluate their ideas in favour of canonically correct ones. Henson (2010) argues that failure to connect learning activities with students’ prior knowledge creates cognitive dissonance and such an approach clearly constrains the CCM process. In other words, if students do not find the teachers’ explanations more viable, then they will hold onto their existing ideas and continue to navigate several sources in the search for answers. In concluding this section, it is worth mentioning that it is unlikely that students and teachers will ever fully agree upon the way sexuality issues should be handled. However, teachers must employ pedagogical practices rooted in constructivist approaches and CCM to ensure that students feel that their input is valued. What becomes even more disturbing is when myths are perpetuated by teachers who are supposed to be the sources of the information. 96  Teachers are challenged to root their explanations in science and provide viable explanations based on canonical science. As discussed throughout this section, it was evident that some of the minor facts around sex, condom use were intentionally omitted by teachers or some half-truths were given to the students. In other scenarios, teachers’ stances around various concepts overshadowed the science behind the phenomena, and these are the very ones which result in the distrust students have for the teachers.  4.2.2 Beyond teachers’ instruction and the school perimeters As clearly explained in Section 3.2, an amalgamation of contextual influences constrain the discourse in various ways. Ultimately, teachers feel that students distrust them. Students consider teachers to be old fashioned and out of touch with reality. They tend to trust their peers more (Siegel, 2013) and other sources such as media. Drawing from my previous experiences in the Ugandan education system and from the analysis of the teachers’ narratives, my view is that these problems go far beyond sexuality discourses as discussed below. Stakeholders need to be aware how far reaching certain beliefs are in order to appreciate why strategies such as “imparting” knowledge, enacting rules about dressing, promoting religious and cultural values, albeit useful, might not fully resolve the problems hovering over the discourse. To explicate this argument, the influence of Western culture will be used, since teachers believed that this factor was one of the main issues constraining their instruction.  Although the teachers viewed Western influence as a constraint, they did not seem to be aware that they themselves were promoting Western tendencies, either consciously or unconsciously. In Uganda, secondary school curriculum of today is largely unrepresentative of the on-the-ground realities in almost all disciplines. Part of this disconnect can be traced back to the colonial days. Specifically, the Westernized version of Uganda’s education system seems to 97  be geared towards promoting Western culture, downplaying a context-specific education, which would inspire students to connect with and ultimately love their own culture. This is evident in many other subjects where rote learning is promoted instead of using real life examples that would enable students to relate what they are learning with their lived experiences and local environments. Furthermore, major textbooks are from the West, and teachers rarely modify the content to give examples specific to Uganda. Right from the lower levels of education, children are introduced to English language (although this is changing with the promotion of local languages in lower grades), and the books they read portray Western culture. Why then wouldn’t adolescents want to dress, talk, and behave like their “modern” counterparts from the West?  Null (2008) in his historical analysis narrative article, observes that the process of curriculum development usually lacks a solid foundation. This is exactly what is happening in the Ugandan education system, particularly in sexuality discourses. Although the colonial masters are long gone in a physical sense, their legacy is entrenched and even revered in the present process of curriculum development. Until the entire curriculum is revamped to reflect the on-the-ground realities and proudly promote the Ugandan culture, one can anticipate that the Western influence on youths in the country will continue to be an issue.   Therefore, in approaching sexuality discourses, educators do not need to take the simplified approach where they assume that students will adopt and put into practice what they are taught. Instead of frowning upon the reality that students refer to them as old fashioned, they should be asking themselves questions such as these: Why do students think of me like that? How is their perception of me affecting their engagement in the classroom? How can I work with this fact to improve teaching and learning? Employing such constructivist approaches and a 98  critical reflexive stance to uncover such intricacies will go a long way in enhancing conceptual change in sexuality discourses.  99  Chapter 5: Conclusions, Implications and Recommendations   “We owe it to children to get this right. If SRE lessons aren’t preparing children properly for life as adults, then they need to be improved”17.  The main objective of this thesis was to investigate teachers’ perceptions of contextual influences on sexuality discourses within secondary schools in Uganda. The inquiry revealed that while there is some form of sex health framework in place, it is largely inadequate and constrained by various contextual influences; hence the need for reform. This chapter therefore expands on the proposals alluded to in the preceding chapters and highlights some possible reforms. Admittedly, these reforms may prove difficult to implement but realizing them is not impossible. The proposals are for teachers as well as curriculum designers, various stakeholders, and policy makers. Suggestions for further research are also highlighted.    This study revealed the dilemmas and opportunities sexual health education teachers in Uganda face. Although the teachers in this study fully supported the SHE provision and aimed to provide it in the best way they could, this was by no means an easy task. Their stories revealed a multitude of tensions and uncertainties prompting me to wonder if the SHE provision in secondary schools will ever be streamlined. The teachers’ stories captured their lived experiences and spoke loudly for the forces, both seen and unseen, which constrain sexuality discourses. Through the whole process, I have come to acknowledge and appreciate the complexity, the fluidity, and the elusive nature of the discourse, both in Uganda and elsewhere.   17 David Butler, Chief executive of the UK National Confederation of Parent Teacher Associations.  100                                                   For instance, although it is common knowledge that culture, religion, and socio economic backgrounds influence sexuality discourses, the way in which these factors unfolded in this study were disturbing. Teachers constantly negotiated between who they were and how to provide an education which met the varying needs of all the stakeholders amidst all the aforementioned contextual factors. Furthermore, some of the cultural values which once molded behaviours are dying, and teachers do not seem to have alternative motivators for students to espouse what they are taught. As a result of these tensions, undesirable outcomes have surfaced where students distrust their teachers, remain with their own preconceived notions, and continue on their relentless search for more information from other sources. The teachers therefore have a steep task to continue searching for appropriate pedagogical approaches to diffuse these dilemmas. As educators, we can never fully change who we are; our stances and beliefs are usually deeply entrenched. However, we should always engage in deep and meaningful self-reflexive conversations to ascertain how our perceptions and social stances have implications for the way we teach. This study challenges teachers to move out of their comfort zones, (re)consider the slippery and complex nature of the discourse, and employ various pedagogical approaches to bring about meaningful learning. This is in line with social constructivist perspectives that human beings approach learning with their own prior knowledge as a foundation, and with the Conceptual Change Model which posits that students abandon their previous held ideas if they find the new knowledge meaningful. This study has confirmed that sexuality is a context specific discipline with no defined boundaries. Teachers therefore need to be cognizant of this fact with the aim to improve the discourse. At a time such as this, we should step away from the dichotomies and work together problematizing the dominant cultures and hegemony which 101  constrain the discourse. We should replace the “versus” with “and” and strive to have meaningful discussions with the aim of improving the discourse.  Finally, this study has raised more questions than I can provide answers for, but it has also raised hope. My thoughts are reflected in the words of renowned curriculum theorist Ted Aoki (2005): “Although not too long ago this chord sounded strange deep inside me, that strangeness is fading. … I am experiencing a sense of committed involvement in co-creating research paths upon which we might meaningfully tread, as before us unfolds a clearer vision of a different research reality” (p. 110). This confidence was gained from the teachers and the commitment they have in providing sex education to their students. What remains for me is to pause and encourage other educators to join the conversation as we ponder the teachers’ narratives. I have no doubt that together we can improve the way sex health education is provided in schools.  5.1 Implications  5.1.1 Implications for sex health education Consistent with the relevant literature, this study confirmed that sexuality is a complex issue, particularly when dealing with adolescents in schools. However, irrespective of this complexity, sex health education can be improved. This study asserts that successful implementation in schools is highly dependent on two main factors: a) the teacher and b) the approach. Although it is widely accepted in scholarly literature that teachers are usually not consulted in the curriculum planning process, and that they are often reduced to the “status of high-level technicians carrying out dictates and objectives decided by experts far removed from 102  the far realities of classroom life” (Giroux, 1988, p. 121), they [teachers] have an opportunity to make an impact on students’ lives in distinct ways. The teacher It takes a special teacher to handle a concept such as sexuality. As elucidated in Section 3.1, teachers from different disciplines (agriculture, luganda, geography, biology, CRE and chemistry) participated in this research. The effectiveness of these teachers primarily depended on who they were as individuals. Among other factors, this teacher must be open minded with a non-judgmental attitude, and yet firm in his/her beliefs. The students need to know that they have an ally on their side, and this would prompt them to open up more to their teachers. This would solve the problem of distrust that the teachers are facing at the moment. The teachers may not necessarily know everything, but the way they handle topics they are not familiar with determines the way students engage with them and with the discourse.  For instance, this could account for the remarkable sex health program in MBO. In particular, there was a teacher who was very enthusiastic and very open minded. Her passion was contagious. Although she had a strong a religious foundation, you could sense that the needs of her students were her number one priority. Quite often, most teachers become too absorbed in their own stances. These stances originate from their religion and culture and tend to overshadow students’ needs. My argument is that although teachers want the best for their students, at the end of the day, the teacher who is attentive to the students’ needs and is willing to modify her/his strategy to tailor it to those needs will ultimately win their trust. Therefore, when the school is identifying this ideal person, regardless of age, subject taught, religious affiliation, and cultural background, such traits must be top priority.  103 The approach Sex Health Education requires a self-reflexive practitioner who constantly engages in conversations with students and fellow colleagues in order to improve his/her practice. This participatory approach has been recognized as an essential tenet of constructivist learning and CCM, albeit a complicated one. As Kelly (1997) observes, the success of the conversations, beyond simply having them, lies with the self-reflexivity of the conservationists, which often times is not an easy task. Teachers highlighted various constraints which posed challenges to engaging in meaningful conversations. Some of these constraints originate from the school as articulated by Olga:  The school is very conservative about such issues and mainly concentrates in the academic development more than the social ones which I personally find disturbing because it may affect the students social and psychological life in the future.  Therefore, as teachers continue to look for long-term solutions and the involvement of other stakeholders, there is much more which could be done. Zeichner (2001) provides a number of questions for self-reflexive practitioners who desire to improve their practice; two of which are relevant for teachers in this study:  i) How can I hold better discussions in my classroom and have a more-learner centred class? ii) Do I conduct my classes in a manner where students feel free to express different opinions and even to disagree with me? This self-reflexive praxis enables teachers to question their beliefs with the aim of problematizing and questioning some of the dominant discourses which constrain SHE. This approach enables educators and other members from the periphery to come to some kind of 104  mutual agreement even around those aspects which the CCM and a constructivist approach may not address.  Teachers in particular are challenged to problematize the dichotomy of teaching, which positions them as masters of knowledge who teach, and  students as receivers who just learn (Apple, 1990). Rather, they are called upon to actively engage their students and have a genuine desire to incorporate their [students’] prior knowledge into practice. Instead of arousing fears in students around various issues, teachers should find ways of relaying the truth to the students. As a result, students will begin to build trust in their teachers, which is a critical foundation for meaningful learning. As articulated by Jolly, sometimes teachers identify that students have a problem, but students refuse to disclose the issues. Although the teachers contend that this behaviour emanates from the culture of young people being raised to not openly communicate with adults (which to some extent is true); a different approach could reverse this trend. Building trust between teacher and student is critically important because without understanding what students are thinking, it is almost impossible to bring about change.  Furthermore, collaboration not only with parents and students but also with fellow teachers was seen to be of great importance. This was the essence of the successful framework in the MBD. In this particular school, it was evident that no program was implemented without the input of other team members. Therefore, teachers handling the discourse, together with other concerned parties including the school matron, senior woman, and school nurse should always come together to agree on what is appropriate. In addition, networking with teachers from other schools would further enrich sex education. I noticed that different schools have unique approaches which could be beneficial to others.   105  In summary, a special teacher and the approach they employ can bring about tremendous changes in the way sex education is provided in schools. However, I must admit that this special teacher needs training to improve the approach even more. A good starting point is for the teachers to avoid being overly dependent on mere speculation and personal experiences and to keep educating themselves through active involvement in research. With this approach, they would be fully informed on what is happening globally within the discourse, hence improving their practice. Ultimately, that is how their voices can be heard and respected during curriculum reforms. Indeed, such teachers are the very ones who normally bring about change, even in schools which are very conservative, due to the teachers’ ability to base their arguments on a solid research foundation.  5.1.2 Implications for sex health education curriculum design Critical consideration of context Designing sex health education curriculum calls for a thorough consideration of the contextual factors which surround the discourse. In this study, cultural and religious norms were so strongly held by the teachers that most innovations were frowned upon as an invasion by Western culture. Although this is common knowledge in the area of sexuality, studies reveal that many initiatives have often been undertaken without a thorough analysis of how these factors play out. In Uganda, concepts such as sexuality are mainly mediated through a social process where young people are enculturated into the new culture by older or more knowledgeable members of the society. As an example, The World Starts with Me, a computer-based  sex health education program, which was developed by the World Population Foundation, Butterfly Works (both Dutch NGO’s) and SchoolNet Uganda (Rijsdijk et al., 2011) could have been greatly improved by thorough consideration of these factors. Moreover, access and use of computers is 106  very limited in Uganda, and yet, they were the main tools of instruction. This is therefore critical for curriculum designers to ensure that these factors are considered so that teachers and other stakeholders do not shun them as a way to promote Western influences. However, care must be taken not to promote certain hegemonic tendencies in the name of these factors. Sex health education curriculum as a tool to dispel the dichotomies  Several dichotomies are evident in sex health education  curriculum, both hidden and formal and this continually constrains the teaching and learning process. In this study, clear dichotomies emerged such as condom use vs. abstinence, Western culture versus African culture, and the appropriate age for implementing SHE. Such dichotomies undermine the discourse. Curriculum designers should draw from Aoki’s (2005) framework of considering curriculum as having multiple orientations or possible ways of approaching a phenomenon. In this way, a new language of possibilities to foster an understanding among one another is sought. Aoki’s framework strives to achieve multiplicity where various doctrines are challenged to ensure that neither party is too comfortable in their own language nor tries to conquer other parties’ territories. Rather, individuals ought to show willingness to change their stances with the knowledge that most ideas are socially constructed. Attempts on how to avoid these dichotomies within the curriculum and how to reach mutual agreement must be sought. Consideration of all social economic backgrounds on sexuality  This research revealed that students with a high socio economic status are as vulnerable to problems resulting from uniformed sexual behaviours as those living in poverty. Yet, a variety of studies have primarily concentrated on poverty. In fact, research in Nigeria (Isiugo-Abanihe & Oyediran, 2004) shows that students from urban area schools with high socio economic status are generally more sexually active than their counterparts from rural area schools with a low 107  socio economic status. The trend is actually not much different in Uganda, drawing from my secondary school years in Kigezi High School where I attended a middle socio economic status school. Because of its nature, the school attracted students from all socio economic backgrounds. I recall that the students who were sexually active were primarily from wealthy families with parents who could afford to give them what they wanted. Most students from poor economic backgrounds concentrated primarily on their studies, provided their parents managed to raise the school fees. This is not intended to downplay the effects of a low socio economic status because they are genuine particularly among girls. Rather, this calls for curriculum developers to be all-inclusive and consider all factors when thinking about sexual health provision in schools. 5.1.3 Implications for policy The need for clear policies around sexuality discourses  The teacher’s narratives revealed several issues around enacting policies in Uganda. Clear polices based on facts need to be implemented and the endorsement would reduce the confusion teachers’ face while navigating the discourse. For instance, clear messages about condom use and abstinence should be stipulated. The government talks about ABC through PIASCY, and yet the next day the president himself campaigns against them as revealed in this excerpt: Our message is put padlocks on your private parts until the time comes to open them when you have a husband. You are not there just to taste and taste (jaribu, jaribu). I can’t tell my daughter or granddaughter to do that. If you start with the right message from the beginning, they will take it – Ugandan President Yoweri Museveni’s speech at the International Women’s day, March 9, 2012 (Okello & Okaba, 2012).  108   In one scenario, the government prides itself on how women are emancipated and have their rights, and the following day a law is enacted banning certain women’s dressing styles. Many groups, including women activists have argued that these laws are ambiguous and that there are no clear strategies to implement them (Kagolo & Alinda, 2014). For instance, Medi Kaggwa, the Uganda Human Rights Commission (UHRC) chairperson has asked the government to urgently re-consider the recent Anti-pornography law to ensure that ambiguities are rectified arguing that it presents many uncertainties which pose a serious threat to the sanctity of human dignity (Masinde, 2014). Teachers should be given autonomy over their practice  Consistent with the literature, the teacher’s narratives in this study alluded to the complexities of their profession where they are treated like technicians and are continually told what to do (Giroux, 1988) unlike most other professions. Indeed, why should a biology teacher be penalized for demonstrating how to use condoms during her class if she/he feels that it  necessary? Ironically, resource persons in other disciplines can use all the materials they deem fit. Instead policy makers should involve the teachers and draw upon and value their lived classroom experiences. After giving teachers this autonomy, policy makers should trust them to implement the policies. Gender particularly problematizing marginalization of girls  Lastly, a study like this cannot be concluded without taking a look at how gender is implicated. Although the focus was not on gender per-se, the magnitude with which it emerged was too strong to ignore.  Paradoxically, the issue of gender is so deeply engrained in people’s ways of being, masking the manner in which it operates. In fact, all the teachers interviewed were female despite my efforts to interview male teachers. On the face of it, this might not be an 109  issue but when one delves deeper, they realize that this trend needs to be problematized. For instance, when I probed Olga from a BBO, as to why she was the teacher in charge of the discourse when one would normally expect a man in this role since this was a boys’ only school, this is what she had to say:  Boys find women to be more of the softer gender, patient, accommodative, and see them more of a mother figure who can relate to them quite comfortably. Rather than male teachers who are by nature aggressive, intolerant and insensitive due to their male ego.  This speaks volumes to the normalization effect which marginalizes certain groups based on gender. Is it really true that nature determines how men and women behave or are all these behaviours socially constructed? As Ellsworth (1994) brilliantly puts it, no teacher whether male or female is free of these learned and internalized oppressions. She acknowledges that because these oppressions are so deeply entrenched, most teachers do not even realize that they perpetuate traits which present barriers to girls. Grumet (1981) advises women educators to re-consider the way they position themselves in relation to the concept of gender inequality within the school system. “It is time”, Grumet charges “for women who call themselves educators to question their participation and practice in schools” (p. 182). Grumet further argues that female teachers can become tools of oppression, based on the logic that objects, consciously or subconsciously, can sometimes oppress their fellow subjects whom they are supposed to emancipate. She therefore proposes that a study into gender matters should not only be limited to sexism but should also explore how both genders are implicated.   Furthermore, Grumet (1981) in her article “Pedagogy for Patriarchy” asserts that “schooling supports the dominance of men in society” (p. 175). Specifically, Grumet argues that the differential treatment accorded to male and female children through activities such as 110  counseling based on their sexual identity marginalizes girls. Giroux (1986) speaks to this notion as well and argues that marginalization of girls through the exclusion of their subjugated knowledge is political. As already discussed, many authors have problematized schooling and have argued that girls are continually considered the weaker sex, who need to be protected. As a result, they are continually overburdened and have no freedom in many aspects of their lives including dress and socialization matters. For instance, why should parents find it culturally “okay” to pack condoms for boys but not for girls? Why should girls be required to wear long skirts because there is a male teacher in class? If young girls in lower grades are developing friendships with older boys, why should it be the girls reprimanded for the behaviour? As Kasente (2003) notes, “UPE18 policy has led to increased access for both sexes, but it does not challenge the social construction of gender in society that tends to disadvantage girls” (pg. 4). Policy makers are therefore challenged to return to the root of the matter and to reconsider how gender permeates curriculum, including sexuality discourses, resulting in the marginalization of girls.  5.2 Recommendations   This research arrives at a set of recommendations and suggestions for sex health education delivery in secondary schools. Specifically, it explores possibilities of engaging all stakeholders in conversations with the aim of devising strategies on how to improve practice.   18 UPE stands for Universal Primary Education and it is a policy which was enacted to ensure that all children, particularly girls are enrolled in schools. In Uganda, this programme took off in 1996 under the leadership of president Yoweri Kaguta Museveni 111                                                   5.2.1 Sensitization of the population about the relationship between comprehensive SHE and promiscuity   The main recommendation is the need to educate the Ugandan population including the teachers on the correlation between comprehensive SHE and promiscuity. It was clearly evident that teachers intentionally omitted certain aspects, some of which were scientifically proven, for fear of encouraging young people’s active involvement in sexual behaviours. Paradoxically, numerous studies have shown that sex health education does not encourage the earlier onset of sex as revealed in the literature review. However, as Claxton (2001) contends, “if parents, teachers, managers, and politicians have at the back of their minds a set of assumptions about learning which are out of date, then we have to start by identifying what they are” (p. 31). This research has identified those assumptions which hover over the discourse and therefore recommends that proponents of SHE should do a thorough job of sensitizing people or else all efforts will be met with resistance.  5.2.2 Inclusion of SHE education within the formal curriculum  The teachers in this study explicitly pointed out the need for sex education within the formal curriculum as a solution to the vast majority of the constraints they are facing. I could not state it better than Olga’s remark, “The Ministry of Education should design and implement a compulsory curriculum on Sex Health Education that must be strictly monitored and supervised”..   Elsewhere, including Uganda’s neighboring country, Kenya, comprehensive sex education programs such as the Kenya Adolescent Reproductive Health Program (KARHP) and Tuko Pamoja are implemented in schools. The education utilizes peer education, life skills education, and mentorship (teachers) to reach youth. In fact, according to the National 112  Coordinating Division of Agency for Population and Reproductive Health Development [NCAPD], (2005), the government recommitted to facilitate the operationalization of the Adolescent Reproductive Health and Development Policy through a national multi-sector approach by 2015. Therefore, further research needs to be conducted on how such models used in other countries could be modified to fit the Ugandan context. This study is timely considering that it is the time when the secondary school curriculum is being revised to make it more relevant. The new curriculum is to be implemented in 2017 according to a report in the national newspaper, The New Vision (Anguyo, 2014). 5.2.3 Suggestions for further research  This research only dealt with a handful of participants. As Connelly and Clandinin (1990) contend, because of such small numbers, narrative inquiry cannot be relied upon on to make major changes. Larger samples which cover many schools should be considered.  Secondly, since teachers gave their views, it would be interesting to see what the students in these schools have to say. This would give the teachers clear feedback on the sex health education they teach and would provide answers on ways to alleviate the tensions which were evident in the teachers’ narratives. Since the goal of educational research of any kind is to improve the learning situations of students, as central players in schools, they should be involved in research (Collins, 2004). As Collins argues, students should be recognized as part of the ecological whole, and they should be allowed to make real contributions.   Lastly, research is needed on how laws and policies are enacted in Uganda. There are many players who influence the discourse, either directly or indirectly depending on the cultural norms, political agenda, and religious beliefs held by different stakeholders. Such should be critiqued. Apple (1990) highlights the hegemony which operates through dominant ideologies 113  within schools to perpetuate inequalities based on race, class, and gender. “Those values”, Apple charges, “reside not only at the top but at our very bottom of our head” (p. 9), and this explains the complexity which surrounds the curriculum within Ugandan secondary schools. Certain inequities are preserved depending on their dominant values and beliefs. As discussed in this thesis, some of these inequities are perpetuated by teachers. Further research needs to be done in this area.      114  References Agaba, J. (2014, June 4). Youths shun condoms during first sexual encounter, The New Vision. Retrieved from http://www.newvision.co.ug/news/656281-youths-shun-condoms-during-first-sexual-encounter.html.  Aikenhead, G. S. (1996). Science Education: Border crossing into the subculture of science. Studies in Science Education. 27, 1–52.   Allen, T., & Heald, S. (2004). HIV/AIDS policy in Africa: What has worked in Uganda and what has failed in Botswana? Journal of International Development, 16(8), 1141-1154.  Anderson, D., & Nashon, S. (2007). Predators of knowledge construction: Interpreting students’ metacognition in an amusement park physics program. Science Education, 91(2), 298-320.  Anderson, D.; Thomas, G. P.; & Nashon, S. M. (2009). Social barriers to engaging in meaningful learning in biology fieldtrip group work. Science Education. 93(3), 511 – 534.  Anguyo, I. (2014, April 7). New O’ level curriculum finalised, The New Vision. Retrieved from http://www.newvision.co.ug/news/654286-new-o-level-curriculum-finalised.html.  Aoki. T. (2005). Toward curriculum inquiry in anew key. In William F. Pinar & Rita L. Irwin (Eds.) Curriculum in a New Key: The Collected Works of Ted T. Aoki. Mahwah, N.J.: Lawrence Erlbaum Associates. pp.89-110.  Apple, M. W. (1990). Ideology and curriculum (2nd Ed.). New York: Routledge.  Ausubel, D. P. (1963). The psychology of meaningful verbal learning: An introduction to school learning. New York: Grune & Stratton.  Bazanye, E. (n.d.). The story of punishment island lives on, The New Vision. Retrieved from http://www.newvision.co.ug/mobile/Detail.aspx?NewsID=645292&CatID=442.  Beijaard, D., Verloop, N., & Vermunt, J. D. (2000). Teachers’ perceptions of professional identity: An exploratory study from a personal knowledge perspective. Teaching and Teacher Education, 16(7), 749–764.  Bell, J. S. (2002). Narrative inquiry: More than just telling stories. TESOL Quarterly, 36(2), 207–213.  Biley, F. C., & Holloway, I. (2011). Being a qualitative researcher. Qualitative Health Research, 21(7), 968–975.   115  BioMed Central/BMC Public Health. (2008, February 11). Quality Schooling Has Little Impact On Teenage Sexual Activity; Socioeconomic Status Does. ScienceDaily. Retrieved September 14, 2014 from www.sciencedaily.com/releases/2008/02/080207203918.htm.   Blake, S. M., Ledsky, R., Goodenow, C., & O'Donnell, L. (2001). Receipt of school health education and school health services among adolescent immigrants in Massachusetts. Journal of School Health, 71(3), 105–113.  Bloor, M. (2001). Techniques of validation in qualitative research: A critical commentary. In R. Emerson (Ed.), Contemporary field research (pp. 383-396). Prospect Heights, IL: Waveland Press.  Bodner, G. M. (1986). Constructivism: A theory of knowledge. Journal of Chemical Education, 63(10), 873–878.  Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.  Briggs, P. (2013). Uganda (7th Ed.). London: Bradt Travel Guides.  Burns, K. (2002). Sexuality education in a girls' school in Eastern Uganda. Agenda, 53, 81-88.   Burr, V. (1995). An introduction to social constructionism. New York: Routledge Press.  Buston, K., Wight, D., & Scott, S. (2001). Difficulty and diversity: The context and practice of sex education. British Journal of Sociology of Education, 22(3), 353-368.  Buston, K., Wight, D., Hart, G., & Scott, S. (2002). Implementation of a teacher-delivered sex education programme: Obstacles and facilitating factors. Health Education Research, 17(1), 59-72.  Cakir, M. (2008). Constructivist approaches to learning in science and their implications for science pedagogy: A literature review. International Journal of Environmental and Science Education, 3(4), 193–206.  Cavanagh, S. (2011). Queer notes on sex education in Ontario. In D. Stanley & K. Young (Eds.), Contemporary studies in Canadian curriculum: Principles, portraits and practices (pp. 237–270). Calgary: Detseling Enterprises.  Center for Advancing Health. (2007, December 23). Sex Education Linked To Delayed Teen Intercourse, New Study Says. ScienceDaily. Retrieved September 14, 2014 from www.sciencedaily.com/releases/2007/12/071220231428.htm.   116  Chase , S.E. (2005). Narrative Inquiry: Multiple lenses, approaches, voices,. In N. K Denzin &Y.S. Lincoln (Eds.), Handbook of qualitative research (3rd ed., pp. 651-679). Thousand Oaks, CA: Sage.  Clandinin, D. J. (2007). Handbook of narrative inquiry: Mapping a methodology. Thousand Oaks, Calif: Sage Publications.  Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and story in qualitative research.  San Francisco: Jossey-Bass.  Claxton, G. (1993). Minitheories. A preliminary model of learning science. In P. Black & A. Lucas (Eds), Children’s informal ideas in science (pp. 45-61). New York Routledge.  Claxton, G. (1996). Integrated learning theory and the learning teacher. In G. Claxton, T. Atkinson, M. Osborn & M. Wallace (EDs). Liberating the learner: Lessons for professional development in education. New York: Routledge.  Claxton, G. (2001). Wise up: The challenge of lifelong learning. London: Continuum International Publishing.  Clement, J. (1993). Using bridging analogies and anchoring intuitions to deal with students' preconceptions in physics. Journal of Research in Science Teaching, 30(10), 1241–1257.  Cobern, W. W. (1996). Worldview theory and conceptual change. Science Education. 80(5), 574 – 610.  Cohen, J., & Tate T. (2006). The Less They Know, the Better: Abstinence-Only HIV/AIDS Programs in Uganda. Reproductive Health Matters, 14(28), 174–178.  Collins, S. (2004). Ecology and Ethics in Participatory Collaborative Action Research: An Argument for the Authentic Participation of Students in Educational Research. Educational Action Research, 12(3), 347-362.  Connell, D. B., Turner, R. R. &and Mason, E. F. (1985). Summary of findings of the School Health Education Evaluation: health promotion effectiveness, implementation and costs. Journal of School Health, 55(8), 316–321.  Connelly, F. M., & Clandinin, D. J. (1990). Stories of experience and narrative inquiry. Educational Researcher, 19(5), 2-14.   Crooks, R., & Baur, K. (1983). Our sexuality. Menlo Park, California: Benjamin/Cummings Publishing Company.  117  Denzin, N. K., & Lincoln, Y. S. (2005). Introduction: The discipline and practice of qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), The Sage handbook of qualitative research (3rd ed., pp. 1-32). Thousand Oaks, CA: Sage.  Diiorio, C., Pluhar, E., & Belcher, L. (2003). Parent-child communication about sexuality: A review of the literature from 1980–2002. Journal of HIV/AIDS Prevention & Education for Adolescents & Children, 5(3-4), 7-32.  Driver, R. & Erickson, G. (1983). Theories-in-action: Some theoretical and empirical issues in the study of students’ conceptual frameworks in science. Studies in Science Education, 10(1), 37–60.  Driver, R. (1983). The pupil as a scientist. Milton Keynes: Open University Press  Driver, R., Asoko, H., Leach, J., Mortimer, E., & Scott, P. (1994). Constructing scientific knowledge in the classroom. Educational Researcher, 23(7), 5–12.  Eisenberg, M. E., Madsen, N., Oliphant, J. A., Sieving, R. E., & Resnick, M. (2010). "Am I qualified? how do I know?" A qualitative study of sexuality educators' training experiences. American Journal of Health Education,41(6), 337–344.  Ellingson, L. L. (2008). Engaging crystallization in qualitative research. Thousand Oaks, CA: Sage.  Ellsworth, E. (1994). Why doesn’t this feel empowering? Working through the repressive myths of critical pedagogy. In Lynda Stone (Ed). The Education Feminism Reader. New York: Routledge.   Flavell, J. H. (1979). Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. American Psychologist, 34, 906-911.  Fontana, D. (1995). Psychology for teachers. London: Macmillan  Geertz, C. (1973). The interpretation of cultures: Selected essays. New York: Basic Books.  Gibson, J. J. (1979). The ecological approach to visual perception. Boston: Houghton Mifflin.  Giroux, H. (1986). Teacher education and the politics of engagement: The case for democratic schooling. Harvard Educational Review, 56(3), 213-238.  Giroux, H. A. (1988). Teachers as transformative intellectuals. In: Teachers as Intellectuals: Toward a Critical Pedagogy of Learning (pp. 121-128). Granby, Mass: Bergin & Garvey.  118  Gitlin, A., Bringhurst, K., Burns, M., Cooley, V., Myers, B., Price, K., Russell, R., & Tiess, P. (1992). Teachers’ voices for school change: An introduction to educative research. New York: Teachers College Press.   Golafshani, N. (2003). Understanding reliability and validity in qualitative research. The Qualitative Report, 8(4), 597–607.  Grumet, M. (1981). Pedagogy for patriarchy: The feminization of teaching. Interchange on Educational Policy, 12(2-3), 165-184.  Gunzenhauser, M. G. (2006). A moral epistemology of knowing subjects: Theorizing a relational turn for qualitative research. Qualitative Inquiry, 12(3), 621–647.   Hall, G. S. (1904). Adolescence: Its psychology and its relations to physiology, anthropology, sociology, sex, crime, religion and education (Vol. 1). Englewood Cliffs: Prentice Hall.  Halperin, D. T., Steiner, M. J., Cassell, M. M., Green, E. C., Hearst, N., Kirby, D., Gayle, H. D, & Cates, W. (2004). The time has come for common ground on preventing sexual transmission of HIV. The Lancet, 364(9449), 1913-1915.   Harding, P., & Hare, W. (2000). Portraying science accurately in classroom: Emphasizing open-mindedness rather than relativism. Journal of Research in Science Teaching, 37(3), 225-236.  Helleve, A., Flisher, A. J., Onya, H., Kaaya, S., Mukoma, W., Swai, C., & Klepp, K. (2009). Teachers' confidence in teaching HIV/AIDS and sexuality in South African and Tanzanian schools. Scandinavian Journal of Public Health, 37(2), 55–64.   Henson, K. (2010). Curriculum planning: Integrating multiculturalism, constructivism, and education reform. (4th Edition) Long Grove, IL: Press.   Herron, J. D., & Eubanks, I. D. (1996). The chemistry classroom: Formulas for successful teaching. Washington, DC: American Chemical Society.  Hewson, P. W., Beeth, M. E., & Thorley, N. R. (1998). Teaching for conceptual change. In K. G. Tobin & B. J. Fraser (Eds.), International Handbook of Science Education (pp. 11, 199 – 218). Dordrecht, Netherlands: Kluwer.  Hinde, E. R. (2004). School culture and change: An examination of the effects of school culture on the process of change. Essays in Education, 12, 1–12.  Hodson, D. (1998). Teaching and learning science: Towards a personalized approach. Buckingham: Open University Press.  119  Hodson, D., & Hodson, J. (1998b). Science education as enculturation: Some implications for practice. School Science Review. 80(290), 17–24.  Hooper, E. (1990). AIDS epidemic moves south through Africa. New Scientist. 1724, 22.  Hymowitz, K. S. (2003). What to tell the kids about sex. Public Interest, (153), 3–18.  Isiugo-Abanihe, U.C. & Kola Oyediran. (2004). Household socioeconomic status and sexual behaviour among Nigerian female youth. African Population Studies, 19(1):81-98.  Jefferson, G. (1985). An exercise in the transcription and analysis of laughter. In T.Van Dijk (Ed.), handbook of discourse analysis (vol.3), London: Academic Press   Johnson, J. R. (2003). Dewey and vygotsky: A comparison of their views on social constructivism in education. ProQuest, UMI Dissertations Publishing.  Johnson, P., & Gott, R. (1996). Constructivism and evidence from children's ideas. Science Education, 80(5), 561-577.  Jones, S (2008). Secondary schooling for girls in rural Uganda: challenges, possibilities and emerging identities (Doctoral dissertation), University of British Columbia. Retrieved from https://circle.ubc.ca/bitstream/id/1179/ubc_2008_spring_jones_shelley.pdf.  Kagolo, F. & Alinda, P. (2014, February 18). Uganda bans miniskirts, pornography, The New Vision. Retrieved from http://www.newvision.co.ug/news/652677-uganda-bans-miniskirts-pornography.html.  Kamukama, P. (2013, April 11). Would men miss the miniskirt, The Observer. Retrieved from http://www.observer.ug/index.php?option=com_content&view=article&id=24696&catid=73.  Kasente, D. (2003). Gender and Education in Uganda. Background paper commissioned for the Education for All global monitoring report 2003/4. Gender and education for all: The leap to equality. Paris: UNESCO.  Kay, J. F., & Jackson, A. (2008). Sex, lies, & stereotypes: How abstinence-only programs harm women and girls. New York: Legal Momentum.  Kelly, G. A. (1955): The psychology of personal constructs (vol. 1). New York: Norton.  Kelly, U. (1997). Schooling desire: Literacy, cultural politics and Pedagogy. New York: Routledge.  Kerby, A.T. (1991). Narrative and the self. Bloomington, IN: Indiana University Press.  120  Kiapi-Iwa, L., & Hart, G. J. (2004). The sexual and reproductive health of young people in Adjumani district, Uganda: Qualitative study of the role of formal, informal and traditional health providers. AIDS Care, 16(3), 339–347.  Kilbride, P. L., & Kilbride, J. C. (1990). Changing family life in East Africa: Women and children at risk. University Park: Pennsylvania State University Press.  Kim, C. R., & Free, C. (2008). Recent evaluations of the Peerpeer-Led led approach in adolescent sexual health education: A systematic review. Perspectives on Sexual and Reproductive Health, 40(3), 144-151.   Kirby, D. (2007). Emerging answers 2007: Research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy.  Lapadat, J. C., & Lindsay, A. C. (1999). Transcription in research and practice: From standardization of technique to interpretive positionings. Qualitative Inquiry, 5(1), 64-86.  Lasky, S. (2005). A socio-cultural approach to understanding teacher identity, agency and professional vulnerability in a context of secondary school reform. Teaching and Teacher Education, 21(8), 899–916.  Lather, P. (2006). Paradigm proliferation as a good thing to think with: Teaching research in education as a wild profusion. International Journal of Qualitative Studies in Education, 19(1), 35-57.  Lesko, N. (2010): Feeling abstinent? feeling comprehensive? touching the affects of sexuality curricula. Sex Education: Sexuality, Society and Learning, 10(3), 281–297.  Levenson-Gingiss, P, & Hamilton, R. (1989). Teacher perspectives after implementing a human sexuality education program. The Journal of School Health, 59(10), 427.   Levesque, R. J. R. (2003). Sexuality education: What adolescents’ rights require. Hauppauge: Nova Science Publishers.   Lieblich, A., Tuval-Mashiach, R., & Zibler, T. (1998). Narrative research: Reading, Analysis, and Interpretation. Thousand Oaks, CA: Sage Publications.  Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.  Livingstone, J. A. (1997). Metacognition: An overview. Retrieved on April 5, 2014 from http://gse.buffalo.edu/fas/shuell/CEP564/Metacog.htm.  Locke, L. F., Silverman, S. J., & Spirduso, W. W. (2010). Reading and understanding research (3rd Ed.). Thousand Oaks, CA: Sage. 121   Lodge, C. (2005). From hearing voices to engaging in dialogue: Problematizing student participation in school improvement. Journal of Educational Change, 6(2):125-146.   Masinde, A. (2014, February 28). Reconsider Anti-pornography law - rights body, The New Vision. Retrieved from http://www.newvision.co.ug/news/653048-reconsider-anti-pornography-law-rights-body.html.  Matthews, M. R. (1994). Science teaching: The role of history and philosophy of science. New York: Routledge.  Meece, J. L. (1997). Child and adolescent development for educators. New York: McGraw-Hill  Mirembe, R. (2002). AIDS and demographic education in Uganda. Comparative Education. 38(2), 161–174.  Mishler, E. G. (1991). Representing discourse: The rhetoric of transcription. Journal of Narrative and Life History/Narrative Inquiry, 1, 255-280.  Morin, S. F., Collins, C., Alagiri, P., & Summers, T.(2002). Abstinence- only vs. comprehensive sex education: What are the arguments? What is the evidence? Retrieved January 5, 2014 from http://ari.ucsf.edu/science/reports/abstinence.pdf.  Morrow, S. L. (2005). Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology, 52(2), 250–260.   Morrow, S. L. (2005). Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology, 52(2), 250–260.  Mudege, N. N. & Undie, C. (2009). Formative evaluation: Presidential initiative on AIDS strategy for communication to youth. Final Report. New York: Population Council.  Muhanguzi, F. K. (2011). Gender and sexual vulnerability of young women in Africa: Experiences of young girls in secondary schools in Uganda. Culture, Health & Sexuality, 13(6), 713-725.  Mutonyi H. (2005). The influence of pre-conceptual and perceptual understandings of HIV/AIDS: A case study of selected Ugandan biology classrooms (Master’s thesis), University of British Columbia. Retrieved from https://circle.ubc.ca/handle/2429/17277.  Mutonyi, H., Nashon, S., & Nielsen, W. S. (2010). Perceptual influence of Ugandan biology students’ understanding of HIV/AIDS. Research in Science Education, 40(4), 573-588.   122  Muyinda, H., Nakuya, J., Whitworth, J. A. G., & Pool, R. (2004). Community sex education among adolescents in rural Uganda: Utilizing indigenous institutions. AIDS Care, 16(1), 69–79.   Naidoo, J., Wills, J., & Royal College of Nursing (Great Britain). (1998). Practising health promotion: Dilemmas and challenges. London: Baillière Tindall.  Nashon, S. M. (2013) Interpreting Kenyan Science Teachers’ Views About the Effect of Student Learning Experiences on Their Teaching, Canadian Journal of Science,Mathematics and Technology Education, 13:3, 213-231Nashon, 2013.  Nashon, S. M., & Anderson, D. (2012). Teacher change: The effect of student learning on science teachers’ teaching in Kenya. Paper presented at the Science Technology Engineering and Mathematics International Conference, Beijing.  National Abstinence Education Association. (NAEA, 2013). Abstinence Works: Sexual Risk Avoidance (SRA) Abstinence Education Programs Demonstrating Improved Teen Outcomes. Retrieved from http://www.thenaea.org/docs/Abstinence_Works.pdf.  National Coordinating Division of Agency for Population and Reproductive Health Development. (NCAPD, 2005). Adolescent Reproductive Health and Development Policy: Plan of Action (2005-2015), Kenya Ministry of Planning and National Development. Retrieved on May 25, 2014 from http://www.policyproject.com/pubs/policyplan/KEN_ARH_POA%202005-15.pdf   Ndawula, S. & Nakawuki, R. C. (2010). Educational resources for HIV/AIDS prevention in uganda: The role of PIASCY program in primary schools. Journal of Educational Research, 13(1), 1027-9776.  Neema, S., Ahmed, F. H., Kibombo, R. & Bankole, A. (2006). Adolescent sexual and reproductive health in Uganda: Results from the 2004 Uganda National Survey of Adolescents, Occasional Report No. 25, New York: Guttmacher Institute.  Nielsen, W. & Nashon, S. (2007). Accessing science courses in rural BC: A cultural border crossing metaphor Alberta Journal of Educational Research. 53(2), 174-188.  Null, J. W. (2008) Curriculum development in Historical perspective.  In F.M. Connelly, M.F. He, & Phillion, J. (Eds.) The Sage Handbook of Curriculum and Instruction. Los Angeles; CA: SAGE  Okello, F.W., & Okaba, P. (2012, March 9). Don’t teach sex in schools – Museveni, The Daily Monitor. Retrieved from http://www.monitor.co.ug/News/National/-/688334/1362342/-/axe1enz/-/index.html.  123  Opio, A., Mishra, V., Hong, R., Musinguzi, J., Kirungi, W., Cross, A., Mermin, J., &  Bunnell, R. (2008). Trends in HIV-related behaviors and knowledge in Uganda, 1989-2005: Evidence of a shift toward more risk-taking behaviors. Journal of Acquired Immune Deficiency Syndrome, 49(3), 320–326.  Otiso, K. M. (2006). Culture and customs of Uganda. Westport, CT: Greenwood Press, 84 – 86.  Pagis, M. (2009). Embodied self-reflexivity. Social Psychology Quarterly, 72(3), 265-283.  Patton, M.Q. (2002). Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage Publications.  Pedretti, E. (1996). Facilitating action research in science, technology and society (STS) education: An experience in reflective practice. Educational Action Research, 4, 307-327.  Peshkin,A . (1985).Virtuous subjectivity: In the participant-observer's eyes. In D. Berg & K Smith( Eds.), Exploring clinical methods for social research (pp. 267-281). BeverlyHills: Sage.  Pew Research Center. (2012). The Global Religious Landscape: A Report on the Size and Distribution of the World’s Major Religious Groups as of 2010. Retrieved from http://www.pewforum.org/files/2014/01/global-religion-full.pdf.  Phillips, D. C. (1995). The good, the bad, and the ugly: The many faces of constructivism. Educational Researcher, 24(7), 5-12.  Phillips, K. P., & Martinez, A. (2010). Sexual and reproductive health education: Contrasting teachers, health partners and former students’ perspectives. Canadian Journal of Public Health, 101(5), 374–379.   Pinnegar, S., & Daynes, J. D. 2007. Situating Narrative Inquiry. In J. D. Clandinin (Ed.), Handbook of Narrative Inquiry: Mapping a Methodology (pp. 3 – 34). Thousand Oaks, CA: Sage Publications.  Pitsoe, V. J., & Maila, M. W. (2011). Towards a reflexive teaching and learning framework in Open Distance Learning (ODL). Journal of Emerging Trends in Educational Research and Policy Studies, 2(6), 485-492.  Polkinghorne, D. (1988). Narrative knowing and the human sciences. Albany: State University of New York Press.  Population Reference Bureau. (PRB, 2012). Adolescents and young people in Sub-Saharan Africa: Opportunities and challenges. Retrieved June 2, 2014 from http://www.prb.org/pdf12/status-report-youth-subsaharan-Africa.pdf  124  Posner, G. J., Strike, K. A., Hewson, P. W., & Gertzog, W. A. (1982). Accommodation of a scientific conception: Toward a theory of conceptual change. Science Education. 66(2), 211–227.  Public Health Agency of Canada. (2008). Canadian guidelines for sexual health education. Ottawa: Public Health Agency of Canada.  Purpel, D. E., & Ryan, K. (1976). Moral education ... it comes with the territory. Berkeley, CA: McCutchan.  Rector, R. (2002). The effectiveness of abstinence education programs in reducing sexual activity among youth. Washington, DC: Heritage Foundation.  Riessman, C. K. (2008). Narrative methods for the human sciences. Los Angeles: Sage Publications.   Rijsdijk, L. E., Bos, A. E. R., Ruiter, R. A. C., Leerlooijer, J. N., de Haas, B., & Schaalma, H. P. (2011). The world starts with me: A multilevel evaluation of a comprehensive sex education programme targeting adolescents in Uganda. BMC Public Health, 11(1), 334.  Santrock, J. W. (2001). Adolescence (8th Ed.). New York: McGraw-Hill.   Schwandt, T. A. (1996). Farewell to criteriology. Qualitative Inquiry, 2, 58-72.  Sequeira, M., & Leite, L. (1991). Alternative conceptions and history of science in physics teacher education. Science Education. 75(1), 45 –56.2008).   Serwadda, D., Sewankambo, N.K., Carswell, J.W., Bayley, A.C., Tedder, R.S., Weiss, R.A., Mugerwa, R.D., Lwegaba, A., Kirya, G.B., Downing, R.G., Clayden, S.A. & Dalgleish, A.G. (1985). Slim disease: A new disease in Uganda and its association with HTLV-III infection. The Lancet, 326(8460), 849-852.  Siegel, D. J. (2013). Brainstorm: The power and purpose of the teenage brain. New York: Penguin Group.  Silver, D. (2001). Songs and storytelling: Bringing health messages to life in Uganda. Education for Health: Change in Learning & Practice, 14(1), 51–51.   Slutkin, G., Okware, S., Naamara, W., Sutherland, D., Flanagan, D., Carael, M., Blas, E., Delay, P. & Tarantola, D. (2006). How Uganda reversed its HIV epidemic. AIDS and Behavior, 10(4), 351-360.  Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S. PloS One, 6(10), e24658.  125  Steinberg, L. (2004). Risk taking in adolescence: What changes, and why? Annals of the New York Academy of Sciences, 1021(1), 51-58.  Sternberg, R. J. (1998). Metacognition, abilities, and developing expertise: What makes an expert student? Instructional Science, 26,127 – 140.  Stinner, A., & Williams, H. (1993). Conceptual change, history, and science stories. Interchange, 24(1-2), 87-103.  Stoneburner, R. L., & Low-Beer, D. (2004). Population-level HIV declines and behavioral risk avoidance in Uganda. Science, 304(5671), 714-718.  Talemwa, M & Mwesigye, S. (2010, February 10). Top 10 schools in last 10 years, The Observer. Retrieved from http://www.observer.ug/index.php?option=com_content&view=article&id=7111:-top-10-schools-in-last-10-years.  The United States President’s Emergency Plan for Aids Relief. (PEPFAR, 2004.). Retrieved April 27, 2014 from http://www.avert.org/pepfar.htm.  Thomas, G., Anderson, D., & Nashon, S. (2008). Development and validity of an Instrument designed to investigate elements of science students' metacognition, self-efficacy and learning processes: SEMLIS. International Journal of Science Education, 30(13), 1701-1724.  Thompson, S. K. (2002). Sampling. New York: Wiley.  Thorley, R. & Stofflet, R.T. (1996). Representation of Conceptual Change Model in science teacher education, Science Education, 80(3): 317–339.  Tracy, S. J. (2010). Qualitative quality: Eight “Big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837–851.  Trenholm, C., Devaney, B., Fortson, K., Quay, L., Wheeler, J., & Clark, W. (2007). Impacts of Four Title V, Section 510, Abstinence Education Programs: Final Report, submitted to the U.S. Department of Health & Human Services, Princeton, NJ: Mathematica Policy Research.  Uganda Bureau of Statistics. (UBOS, 2007). Uganda demographic and health survey 2006. Kampala, Uganda & Calverton, Maryland, USA: UBOS and Macro International Inc.  Uganda Bureau of Statistics. (UBOS, 2012). Uganda demographic and health survey 2011. Kampala, Uganda & Calverton, Maryland, USA: UBOS and ICF International Inc.  126  United Nations [joint program for] AIDS. (UNAIDS, 1998). A measure of success in Uganda: The value of monitoring both HIV prevalence and sexual behavior. Retrieved May 12, 2014 from http://data.unaids.org/publications/irc-pub04/value_monitoring_uganda_en.pdf.   United Nations [joint program for] AIDS. (UNAIDS, 2004). Life-skills-based HIV/AIDS education in schools: Retrieved March 30, 2012 from http://www.unaids.org/ungass/en/global/UNGASS19_en.htm.  United Nations [joint program for] AIDS. (UNAIDS, 2012). Report on the global AIDS epidemic: Retrieved on April 5, 2014 from http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_UNAIDS_Global_Report_2012_with_annexes_en.pdf.  United Nations Educational, Scientific, and Cultural Organization. (UNESCO, 2009). International Technical Guidance on Sexuality Education. Paris: UNESCO. Available at: http://unesdoc.unesco.org/images/0018/001832/183281e.pdf.  United Nations Educational, Scientific, and Cultural Organization. (UNESCO, 2010). Levers of Success: Case studies of National Sexuality Education Programmes. Paris: UNESCO. Available at: http://unesdoc.unesco.org/images/0018/001884/188495e.pdf.  United Nations Population Fund. (UNFPA, n.d.). Adolescents and youth. Retrieved July 2, 2014 from http://www.unfpa.org/public/adolescents.  United Nations. (UN, 2013). The Millennium Development Goals Report. Retrieved on May 15, 2014 from http://www.un.org/millenniumgoals/pdf/report-2013/mdg-report-2013-english.pdf.  Vygotsky, L. S. (1978). Mind in Society: The Development of Higher Psychological Processes. Cambridge, MA: Harvard University Press.   Vygotsky, L. S. (1986). Thought and Language. Cambridge, MA: MIT Press.   Weick, K. E. (2007). The generative properties of richness. Academy of Management Journal, 50, 14-19.  Weller S. C, & Davis-Beaty, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD003255.  Wepukhulu, R.N., Mauyo, L.W., Poipoi, M.W., Achoka, J.S.K., Kafu, P. & Walaba, A. A. (2012). Influence of socio-economic status on attitudes towards premarital sex (PMS) among secondary school students in western Kenya: Case study of Bungoma county. Journal of Emerging Trends in Economics and Management Sciences 3(4), 298-301.   127  World Health Organization (WHO, 2006). Defining sexual health: Report of a technical consultation on sexual health, 28–31 January 2002. Geneva: World Health Organization. Available at http://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf.  World Health Organization. (WHO, 2011). Guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries. Geneva: World Health organization. Available at: http://whqlibdoc.who.int/publications/2011/9789241502214_eng.pdf.  Yardley, L. (2000). Dilemmas in qualitative research. Psychology & Health, 15, 215-228  Yuruk, N., Ozdemir, O., & Beeth, M. E. (2003). The role of metacognition in facilitating conceptual change. Paper presented at the Annual Meeting of the National Association for Research in Science Teaching (Philadelphia, PA, March 23-26.  Zeichner, K. (2001). Educational action research. In P. Reason & H. Bradbury (Eds.) Action Research: Participative Inquiry and Practice. London: Sage.    128  Appendices Appendix A: Introductory Letter Form I: Introductory Letter Dear Sir/Madam, I am writing to invite you to participate in a research project entitled: “Sexuality Education Discourses in Uganda’s Secondary School Curriculum: Teachers’ Experiences of Contextual Influences on Instruction and Student Engagement”. The research is interested in understanding how contextual (local) factors have influenced teachers while engaging with sexuality education in secondary schools. In particular, the research seeks to give sex health teachers a voice to narrate their experiences. Through analysis of these stories, an understanding of their perceptions of contextual  factors which influence their instruction and student engagement will be drawn. The outcomes  will lead to recommendations for successful implementation of sex education in schools.  I am a Masters student in the Faculty of Education at the University of British Columbia, working under the supervision of Professor Samson Nashon, who is the Principal Investigator in this study. I am seeking to benefit from your expertise by participating in this research and invite you to review the consent form attached herewith which contains the details of the study. I greatly appreciate the value of your input. I would be delighted if you are willing to participate in this interview. Please do not hesitate to contact me at ………... or by email at ............................... should you have any queries. Yours sincerely Annette Tushabomwe  129  Appendix B: Consent Form II: Consent Letter  Title: Sexuality Education Within High School Curriculum in Uganda: Exploring Teachers’ Perceptions of Contextual Influences on Classroom Discourses  Principal Investigator: Dr. Samson Nashon, Associate Professor, School of Education, University of British Columbia. Co-Investigator: Dr. Sandra Scott, Science Instructor - School of Education University of British Columbia. Co-Investigator: Annette Tushabomwe, Masters’ Student, Faculty of Education, University of British Columbia. Ethical Research: The University of British Columbia, the Principal and Co-Investigators are committed to doing research in ethical and respectful ways while studying sexuality education discourses in Uganda’s Secondary schools. We want to be sure that you, as an interview candidate, understands how and why this research is being conducted. We also want to be sure that you are comfortable while you are participating. Purpose: The purpose of this research is to investigate the role of contextual (local) influences on teachers’ instruction and student engagement during sexuality education provision in secondary schools in Uganda. Specifically, it attempts to answer three main questions; a) what contextual (local) factors influence sex health provision within the secondary school curriculum in Uganda? b) how do these contextual factors influence teachers’ instruction and student engagement? and c) how do teachers perceive sexuality discourses within the curriculum implicating student’s sexual behaviour after their engagement? Findings from this study will 130  invariably lead to recommendations for successful implementation of sex education in schools. As a teacher who has had firsthand experience with sex health education, your story will provide wonderful insights for this study.   Procedure: The general research anticipates a total of 2-3 per hours per participant. This involves time to fill a questionnaire, a follow up telephone interview to probe insights emergent from the questionnaire data and a post interview telephone conversation for areas that might need clarity. You must be a biology, religious education or senior woman/man teacher who has been involved with sex health provision for at least two years. Please let me know about your interest to participate within a week of receiving this consent form so that we arrange for a date and time for you to fill the questionnaire. All interviews will be audio recorded. The data will be analysed and presented in form of themes although individual story extracts will be featured.  Confidentiality: In order to respect your confidentiality, your identity will be concealed by use of a pseudonym. To ensure that participation does not in any way adversely impact on you, no data identifying individuals will be made available to persons other than the Principal Investigator and Co-Investigator. In addition, narrating your experiences is entirely voluntary and you can divulge as little, or as much detail as you are willing and you can decide to end the interview anytime without facing any consequences. Interview records and documents will be coded and stored in a locked filing cabinet. Audio files will be downloaded onto a password protected computer that only the Principal Investigator and Co-investigators have access to. Once the analysis is done, you will be sent any material that features your contribution for your final consent and to ensure that the findings represent your story.   131  Remuneration: Participating in this research is voluntary and you will be given a total of 30,000 Ug shillings (equivalent of about $15 depending on the exchange rate) for refreshment. This amount will be given in three instalments- that is; after submitting questionnaires, conducting the follow up telephone interviews and then after post telephone interviews.    Contact Information: Both the Principal and the Co-Investigator are available to answer any questions concerning this research. You may contact the Principal Investigator at: …….and the Co-Investigator at: .............. Should you have any concerns about the manner in which this research has been conducted, you may register these concerns in the UBC Office of Research Services at ………. Fax: …………. Email: ............... Consent: I understand that my participation in this research is voluntary and that I may refuse to participate or withdraw from the study at any time without jeopardy to my status. My signature below indicates that I have received a copy of this consent form for my records and that I have consented to participate in this study. I agree/ do not agree (cross one) to have interview sessions audio-recorded.  Signature _________________________________   Date___________________________ Full name      132  Appendix C: Interview Script Form III: Interview Script Sexuality in High School Curriculum in Uganda: Exploring Teachers’ Perceptions of Contextual Influences on Classroom Discourses   These sample questions are meant to elicit teachers’ narratives around issues of sexuality in Uganda’s secondary schools. They are simply provided as a starting place from which I will build up a conversation in the follow up telephone interview phase to expound on the narratives.   Personal data: Please tick the circle that applies  Contact: Telephone:    E-mail:  Your  school (Tick all that apply): Day          Boarding               Private                    Public  Your age (years): 20 -30  30-40              >40  Years of teaching Sex Health Education:  <2  2-4              5-10            >11  Location of your school: Central Western  Other   Type of school: Girls  Boys  Mixed   Your Sex: Female Male   133  1. What has been your role or in what capacity and to what degree have you been involved with sexual health provision in schools?  2. Can you please narrate (explain in detail) what your experience has been while teaching sexual health education in schools? 3. a. What, in your opinion are the factors which influence the delivery of sexual health education in schools?  b. Will you please explain how the above factors influence the way you teach sexuality to students? 4. What do you think is the effect of the above factors on students as they the engage in classroom activities related to sexuality? 5. In your opinion, how does Sexual Health Education provided in schools influence the sexual behavior of the students after their engagement?  6. Please explain what you like /don’t like about the way sexual health education is conveyed in schools?  Like/why:  Don’t like/why: 7. What is your opinion regarding the way students perceive the type of sexual health education provided to them?  8. Given an opportunity to redesign the way sex health education is provided, how would go about the change?   9. These are some of the questions I have for you today. Is there anything else you would like to add on this issue at this time? 10. Are you still willing to be contacted for a phone conversation with me as a follow up on the issues contained in this interview?  Thank you for taking the time to do this interview.  Annette Tushabomwe, MA student - Faculty of Education, UBC.  134  


Citation Scheme:


Citations by CSL (citeproc-js)

Usage Statistics



Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            async >
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:


Related Items