fullscreen
ImpactMojoSexual Health 101www.impactmojo.in
ImpactMojo 101 Series · Free Forever
Sexual
Health
101
Sexual & Reproductive Health and Rights — a Rights-Based, Non-Judgemental Foundation for Development & Health Practitioners in South Asia
Rights-BasedMedically AccurateSouth Asia FocusFree Access
ImpactMojoSexual Health 101www.impactmojo.in
What We Cover
01
What SRHR Means
Slides 3–10
02
The Rights Framework
Slides 11–18
03
Bodies & Puberty
Slides 19–26
04
Contraception & Family Planning
Slides 27–38
05
Pregnancy & Maternal Health
Slides 39–47
06
Safe Abortion & the Law
Slides 48–55
07
STIs & HIV
Slides 56–64
08
Comprehensive Sexuality Education
Slides 65–73
09
Gender, Consent & GBV
Slides 74–82
10
Adolescents & Access
Slides 83–89
11
SRHR in South Asia & Practice
Slides 90–99
ImpactMojoSexual Health 101www.impactmojo.in
01
Section One
What SRHR Means
ImpactMojoSexual Health 101www.impactmojo.in
Sexual health is health, not just the absence of disease
Sexual and reproductive health is part of being well — not merely the absence of infection or unwanted pregnancy. The World Health Organization frames it as a state of physical, emotional, mental and social well-being in relation to sexuality.
Sexual health (WHO)
A state of physical, emotional, mental and social well-being in relation to sexuality; not merely the absence of disease, dysfunction or infirmity. It requires a positive and respectful approach to sexuality and sexual relationships.
This is a practitioner's starting point: SRHR is about dignity and well-being, approached without shame or judgement.
ImpactMojoSexual Health 101www.impactmojo.in
Unpacking S, R, H and R
Sexual
Sexuality, pleasure, relationships, identity — across the whole life course
Reproductive
Fertility, pregnancy, childbirth and the ability to decide whether and when to have children
Health
Well-being and access to information, services and care
Rights
Entitlements rooted in human rights — autonomy, equality, non-discrimination
ImpactMojoSexual Health 101www.impactmojo.in
SRHR spans the entire life course
01
CHILDHOOD: age-appropriate body knowledge & safety
02
ADOLESCENCE: puberty, consent, contraception, CSE
03
ADULTHOOD: family planning, pregnancy, STIs, fertility
04
LATER LIFE: menopause, ageing, continued sexual well-being
SRHR is not only about young women of reproductive age. It concerns men, adolescents, older people, and people of every gender and sexuality.
ImpactMojoSexual Health 101www.impactmojo.in
SRHR is for everyone
A rights-based approach is explicitly inclusive. SRHR belongs to people of all genders and sexual orientations, to unmarried as well as married people, and to persons with disabilities.
  • LGBTQ+ people have the same rights to information and care
  • Persons with disabilities are sexual beings with equal rights, too often denied autonomy
  • Unmarried people, including adolescents, need services and respect
  • Men and boys are partners in SRHR, not bystanders
ImpactMojoSexual Health 101www.impactmojo.in
Why SRHR sits at the centre of development
Health & survival
  • Maternal & newborn survival
  • Preventing and treating STIs and HIV
  • Preventing unsafe abortion
Equality & opportunity
  • Girls staying in school
  • Women's economic participation
  • Gender equality and autonomy
SRHR is woven through the Sustainable Development Goals — on health (SDG 3) and gender equality (SDG 5).
ImpactMojoSexual Health 101www.impactmojo.in
How we talk about it shapes whether people seek help
Stigma and shame keep people from clinics, classrooms and conversations. Practitioners set the tone: respectful, accurate, non-judgemental language is itself a form of care.
AvoidPrefer
Shaming or moralising toneNeutral, factual, respectful
Assuming everyone is heterosexual / marriedInclusive, open questions
Euphemism that confusesClear, correct anatomical terms
Blaming the personFocusing on rights and support
ImpactMojoSexual Health 101www.impactmojo.in
Where this course goes next
  • The rights framework that underpins SRHR (ICPD, Guttmacher–Lancet)
  • Bodies, contraception, pregnancy, abortion, STIs — the clinical core
  • Comprehensive sexuality education and the evidence behind it
  • Gender, consent and GBV, and access for adolescents
  • SRHR in the South Asian context — barriers, programmes, practice
Throughout, examples are India-centric, with sources named so you can verify and go deeper.
ImpactMojoSexual Health 101www.impactmojo.in
02
Section Two
The Rights Framework
ImpactMojoSexual Health 101www.impactmojo.in
SRHR is grounded in human rights
The 'R' in SRHR is not rhetorical. These are existing human rights — to life, health, privacy, equality, non-discrimination and to be free from violence — applied to sexuality and reproduction.
Reproductive rights
The right of all individuals and couples to decide freely and responsibly the number, spacing and timing of their children, and to have the information and means to do so — free of coercion, discrimination and violence.
ImpactMojoSexual Health 101www.impactmojo.in
ICPD Cairo, 1994: a turning point
The International Conference on Population and Development (ICPD), held in Cairo in 1994, shifted the global agenda from demographic targets to individual rights and well-being. 179 governments endorsed its Programme of Action.
  • Moved from population control to reproductive rights and choice
  • Centred women's empowerment, health and dignity
  • Rejected coercive targets and incentives in family planning
  • Linked reproductive health to broader development
ImpactMojoSexual Health 101www.impactmojo.in
From population targets to people's rights
Before ICPD
Numeric targets, demographic goals, and — in some places — coercive sterilisation drives. People treated as numbers to be managed.
After ICPD
Voluntary, informed choice; quality of care; rights and well-being at the centre. The individual, not the target, comes first.
India formally moved to a 'target-free' approach in family planning after Cairo — a direct legacy of ICPD.
ImpactMojoSexual Health 101www.impactmojo.in
Bodily autonomy is the core principle
Bodily autonomy
The right to make decisions about one's own body and future, free from coercion, violence or discrimination — including decisions about sex, contraception, pregnancy and health care.
Autonomy means a person can say yes, say no, and decide for themselves — the foundation on which all of SRHR rests.
ImpactMojoSexual Health 101www.impactmojo.in
The Guttmacher–Lancet definition of SRHR
In 2018 the Guttmacher–Lancet Commission set out an integrated, comprehensive definition of SRHR — widely used as a benchmark for what a full package of rights and services includes.
Sexual and reproductive health is a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity.
— Guttmacher–Lancet Commission, 2018
ImpactMojoSexual Health 101www.impactmojo.in
What a comprehensive SRHR package includes
  • Comprehensive sexuality education
  • Contraceptive counselling and a full method choice
  • Antenatal, childbirth and postnatal care
  • Safe abortion care and post-abortion care
  • Prevention and treatment of STIs, including HIV
  • Prevention and care for gender-based violence
  • Counselling and care for sexual health and infertility
Source: Guttmacher–Lancet Commission (2018). These elements are interdependent — gaps in one weaken the rest.
ImpactMojoSexual Health 101www.impactmojo.in
Availability, accessibility, acceptability, quality
Available
Services and supplies actually exist and are stocked
Accessible
Reachable, affordable and non-discriminatory for all
Acceptable
Respectful of dignity, confidentiality and culture
Quality
Medically appropriate, safe and good quality
The 'AAAQ' framework (from the right to health) is a practical checklist for assessing any SRHR service.
ImpactMojoSexual Health 101www.impactmojo.in
03
Section Three
Bodies & Puberty
ImpactMojoSexual Health 101www.impactmojo.in
Accurate, non-shaming body knowledge
People — especially adolescents — have a right to correct information about their own bodies. Using accurate anatomical terms, without shame, helps people understand health, recognise problems and seek care.
Myths and silence cause harm. Naming body parts and processes plainly is part of safeguarding and good health practice.
ImpactMojoSexual Health 101www.impactmojo.in
Puberty: a normal stage of development
Puberty is the transition to reproductive maturity, driven by hormones, usually beginning between roughly ages 8 and 14. Timing varies widely and normally — there is no single 'right' age.
Common changes
  • Growth spurts and body changes
  • Development of secondary sex characteristics
  • Onset of menstruation; capacity for reproduction
Also normal
  • Mood changes and new emotions
  • Wide variation in timing between individuals
  • Curiosity and questions about sexuality
ImpactMojoSexual Health 101www.impactmojo.in
The menstrual cycle, simply
The menstrual cycle is the monthly preparation of the body for a possible pregnancy. A common average is about 28 days, but cycles between roughly 21 and 35 days are normal and vary between people.
01
MENSTRUATION: the lining sheds (the 'period')
02
FOLLICULAR: an egg matures; lining rebuilds
03
OVULATION: an egg is released (around mid-cycle)
04
LUTEAL: body prepares; if no pregnancy, cycle repeats
ImpactMojoSexual Health 101www.impactmojo.in
When pregnancy is possible
Pregnancy is most likely around ovulation, in the days before and the day of egg release — the 'fertile window'. Because cycles vary, this window is not perfectly predictable, which is why fertility-awareness methods require care and training.
Accurate cycle knowledge supports informed choices — but on its own it is one of the less reliable ways to avoid pregnancy. We return to method effectiveness in the next section.
ImpactMojoSexual Health 101www.impactmojo.in
Menstrual health and hygiene
Menstrual health and hygiene (MHH) means being able to manage menstruation safely, with dignity and without shame — access to clean materials, private spaces, water, soap and safe disposal, plus accurate information.
  • Clean menstrual materials, changed as needed
  • Private, safe space with water and soap
  • Safe disposal or hygienic reuse of materials
  • Freedom from stigma, restriction and exclusion
ImpactMojoSexual Health 101www.impactmojo.in
Menstrual stigma has real costs
Across South Asia, menstruation is surrounded by taboos and restrictions — on movement, food, worship and school. These are cultural constructs, not health requirements, and they can harm well-being and education.
Menstruation is normal and healthy. Practical support — toilets, materials, accurate information — matters more than any taboo. Challenge shame gently and factually.
ImpactMojoSexual Health 101www.impactmojo.in
Common concerns that deserve a check-up
  • Periods that are extremely heavy, very painful or absent
  • Bleeding between periods or after sex
  • Unusual discharge, sores, pain or itching
  • Any concern about development, fertility or sexual health
Normalising help-seeking is part of the job: many treatable conditions go unaddressed because of embarrassment or lack of information.
ImpactMojoSexual Health 101www.impactmojo.in
04
Section Four
Contraception & Family Planning
ImpactMojoSexual Health 101www.impactmojo.in
Deciding whether and when to have children
Family planning lets people decide the number, spacing and timing of children. It is a recognised human right and one of the most cost-effective health interventions — preventing unintended pregnancies, unsafe abortions and maternal deaths.
The goal is informed, voluntary choice — never coercion, never a target. The person chooses the method that fits their life.
ImpactMojoSexual Health 101www.impactmojo.in
A map of contraceptive methods
FamilyExamplesNotes
BarrierMale & female condoms, diaphragmCondoms also prevent STIs/HIV
Short-acting hormonalPills, injectables, patchUser must remember / re-dose
Long-acting reversible (LARC)IUD/IUCD, implantYears of protection; reversible
PermanentFemale & male sterilisationIntended to be permanent
EmergencyEmergency contraceptive pillAfter unprotected sex; not routine
Fertility-awarenessCycle tracking, withdrawalLess reliable in typical use
No method is 'best' for everyone — the right method depends on health, preferences, stage of life and partner.
ImpactMojoSexual Health 101www.impactmojo.in
Typical use vs perfect use
Effectiveness has two numbers. Perfect use assumes the method is always used correctly; typical use reflects real life, with the occasional missed pill or unused condom. Typical use is what matters for counselling.
Typical-use effectiveness
The percentage of users who avoid pregnancy over a year as the method is actually used in everyday life — usually lower than perfect-use effectiveness.
ImpactMojoSexual Health 101www.impactmojo.in
Effectiveness by method (typical use)
Approx. % of users avoiding pregnancy in 1 year (typical use)
Well-established typical-use figures (e.g. WHO / CDC family planning guidance)
Long-acting methods (implant, IUD) are the most effective because they remove the chance of user error. Figures are rounded and well-established; exact values vary slightly by source.
ImpactMojoSexual Health 101www.impactmojo.in
Condoms protect twice over
Condoms are unique: they prevent both pregnancy and the transmission of STIs, including HIV. This is called dual protection.
Even when another method (a pill or IUD) is used for pregnancy prevention, a condom may still be needed for STI/HIV protection. The two jobs are different.
ImpactMojoSexual Health 101www.impactmojo.in
Emergency contraception, accurately
The emergency contraceptive pill can reduce the chance of pregnancy after unprotected sex or method failure, and works best the sooner it is taken. It is a backup, not a routine method.
Important: emergency contraception is not an abortion — it works mainly by preventing or delaying ovulation. It also does not protect against STIs.
ImpactMojoSexual Health 101www.impactmojo.in
Good counselling is the heart of family planning
  • Present the full range of methods, not just one
  • Explain effectiveness, use, side-effects and reversibility honestly
  • Respect the person's preferences, life stage and circumstances
  • Make clear they can switch or stop at any time
Quality of care — not just supply — is what makes family planning rights-based. Coercion of any kind violates it.
ImpactMojoSexual Health 101www.impactmojo.in
Unmet need for family planning
Unmet need
The share of people who want to avoid or delay pregnancy but are not using any contraceptive method — a key indicator of gaps in access, information and autonomy.
Reducing unmet need is a core SRHR goal. In India, modern contraceptive use has risen and unmet need has fallen over successive NFHS rounds, though gaps persist — especially for spacing methods and among young and newly married women.
Source: National Family Health Survey (NFHS), successive rounds. Always check the latest round for current figures.
ImpactMojoSexual Health 101www.impactmojo.in
Modern contraceptive use is rising in India
Modern contraceptive prevalence rate (mCPR), India (% of married women 15–49)
Illustrative trend patterned on NFHS rounds; check latest NFHS for exact figures
Modern method use has risen and unmet need has fallen across NFHS rounds. Values shown are illustrative of the trend — consult the latest NFHS factsheet for exact numbers.
ImpactMojoSexual Health 101www.impactmojo.in
India's method mix is shifting
Historically, India's contraceptive use leaned heavily on female sterilisation. A rights-based system widens the mix — adding spacing methods (pills, IUDs, injectables, condoms) so people have real choice across their lives, not just one permanent option.
A balanced method mix — and more male responsibility — is a marker of a maturing, choice-based programme.
ImpactMojoSexual Health 101www.impactmojo.in
Family planning is not only women's work
In much of South Asia, the burden of contraception falls overwhelmingly on women. Yet condoms and vasectomy are safe, simple options, and men's support shapes whether women can use any method at all.
Engaging men and boys — as users and as supportive partners — is a recognised way to improve both uptake and gender equality.
ImpactMojoSexual Health 101www.impactmojo.in
05
Section Five
Pregnancy & Maternal Health
ImpactMojoSexual Health 101www.impactmojo.in
A continuum of care around pregnancy
01
PRE-PREGNANCY: nutrition, planning, anaemia care
02
ANTENATAL: check-ups, screening, counselling
03
CHILDBIRTH: skilled, safe delivery
04
POSTNATAL: care for mother & newborn after birth
Most maternal and newborn deaths are preventable with timely, quality care across this whole continuum.
ImpactMojoSexual Health 101www.impactmojo.in
Antenatal care (ANC)
Antenatal care is care during pregnancy: monitoring the mother and baby, screening for and managing complications, and counselling on nutrition, danger signs and birth planning. WHO recommends at least eight ANC contacts for a positive pregnancy experience.
  • Detect and manage anaemia, hypertension and infection early
  • Iron-folic acid and other supplementation as advised
  • Tetanus protection and screening for STIs/HIV
  • Plan for a skilled, safe birth
ImpactMojoSexual Health 101www.impactmojo.in
Skilled birth attendance saves lives
Having a skilled birth attendant — and a facility able to manage emergencies — is the single biggest protector against maternal and newborn death. Institutional delivery in India has risen substantially over the NFHS rounds.
Source: NFHS. Programmes such as Janani Suraksha Yojana and Janani Shishu Suraksha Karyakram promote and support institutional delivery.
ImpactMojoSexual Health 101www.impactmojo.in
Institutional delivery has risen sharply
Births delivered in a health facility, India (%)
Illustrative trend patterned on NFHS rounds; check latest NFHS for exact figures
One of India's clearest public-health gains. Values are illustrative of the well-documented upward trend — consult the latest NFHS factsheet for exact figures.
ImpactMojoSexual Health 101www.impactmojo.in
What is maternal mortality?
Maternal Mortality Ratio (MMR)
The number of maternal deaths per 100,000 live births. It captures deaths from pregnancy- and childbirth-related causes — a sensitive marker of a health system's reach and quality.
Leading direct causes include severe bleeding, infection, high blood pressure disorders (pre-eclampsia/eclampsia) and complications of unsafe abortion — most of them preventable or treatable.
ImpactMojoSexual Health 101www.impactmojo.in
India's maternal mortality has fallen substantially
India's Maternal Mortality Ratio over time (deaths per 100,000 live births)
SRS, Office of the Registrar General of India (trend; figures rounded)
India's MMR has fallen markedly per the Sample Registration System (SRS). The downward trend is well established; exact values are SRS estimates and are revised periodically — check the latest SRS bulletin.
ImpactMojoSexual Health 101www.impactmojo.in
The postnatal period is high-risk and often neglected
Many maternal and newborn deaths happen in the days after birth, yet postnatal care is often the weakest link. Care in this window protects both mother and baby.
  • Postnatal check-ups for mother and newborn
  • Support for breastfeeding and newborn warmth
  • Watch for danger signs (bleeding, fever, infection)
  • Family-planning counselling and emotional/mental-health support
ImpactMojoSexual Health 101www.impactmojo.in
Maternal health gaps are equity gaps
National averages hide large gaps. Maternal outcomes are worse for poorer households, less-educated women, some states and districts, and marginalised communities — the people furthest from quality care.
Improving the average is not enough. Rights-based maternal health means closing the gap for those left behind. Disaggregate before you conclude.
ImpactMojoSexual Health 101www.impactmojo.in
06
Section Six
Safe Abortion & the Law
ImpactMojoSexual Health 101www.impactmojo.in
Safe abortion is essential health care
Access to safe abortion is part of comprehensive SRHR. Where it is unavailable or stigmatised, people resort to unsafe abortion — a major, preventable cause of maternal death and injury worldwide.
This is a clinical and rights matter, approached without judgement. In India, abortion is legal under specified conditions — many people do not know this.
ImpactMojoSexual Health 101www.impactmojo.in
The Medical Termination of Pregnancy (MTP) Act
India's Medical Termination of Pregnancy (MTP) Act, 1971 permits abortion by a registered medical practitioner under specified conditions — for example, risk to the woman's physical or mental health, fetal abnormality, or pregnancy from rape or contraceptive failure.
Note: abortion in India is governed by medical conditions and gestational limits in law — it is permitted on broad grounds, but it is not 'abortion on request' at any stage.
ImpactMojoSexual Health 101www.impactmojo.in
The MTP (Amendment) Act, 2021
The 2021 amendment expanded access. Among its key changes:
  • Raised the upper gestational limit to 24 weeks for specific categories of women (as defined in the rules)
  • Allowed certain abortions up to 20 weeks on the opinion of one provider
  • Recognised failure of contraception for unmarried women, not only married women
  • Required confidentiality — the provider must not reveal the woman's identity except as permitted by law
Beyond 24 weeks, certain cases (e.g. substantial fetal abnormality) may be considered by a Medical Board. The exact categories are set out in the MTP Rules.
ImpactMojoSexual Health 101www.impactmojo.in
Comprehensive abortion care
Comprehensive abortion care
Information, safe abortion services (medical or surgical, as appropriate), and post-abortion care — including contraceptive counselling — delivered with dignity and confidentiality.
  • Accurate information and supportive counselling
  • Safe method appropriate to the gestation
  • Management of any complications
  • Post-abortion contraception, if the person wants it
ImpactMojoSexual Health 101www.impactmojo.in
Two laws that are easy to confuse
MTP Act
Governs when and how a pregnancy may be legally terminated. It is about access to safe abortion care.
PCPNDT Act
The Pre-Conception and Pre-Natal Diagnostic Techniques Act bans sex-selective determination to prevent sex-selective abortion. It does not restrict legal abortion itself.
Conflating the two can wrongly deny women lawful abortion care. They serve different purposes.
ImpactMojoSexual Health 101www.impactmojo.in
The cost of restricting safe care
Where safe, legal abortion is hard to reach, people turn to unsafe methods — untrained providers, unsafe procedures, dangerous self-medication. Unsafe abortion is a leading, and almost entirely preventable, cause of maternal death and injury.
The evidence is clear: restricting access does not reduce abortions — it makes them less safe. Safe, legal services save lives.
ImpactMojoSexual Health 101www.impactmojo.in
Why legal does not always mean accessible
  • Stigma and fear of judgement keep people away
  • Providers and clients unaware of what the law allows
  • Shortage of trained providers and approved facilities
  • Confusion with the PCPNDT Act leading to denial of care
Practitioners can help by knowing the law accurately, providing confidential information, and referring to safe, approved services.
ImpactMojoSexual Health 101www.impactmojo.in
07
Section Seven
STIs & HIV
ImpactMojoSexual Health 101www.impactmojo.in
What are STIs?
Sexually transmitted infection (STI)
An infection passed mainly through sexual contact. STIs can be bacterial (e.g. syphilis, gonorrhoea, chlamydia), viral (e.g. HIV, herpes, HPV) or parasitic. Many are curable; viral ones are usually manageable.
Many STIs cause no symptoms, especially early on — so people can transmit them without knowing. This is why testing matters, not just symptoms.
ImpactMojoSexual Health 101www.impactmojo.in
Preventing STIs and HIV
  • Condoms — correct, consistent use is highly protective
  • Testing — know your status; many STIs are silent
  • Vaccination — e.g. HPV vaccine prevents cervical cancer
  • Prompt treatment — treat partners to stop re-infection
Condoms remain the cornerstone — the only method offering dual protection against both STIs/HIV and pregnancy.
ImpactMojoSexual Health 101www.impactmojo.in
HIV and AIDS, accurately
HIV is a virus that weakens the immune system; untreated, it can progress to AIDS. It spreads through specific routes — unprotected sex, infected blood, shared injecting equipment, and from mother to child — not through everyday contact.
HIV is not spread by sharing food, hugging, shaking hands, toilets or mosquito bites. Myths fuel stigma; facts dismantle it.
ImpactMojoSexual Health 101www.impactmojo.in
HIV is now a manageable condition
Antiretroviral therapy (ART) suppresses the virus, lets people live long, healthy lives, and — when the virus is undetectable — means it is not sexually transmitted (the 'Undetectable = Untransmittable', or U=U, principle).
Test
Free, confidential testing
Treat
Lifelong ART, available free in India
U=U
Undetectable = Untransmittable
ImpactMojoSexual Health 101www.impactmojo.in
Prevention of mother-to-child & PrEP
  • PMTCT: treatment in pregnancy can prevent transmission to the baby in the great majority of cases
  • PrEP: medicine taken by HIV-negative people at higher risk to prevent infection
  • PEP: emergency medicine soon after a possible exposure
  • Condoms: still central, and protect against other STIs too
India's HIV response is delivered largely through NACO (the National AIDS Control Organisation) and its programmes.
ImpactMojoSexual Health 101www.impactmojo.in
Stigma is a barrier to testing and treatment
Fear of judgement stops people testing, disclosing and seeking care — which harms both individuals and public health. People living with HIV or an STI deserve confidentiality, dignity and non-discrimination.
Use accurate, non-blaming language. STIs are infections, not moral failings. Reducing stigma is itself a prevention strategy.
ImpactMojoSexual Health 101www.impactmojo.in
Some STIs at a glance
STITypeNote
Chlamydia / gonorrhoeaBacterialOften silent; curable with antibiotics
SyphilisBacterialCurable; dangerous in pregnancy if untreated
HIVViralManageable lifelong with ART
Herpes (HSV)ViralManageable, not curable
HPVViralVaccine-preventable; can cause cervical cancer
Untreated STIs can cause infertility, pregnancy complications and increased HIV risk — another reason testing and early treatment matter.
ImpactMojoSexual Health 101www.impactmojo.in
HPV, cervical cancer and prevention
Most cervical cancer is caused by HPV, a common sexually transmitted virus. It is one of the most preventable cancers — through HPV vaccination and screening — yet remains a major cause of cancer death among women in the region.
HPV vaccination (ideally before sexual debut) plus screening can prevent the great majority of cervical cancers. WHO has a global elimination strategy.
ImpactMojoSexual Health 101www.impactmojo.in
08
Section Eight
Comprehensive Sexuality Education
ImpactMojoSexual Health 101www.impactmojo.in
What comprehensive sexuality education is
Comprehensive sexuality education (CSE)
Age-appropriate, scientifically accurate, rights-based teaching about the cognitive, emotional, physical and social aspects of sexuality — bodies, relationships, consent, gender, health and rights.
CSE is far broader than 'sex' — it builds knowledge, skills, attitudes and values that help young people protect their health and form respectful relationships.
ImpactMojoSexual Health 101www.impactmojo.in
More than biology
Knowledge
  • Bodies, puberty and reproduction
  • Contraception and STI/HIV prevention
  • Where to get help and services
Skills & values
  • Consent and communication
  • Recognising and resisting coercion and abuse
  • Respect, gender equality and rights
ImpactMojoSexual Health 101www.impactmojo.in
Age-appropriate and incremental
CSE is age-appropriate: young children learn about bodies, feelings, safety and respect; older adolescents learn about relationships, contraception and rights. Content is matched to developmental stage.
01
EARLY: body autonomy, naming parts, 'safe vs unsafe' touch
02
PRE-TEEN: puberty, emotions, respect, online safety
03
ADOLESCENT: relationships, consent, contraception, STIs
04
OLDER: rights, services, planning, gender equality
ImpactMojoSexual Health 101www.impactmojo.in
CSE does NOT increase sexual activity
This is one of the best-established findings in the field. Rigorous reviews show that good CSE does not lead young people to start having sex earlier or to have more partners.
If anything, the evidence points the other way: CSE is associated with delayed sexual debut and safer behaviour when young people do become sexually active.
ImpactMojoSexual Health 101www.impactmojo.in
What the evidence shows CSE does
  • Increases knowledge and corrects myths
  • Is linked to later sexual debut and fewer partners
  • Increases use of contraception and condoms among the sexually active
  • Builds skills to recognise abuse and seek help
Source: UNESCO and WHO reviews of sexuality education evidence. Quality and rights-based content matter — 'abstinence-only' programmes do not show these benefits.
ImpactMojoSexual Health 101www.impactmojo.in
What good CSE shifts
Direction of effect of quality CSE on key outcomes (schematic)
Illustrative schematic of findings in UNESCO/WHO evidence reviews
Schematic, not measured magnitudes: CSE raises knowledge and safer behaviour while the feared effect — earlier debut — does not appear. Source: UNESCO/WHO evidence reviews.
ImpactMojoSexual Health 101www.impactmojo.in
Common myths about CSE — and the facts
MythFact
It encourages young people to have sexEvidence shows the opposite or no effect
It is 'too much, too young'Content is age-appropriate and incremental
It is against our cultureIt builds respect, safety and consent — shared values
Silence keeps children safeKnowledge helps children recognise and report abuse
Addressing myths respectfully — with evidence — is often the key to gaining community and parental support.
ImpactMojoSexual Health 101www.impactmojo.in
CSE in the Indian context
India delivers adolescence and life-skills education through school and health programmes (for example, the Adolescence Education Programme and the Health and Wellness Ambassador / 'School Health Programme' initiatives), though coverage and content vary by state.
Framing matters: 'life skills', 'adolescent health' and 'wellness' framings often gain acceptance where the label 'sex education' meets resistance — while keeping the rights-based content.
ImpactMojoSexual Health 101www.impactmojo.in
09
Section Nine
Gender, Consent & GBV
ImpactMojoSexual Health 101www.impactmojo.in
Consent is the foundation of healthy sexuality
Consent
A clear, freely given, informed and reversible agreement to a specific activity. It must be ongoing, and it cannot be given under pressure, deception, intoxication, or by someone below the legal age.
Consent is enthusiastic and reversible: silence is not consent, and a yes can be withdrawn at any time.
ImpactMojoSexual Health 101www.impactmojo.in
The features of real consent
  • Freely given — no pressure, threat or manipulation
  • Informed — the person knows what they are agreeing to
  • Specific — to one thing, not a blanket permission
  • Reversible — can be withdrawn at any moment
  • Ongoing — checked each time, not assumed
ImpactMojoSexual Health 101www.impactmojo.in
What is NOT consent
  • Silence or no resistance — absence of 'no' is not 'yes'
  • A previous yes — consent to one act or occasion is not consent to all
  • Agreement under pressure, fear, deception or coercion
  • From someone who cannot consent — below the legal age, asleep, or heavily intoxicated
Within marriage too, consent matters: sex without consent is violence, whatever the relationship.
ImpactMojoSexual Health 101www.impactmojo.in
Gender-based violence and SRHR
Gender-based violence (GBV)
Harmful acts directed at a person because of their gender — including physical, sexual, emotional and economic violence, and harmful practices. It is rooted in gender inequality and abuse of power.
GBV is both a violation of rights and a major SRHR issue: it drives unintended pregnancy, STIs, injury, and mental-health harm, and it blocks people from seeking care.
ImpactMojoSexual Health 101www.impactmojo.in
A survivor-centred response
  • Safety first — for the survivor and any children
  • Confidentiality and respect — never blame the survivor
  • Choice — the survivor decides next steps
  • Referral — to health, legal, psychosocial and shelter support
Know your local referral pathway and helpline numbers before you need them. Care includes emergency contraception, STI/HIV prophylaxis and mental-health support.
ImpactMojoSexual Health 101www.impactmojo.in
POCSO and protecting children
India's Protection of Children from Sexual Offences (POCSO) Act, 2012 criminalises sexual offences against anyone under 18 and sets up child-friendly procedures for reporting, investigation and trial.
POCSO places a legal duty to report child sexual abuse. Practitioners working with children must know their reporting obligations and child-protection protocols.
ImpactMojoSexual Health 101www.impactmojo.in
Legal age of marriage in India
Under the Prohibition of Child Marriage Act, 2006, the legal minimum age of marriage in India is 18 for women and 21 for men. Child marriage is associated with early pregnancy, school dropout and greater health risk.
Note: proposals to raise the age for women to 21 have been debated. State the current law accurately and check for updates before advising.
ImpactMojoSexual Health 101www.impactmojo.in
LGBTQ+ inclusion in SRHR
A rights-based approach serves people of all sexual orientations and gender identities. In India, the Supreme Court read down Section 377 in 2018 to decriminalise consensual same-sex relations, and the NALSA judgment (2014) affirmed the rights of transgender persons.
Inclusive practice means non-judgemental services, correct names and pronouns, confidentiality, and care that does not assume everyone is heterosexual or cisgender.
ImpactMojoSexual Health 101www.impactmojo.in
10
Section Ten
Adolescents & Access
ImpactMojoSexual Health 101www.impactmojo.in
Adolescents have distinct SRHR needs
Adolescence (roughly ages 10–19) is when many SRHR needs emerge — puberty, first relationships, risk of early pregnancy and STIs — yet young people often face the greatest barriers to information and services.
South Asia has a very large young population. Meeting adolescents' SRHR needs is both a rights obligation and a major opportunity.
ImpactMojoSexual Health 101www.impactmojo.in
India's adolescent health programme (RKSK)
Rashtriya Kishor Swasthya Karyakram (RKSK) is India's national adolescent health programme. It takes a holistic view of adolescent well-being and includes SRHR among its priority areas.
  • Sexual and reproductive health
  • Nutrition (including anaemia)
  • Mental health and substance misuse
  • Injuries, violence and non-communicable disease
RKSK promotes peer educators and Adolescent Friendly Health Clinics (AFHCs) to reach young people.
ImpactMojoSexual Health 101www.impactmojo.in
What stops adolescents getting care
  • Fear of being judged, or of parents finding out
  • Providers reluctant to serve unmarried young people
  • Lack of confidentiality and privacy at facilities
  • Cost, distance, clinic timings and lack of information
Many of these are about how services treat young people — not about the law. Attitudes are often the biggest barrier.
ImpactMojoSexual Health 101www.impactmojo.in
Confidentiality builds trust
Adolescents are far more likely to seek help when they trust that their visit will be private and confidential. Breaching confidentiality — or threatening to — drives them away and can put them at risk.
Balance confidentiality with safeguarding: where there is abuse or serious risk (e.g. under POCSO), legal duties to protect the child apply. Know where that line sits.
ImpactMojoSexual Health 101www.impactmojo.in
What makes a service youth-friendly?
Accessible
Convenient hours, location and low or no cost
Acceptable
Private, confidential, non-judgemental staff
Equitable
Serves all young people, married or not
Effective
Trained providers, the right supplies in stock
Youth-friendly is a way of working, not just a separate room. Provider attitude is the single biggest factor.
ImpactMojoSexual Health 101www.impactmojo.in
Reach adolescents where they are
  • Peer educators — young people trust other young people
  • Schools and life-skills sessions — reach those still enrolled
  • Digital and helplines — private, accessible information
  • Community outreach — for those out of school
Involve adolescents in designing services for adolescents. Participation improves both relevance and uptake.
ImpactMojoSexual Health 101www.impactmojo.in
11
Section Eleven
SRHR in South Asia & Practice
ImpactMojoSexual Health 101www.impactmojo.in
The South Asian SRHR landscape
South Asia has made major SRHR gains — falling maternal mortality, rising contraceptive use and institutional delivery — alongside persistent challenges: taboos, gender inequality, son preference and uneven access.
Progress is real but uneven. The task is to extend quality SRHR to those still left behind — the poorest, the youngest and the most marginalised.
ImpactMojoSexual Health 101www.impactmojo.in
Silence and stigma are health barriers
Cultural silence around sex, menstruation and abortion keeps people from information and care. Breaking that silence — respectfully, without offending values — is core SRHR work.
Work with communities, families and trusted local voices. Confrontation hardens resistance; respectful engagement opens doors.
ImpactMojoSexual Health 101www.impactmojo.in
Where the gaps are widest
  • Rural and remote areas with few trained providers
  • Unmarried adolescents and young people
  • Poor, Dalit, Adivasi and other marginalised communities
  • LGBTQ+ people and persons with disabilities
Equity lens: ask not just 'how is the average doing?' but 'who is still being missed, and why?'
ImpactMojoSexual Health 101www.impactmojo.in
Key Indian programmes and platforms
Programme / cadreFocus
ASHA & ANM workersCommunity-level SRHR outreach and referral
RKSK / AFHCsAdolescent health, including SRHR
JSY / JSSKSafe, institutional delivery and maternal care
NACOHIV prevention, testing and treatment
Family planning programmeCounselling and a basket of methods
Frontline workers — especially ASHAs and ANMs — are the backbone of SRHR delivery in India.
ImpactMojoSexual Health 101www.impactmojo.in
Principles of respectful SRHR counselling
  • Be non-judgemental — whatever the person's choices
  • Protect privacy and confidentiality
  • Give accurate, complete information, not opinions
  • Support the person's own decision — do not decide for them
  • Be inclusive of all genders, orientations and abilities
ImpactMojoSexual Health 101www.impactmojo.in
Common practice pitfalls to avoid
PitfallBetter practice
Pushing one method or a targetOffer the full range; respect choice
Refusing care to unmarried youthServe all who need care, lawfully
Moralising or shamingStay neutral, factual, supportive
Breaching confidentialityProtect privacy; know safeguarding limits
The test of rights-based practice: did the person leave better informed, respected and free to decide?
ImpactMojoSexual Health 101www.impactmojo.in
A practitioner's SRHR checklist
  • Am I being accurate, and non-judgemental?
  • Am I protecting privacy and confidentiality?
  • Am I including everyone — all genders, married or not, disabled or not?
  • Am I supporting the person's own informed choice?
  • Do I know the law and the local referral pathway?
ImpactMojoSexual Health 101www.impactmojo.in
Where to learn more
  • WHO — sexual and reproductive health guidance and definitions
  • Guttmacher Institute — SRHR research and the Guttmacher–Lancet definition
  • UNFPA — the United Nations sexual and reproductive health agency
  • UNESCO — International Technical Guidance on Sexuality Education
  • NFHS & SRS (India) — national data on health and fertility
Pair this deck with ImpactMojo's Gender, Public Health and Adolescent Health 101 courses.
ImpactMojoSexual Health 101www.impactmojo.in
If you remember five things
  • SRHR is a right — rooted in bodily autonomy and dignity
  • Condoms protect twice — against pregnancy and STIs/HIV
  • Abortion is legal in India under the MTP Act (amended 2021)
  • CSE works — and does not increase sexual activity
  • Be non-judgemental and inclusive — care for everyone
ImpactMojoSexual Health 101www.impactmojo.in
Sexual Health 101 · Complete
Care without
judgement.
CC BY-NC-ND 4.0·Free Forever·ImpactMojo 101 Series