BACKGROUND Reproductive health problems such as HIV, unwanted pregnancy and unsafe abortion among adolescents are closely linked to insufficient knowledge about sexuality and reproduction and lack of access to contraceptives. Supported by international agencies, Zambia has introduced an ambitious nation-wide program for comprehensive sexuality education (CSE) to be implemented into ordinary school activities by teachers. The curriculum is firmly based in a discourse of sexual and reproductive rights, not commonly found in the public debate on sexuality in Zambia. This paper explores how teachers perceive the curriculum and practice discretion when implementing the CSE in mid-level schools in Nyimba district in Zambia. METHODS Using a case study design, data were collected through in-depth interviews with 18 teachers and analyzed thematically drawing upon theories of discretion and policy implementation. RESULTS Individual teachers make decisions on their own regarding what and when to teach CSE. This discretion implies holding back information from the learners, teaching abstinence as the only way of preventing pregnancy or cancelling sexuality education sessions altogether. Teachers' choices about the CSE program were linked to lack of guidance on teaching of the curriculum, especially with regards to how to integrate sexuality education into existing subjects. Limited prioritization of CSE in the educational sector was observed. The incompatibility of CSE with local norms and understandings about adolescent sexuality combined with teacher-parent role dilemmas emerged as problematic in implementing the policy. Limited ownership of the new curriculum further undermined teachers' motivation to actively include CSE in daily teaching activities. Use of discretion has resulted in arbitrary teaching thus affecting the acquisition of comprehensive sexual and reproductive health knowledge among learners. CONCLUSION The CSE had limited legitimacy in the community and was met with resistance from teachers tasked with its' implementation. In order to enhance ownership to the CSE program, local concerns about the contents of the curriculum and the parent-teacher role dilemma must be taken into consideration. Not addressing these challenges may undermine the policy's intention of increasing knowledge about sexuality and reproduction and empowering adolescents to access contraceptive services and avoid unwanted pregnancies.

中文翻译：

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为什么要在学校教授性教育？教师在赞比亚农村实施全面性教育的自由裁量权。

背景艾滋病毒、意外怀孕和青少年不安全堕胎等生殖健康问题与性和生殖知识不足以及无法获得避孕药具密切相关。在国际机构的支持下，赞比亚推出了一项雄心勃勃的全国性全面性教育（CSE）计划，由教师将其落实到普通学校活动中。该课程牢固地以性权利和生殖权利的论述为基础，这在赞比亚关于性的公开辩论中并不常见。本文探讨了在赞比亚宁巴区的中级学校实施全面性教育时，教师如何看待课程和实践自由裁量权。方法 采用案例研究设计，通过对 18 名教师的深入访谈收集数据，并利用自由裁量权和政策实施理论进行主题分析。结果 个别教师自行决定教授 CSE 的内容和时间。这种自由裁量权意味着隐瞒学习者的信息，教导禁欲作为预防怀孕的唯一方法或完全取消性教育课程。教师对全面性教育项目的选择与缺乏课程教学指导有关，特别是在如何将性教育融入现有学科方面。据观察，全面性教育在教育部门的优先顺序有限。全面性教育与当地规范和对青少年性行为的理解不相容，再加上教师与家长的角色困境，成为政策实施过程中的问题。新课程的有限所有权进一步削弱了教师积极将全面性教育纳入日常教学活动的积极性。自由裁量权的使用导致了教学的任意性，从而影响了学习者对性健康和生殖健康知识的全面掌握。结论 CSE 在社区中的合法性有限，并且遭到了负责其实施的教师的抵制。为了增强对全面性教育项目的主人翁意识，必须考虑当地对课程内容和家长与教师角色困境的担忧。如果不解决这些挑战，可能会破坏该政策旨在增加性和生殖知识以及增强青少年获得避孕服务和避免意外怀孕的能力的意图。