Implementation of Comprehensive Sexuality Education in Primary Schools in a Province of Northern Thailand

Implementing comprehensive sexuality education combats unsafe sexual behavior among children and adolescents. However, risky sexual behavior among teenagers still exists globally, including in Thailand. This qualitative descriptive research aimed to explore the implementation of comprehensive sexuality education in primary schools in a province of northern Thailand and to identify facilitators and barriers related to its implementation. Data were collected from June 2021 to May 2022 through in-depth interviews with 15 primary school teachers and nine primary school principals/deputy directors of academic affairs and analyzed using thematic analysis. Four themes emerged: 1) Promoting implementation of comprehensive sexuality education, including the policy level and the teacher levels, 2) Informal teaching, including non-compulsory subjects, differential content coverage, teaching informal style, availability of teaching aids, and unstructured evaluation, 3) Motivation as a facilitator for implementing comprehensive sexuality education, including teachers’ eagerness, children’s enthusiasm, changes in children’s outcomes, and support for teaching comprehensive sexuality education, and 4) Challenges and overcoming the barriers to implementing comprehensive sexuality education, including traditional vs. a paradigm shift, sensitive issues, lack of coordination, and lack of continuity and sustainability.             The findings provide essential evidence that informal teaching in comprehensive sexuality education as a non-compulsory subject is valued, but some barriers should be eliminated by nurses to enhance children’s well-being and actively contribute to the prevention of health issues, including comprehensive sexuality education. Additionally, nurses play an active role in developing prevention programs and promoting healthy lifestyles, which encompass comprehensive sexuality education. The collaboration among nurses, school administrators, and teachers would support the effectiveness of implementing comprehensive sexuality education.