Using an integral approach to breake taboos

“Love Matters - Family Matters”

Von Juan Francisco Ramirez Flores & Monika Christofori

Working on sexual reproductive health and rights is deemed increasingly unpopular in Paraguay. The conservative Government is fiercely regulating the information available to the public. Within this restrictive context, Fundación Vencer continues its work in a subtle manner, providing sexual and reproductive health education to young children and adolescents at school, their parents, teachers and health workers in an integral manner. Braking taboos has paid off: parents feel more confident to talk to their children about sexuality and reproductive health; teenagers have learnt on how to avoid early pregnancies and teenagers have increasingly utilized the public health services.

“Love Matters - Family Matters”

Sexual education and transmission of HIV at school. Photo: © Fundación Vencer 



In Paraguay, almost 28% of the population (6.8 mio people) are young people or adolescents between 15 to 29 years of age (EPH 2017). Sexual relations of young people start early, particularly among boys. One in four boys had a sexual relation before the age of 14. While 50% of the girls protect themselves against an unwanted pregnancy, around 20% of girls become pregnant between the ages of 15 to19 years. 6 % of new HIV cases are adolescents between 15 to 19 years.



Total in %

Male in %

Female in %

Having had some kind of sexual relation in his/her life.




Among those respondents, who had a sexual relation, the first sexual relation was before the age of 14 years.




Had sexual relations with two or more persons in his/her life.




Among those respondents, who had a sexual relation in the past 12 months, used a condom in the last relation.




Among those respondents, who had a sexual relation in the past 12 months, used any other contraceptive method in the last relation.




Figure: Sexual relations in young people between 14-18 years of age (Global Survey of School Health; 2017) 

Even though the national data shows that sexual engagement starts early, the existence of conservative groups within the Government and decision-makers of Paraguay makes it difficult for us to work on comprehensive sexuality education. A Ministerial resolution No. 29.664 initiated in 2017 has declared the "prohibition of any debate in schools on the theory or perspective of gender and sexuality". Materials were ceased and reviewed by the Government and an officially approved version of sexuality education curriculum launched, which covers only male and female body organs, and misses out completely on sexuality and sexual and reproductive rights.


The Fundacion Vencer’s working approach

Fundación Vencer, an organization founded on February 5, 1999, working in defense of the Human Rights of people living with HIV-AIDS, ensures access to sexual and reproductive health and promotes sexual and reproductive rights. The areas of work comprise of health interventions, education, policy dialogue and influence as well as research to generate more evidence.

Despite the conservative working context in the area of sexual reproductive health and rights (SRHR), Fundación Vencer follows an integral working approach, bringing youth, adolescents, their parents, teachers and health workers of the local family health units together to jointly tackle SRHR issues. Fundación Vencer adapts their approach and content according to the age groups, providing life skills and enhancing self-confidence of the young people, their peers and guardians. While children and teenagers are at the center of the approach, their family, teachers and health staff are part of the intervention. The articulated work between the actors and the civil society contributes to reduce the rate of pregnancies in young people and contributes to reduce the rate of sexually transmitted infections.


Graphic: The integral approach applied by Fundación Vencer


Working with children and adolescents at school

With the consent of the school, Fundación Vencer introduces sexual and reproductive health and rights as part of the extra curriculum activates to school children. Starting at the age of 5 years already, knowing one’s body, and being assured, that the body is “my own property”, already small children are taught about bodily integrity and life skills to say no. Moving up to older age groups, the education becomes more sexuality and rights focused, involving peer to peer education, as well as adapting to the problems and language that youth uses.


Sexual education and transmission of HIV at school. Photo: © Fundación Vencer


Parent’s circles

Parents are regularly invited to meet and discuss issues and difficulties they face at home and in the family. Vencer attempts to educate parents and enhance their knowledge and break down barriers. The circles create an open dialogue and foster understanding by addressing shame, myths, taboos and cultural issues around sex and sexuality. Furthermore parents learn the language used by the children and youth. Overcoming these “language barriers” has proved to useful in enhancing inter-family communication about sexuality. Parents also support teachers and back them up.

Parents circle meeting. Photo: © Fundación Vencer


Teachers training

Teachers of all disciples, and not only science teachers, take part in the teachers training, where teachers acquire the capacity to talk about sexual and reproductive health and rights. They facilitate the sessions with the youth. At the start, they are supported by the staff of Fundación Vencer, and ultimately perform the education on their own.

Health worker training

Health workers are sensitized to the health needs of young people and adolescents. The project supports the health providers in developing an adolescent friendly approach, meeting the demands of young people in a non-judgmental manner.


Advantages of the approach

  • Sexuality education as an integral approach is the joint responsibility and the task of all the actors of the community, not only of the school or the teachers.
  • The Family Health Units have started to provide youth friendly services for adolescents and young people without stigma and discrimination by adopting a comprehensive view of sexuality.
  • The adolescents and young people continue to educate each other and learn among themselves in dynamics that facilitate conversations about their realities and experiences.
  • The transmission of prejudices within generations is addressed by providing spaces for reflection for adults (parents, teachers) about sexuality.
  • The model is ready to be replicated in other communities.


Starting sexuality education already at very young age. Photo: © Fundación Vencer


The impact of the work

Since the start of the project interventions in year 2016, the project has yielded the following impact:

  • 1’505 of the adolescents and young participants have increased their knowledge about sexuality, HIV/AIDS and they know their legal rights.
  • A 15% increase in access to sexual and reproductive health services by those adolescents and young people, who participated in the educational training in 2016.
  • 92% of students who have participated in this project know how to avoid teenage pregnancies.
  • Parents in general feel more confident to talk to their children about sexual health.


Prevailing challenges

Continuing and replicating the work of integral sexuality education in other communities particularly starting at young age, requires a good understanding and time to get a buy-in from the school and parents. The conservative political environment does not allow a high visibility and promotion of the approach, despite the fact that Government is aware about the increase of adolescent pregnancies. The school management can act as “champions” in terms of daring and encouraging to implement the integral approach for new schools. Because of the restrictive environment, only a subtle advocacy on sexuality education and legal rights is possible. The same accounts for the mobilization of networks of organizations, which work on the sexual and reproductive health and rights. While it is difficult to find out about like-minded organizations, it would value and strength the advocacy work while supporting each other in the present context.


What the future holds

The sustainability of the integral approach requires further strengthening by creating strong links between the community actors and by empowering them to teach others through a training of trainers approach. In order to reach more parents and keep the momentum in the parents groups, groups of mothers and fathers who talk about sexuality among themselves and with their sons and daughters will be multiplied. Peer education will be further promoted through the analyses of the young people realities and decision-making. And last but not least, Fundación Vencer will continue with subtle lobbying to influence the incorporation of sexuality education and youth promotion into the plans and programs of the state in the formal and non-formal educational system.

Social Networks: @fundacionvencer
Telephone: +59521331139



Juan Francisco Ramirez Flores & Monika Christofori

Juan Francisco Ramirez Flores, Fondacion Vencer, Paraguay is a social work student, works as a counsellor living with HIV for the Vencer Foundation, contributing to the fight against stigma, discrimination, access to comprehensive, friendly health information, and is also an activist for the creation of the youth and adolescents network living with HIV in Paraguay with the aim of contributing to stopping stigma and discrimination against young people living with HIV, disseminating updated information on sexual and reproductive rights, creating a more inclusive society free of discrimination and social protection by public policies created with the accompaniment of young people living with HIV.  

Monika Christofori-Khadka
: Health Advicer, Swiss Red Cross Headquaters; Switzerland. MMS board member.


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