Teachers’ conflicting cultural schemas of teaching comprehensive school-based sexuality education in Kampala, Uganda

Abstract Teachers can feel uncomfortable teaching sexuality education when the content conflicts with their cultural values and beliefs. However, more research is required to understand how to resolve conflicts between teachers’ values and beliefs and those implicit in comprehensive approaches to sexuality education. This study uses cultural schema theory to identify teachers’ cultural schemas of teaching sexuality education and the internal conflicts arising between them. In-depth interviews were conducted with 40 secondary school teachers in Kampala, the capital city of Uganda. Embedded in a context of morality, conflicting cultural schemas of sexuality education and young people’s sexual citizenship in traditional and present-day Ugandan society were found: young people are both innocent and sexually active; sexuality education both encourages and prevents sexual activity; and teachers need to teach sexuality education, but it is considered immoral for them to do so. In countries such as Uganda, supportive school regulations and a mandate from society could help teachers feel more comfortable adopting comprehensive approaches to sexuality education.


Introduction
Social structures in sub-Saharan African countries have recently been subjected to change that has affected young people's transition to adulthood. Traditionally, the period between puberty and marriage was short due to early family formation, and young people would transit from childhood to adulthood as determined by cultural rites of passage (Magadi and Agwanda 2009;Martínez Pérez and Namulondo 2011). Social change has created and lengthened the adolescent period between puberty and marriage in which young people may have physically matured but are not considered mature by society because they are still attending school and have not yet reached the age of majority (Calvès, Kobian, and Martel 2007;Lloyd 2005;Magadi and Agwanda 2009;Munthali and Zulu 2007). These 'adolescents' have thereby become 'a specific social segment of the population' in sub-Saharan Africa (Calvès, Kobian, and Martel 2007, 265).
Traditionally, initiation ceremonies in sub-Saharan Africa were important for teaching young people about sexuality. For instance, among the Baganda, a large ethnic group in central Uganda, paternal aunts, known as ssengas, educated their nieces about matters of sexuality and the behaviours and roles expected of them as married women (Tamale 2006). Nowadays the media and peers have become more important sources for young people's information on sexuality issues (Darabi et al. 2008;Munthali and Zulu 2007). Although these information sources can be valuable, their quality can be inconsistent or poor, and they can provide conflicting messages and problematic representations of sex (Attwood et al. 2015;Cheetham 2014;UNESCO, UNAIDS, UNFPA, UNICEF, and WHO 2009).
Sexuality education may seek to balance the information and values received from these sources. It enables young people to develop and understand themselves as sexual beings and to make informed decisions regarding their sexual and reproductive health and rights (Robinson 2013;UNESCO, UNAIDS, UNFPA, UNICEF, and WHO 2009). From a human rights perspective, young people have the right to 'sexuality education and information necessary and useful' (IPPF 2008;7) to exercise their full sexual citizenship, which refers to 'the sexual rights granted or denied to' them as members of a particular social group (Richardson 2000, 107).
In debates regarding young people's need for sexuality education, a distinction is often made between abstinence-only and comprehensive sexuality education. Whereas abstinence-only programmes may omit certain information, such as about contraception, comprehensive sexuality education adopts a positive and holistic approach to young people's sexual wellbeing and citizenship. IPPF (2010, 6) stresses that 'a rights-based approach to Comprehensive Sexuality Education seeks to equip young people with the knowledge, skills, attitudes and values they need to determine and enjoy their sexuality -physically and emotionally, individually and in relationships. It views "sexuality" holistically and within the context of emotional and social development' . Francis (2016) indicates how sexuality education and HIV prevention have become largely synonymous in South Africa. In addition, in Uganda, the HIV epidemic since the 1980s has given new meaning to sexuality education, as it triggered public HIV prevention interventions, which were retrospectively interpreted and defined as constituting the ABC strategy: abstain, be faithful, and correct and consistent condom use (Kinsman 2008;Parikh 2015;Parkhurst 2011). Sexuality education has thereby become a public matter 'populated with competing moral discourses' (Parikh 2015, 255). Tamale (2006, 89) describes how, beforehand, interactions between Uganda's patriarchal society and colonialism, which brought with it Christianity, had intensified 'the repression and surveillance of African women's sexuality' , whereby traditional practices were used 'to introduce new sexual mores, taboos and stigmas' . Now, faced with the HIV epidemic, but also other contributing factors such as urbanisation, sexuality education was brought into the public domain, disrupting 'what had been considered appropriate and age-specific social spaces' (Parikh 2015, 30). For instance, it enabled the emergence of commercial ssengas from what used to be private initiation rites (Tamale 2006).
In addition, Uganda has received substantial amounts of foreign assistance for its HIV prevention programmes, and the government strategically aligned its policies with the agendas of influential donors (Parkhurst 2005). For instance, US-funded PEPFAR allocated a substantial part of its HIV prevention budget between 2003 and 2008 to abstinence-only programmes for young people. One of its interventions concerned the HIV prevention education programme known as the Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) (Santelli, Speizer, and Edelstein 2013). This abstinence-only programme was developed by the Ugandan government and implemented in primary and secondary public schools from 2003 onwards (Cohen 2006). At the same time, however, more comprehensive approaches to sexuality education were also being implemented by non-governmental organisations in secondary schools (de Haas 2017).
Several studies have advocated the need to implement comprehensive, rights-based sexuality education in Ugandan schools Aggleton 2013, 2014;Rijsdijk et al. 2013). However, recent developments are hindering such initiatives. In 2016, the government announced that comprehensive sexuality education should not be taught in Ugandan schools (Kisakye 2016). This announcement was provoked by a newspaper article claiming that more than 100 Ugandan schools had been 'tricked' into teaching homosexuality through a comprehensive sexuality education programme developed by the Netherlands-based non-governmental organisation Rutgers (Ahimbisibwe 2016). The ban was soon challenged by Ugandan youth at an intergenerational dialogue organised by Rutgers partner RAHU, a Ugandan youth-led organisation (Kato 2016). In 2017, the Ugandan government presented a new, draft 'sexuality education framework' for young people in schools 'based on cultures, customs, religious beliefs and aspirations of the Uganda people' . This framework was supported by Uganda's Interreligious Council and aims to protect 'the morals of young people' (Museveni 2017).
Teachers in urban Ugandan secondary schools are currently requested to teach sexuality education against this backdrop in which competing interpretations and meanings of sexuality education coexist, and in which young people are sexually active, while the government works with religious leaders to insert moral values and beliefs via abstinence-only education (Tamale 2006).
Research indicates that teachers can feel discomfort teaching sexuality education due to conflicts between the content of comprehensive sexuality education programmes and their perceived sociocultural norms and cultural and religious beliefs (Ahmed et al. 2006(Ahmed et al. , 2009Helleve et al. , 2011Kinsman et al. 2001;Renju et al. 2010). These cultural beliefs may result in abstinence-only messages and being reticent about safe-sex practices. For instance, teachers may feel that sex before marriage and related sexual practices are not appropriate for young people, and that discussing safe-sex issues, such as condoms, will condone or encourage young people to have sex (Ahmed et al. 2006(Ahmed et al. , 2009Gallant and Maticka-Tyndale 2004). Francis (2013Francis ( , 2016 has found that, generally speaking, teachers only teach those parts of sexuality education with which they feel comfortable and argues that research on sexuality education should 'prioritise teacher comfort' . Other studies have shown that schoolbased sexuality education programmes are more likely to be successfully implemented when teachers feel confident and comfortable teaching them (Ahmed et al. 2006;Mathews et al. 2006;Rijsdijk et al. 2014).
This study aims to obtain a better understanding of teachers' cultural values and beliefs, the conflicts they may experience, and how these relate to their experienced level of comfort teaching comprehensive sexuality education within the Ugandan context.

Theoretical background
Teachers' cultural values and beliefs were studied using cognitive-anthropological cultural schema theory. Schemas are internal conceptual structures that allow people to identify objects and events. They may include beliefs, emotions and values (D'Andrade and Strauss 1992;Holland and Cole 1995). Some schemas, such as personal experiences, are individual to a person; others, so-called cultural schemas, are shared by a group of people based on shared knowledge and experiences.
Cultural schema theory aims to understand how individual reasoning is motivated by these cultural schemas. Schemas can act at the lower, middle and higher level and are hierarchically linked. Higher-level schemas, such as goals, values and discourses, are considered to have high motivational force, whereas middle-level schemas sometimes, and lower-level schemas only, generate goals in interaction with higher-level schemas (D'Andrade 1992; Garro 2000). For instance, whenever a low-level schema -for example, teaching in classdirects to a higher-level schema -for example, the well-being of a teacher -these schemas may motivate behaviour.
Cultural schemas are not fixed but dynamic, due to new information and experiences. Cultural schemas thus change, and due to the time dimension of cultural schemas, individuals may experience cultural change. They may constantly reconstruct their past experiences and knowledge based on their present constructions of the cultural meaning system (Garro 2000). Manago (2012) explains that cultural change is a gradual process of negotiating a pathway through old and new values. However, Harkness, Super, and Keefer (1992, 164) argue that individuals may find 'the pace of culture change' overwhelming when the experienced culture change requires 'a fundamental shift in thinking' .
Individuals may experience such cultural transitions in society -for instance, due to globalisation or technical improvements. In such transitions, 'the present is separated from the past' , and individuals need to 'reconsider and restructure past elements from the point of view of the present' (Harkness, Super, and Keefer 1992, 172).

Participant recruitment and background
Data collection took place between September and December 2011. The aim was to involve teachers from different sexuality education programmes at secondary schools to obtain a comprehensive view of how teaching sexuality education is embedded in the kind of curriculum and education used.
Three Ugandan non-governmental organisations that implement sexuality education in secondary schools connected the first author (a Dutch female researcher) to teachers working in secondary schools in Kampala, the capital of Uganda, and its surrounding districts (see de Haas 2017 for a reflection on issues of positionality). This region can be considered the most urbanised and wealthiest region of Uganda (Uganda Bureau of Statistics and ICF International Inc 2012).
Teachers introduced the researcher to the school administration and to teacher colleagues who might be interested in participating in the research. A flyer was also distributed in staffrooms to recruit participants. Thereafter, a snowball technique was used, to introduce the researcher to colleagues in the school or neighbouring schools. These recruitment strategies may have led to some selection bias in cases where the Ugandan non-governmental organisations introduced the researcher to schools that are known to be actively implementing their sexuality education programme, and in cases where teachers with particularly strong views on teaching sexuality education volunteered to participate in this study (Hennink, Hutter, and Bailey 2011). Data saturation, when no new information was collected, was felt to have been reached after the 36th interview. Four additional interviews helped diversify the background characteristics of participants by via the inclusion of two more male participants and interviews at a boys-only school and at a Catholic school (Hennink, Hutter, and Bailey 2011).
In total, 40 sexuality education teachers from 16 secondary schools participated in the study. The teachers comprised both men (n = 18) and women (n = 22) aged 22-53 years. Seven women and two men were aged 40 or above. Although the teachers worked in and around Kampala, many of them were born in rural areas, and some still lived there during weekends and holidays. Many of the teachers were Baganda. The teachers adhered to different religions: Pentecostal (n = 12), Protestant (n = 11), Catholic (n = 10), Muslim (n = 4) and Seventh Day Adventist (n = 3).
Most of the participating teachers taught sexuality education as an integral part of their lessons. These lessons included Christian Religious Education (CRE), Biology and PIASCY. Some teachers taught sexuality education as patrons of extracurricular clubs focusing on HIV prevention or sexual and reproductive health in general, and other teachers taught sexuality education in their role as a counsellor or warden within the school. The secondary schools were as follows: Catholic (n = 2), Pentecostal (n = 1), Protestant (n = 3), Muslim (n = 3), Seventh Day Adventists (n = 2), and secular (n = 5); private (n = 9) and public (n = 7); day (n = 5), boarding (n = 4) and day-boarding (n = 7); and girls-only (n = 2), boys-only (n = 1) and coeducational (n = 13). Schools also varied in location and socio-economic character. Some schools could be noisy, as they were located in the centre of Kampala, whereas others were more remote and quiet. Typical class sizes were 50-80 students.
The teachers' general teaching experience ranged from one to 26 years (nine years on average), and their experience of teaching about HIV and sexuality ranged from zero to 21 years (six years on average). Some teachers' education to teach sexuality education comprised a course on guidance and counselling during their teacher education; others had received additional education, including from non-governmental organisations to teach school-based HIV prevention or sexuality education and government workshops to teach PIASCY.

Data collection
The semi-structured interview guide contained topics that were expected to be relevant for identifying schemas of teaching sexuality education, including cultural schemas and personal experiences of relationships, sexual intercourse, HIV and AIDS, contraception, receiving sexuality education, and teaching sexuality education to secondary school students.
Most of the in-depth interviews were conducted in the school compound. Although not always possible in a crowded school environment, it was aimed to conduct the interviews in private spaces such as secluded classrooms or under a tree. For the convenience of the participants, three of the interviews were conducted outside the school compound. The in-depth interviews lasted 2:05 h on average, ranging from 0:45 to 3:40 h. The interviews were conducted in English, the official language of Uganda. The interviews were digitally audio-recorded. Participant observation in the school compounds and observations of sexuality education lessons helped obtain an emic perspective and validate the findings from the interviews (see also de Haas 2017). The aim was to observe at least one sexuality education lesson associated with each teacher interviewed. Unfortunately, sexuality education lessons were found to take place irregularly, especially at times of packed school timetables and examination periods. In total, 38 sexuality education lessons involving 22 participating teachers were observed.

Data analysis
The in-depth interviews were transcribed verbatim and analysed using MAXQDA version 10 software (VERBI Software GmbH, Berlin, Germany). The analytical process applied principles of grounded theory as described by Corbin and Strauss (2008). The process started with open coding, using many in vivo codes, such as 'African Traditional Society' . The next stage of analysis identified the content of teachers' sexuality education messages and the cultural schemas and personal experiences that teachers rely on to support their reasoning for teaching this content. Subsequently, the codes were grouped, and code families were identified that were hypothesised to be related to teachers' cultural values and beliefs regarding teaching sexuality education. These code families were then abstracted to four cultural schemas: (1) young people's sexual citizenship and (2) sexuality education in 'traditional' Uganda; and (3) young people's sexual citizenship and (4) sexuality education in 'present-day' Uganda. To enable a deeper understanding of the data, cultural schema theory was deductively used to develop 'explanations of data' , and those explanations were in turn validated by 'returning to the data' (Hennink, Hutter, and Bailey 2011, 237). For instance, in the next stage of analysis a matrix was created that compared cultural schemas, which helped to identify conflicts between teachers' cultural schemas of sexuality education and young people's sexual citizenship in 'traditional' and in 'present-day' Ugandan society.

Ethics and data validation
This research was approved by the Uganda National Council for Science and Technology (UNCST) under reference SS 2626. The study was also granted clearance by the ethical clearance committee of the Faculty of Spatial Sciences, University of Groningen. After being informed about the study's content and aims, that their participation was voluntarily, that they could withdraw from the study at any time, and that everything discussed would be treated anonymously and confidentially, the school administrations and participating teachers provided written informed consent. Pseudonyms were assigned to protect the anonymity of the participants.
In February 2013, the interview transcripts were shared with the participants, and a report with preliminary research findings was disseminated among research participants and other stakeholders, such as Ugandan non-governmental organisations implementing schoolbased sexuality education. After reading this report, 17 of the initial research participants participated in a follow-up interview in which they reflected on the report's general findings, how the findings related to their initial interview, and whether they felt the data had been interpreted correctly. These interviews helped validate the findings of this research and formulate implications (see also de Haas 2017).

The content of teachers' sexuality education messages
About one-third of the teachers (aged 23-43) interviewed claimed to be teaching abstinence-only, a further one-third (aged 22-53) taught about condoms as a 'last resort' , and another one-third (aged 23-36) taught both abstinence and contraception. Comparatively, it was younger teachers, and more men than women, who wanted to teach both abstinence and contraception, rather than teach about condoms as a 'last resort' in case students did not 'manage' to abstain. The group who wanted to teach abstinence-only consisted equally of male and female teachers. For two teachers who were themselves abstaining until marriage, religion appeared to be an important motivation. However, the following quote from one of them shows how religion interacted with the hardship he had encountered after his parents had died from AIDS: I normally encourage young girls and boys to abstain from sex because I know the dangers… For us we are victims of what our parents did… So normally when we are teaching some of, eh, these topics, huh? We basically use the Bible … how can ... a Christian ... how can a youth abstain from sex? (Peter, age 28) There were examples of teachers who did not teach abstinence-only despite their religious beliefs, such as in the case of this female teacher who was a church pastor: If I'm addressing a congregation of strictly Saved girls and boys, I will not mention a condom… But if I'm talking to these lay people … I would warn them and tell them: [chuckles a bit] 'You had better use a condom' . Me, I believe it is much safer, because one it will protect, it will protect somebody from ... HIV but also pregnancy. (Grace,age 37) This example shows that teachers' personal religious beliefs do not necessarily direct the content of their messages to students. Rather, various teachers indicated that school regulations and the curriculum were more important. The following quote illustrates the vulnerability of teachers who teach comprehensive sexuality education against school policy: You may say it at the risk of your job. Because if you do it ... consistently, you may be looked at as a person who is spoiling … you need some insulator, something to insulate you from ... the culture and the religious and the other ... the other pressures that try to inhibit people doing such sexuality education. (Paul,age 32) This suggests that it may be more institutionalised religion preventing teachers from adopting comprehensive approaches to sexuality education, such as in the following example of a teacher working at a Catholic school: Yes, because first of all this is a Christian school, it's a Catholic founded school, and ... those [accepted sexual acts] are the principles we teach in the school ... we base our teaching on the Bible... (Vivienne, age 43)

Breaking the cycle of poverty
Whether they taught abstinence-only or adopted more comprehensive approaches to sexuality education, the findings suggested that an important motivator for teachers to teach sexuality education was enhancing their students' well-being by ensuring that they completed their education and became financially independent. Traditionally, abstinence until marriage used to be seen as important because of the cultural values attached to virginity and the risks of pregnancy, but being sexually active in present times has additional risks, according to some teachers, the most significant being becoming infected with HIV or being expelled from school because of a pregnancy: Because to a young girl, when you get involved into sex, you're still school-going, you need to fulfil your goal, you need to complete your education, and now you are pregnant, there is a way you become stuck and your goals are not meant to be achieved as expected. (Beatrice,age 35) One teacher explained that he advised abstinence because students' education is important to break 'the cycle of poverty' . He related this to enhancing not only individual but also societal well-being: Of course, I emphasise abstinence … we have to emphasise it, because when we do this, I'm sure we will have, eh, a better living population, hmm? … There should be an end of suffering… The vicious cycle of poverty should stop… If they manage to go through the academic ladders, of course, they will be financially stable. (Steven,age 29) To enhance societal progress, the following teacher explained that the teacher's duty is to bring up 'morally upright' young people:

Conflicting schemas between 'traditional' and 'present-day' Uganda
Although most teachers acknowledged the importance of teaching sexuality education to enhance their students' well-being, they differed in their reasoning as to whether this implied the necessity of teaching about contraception. Important in this respect were the conflicts teachers appeared to experience between their cultural schemas of young people's sexual citizenship and sexuality education as they related to 'traditional' and 'present-day' Uganda. Three of these conflicts are discussed below.

Students' sexual citizenship
Teachers' narratives about sexual citizenship revealed their perceptions that in 'traditional society' young, unmarried people were not considered to need information about sexuality until they were expected to put the information they had learned into practice. They indicated how issues of sexuality were silenced, so that unmarried people would not hear about them: You know, in our culture … sex is supposed to be kept ... a secret, such that these young people are not supposed to know anything about it… Traditionally, things related to sex were not supposed to be ... to be exposed to the young people until they have reached the age of marriage. (Jane,age 32) In line with these traditional schemas, some teachers perceived their students as 'young' and 'innocent' . They felt that their students knew little about sex, that they were not yet sexually active, and that they were not yet ready or mature enough to receive sexuality education.
However, there were also teachers who indicated that society had changed, which had consequences for how young people's sexual citizenship was viewed. They felt that traditional sexuality education messages were no longer adequate because nowadays young people are already sexually active before marriage. Furthermore, they felt that young people already receive much information from the media and peers, which makes it no longer workable for elders to keep silent or to provide only threats and restrictions: These days, kids tend … to know about sex … culture has created a gap between the ... the young and the old. Simply because the old fear to talk about sex. They always want to keep it as a secret, yet it can never be a secret in today's society. (Samuel,age 26) A majority of the teachers felt that respectable elders should step in to provide young people with the correct information and balance positive messages circulating in society by emphasising the risks of sex. This was considered particularly necessary for older, assumed sexually active, students. However, various teachers expressed difficulty in teaching sexuality education to a group of students, because they felt that some of the students were sexually active whereas others were 'sexually innocent' , which would require heterogeneous messages: Now there are those who are still very young and very innocent… So, for example, if there is a child of 13 years old … and there is another one of 16 in S1 … are [we] going to give this child the same session with the one who is 13? … this child is going to ask you more challenging questions ... that a child of 13 might not be comfortable with, might not even understand. (Salimah,age 39) This female teacher's solution was to provide older students, who she assumed were sexually active, with more detailed information in private sessions.

Sexuality education can encourage and prevent sexual activity
A second conflict related to the perception that sexuality education could both encourage and prevent (unprotected) sexual activity. Because, traditionally, young people were not supposed to receive information on sexuality, some teachers feared that teaching sexuality education would arouse students' curiosity about sex and lead them to become sexually active: One thing is, we fear, for example, if you demonstrated how ... eh, a condom is used in a secondary setting, we fear that maybe a student ... they go and practise [laughs]… So, we prefer that you'd rather keep ... a student in the dark, when they don't know particular things. (Grace, age 37) Subsequently, teachers might be afraid that students could interpret comprehensive sexuality education messages as approval from their teacher to become sexually active: 'If I told them, eh, they would say, after all … the tools [condoms] are there, and we have been shown how to use them, then we should go ahead' . (Steven, age 29) Jamal, a 30-year-old teacher, described how a condom demonstration by his aunt when he was 12 years old made him curious about becoming sexually active, which he felt would not have happened if she had not talked to him: 'I developed a bit of curiosity. Immediately after that talk. Because she talked about certain things ... that were very unimaginable. I had never sat myself down to imagine them, huh?' . Despite some teachers feeling that sexuality education might instigate curiosity about sexual practices, the majority of the teachers regarded sexuality education as an opportunity to teach students good moral values that might help them abstain and resist the 'temptations' of society.

Morality of teaching sexuality education
Maintaining not only their students' but also their own well-being was an important consideration in teachers' reasoning to teach sexuality education. As noted earlier, some teachers felt vulnerable teaching contraception because they feared they could lose their job. Another element of their well-being concerned their moral image as a teacher when teaching sexuality education. Teachers could recall how, traditionally, specific older members of the community were appointed to teach sexuality education. Some teachers explained that the cultural traditions of ssengas (paternal aunt) and kojjas (maternal uncles) teaching sexuality education were fading due to societal changes, meaning that young people no longer automatically received sexuality education.
Although some teachers felt that it was parents' responsibility to teach their children sexuality education, a majority of the teachers interviewed thought that teachers should also be teaching sexuality education at school, especially if parents are not doing so. However, many teachers were concerned that society would consider them immoral for 'encouraging' young people to become sexually active. They feared that their teaching of sexuality education, especially demonstrating condoms or other means of contraception, might be interpreted as approval for students to become sexually active. This fear may be prompted by their autocratic teaching style, and contributing to teachers' perceptions that they should tell students only what is considered moral behaviour and omit behaviours considered immoral: We just tell them: don't have sex … or use a condom. But so much it is that when you teach a kid how to use a condom, then the kid will go and, and use it! … So ... that idea of sharing ... information, it's more of ordering, I think, it's from the side of the teachers, because we are used here more to give in commands rather than discussing and sharing experiences. (Paul,age 32) Therefore, some of the teachers preferred to wait for students to become sexually active or to receive the information from other sources first, and then they provided them with correct information to refine their knowledge and behaviour.
If you bring [condoms] to an S6 class or S4 class ... some of them have ever used condoms … so it's not new to them… You have to emphasise because yes, some of them know, they have ever used them but most of them use them badly. They don't know how to use them. So, you have to teach them what they should do. (Flavia, age 23)

Unravelling cultural schemas of Uganda as a 'traditional' and 'present-day' society
Of the 40 participants, 18 teachers taught Christian Religious Education (CRE) or Divinity, which aims to promote the 'spiritual and moral development of the learner' (NCDC 2016). The CRE syllabus illustrates how sexuality education is approached within religious education. It links 'African traditional society' to biblical teaching and creates a separation between 'African traditional society' and 'modern society' -for instance, by first discussing 'Sex education in traditional Africa' , followed by 'Limitations to imparting sex education in the modern society' . It also suggests that the establishment of human rights in modern society may be encouraging 'sex misuse' , including premarital sex: 'There was a limited level of permissiveness and fundamental human rights in traditional Africa, hence limiting cases of prostitution unlike today where emphasis on human rights has paved the way for sex misuse in various forms such as prostitution' (Fulgence 2007, 18).
In their narratives about sexuality education in the past, teachers often referred to traditional society. As in the CRE syllabus, they tended to refer to the traditional society of Africa as a whole. To illustrate, the phrase 'African Traditional Society' was mentioned 27 times in the interviews. On other occasions, they would refer to past traditions in their own or other ethnic groups, or to their own personal childhood experiences. Sometimes, teachers also referred to present-day rural areas of Uganda when discussing traditional society, thereby distinguishing between modern urban societies and traditional rural communities. To distinguish present society from the past, teachers used words such as 'modern' (n = 33), 'modernity' (n = 9), 'present' (n = 59), and 'nowadays' (n = 80). Nyanzi (2013, 953) argues that the perception of there being one 'African tradition and culture' is a reified dominant discourse 'situated within authoritarian institutions' (ibid., 963) that dismisses all sexual identities and practices that do not conform to 'the notion of one homogenous heterosexual family' (ibid., 954). Karlström (2004, 596) also rejects the representation of African society in terms of a 'traditional/modern dichotomy' . He argues that the Baganda created a 'moral collectivity' (Karlström 2004, 604) grounded in an imagined traditional society in response to societal disruptions 'to sustain an aspirational engagement with their changing world' (ibid., 595). This moral collectivity particularly aimed to socialise young people. Schools play 'important roles in [this] social reproduction and the moralisation of youth' (Karlström 2004, 600). Thus, 'traditional society' discourse not only denies the pluralism of Ugandan society at present and in the past but is also used by powerful institutions, such as government and religions, to produce specific kinds of moral persons. The embeddedness of sexuality education in cultural and religious teachings, such as in PIASCY and CRE, suggests that school-based sexuality education functions as one such mechanism of social reproduction.

Discussion
Although currently banned by the Ugandan government, the lived realities of young people show a need for comprehensive, rights-based sexuality education in Ugandan schools (Rijsdijk et al. 2013). According to Aggleton (2013, 2014, 432), Ugandan teachers in their study often taught abstinence-only because of personal religious beliefs and 'advocated' a 'morally conservative approach' . This suggests a certain level of agency in which teachers choose which content to teach, guided by their own values and beliefs (Robbins 2007). This study partly confirms those findings but also shows that teachers can feel conflicted about the type of messages their students need and can feel vulnerable to adopting more comprehensive approaches within a school system that expects them to teach abstinence-only.
Similar to this study, research on sexuality education in South Africa has identified the use of culture to restore moral values, justify abstinence-only teachings and silence issues of sex (DePalma and Francis 2014; ). In line with Karlström (2004), this study suggests that Ugandan school-based sexuality education functions as a mechanism for the social reproduction of cultural and religious values and beliefs. Teachers perceive it as their duty to bring up 'morally-upright' citizens and to support students to finish their education and attain a better future. The narrative of a moral traditional society supports the idea that teaching abstinence-only can enhance students' well-being. However, this narrative also undermines students' sexual citizenship and perpetuates harmful gender roles and stereotypes (de Haas, Hutter, and Timmerman 2017). Such a perspective is endorsed by DePalma and Francis (2014) who describe the use of culture in sexuality education as a static notion that cannot be challenged, and which prohibits certain voices being heard, such as those of sexually active students. Teachers' cultural schemas and institutionalised morality limit and define young people's sexual citizenship and the opportunities for teaching comprehensive sexuality education. Taking this into account, it can be asked whether school is the most appropriate setting for teaching sexuality education and whether teachers are the most appropriate sex educators. However, schools do offer the opportunity to educate both boys and girls, and its implementation by teachers can be considered a low-cost and thus a sustainable implementation strategy (Kivela, Ketting, and Baltussen 2011).
Studies of school-based sexuality education recommend better quality education for teachers (Francis 2016;Kinsman et al. 2001;Mturi and Hennink 2005). Teacher education that improves their knowledge and skills could increase teachers' confidence and comfort in teaching sexuality education (Ahmed et al. 2006). Teacher education could also challenge cultural discourses of childhood innocence, help teachers to adopt a more a learner-centred pedagogy, and redefine culture as 'dynamic' and 'interactive' (e.g. as recommended by Kinsman et al. 2001;DePalma and Francis 2014, 558). This will enable teachers to have students discuss issues with each other and takes away the focus on the teacher. However, as an autocratic teaching style seems so central to teachers' professional identity, it may be difficult for many teachers to adopt more learner-centred pedagogies (Francis 2017;de Haas 2017).
Although various teachers indicated that moral teaching means teaching abstinence-only, teachers also believed that it is important for young people to receive accurate and complete information. A supportive school environment could reduce teachers' vulnerability regarding the adoption of such comprehensive approaches to sexuality education. This could be achieved through the integration of sexuality education into broader interventions, such as the adoption of a 'whole-school approach' . A whole-school approach could also include the development of supportive school policies and collaborations with parents and youthfriendly health services (Francis 2017). Further research is recommended to include the perspectives of other stakeholders, such as parents and school administrations, to understand how, and to what extent, a whole-school approach can enhance young people's sexual and reproductive health and rights by creating an enabling environment for the delivery of comprehensive sexuality education.