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Country Profile: Malaysia

Contents

Primary sources ............................................................................................................75


Policy............................................................................................................................75
Curriculum ...................................................................................................................76
Subject placement and teaching materials ...............................................................76
Skills-based approach of family health education....................................................77
Curriculum content...................................................................................................77
Primary school (Grade 1-6, ages 6-11) ................................................................77
Secondary schools (grades 7-11, ages 12-16) ......................................................78
Teacher training............................................................................................................82
Peer education ..............................................................................................................82
Barriers to implementing reproductive and sexual health education in schools ..........82

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Primary sources
Respondent

• Dr Mary Huang, Lecturer, Department of Nutrition and Community Health


Sciences, Universiti Putra Malaysia, Serdang, Malaysia (September, 2000)

Documents

• PROSTAR: Community (Youths) Mobilisation Programme on AIDS, Ministry of


Health, Malaysia, AIDS/STD Section. October 1999 (report)
• Huang, Mary Soo Lee, PhD (1999) Case Study on Adolescent Reproductive and
Sexual Health – Malaysia (A report undertaken for UNESCO)
• Family Health Education, Curriculum Development Centre, Ministry of
Education, Malaysia, September, 1995 (Outline of the reproductive and sexual
health curriculum for primary and secondary school students)
• Malaysian AIDS Council (1995) Malaysian AIDS Charter: Shared rights, shared
responsibilities.

Policy
There are currently no government policies relating to sexual and reproductive health
in Malaysia. Despite this, there is a national-wide school-based program within
schools, called Family Health Education (see curriculum section).

The Malaysian AIDS Council, a non-government organization, has produced the


Malaysian AIDS Charter. The Charter covers a range of HIV/AIDS related issues,
one of which is school-based education. In section five, “Rights and responsibilities in
relation to education”, the following point are made:

• All individuals affected by HIV/AIDS shall have equal access to schools and
education institutions
• Laws and policies shall not hamper the development and dissemination of
HIV/AIDS education materials
• Educational materials shall incorporate shared religious values and principles to
ensure responsible behaviour

The Malaysian AIDS Charter is only effective within non-government organizations.

The Ministry of Health is currently developing a policy on adolescent and


reproductive sexual health, though we have no specific detail in relation to its
contents. It is unclear if the policy will cover school-based education.

Malaysia is signatory to the ICPD Plan of Action. Whilst the Plan of Action endorsed
reproductive health rights, the implementation of reproductive health programs and
universal human rights, it also agreed that action should be conducted within the
bounds of national sovereignty and be in accord with religious, ethical and cultural
values. In the Malaysian context the sovereign proviso has worked to exclude those

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who are unmarried from having reproductive rights (as they relate to sexual activity).
One only has the right to engage in sexual activity within marriage.

Curriculum
In Malaysia, school-based sexual and reproductive health education is called Family
Health Education (FHE). FHE has been delivered to secondary school students since
1989 and elements of it were introduced into primary schools in 1994.

Family Health Education, as the title suggests, is focused on the family as a basic
institution. The stated aims of the curriculum are preserve the family institution for all
time and provide “accurate and up-to-date knowledge about human sexuality in its
biological, psychological, socio-cultural and moral dimensions.”

School-based reproductive health education is grounded in a presupposition that


young people will not engage in sexual activity until married. In 1990 the average age
of marriage in Malaysia was above 23 and has been rising since the 1970s. The trend
toward late marriage increases the need to deliver sexual and reproductive health to
young people, many of whom may engage in premarital sex.

Subject placement and teaching materials


Family Health Education is integrated into a range of different subjects and includes
the following:

Subject Comments
Physical and Health Compulsory no examinable subject
Education
Science/Additional Compulsory and examinable
Science
Biology Compulsory and examinable
Morality Education Compulsory and examinable for all non-Muslim students
Islamic Education Compulsory and examinable for all Muslim students. Sex and sexual
practice is not addressed per se. Abstinence, fidelity and cleanliness are
discussed
Informal NGO One-off presentations, although lacking in continuity, are more likely to
presentations specifically address sex behaviour.

Textbooks are standardised for the whole country. Workbooks are produced that are
base on the curriculum. FHE comprises five modules with teacher lesson notes. We
do not have copies of the modules and notes.

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Skills-based approach of family health education
FHE aims to improve students’ capacities in the following areas:

• Self-esteem
• Effective communication skills
• Values clarification skills
• Responsible decision making skills
The approach is skills-based and employs interactive learning techniques such as
discussion, debate, case studies, role-playing and simulation.

Curriculum content
Below is a brief outline of topics covered in Family Health Education, broken down
by year and subject:

Primary school (Grade 1-6, ages 6-11)

Physical and Health Education is the only primary school subject within which
Family Health Education is delivered. Cleanliness and family relationships are the
first topics to be introduced and are emphasised throughout primary school. Genital
health is first mentioned in grade 5 in relation to menstruation hygiene. The
differences between the sexes are emphasised throughout, and puberty is first
mentioned in grade 4, and elaborated in grades 5 and 6.

Physical and Health Education

Grade 1
• Body cleanliness

Grade 2
• Physical differences between sexes
• Physical differences between boys and girls: physical, emotional and activity
based
• To express “pride and joy in one’s sex”
• Process of a baby’s birth
• Love for one’s parents

Grade 3
• Identify family members and their geographical distribution
• Explain the concept of the family including love, close ties, cooperation, loyalty to
parents, etc.

Grade 4
• Puberty: a stage of growth; physical changes during; differences between boys and
girls

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Grade 5
• State the meaning of menstruation and nocturnal emissions
• Practices of menstruation hygiene
• Explain the meaning of sexually transmitted diseases
• State how diseases are transmitted and prevented

Grade 6
• Identify common physical problems faced by teenagers and how they are
overcome

Secondary schools (grades 7-11, ages 12-16)

In secondary schools, Family Health Education is taught in Physical and Health


Education, Science, Additional Science, Biology and Islamic Education. Each is
discussed below.

Physical and Health Education

The prevention of STDs is introduced in the final three years of high school but is
most extensively dealt with in the final two years. STDs (including AIDS) are
positioned as the effect of “unhealthy lifestyles”. Avoidance of “casual and
promiscuous” sex is promoted. Safe sex is not discussed. Sexual relations and practice
are framed by the family institution, including sex outside of marriage, elopements
and teenage marriage (all of which are discussed under the heading of “common
family problems”).

The contents of Physical and Health Education are outlined below:

Grade 7
• Describe physical, emotional, and social changes of teenage years
• Discuss measures of dealing with strangers
• Discuss, explain and exemplify a range of health-related issues: neglect,
responsibility, consequences of neglect, and decision making

Grade 8
• Explain personal, family and community health
• Discuss positive and negative values that affect health
• Explain the relationship between physical, mental, emotional, social and spiritual
health; effect of conflict on health and overcoming those conflicts
• Practise decision-making regarding emotional and social changes and pressures
experienced during adolescence
• Discuss the responsibility of guarding one’s own health during teenage years
• Discuss physical changes that affect emotion and behaviour
• Describe and discuss aspects of urogenital health

Grade 9
• Discuss classroom friendship patterns
• Investigate good behaviour and interaction

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• Discuss needs of and responsibilities to friends, family and community
• Discuss a code of ethics for responsible social interaction outside of school
• Discuss personality development; the influence of others, and being responsible
• Discuss the implication of developing fertility on social etiquette and behaviours
• Discuss the roles and responsibilities of various family members and parenthood
• Discuss lifestyle diseases: e.g. sexually transmitted diseases, AIDS, drug abuse,
cardiovascular disease, cancer, emotional stress, high blood pressure, and diabetes
Grades 10 and 11
• Discuss the concept and characteristics of a happy family
• Discus family member roles and responsibilities from a range of different
perspectives
o Before marriage: the institution of marriage; preparedness for marriage;
money matters; the right match; marriage customs; religious and civil
laws; governance of marriage; rights and responsibilities between husband
and wife
o Adjusting to married life: before and after children; conception and birth;
misconceptions regarding fertility and pregnancy
• Discuss issues of marriage: family planning; domestic management; polygamy;
different expectations; family interference; sexual problems (infertility and
impotence)
• Investigate laws that govern the family and protect children
• Discuss common family problems: teenage marriage; elopements; pregnancies
outside of marriage; broken families; runaway children; child abuse; spouse abuse
• Discuss the classification, sign and symptoms of disease:
o Diseases spread though multiple means (i.e. AIDS [sic] and hepatitis B are
spread through sexual intercourse, blood transfusions, injections, and the
transfer of bodily fluids)1
o Sexually transmitted diseases: AIDS [sic], gonorrhoea, syphilis, hepatitis B
and herpes
• Discuss disease prevention and control2
o Health education
o Healthy habits
o Avoidance of casual sex and promiscuity
o Reporting cases of diseases to the relevant authorities
o Early detection and treatment
o Cooperating with the relevant authorities

Science; Additional Science and Biology

The biological aspects of human reproduction, disease, and growth are extensively
covered in all these subject areas. As would be expected, these subjects are dealt with
from a scientific perspective. Contraception is not introduced until the final year of
high school. Condoms are introduced as one of the many forms of contraception

1
Note that AIDS rather than HIV is identified as being spread through a range of practices. HIV is not
differentiated from AIDS.

2
Condoms are not specifically mentioned as method of preventing HIV gonorrhoea and syphilis.

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• Reproduction
o Sexual and asexual reproduction
o Male and female sex organs
o Sperm and ovum
o The menstrual cycle and its effects
o Fertilisation and implantation
o Stages from pregnancy to birth
o Nutrition and the foetus
o Meiosis
o Foetal development
o Birth
o Twins
o Problem relating to fertilisation
o The placenta and its functions
o Reproductive technologies: artificial insemination, invitro fertilisation and
contraceptive methods

• Disease
o A range of viruses that cause diseases, including HIV (AIDS is referred to
as being caused by a virus). It is noted that viruses in general are incurable
and that practising a healthy lifestyle is the best form of prevention
o Disease spread by sexual activity, such as AIDS (sic) and venereal
diseases

• Human growth and development


o The development of secondary sexual characteristics
The menstrual cycle and hormonal control

Islamic Education

Family Health Education is included in grades 9 and 11. The emphasis is on moral
and spiritual virtue and the prevention of illicit deeds. It includes a discussion of:

Grade 9
• The illicit deeds committed by man before Prophet Muhammad’s time
• The consequences visited upon those who commit illicit deeds
• Teachings that are exemplary (e.g. the story of Lot, his people and wife)

Grade 11
• The blessings of marriage as ordained by Allah
o To propagate lawful progeny
o To produce a clean, new generation
o To nurture love to prevent illicit deeds
o To promote spiritual ties

• How to produce a clean, new generation and how to overcome the problems of
contemporary Islamic youth.

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Overview of curriculum content, and teaching practice

Content – Specific Yes/No Comments


HIV/AIDS and STD Yes In Physical and Health Education HIV is not differentiated form
knowledge AIDS. “AIDS” is positioned as being transmissible. In Science, AIDS
is positioned as being cased by a virus but in Additional Science,
AIDS is positioned as being “spread by sexual activity”
Human reproduction Yes Is extensively covered in Science and Additional Science and
Biology
Puberty: physiological Yes
changes
Puberty: psychosocial Yes
changes
Sexual abstinence Yes Abstinence is stressed for the unmarried
Fidelity Yes Fidelity is stressed for the married
Condoms as a Yes Discussed as a contraceptive in marriage. Introduced in the final
contraception year of high school
Condom as disease No See above
prevention
Aspects of Yes Discussed only in the context of marriage, if at all.
interpersonal sexual
relationships
Transmission modes Yes Mentioned in terms of “sex”, assumed to be vaginal intercourse.
Anal and oral intercourse are not mentioned.
“Safe sex” No
Gender relations Yes Focused upon specific roles and responsibilities rather than gender
inequality
Sexual preference (e.g. No There is a presumption of heterosexuality in the Family Health
homosexuality) Education curriculum

Style of delivery Yes/No Comments


Mostly information Yes
Balance of info/ Yes Significant attention to attitudes and values, esp. abstinence and
attitudes/values/skills fidelity

Teaching/learning Yes/No Comments


processes
Mostly didactic Yes
Mostly interactive No
Teaching materials Yes Textbooks; lesson modules; lesson notes
provided
Assessed or graded Yes FHE is only assessed when incorporated into examinable subjects
(i.e. Biology, Science, Religion and Moral Education)

Coverage Yes/No Comments


Compulsory Yes Not necessarily examinable (see section on subject)
Primary schools Yes 100%
Secondary schools Yes 100%

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Teacher training
We have very little information relating to teacher training. Some short-term in-
service courses are conducted by The Ministry of Education and non-government
organizations (e.g. Malaysian AIDS Council). Most training has focused on biological
and scientific aspects of sexual and reproductive health. Skills-based approaches are
increasingly common. Harm minimisation is sometimes used and frequently
criticised.

Teacher Training Yes/No Comments


Pre-service ?
In-service: long term No
In-service: short term Yes

Peer education
There are no existing school-based peer education programs. There is however a large
scale peer education program funded by the Ministry of Education, ProStar
(Community Youths Mobilisation Program on AIDS). As of mid-1999, 445 training
sessions had been conducted and over 17000 facilitators had been trained. The project
is ongoing and is focused upon healthy lifestyles and the development of good moral
values.

Barriers to implementing reproductive and sexual health


education in schools
• Sex education, understood as educating about sexual practice, is still not available
in Malaysian schools despite a demonstrated need among young people (Huang,
1999: see Primary Sources above). The introduction of sex and sexual health
education has met strong resistance from parents and religious leaders. For those
political leaders who support sex education, they are fearful of the religious
repercussions entailed.
• Family Health Education has been introduced into a variety of different school
subjects. This has the danger of fragmenting the overall curriculum thus making it
difficult to ensure that the content is covered in a coherent manner.
• There is a misunderstanding among teacher and parent associations that sex
education will encourage sexual activity
• Religious leaders are totally opposed to discussing male/female relationships
based upon an understand that religion forbids it and therefore the topic should not
be discussed at all
• Given that contraception is forbidden to unmarried couples it is almost impossible
to introduce harm minimisation approaches Young people may introduce the topic
but teachers should not
• Students are aware of how HIV is transmitted but the curriculum introduces l
transmission in the broadest terms (i.e. sexual transmission). It is unlikely that the
relative risks of different sexual practices are understood.

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