Sex education in schools is not at the core of the national sexual health strategy that will be released at the end of November, with the onus being shifted onto parents, TheSunday Times has learnt.

The last thing I want is for people to think the launch of the strategy is some fantastic endpoint

Health chief medical officer Natasha Azzopardi Muscat explained that sex education in schools would be rolled out by the education authorities, not the Health Ministry, which would, however, provide the necessary resources.

“They are the educators, but we will be there to provide the support they need... I’m very apprehensive about this fixation with schools, because the evidence seems to be showing that we need to be working more with parents and the home environment,” she said.

The policy, published last year to serve as a stepping stone for the strategy, had highlighted the “scanty and uncoordinated” sexual education in schools. But when asked how the strategy was addressing this situation, Dr Azzopardi Muscat directed the questions to the Education Ministry.

Asked if sex education would be delivered uniformly in all schools and not left to up to the individual scruples and beliefs of individual teachers and school heads as was currently the case, an Education Ministry spokesman said the National Minimum Curriculum obliged all teachers to follow the personal and social development (PSD) syllabus.

Sexuality and RelationshipsEducation, which is tackled in PSD, targets students as young as Year 4 and continues until the end of compulsory schooling.

Asked if the curriculum would ensure proper condom use was taught and not mentioned as a last resort if not downright banned, the spokesman said SRE was a comprehensive programme that included abstinence, sexually transmitted diseases and contraception.

Dr Azzopardi Muscat believes there has been too much focus on schools.

“They’re important but there’s a lot beyond schools. There is a gap between people leaving school and settling down in a stable relationship later on in life and it needs to be addressed,” she stressed.

After the launch of the policy – which for 11 years had been handled with kid gloves by authorities who took great care not to offend the Church – Health Minister Joe Cassar tasked Dr Azzopardi Muscat with putting together a document that would spell out an action plan to take it forward.

The strategy was scheduled to be released last February, but Dr Azzopardi Muscat admitted this had been an ambitious deadline and she had not wanted to rush the important discussion taking place within the workshops.

One of the things that emerged from the workshops was that everyone had been focusing too much on schools.

But how will sexual health be delivered in schools?

“You see it’s not a question of delivery; it’s more a question of consistency. The strategy is still going through the final approval stages, but one important gap that emerged is the need to involve parents,” she said.

“It’s important parents are knowledgeable, equipped and will reinforce the same message children receive in schools.

“As health, the strategy will be focusing on the development of resources that can be used for parents and teachers, such as CDs or a website. There are so many mechanisms these days, there’s no need to rely on sessions or leaflets.”

A doctor by profession, Dr Azzopardi Muscat is intent on getting things done and does not see the dilly-dallying of the past that she inherited, especially when it came to reconciling the Church’s stand on the matter, as an obstacle.

“One has to accept that there are diverse viewpoints that can never be reconciled,” she said.

“As much as possible we wanted to try to find a consensual way forward. This does not mean what we have come up with is necessarily going to be in line with everyone’s expectations, but for us it’s important to take things forward.”

This is exactly what Dr Azzopardi Muscat has done. Even though the publication of the sexual health strategy was delayed, she has already set important aspects of it in motion.

“Humbly, I’d like to say that I’ve already made things happen... I chose not to stay waiting until the strategy was issued,” she said.

She has instigated a specialists’ training programme for medical staff between Malta and the UK, which has already been approved by the Specialists’ Accreditation Committee.

“It’s very nice to talk about a strategy, and you can talk about a hundred deliverables, but you need a core competent workforce that can then act as a focal point and reach out to a circle of people, be it supporting teachers, supporting people working with youngsters and in primary care...” she said.

Communities, such as sports and social clubs, where adolescents hang out, will also be targeted. Another step she has taken is to commission a survey among young adults – that can include anyone under the age of 40 – that will be carried out in the first quarter of next year.

This is intended to provide a better understanding of where people get their knowledge from, what kind of knowledge they have and where they go to for information on sexual health.

A call has also been issued for chlamydia sentinel surveillance where GPs are being encouraged to subscribe to a programme of opportunistic screening for this sexually transmitted infection.

Dr Azzopardi Muscat concedes that the strategy does focus more on training and preparation in the beginning, but this was essential to provide a solid foundation.

The training will also serve to equip the new Genitourinary Clinic at Mater Dei Hospital, which the ministry will open at the end of January, with much needed human resources. At the moment, the clinic is run by just one consultant, Philip Carabot, and a nurse.

The strategy does not give specific timelines and Dr Azzopardi Muscat said it would be premature to do so at this stage.

“The last thing I want is for people to think that the launch of the strategy is some fantastic endpoint. It’s just a tool to help prioritise resources, funding and to keep us on track to ensure implementation,” she said.

“We make these strategies, we should not feel straitjacketed by them and they are there as a tool to help us deliver.”