Education and HIV/AIDS: A Sourcebook of HIV/AIDS Prevention Programs - Volume 2: Education Sector-Wide Approaches

This volume from the International Bank for Reconstruction and Development and the World Bank describes 10 school-based HIV prevention programmes from the Dominican Republic, Eritrea, The Gambia, Ghana, Israel, Kenya, Namibia, and Nigeria. All of the programmes involve teachers, focus on school-age children, and are considered by the authoring organisation to be successful, well implemented, and innovative, with the potential to be replicated and scaled up.

The first volume of this Sourcebook was published in 2004 in response to requests from educators in affected countries. It documented education-based HIV prevention programmes from seven Sub-Saharan African countries. This new volume was produced in response to requests from educators for programmatic examples of education sector-wide approaches. With lessons that are intended to be replicable and scalable, this new analysis of HIV/AIDS prevention programmes - from 6 Sub-Saharan African countries as well as the Dominican Republic and Israel - is part of a global effort to accelerate the sector’s response to HIV/AIDS, particularly in Africa, and reflects the increasing recognition of the role of education in making a contribution to reducing stigma and discrimination and helping young people avoid infection.

Programmes and communication-related lessons learned include the following:
1. Programa de Educación Afectivo Sexual (PEAS), the Dominican Republic - Implementation of the programme varies widely across schools, suggesting that merely training teachers in HIV/AIDS curricula is not enough: programme officials must ensure that teaching is monitored and teachers are able to access support, receive ongoing training, and provide input into programme development. Both the PEAS manager and programme implementers believe the programme would benefit from further advocacy and partnership-building efforts. Parental and community support for PEAS is currently sought through advocacy and parent-teacher meetings.

2. The Rapid Results Initiative (RRI), Eritrea - The active involvement of teachers, students, and community members in implementing, monitoring, and evaluating the programme as well as the active and participatory teaching and learning methods used were important. In collaboration with the developer of the RRI, the Ministry of Health initiated the programme at a launch attended by all sectors of society, including members of the national government, various ministries, local government, and civil society. Public relations were needed to ensure that all students, teachers, communities, and other stakeholders were fully informed about the programme as quickly as possible. To do so, the programme used radio and television to publicise activities and produced brochures and magazines about the programme.
The success of the programme can be attributed to several factors:
• Each phase of the programme could be implemented within a 100-day period.
• Strong advocacy and sensitisation workshops garnered support from all stakeholders at all levels of the programme.
• Constant assessment and evaluation ensured that the programme was able to build on successes and rectify shortcomings at each phase of the programme.
• Development of new training and teaching materials at all phases ensured that they were relevant.
• Training at all phases of the programme ensured that implementers were able to make good use of the revised materials.

3. Integrated Sectorwide HIV/AIDS Preventive Education, The Gambia - The Gambia adopted a range of strategies to educate young people about HIV/AIDS. Activities are implemented by a wide variety of partners, particularly educators, including those at religious schools, and supported by sector-wide education and participation of members of Department of Secondary Education (DoSE). A concern when many different types of work are being undertaken by many actors is that messages may clash and efforts may be duplicated. The Gambia has responded to these concerns by putting in place a system of coordination through DoSE’s HIV/AIDS coordination unit, which ensures that all stakeholders act in a concerted fashion so that strengths can be built on and activities synergised.

4. The School Health Education Program (SHEP), Ghana - SHEP coordinates the efforts, actions, and resources of a range of stakeholders to enable an education sector response to HIV that reaches as many of Ghana’s schools as possible. Its structure enables implementation, collaboration, and coordination at all levels of government. A key aspect of the Alert model, developed as part of SHEP, has been the idea of its becoming a recognisable "brand" within the education sector. The model’s award levels and associated benefits are intended to maintain schools’ motivation for activities. It is hoped that schools in the area will feel the competitive urge to match or outperform the successes of their peers.

5. The Jerusalem AIDS Project (JAIP), Israel - JAIP is a volunteer-based non-governmental organisation (NGO). Its school-based education activities are partly financed by the Ministry of Education. The Ministry of Health provides JAIP with funding for a telephone hotline, which provides information and advice about HIV/AIDS. Factors involved in its implementation include:
• The programme has a simple, easily replicated formula that can be delivered to people in a wide range of contexts.
• The programme’s cartoon materials can be adapted to a wide range of situations.
• The programme has adapted to changes in knowledge about HIV/AIDS and the cultural contexts in which the programme is offered.
• The programme’s use of volunteer medical students as AIDS educators allows messages to be delivered by people who are both authoritative and respected and close in age and experience to learners.
• The programme’s contact with students over the course of their school and military careers enables messages to be repeated and reinforced in an age-appropriate fashion.

6. Primary School Action for Better Health (PSABH), Kenya - The PSABH programme: used upper-primary schools as the locus for activities, enabling the majority of children in a community to be reached; included a range of key stakeholders providing political will, curriculum expertise, and management efficiency; and employed a management and training structure - a model of training called a “strengthened cascade" that allows quality to be maintained in the face of rapid expansion.

7. The Primary School AIDS Prevention Program, Kenya - By attending to the controversial nature of culturally acceptable HIV/AIDS education, this programme was able to employ HIV prevention approaches that were both effective and culturally and politically uncontroversial by using a small number of well-designed and simple school-based interventions that have a measurable impact on factors that lead to the transmission of HIV. Documentation of the efficacy of three of the programme's components - debating and essay writing (including a competition),
sugar-daddy talk (including a video), and provision of free school uniforms to ensure continuing primary education for economically disadvantaged students - increases their long-term sustainability as well as the likelihood that they will be scaled up across Kenya. Key stakeholders in the Kenyan government were involved in the project from its inception, through high-level annual meetings at which progress and results were discussed, and focusing international and national attention was done through showcasing the results in the popular press and in international development publications.

8. The Window of Hope Program, Namibia - This programme is designed to be culturally specific and student-centred; it uses a "participatory and playful" learning style; and it emphasises attitudes and skills that are not easily measurable and are difficult to teach in the classroom, such as self-esteem. As of the deadline for this publication (2007), the in-school component had not been implemented. While advocacy continues with regard to the curricular component, the after-school component provides supplemental subject teaching on HIV/AIDS. After-school clubs follow a teacher-led club model. Trainers are trained during a four- to five-day workshop. Training methods include lectures; role-playing; acting-out sessions; storytelling; drawing; working in groups, pairs, and individually; reading assignments; and open discussion formats. One-day refresher training is offered that provides an opportunity to measure progress in programme implementation, address challenges and obstacles that may have arisen during implementation, and reinforce personal motivation for participating in the programme.

9. The Expanded Life Planning Education Program (ELPE), Nigeria - ELPE has become an accepted part of secondary education in Oyo State as a result of a number of factors, including intersectoral collaboration, community advocacy, effective training of teachers and peer educators, and quality research (including monitoring and evaluation). The programme engaged in advocacy intended to bring the implementing NGO and the government ministries together. Ultimately the ministries accepted training on programme management. The programme created partnerships and gained the support of politicians, schools, teachers, and communities. The programme has been replicated in other states.

10. The National Family Life HIV/AIDS Education (FLHE) Curriculum Implementation Program, Lagos State, Nigeria - FLHE curriculum includes interactive skill-building activities, which form the basis of effective teaching-learning about HIV/AIDS. The National Council on Education approved the curriculum developed over 4 years through advocacy and consultative meetings among state and national AIDS organisations, parent and teacher organisations, the teachers' union, principals' organisations, government officials, media representatives, and religious leaders. A possible solution to small classroom size and large classes suggested by the programme manager is to encourage teachers to conduct activities outside on school premises. The shortage of trained teachers is being addressed by the ongoing FHLE teacher training programme. Education on FHLE is also being integrated into tertiary teacher education at the pre-service level. The programme tries to motivate teachers through non-monetary incentives, such as awarding training certificates, involving teachers in implementation processes, publicly acknowledging teachers’ contributions, recognising outstanding performances during award ceremonies, distributing resource materials to outstanding teachers, providing transportation allowances for meetings, and allowing some teachers to share their experiences in other states.

This document is free to download in PDF format from the link below and may be ordered  in a paper edition from the contact for US$45.00.