Evaluation of the Pilot Stepping Stones Program - Fiji

Carried out by the Secretariat of the Pacific Community in Fiji, this is an evaluation of a pilot Stepping Stones (SS) Programme that was implemented by the Pacific Regional HIV/AIDS Project in an effort to improve Fijians' sexual health and to decrease HIV/AIDS in that country through community participation and local-level decision making. The 60-page document reflects how 2 different evaluation approaches - the "Gemscale Model" and the "Most Significant Change Technique" - have been used to gather information about future plans for the use of SS in the Pacific.

As explained here, SS is based in participatory learning techniques, and focuses on improving cross-gender communication, relationship skills, and awareness of the consequences of risk-taking behaviour. SS was originally developed in the early 1990s for use in rural African communities, but has been adapted and implemented in over 100 countries in Asia, Europe, and Latin America. The 18-module manual (which is implemented over a 4- to 12–week period) has been translated into 13 languages. The sessions involve participants working in age- and sex-appropriate peer groups; the goal is to create a non-threatening environment, and to encourage trust and openness to discuss taboo topics such as sexual health, relationship issues, and gender. At designated points throughout the programme, the different peer groups come together to present key issues through the use of skits and/or drama. Upon completion of the programme, participants are given the opportunity to present "special requests" to their community, which may involve asking their community to change in relation to such things as violence, unsafe sex, alcohol consumption, and other risk-taking behaviours. In June 2006, the Pacific Regional HIV/AIDS Project (PRHP) piloted the SS programme in Fijian communities. This evaluation report analyses the effects of the SS programme in Fiji, and provides recommendations for the scaling up of the programme into other Pacific Island countries.

(Editor's note: Strategies for Hope is the initiator and publisher of SS. Development and production of the original SS manual and video were originally funded by: ActionAid, Charity Projects, OXFAM, Redd Barna, the Swiss Development Cooperation, the United Nations Development Programme, or UNDP (Regional Bureau for Africa), and the World Health Organization, or WHO (Global Programme on AIDS).)

An excerpt from the Executive summary follows:

"SS remains a program that has had remarkable success worldwide, improving negative gender norms and empowering communities to bring about change specific to their needs in relation to HIV vulnerability. A total of twenty-three facilitators from thirteen communities were trained at the inaugural SS workshop carried out in Fiji from the 13th-23rd June 2006.

"Positive outcomes uncovered from this evaluation include a number of inspiring client and implementer 'Most Significant Change' (MSC) stories from Waikubukubu and Sasa village, improvement in gender equitable attitudes among men who participated in SS training, and the creation of a Youth Council in Sasa village, an initiative that was a direct result of young men and women completing the SS program...

Evidence from the fifteen stories collected (10 client and 5 implementer) showed that SS had facilitated improved HIV related behaviour change amongst both clients and implementers of SS. Of the ten client stories collected, six reported an improvement in communication with their community, family or sexual partner and spoke of new skills and confidence to speak about HIV and sexual health issues. This in-turn led to clients reporting improved relationships with sexual partners, less community fighting and better communication and trust between parents and children. Seven of the ten sampled client stories and three of the five implementer stories reported that SS had facilitated an increase in HIV related knowledge, particularly modes of transmission and prevention strategies. Six client stories also reported an increase in positive HIV related skills such as assertive communication and 'I statement' skills...

Evidence from this evaluation found that when well implemented, the Community Self Assessment can be an effective way of monitoring program outcomes and capacity development. Its strengths lie in its inclusive approach and its encouragement of communities to become empowered to find their own responses to HIV/AIDS. In particular, the evaluator observed that Sasa village, a community that went through the pre and post Community Self Assessment was prompted to think of program outcomes early, and therefore had well thought out suggestions for their 'final requests' ceremony. In addition to this, during community discussion around risk and vulnerability to HIV/AIDS, Sasa village identified alcohol use and criminal activity as an issue affecting the community. In response to this, and a process initiated by the AIDS Competence Assessment, the village approached the local police department and asked them to give awareness sessions on drugs and alcohol to community members. While this activity wasn't a direct result of Stepping Stones, it does demonstrate how the Community Self Assessment can assist communities in clarifying issues that are relevant to them.

The 'Gender Equitable Men' (GEM) Scale questionnaire also proved to be an effective and easy way of obtaining pre and post program data on gender norms from male SS participants. All men reported finding the questions easy to answer and many men stated they liked being challenged by some of the questions that were asked. Evidence from the GEM Scale questionnaires conducted in Sasa and Fiji Network of positive people (FJN+) found that there had been an improvement in positive gender norms as a result of SS, (fifteen and twelve point improvement respectively). In addition to this, male SS facilitators reported that it was an easy monitoring and evaluation tool to administer."