Nazareth AIDS Prevention Program for Out-of-School Youth
FCO# 33677
| Implementing agency: |
Family Guidance Association Of Ethiopia (FGAE ) Nazareth |
| Geographic focus: |
Nazareth |
| Target population: |
Out of school youth |
| Length of project: |
April, 1995 - December 31, 1995 |
Background
FAGE - Nazareth is one of the branch offices providing family planning services to the Eastern part of the country. This subproject was designed to educate out of school youth through peer education program and additional community members through drama in the town of Nazareth. It was funded under an LOA to run for six months. The project strategies included training of PHEs, IEC/BCC, and free condom distribution to the target population from FGAE 's supplies.
Accomplishments
At startup, a baseline KABP was conducted to help refine IEC/BCC strategies and approaches. The project trained 30 PHEs who in turn educated 644 (109 female and 535 male) out of school youth in three months with one to one discussions at places where youth frequently congregate. During those sessions, 5,567 condoms were also distributed. In addition, 49 females and 686 males have been reached through drama and video shows followed by discussions.
Mass education on HIV/STI prevention reached 3,200 community members on World AIDS Day during which MSIE distributed 5,500 condoms, 2,700 leaflets and 250 posters. On another Ethiopian holiday, "Meskel", the project passed information on HIV/AIDS prevention to an estimated 750 people and distributed 9,000 condoms. 1,111 leaflets, 85 posters, 2 poems, 3 articles, 3 plays, and 4 dramas were produced and distributed during project activities.
Constraints
- Difficulty in reaching the target population as there are few recreational places in the town.
- Harassment and provocation experienced by female PHEs from community members, particularly the youth.
- Reluctance to attend education sessions on the part of the target population.
- Discontent of PHEs due to lack of incentives.
- Parents' resistance to let the PHEs participate in the intervention due to lack of awareness about the problem of AIDS and lack of involvement of the community members in the design of the project
- Inability to reach the targeted number of youth because actual intervention time available was limited to three months.
Recommendations
- In order to maintain the existing relatively high levels of knowledge of youths about STIs/AIDS, and to promote consistent condom use, prevention programs need to continue.
- Better formative research using FGDs needs to be done at the beginning of project implementation in order to better understand the sexuality and unmet needs of the youth.
- More sustainable interventions require involving the wider community in the process of reaching youth.
- Interventions need to provide the youth with practical skills which will eventually lead them to self employment after project completion.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| FGAE - Nazareth |
Individuals educated |
5,329 |
| Individuals trained |
30 |
| Materials distributed |
4,158 |
| Condoms distributed free |
20,067 |
AIDS Prevention Among Youth in Awassa Town
FCO# 33594
| Implementing agency: |
Family Guidance Association of Ethiopia ( FGAE ) Awassa |
| Geographic focus: |
Awassa |
| Target population: |
Out of school youth |
| Length of project: |
April, 1995 - December 31, 1995 |
Background
FGAE-Awassa is one of the FGAE branch offices located in the Southern Region of the country in Awassa town. The NGO works with youth in a family planning community based distribution program.
During the project, FGAE targeted out of school youth with HIV/STI prevention through training of youth already engaged in the community based distribution of contraceptives. Strategies included training 25 selected youth as PHEs, IEC/BCC through informal one to one and small group discussions, drama and video shows, condom promotion and distribution, and STI referrals.
Accomplishments
At the beginning of activities, this six-month subproject trained 22 youth and conducted a baseline KABP survey to refine IEC/BCC strategies and approaches.
The project then educated 3,649 out of school youth, showed 17 video shows to 567 males and 203 females, and distributed 2,964 condoms, 2,000 leaflets and 550 caps with messages on AIDS. As part of the intervention activity, PHEs referred 46 youth to the Awassa Health Center for STI treatment.
Constraints
- Delay starting actual intervention as training of PHEs and collection of baseline data took considerable time to complete. There was only three-months left to actually educate the target population.
- The short duration of the project period was too short a period to achieve a sustainable, effective intervention.
Recommendations
- Intervention programs designed to address a vulnerable group like the youth should be given more time to see effective change.
- Video and drama shows are highly accepted by the youth as an entertaining and educational approach, thus, future interventions should use dramas, videos and mass media to strengthen behavior change.
- It was shown that incentives for PHEs contribute greatly to a better outcome of efforts.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| FGAE Awassa |
Individuals educated |
4,419 |
| Individuals trained |
22 |
| Materials distributed |
4,850 |
| Condoms distributed free |
2,964 |
Minimizing HIV Infection in Out-of-School Youth in Mekele
FCO# 36477
|
|
| Implementing agency: |
Tigray Development Association (TDA) |
| Geographic focus: |
Mekele |
| Target population: |
Out of school youth |
| Length of project: |
October, 1994 - December 31, 1995 |
Background
Tigray Development Association (TDA) was founded in 1989 in Washington, DC,during the Ethiopian civil war as a nonprofit, humanitarian organization with chapters and support groups in major US cities, Canada, Europe and Africa, the Middle East and Ethiopia.
Later in 1992, TDA established itself as an Ethiopia charitable organization and moved its international office to Mekele in the Tigray region of Ethiopia. TDA is actively involved in development programming including providing health services. Within this context, TDA designed this project to educate out of school youth in Mekele as a one-year project.
Strategies used included selecting PHEs from among the target population, organizing them as an Anti-AIDS core group, and providing IEC/BCC through formal and informal discussions. The informal discussions were conducted in recreational places and other areas where youth congregate, while the formal education was conducted through dramas or discussions about HIV/AIDS/STIs.
Accomplishments
First, TDA conducted a planning meeting with the project officer, a physician consultant, PSI representative and an STI clinic physician from the Mekele Health Center. Next, 40 youth were selected as peer educators and trained in prevention of HIV/STI. A baseline KABP was also conducted among the target population with 304 respondents. The 40 trained group were organized as anti AIDS club core group.
Strategies for educating the out of school youth by these PHEs include development and staging of dramas, video films, one to one discussion at recreational places and in small groups where appropriate. Seventeen (17) of the core group were also trained on video production and filming.
During the life of the project, the 40 PHEs held 164 discussions for 5,005 out of school youth, screened 31 video films, distributed 6,000 leaflets, and staged three dramas for 8,606 school youth that were produced by the core group. FGDs have been conducted twice at the beginning and end of the project period among male and female participants.
Constraints
- Lack of incentive for the PHEs hampered activities, because the youth are unemployed and were not motivated to volunteer their time.
Recommendations
- Allocate incentives for PHEs in order to better ensure effective results of interventions.
- Future interventions should put more funds towards drama and video shows which were found to be recreational and educational, and very popular among the youth.
- Education programs should be sustained over longer time periods to achieve the desired behavior change.
- The FSIT should continue to work together beyond AIDSCAP funding.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| TDA |
Individuals educated |
13,611 |
| Individuals trained |
40 |
| Materials distributed |
6,000 |
| Condoms distributed free |
NA |
Prevention and Control of AIDS among Out of School Youth in Addis Ababa
FCO# 36484
| Implementing agency: |
Integrated Holistic Approach Urban Development Project (IHAUDP) |
| Geographic focus: |
Addis Ababa |
| Target population: |
Out-of-school youth |
| Length of project: |
April, 1995 - December 31, 1995 |
Background
IHAUDP was established in June, 1983, to assist destitute people (the poorest of the poor) in the slum areas of Addis Ababa, namely kebeles 30, 41, 42 and 43, in an integrated holistic approach. The total population served is about 40,000.
As an indigenous organization, IHAUDP first successfully implemented a smaller project under the RRF mechanism. A second project was then funded under an LOA.
In designing the first project under the RRF, the aim was to educate community members in the project area on the prevention of AIDS through staging dramas produced by a youth drama group. In the second proposal under the LOA, the intervention focused more on one segment of the population, youth, providing outreach for the youth themselves, using dramas, distribution of condoms and leaflets.
Accomplishments
During the six-month intervention, 30 trained PHEs were given a refresher TOT, followed by a rapid assessment KABP among the target population.
The trained PHEs reached 17,699 youth through health education and video drama on HIV/STI prevention, and distributed 2,300 leaflets and 888 condoms.
Constraints
- Inadequate fund allocation for KAP survey.
- Lack of free condoms to distribute for those who can't afford to buy.
Recommendations
- As this community is the poorest in town, most of the household heads are females, and many women and some of their children are MPSCs. Behavior change communication with innovative messages is still needed to continue to address high risk behavior due to economic difficulties.
- Condoms need to be more efficiently promoted among the target population.
- STI services should be initiated for the community members in IHAUDP's upgraded clinic.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| IHAUDP |
Individuals educated |
17,699 |
| Individuals trained |
30 |
| Materials distributed |
2,300 |
| Condoms distributed free |
888 |
Control and Prevention of HIV/STD among Females in Two Target Sites in Addis Ababa
FCO# 36483
| Implementing agency: |
Society for Women and AIDS/Eth (SWAA-E) |
| Geographic focus: |
Addis Ababa |
| Target population: |
Female entrepreneurs |
| Length of project: |
May, 1995 - December 31, 1995 |
Background
The Society for Women and AIDS in Africa/Ethiopia branch was founded in 1990 and started activities under the national AIDS control program. In 1992, SWAA-E formed its own executive committee with the active participation of women from different sectors.
During the formulation of this project proposal, SWAA-E targeted 500 women entrepreneur and 400 university female students to educate them on HIV prevention. Strategies used include selection and training of peer educators among the target population, conducting IEC/BCC, promoting condom use, and encouraging early treatment of STIs. In addition, the project planned sensitization of AAU administrative and technical staff, and of the executive members of the women's entrepreneur association. However, due to several factors, activities planned were not fully implemented.
Accomplishments
SWAA trained 15 PHEs from among women entrepreneurs, collected baseline KABP data on 150 women, and conducted a seminar for 450 women entrepreneurs.
Constraints
- Irregular meetings of the executive members of SWAA-E to guide the project coordinator and solve problems encountered.
- Difficulties reaching the university dean coupled with high turnover of key university staff who SWAA/E hoped would facilitate the university program.
- SWAA-E's project coordinator resigned and recruiting and hiring another one took significant time which in turn delayed implementation.
- Reelection of women entrepreneur association executives, further affecting implementation.
- SWAA/E refused to return unused funds despite repeated contact by AIDSCAP/E.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| SWAA-E |
Individuals educated |
450 |
| Individuals trained |
15 |
| Materials distributed |
NA |
| Condoms distributed free |
NA |
A Video Cassette Production of a Drama on the Danger of the Spread of HIV
FCO# 33482
| Implementing agency: |
Development Aid For You (DAY) |
| Geographic focus: |
Nationwide |
| Target population: |
General population |
| Length of project: |
May, 1994 - December 31, 1995 |
Background
DAY is an Ethiopian NGO founded in 1989 by Ethiopian businessmen and professionals concerned about the development needs of youth, children and women. Initially DAY's focus was on the problem of youth unemployment but the IA later changed its focus to the whole community based on an integrated approach.
As part of its health program, DAY has been treating STI patients and giving health education on HIV/AIDS prevention through the existing MCH program. As part of the health education program, DAY has also been staging dramas for mothers and youth. A youth drama group was formed later in the process and produced a popular drama on AIDS that was well received by most community members, donors and others who viewed the drama. DAY then collaborated with AIDSCAP to video tape the drama to reach a larger number of mothers, youth, and other community members.
Accomplishments
As the idea was to film the drama using a professional company, major activities to complete the film production included the following:
- Identification and screening of a company to do the filming
- Rewriting the drama script to adopt it for film shooting
- Training of the drama group on screen acting
- Choosing the right costumes and places
- Decorating the interior of the scene and putting on make up
- Filming, editing and putting subtitles in English
- Producing the final edition and making 35 copies on U-Matic cassettes
- Preparing discussion guide to be distributed with the films to AIDSCAP implementing agencies.
Constraints
- Under estimated budget needed for film production and time needed rewrite the script for filming and train the actors.
- Actors expected to be well paid then lost interest when their pay did not meet their expectations.
- Comments from AIDSCAP review team were made after filming took place, creating more delays while refilming and editing.
- The closing down of DAY's health program made it impossible to complete the activities in the agreement, specifically, screening the film for 20 percent of the target population in the project area. This has never taken place.
Recommendations
- It was a good learning experience for both DAY and AIDSCAP that film production needs thorough planning including allocation of enough time and financial resources.
- Review comments should be done on the scripts and during rehearsal of the drama rather than after filming to avoid having to refilm.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| DAY |
Individuals educated |
NA |
| Individuals trained |
NA |
| Materials distributed |
35 copies of video |
| Condoms distributed free |
NA |
AWI - Africa Regional/Ethiopia
FCO# 56073
| Implementing agency: |
Marie Stopes International Ethiopia |
| Geographic focus: |
Addis Ababa |
| Target population: |
Out of school youth |
| Length of project: |
September 9, 1996 - January 31, 1996 |
Gender and AIDS
AIDSCAP's Africa Regional Office and Women's Initiative (H.Q.), along with the Regional Economic Development Service/East & Southern Africa (REDSO/ESA), convened a Gender and AIDS Workshop twice to equip top policymakers with information and skills to address gender issues. Groups of participants from five African countries prepared action plans for each country including Ethiopia.
MSIE was selected by the Ethiopia group to implement a five-month Gender and AIDS Project among male and female adolescents in Addis Ababa, based on their previous experience with the target population.
The objectives of the project included the following:
- Enable male and female out of school adolescents to develop safer sex negotiation skills that would protect them from contracting HIV/STIs;
- Establish a forum for male and female adolescents to discuss the need to shoulder equal responsibility to fight HIV/AIDS/STIs;
- Integrate family planning services for male and female adolescents who are participating in this HIV/AIDS/STIs intervention;
- Continue/strengthen the existing STI referral system for male and female adolescents in collaboration with the health centers based on previous agreement and arrangement with the Region 14 Health Bureau.
Accomplishments
The project trained 75 (39F, 26M) youth AIDS communicators and held a seminar for 19 (8 male, 11 female) Kebele leaders. 8,220 (3838 males and 4382 females) were subsequently reached through individual and group discussions, video and drama shows. 10 female and 32 male STI patients have been referred to a health center for appropriate treatment. Two youth centers called "Fleet of Life" were established in two Woredas where youth meet and discuss HIV/AIDS and other problems. Income generating activities such as selling of tea is being undertaken in the centers. Debating and dialogue were found to be effective strategies for addressing gender issues during the meetings in the youth centers.
Constraints
- The dropouts of YACs created extra work in recruiting and training for replacement;
- STI patients were usually reluctant to identify their partners thus making contact tracing difficult;
- Funds were too limited to continue and expand the project.
Lessons Learned
- The most effective and acceptable ways of teaching youth about AIDS were found to be through entertainment combined with an education program that includes drama, video shows, debating , poetry, and sports competition.
- Creating income generating activities serves as an incentive that encourages the youth to participate in HIV prevention projects for longer periods.
- The best way to educate the youth is by using the youth themselves. Any gender-related issues are better discussed when the discussion occurs between the same sex and similar age groups.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| MSIE |
Individuals educated |
8,239 |
| Individuals trained |
75 |
| Materials distributed |
NA |
| Condoms distributed free |
NA |
Ethiopia Social Marketing Project (ESMP)
FCO# 22467, 32468
Task Orders # 12, 23
| Implementing agency: |
DKT/Population Services International (PSI) |
| Geographic focus: |
National |
| Target population: |
Sexually active general population |
| Length of project: |
January 1, 1993 to September 30, 1995 |
Background
DKT/PSI began the ESMP in 1991 with the support and assistance of the MOH's Department of AIDS Control, and sold over 11.5 million HIWOT condoms in the first two and a half years of operation. Early constraints to implementation include the lack of a developed commercial marketing and distribution system, the expanding civil war, and the relative unfamiliarity with condoms on the part of the target population. Both task orders with AIDSCAP provided partial support for further expansion of ESMP sales, distribution, promotion and advertising activities nationwide.
Accomplishments
This support was instrumental in the ESMP's efforts to increase knowledge, accessibility, and use of condoms for AIDS prevention in Ethiopia. During the project period, sales of HIWOT (Amharic for "life") condoms more than doubled. The increased rate of sales has been sustained over a period months, achieved by expanding the kinds of outlets that carry condoms, as well as the geographic coverage of the product distribution system. Of particular relevance is that sales through bars and hotels accounted for nearly 25% of all ESMP sales. By helping to achieve this success, the AIDSCAP support contributed to securing longer term funding from USAID and the Dutch Government for the continued operation and expansion of social marketing in Ethiopia through 1999.
The ESMP has emerged as one of the most successful social marketing projects in Africa. During the 33 months of AIDSCAP assistance, the project sold over 42 million condoms through over 10,000 outlets in 533 different cities, towns and villages. In 1995, HIWOT Trust sold at nearly three times the rate it did in 1992, the year before AIDSCAP assistance began. Radio messages advertising condoms and condom use and educating about AIDS averaged over three messages per day over the period of AIDSCAP assistance. IEC activities reached 144,794 individuals through seminars, workshops, lectures, and training programs for a broad range of audiences throughout Ethiopia.
Process Indicator Summary
| AIDSCAP Partner |
Process Indicators |
Actual |
| DKT/PSI |
Individuals educated |
144,794 |
| Individuals trained |
NA |
| Materials distributed |
NA |
| Condoms sold |
42,333,993 |
