Cooperation Bases System for Educational Cooperation in 2007
by the Japanese Ministry of Education, Culture, Sports Science and Technology

Life Skills
Knowledge

Programs ManualLife Skills

To have a

Educationbetter life

The Possibilities and Challengesof

HIV/AIDS Education

Life Skills Programs Manual

The Possibilities and Challenges of HIV/AIDS Education
Cooperation Bases System for Educational Cooperation in 2007
by the Japanese Ministry of Education, Culture, Sports Science and Technology
Published in March 2008 by Japan NGO Network for Education（JNNE）
Writers：Part1 :Yasushi KATSUMA／Associate Professor,
Graduate School of Asia-Pacific Studies, Waseda University
Part2 1:Nobuhiko KATAYAMA／World Vision Japan(WVJ)
Part2 2-1,2-3,Part3-1,Part3-2：Haruko FUJIME／
Community Action Development Organization (CanDo)
Part2 2-4(General Administration, Educational Administration)：Hiroaki NAGAOKA／(CanDo)
Part2 2-2,2-4(Health Administration),Part3-3：Atsuko MURAI／(WVJ)
Following persons gave valuable comments on draft manual.
Chizuko Ikegami

Masashi Yamaguchi

Dusit Duongsaa

Editor: Toru MORI
Translator: Yoshiko TONEGAWA
Produced by: Japan NGO Network for Education（JNNE）
Office: Shanti Volunteer Association (SVA) 31 Daikyocho Shinjuku-ku Tokyo, JAPANWelcome to
the Life Skills
Programs
ManualTo improve the quality of educationand empower children to have a better life
All over the world, countries aim to achieve universal primary education (UPE) by 2015.
The quality of education and prevalence of HIV/AIDS , however, are serious obstacles toachieving UPE.

As a means of improving the quality of education, many international agencies arepromoting “life skills education.” Our goal is the attainment of life skills, to serve as tools
to translate knowledge into action in order to improve our lives. Life skills can be usedbroadly, in any place, including schools, communities and medical institutions. We
sincerely hope that this manual will be used in a range of areas, such as community
development, human rights and disaster rehabilitation.

We would like to complete this manual with its readers. Therefore, we highly appreciate
any chance to receive your knowledge and experience.

March 2008

Japan NGO Network for Education (JNNE)
e-mail：jnnegeneral@hotmail.co.jp
URL：http://jnne.org/

Another Life Skills Programs ManualLife Skills Programs Manual: “Promotion of
Reading Activities in Developing Countries”
This is a guideline for life skills for a better
living with the pleasure from reading.

1

―――

Table of Contents―――

This manual introduces …
concepts of “life skills” for HIV/AIDS education and points for the implementation of programs on HIV/AIDS inschools and communities. ・・・5Structure of this Manual ・・・6

Part1 Orientation
Partnerships between Education and HealthInternational Trends in HIV/AIDS Education

1. “Life Skills”: A Bridge between Health and Education ・・・8

2．Impacts of HIV/AIDS on Education
2-1. Children miss education opportunities due to loss of teachers’ lives.・・・92-2. Several international agencies support education for HIV/AIDS prevention.・・・10

3. Suggestions for Life Skills from the Dakar Framework for Action
3-1. Skills-based Health Education・・・11
3-2. Life Skills for Health Education・・・12

4．Health Education against HIV Infection ・・・14

5． Practice of the “Child-to-Child” approach needs partnership between education and health sectors.・・・21

Part2 The Possibilities
HIV/AIDS Education as Life Skills Education
1. Keys to Effective HIV/AIDS Measures: Participation and Cooperation
1-1. Three Points for Effective HIV/AIDS Measures Learned from Policies・・・22
1-2. Life Skills education is necessary and can be utilized in all phases, from prevention to treatment. ・・・24
1-3. Three Keywords for Life Skills Education on HIV/AIDS・・・24

2. The Possibilities HIV/AIDS Education・・・25
2-1.Expectations for Teachers・・・25①

Expectations of Teachers with Accurate Knowledge about HIV/AIDS・・・26

2

②

Expectations of Teachers with Appropriate Attitudes and “Mainstreaming” of HIV/AIDS・・・26③

The Possibility of lessons about the “Child-to-Child” Approach・・・27④

The Possibility of “Teacher-to-Child” Lessons・・・27

2-2. Expectations for Children・・・28①

Expectations from Attaining Accurate Knowledge about HIV/AIDS・・・30②

The Possibility of Children’s Behavioral Changes・・・31

2-3. Community― Expectations for Parents and Communities・・・32
Potential after Adults come to understand HIV/AIDS・・・33
2-4. Expectations for Partnerships between Government and NGOs・・・33■General Administration: Expectation for Advocacy to Citizens・・・33■Educational Administration: Expectations for the Introduction of HIV/AIDS Education to School
Curriculum Guidelines・・・34■Health Administration: Expectations for Medical System・・・34

Part3 Practices
Part3-1 Preliminary Survey for Implementationof HIV/AIDS Education
1-1. Before starting HIV/AIDS Education・・36
1-2. Understanding the area and seeking to enforce HIV/AIDS education・・・37
1．Literature Review and Data Collection・・・37
2．Completing Research Designs・・・37
3．Determination of Methodologies for Survey・・・37
4．Determination of Questions・・・40
5．Preparation of Surveys・・・42
6．Conducting Surveys・・・42
7．Analysis of results from the Survey・・・43
1-3. Strengthening HIV/AIDS Education・・・45

Part3-2 Life Skills for HIV/AIDS Educationin Primary Schools
1. Practices for Appropriate and Effective HIV/AIDS Education・・・46
2. HIV/AIDS Education in Primary Schools, and Parent Participation and Involvement
2-1. Teacher Training ・・・48
Session① Meanings and Significance of HIV/AIDS Education・・・51
Session② Model Lesson (Natural Science)・・・52

Experiences

Session③ How to find a message・・・53

in Asia

Session④ Basic Knowledge on HIV/AIDS・・・54

Prejudice and Discrimination

Session⑤ Discriminatory Expressions・・・55

against HIV/AIDS・・・56

Session⑥ Model Lesson (Religious Education)・・・58

3

Session⑦ Searching for units which can be integrated with HIV/AIDS issues ・・・60
Session⑧ Making a teaching plan・・・61
Session⑨ Improvement of Education Approach・・・62
Session⑩ Future Activity Planning・・・64
Evaluation of Teacher Training・・・65

2-2. Open Class・・・67
Good Examples with High Quality・・・69
Examples of Failure to Provide Appropriate Intervention・・・72
2-3. Child Presentation Day・・75
2-4. Parent Meeting・・・80
2-5. AIDS Learning Workshops・・・84

Part3-3 HIV/AIDS Activities Engaged by Community
1. Organization of Community Groups for Care
1-1. Understanding the Current Situation・・・90
1-2. Forming a Community Organization・・・91
1-3. Deciding Components of Activities・・・92
2. HIV/AIDS Activities by Community
2-1. Preventive Education・・・94
2-2. Care・・・96
2-3. Utilization of VCT and Health Centers・・・97
Examples・・・99

Part4

Appendix

Appendix 1：Focus Group Interviews for Teachers Questioning Route (Part 3-1) ・・・105
Appendix 2： In-depth Interviews for Parent Questioning Route (Part 3-1) ・・・106
Appendix 3：Questionnaire for Feasibility Study of School Health Project in Nuu (Part3-1) ・・・107
Appendix 4：Sample Lesson Plan and Lesson Note (for facilitation) /Religious Education for 5th Grade (Part 3-2)
A SAMPLE LESSON PLAN ・・・110
Lesson Note (for facilitation) ・・・111
Appendix 5：Sample Lesson Plan and Lesson Note (for facilitation)/Social studies for 5th Grade (Part 3-2) ・・・113
Appendix 6：Basic Information on HIV/AIDS (Part 3-2) ・・・114
Appendix 7：Questionnaire 1 ‒ Households of OVC

References・・・128

4(Part 3-3) ・・・121

This manual introduces …
concepts of “life skills” for HIV/AIDS education and points for implementation of programs on
HIV/AIDS in schools and communities.

With the rapid prevalence of HIV/AIDS, HIV/AIDS education is implemented in many countries.
There are, however, many obstacles to advocating on HIV/AIDS in education and communities.
In these difficult situations, activities that place importance in life skills are needed for more effective
HIV/AIDS education.

This is not only learning, but also the attainment of self-management andcommunication skills, including actions for self-defense and attitudes to others.

Although there are various manuals dealing with HIV/AIDS education, this manual especially focuses
activities in schools and communities from the perspective of life skills education.

Also, it looks atperceptions, attitudes and behavioral changes of not only the children who receive HIV/AIDS education,
but also the adults who carry it out.

We believe that this manual provides new ideas to readers, including

those who work in HIV/AIDS education.

The examples of activities and points made in this manual are mainly based on a 2006 survey. Kenya is
one of the African countries with a high HIV infection rate (The national average was 6.7 percent in 2003).
Therefore, HIV/AIDS issues relate to everyone’s daily life in Kenya. Moreover, HIV/AIDS education has
been included in the primary education curriculum since 2001. Children learn about HIV/AIDS from thefirst year of primary school. Please note that some examples and points made in this manual do notalways apply in areas where HIV/AIDS are not as prevalent as Kenya.

Children
Schools◆Headteachers are negative about the practice of HIV/AIDS
education.

◆Even if they receive HIV/AIDS education, it cannot
be realized as actual practices.
◆Even if entering schools, many children drop out
before receiving HIV/AIDS education.

◆Teachers are not trained for HIV/AIDS education and do nothave enough knowledge and confidence to teach children.
◆Teachers cannot give consideration to people with HIV/AIDS.
◆The curriculum on HIV/AIDS does not include condoms as a
HIV/AIDS preventive method.
◆Headteachers try to avoid talking to parents about HIV/AIDS
education.

Parents and Communities◆Many parents are negative about HIV/AIDS education at primaryschool.
◆They do not discuss what children learned about HIV/AIDS at
home.
◆Highly infectious customs are practiced in the area.

Support from Public and externalorganizations◆The relationship between the education and health sectors is◆HIV/AIDS carriers have difficulties in having counseling, tests andtreatments due to discrimination and exclusion in the community,◆Influential persons and leaders have fixed ideas about HIV/AIDS
and encourage discrimination.

weak.

5

Structure of this Manual

Part1 Orientation
Partnerships between Education and HealthInternational Trends in HIV/AIDS Education

Part 1 indicates that knowledge alone is notenough for protecting ourselves from HIV/AIDS.
Interpersonal and self-controlling abilities, as wellas life skills, are necessary.

It also shows how

international agencies and NGOs should work for
AIDS based on “life skills” as a keyword.
The definition of “life skills” is explained based onchild behaviors.

Part2 The Possibilities
What does HIV/AIDS education bring?
Possibilities and Challenges for HIV/AIDS Education as Life Skills Education

Part 2 analyzes what kind of behavioral
change can be expected for teachers, children
and people in the community through theattainmentofknowledgeon

HIV/AIDS,

desirable attitudes, and life skills.

Also, itanalyzes what limitations and challenges
exist.
Moreover, it examines what can be expectedfrom administrative bodies.

6Part3 Practices
Part3-1 Preliminary Survey for Implementationof HIV/AIDS Education

Part3-2 Life Skills for HIV/AIDS Educationin Primary Schools

There

are

variousdifficulties

HIV/AIDS education in schools.

inpracticing

Part3-3 HIV/AIDS Activities

A clear strategy

engaged by Communityand finely–tuned considerations in every phase areimportantformakingaquality

HIV/AIDS

education.

This section explains this throughParticipation in advocacy activities

examples.

and care are good chances for adults

This section also shows that teachers need toand children to improve their life

consider other people and attain life skills.

skills.

At the same time, the importance of sharing

people who need care reduce theirperceptions of HIV/AIDS among schools, parents

anxieties about discrimination andand the society is indicated.

isolation.

Through their participations,

Part4 Appendix
In this part, there are questionnaires to teachers and thecommunity, teaching plans, and materials about HIV/AIDS
knowledge for the community.

7

Part1 Orientation
Partnerships between Education and HealthInternational Trends in HIV/AIDS Education

1．“Life Skills”: A Bridge between Health and Education■Cross-sectoral Issue
After the World Conference on Education for All (WCEFA) in 1990, the expansion ofbasic education has been an essential goal internationally.

One of the cross-sectoral

targets for Education for All (EFA) is to expand health education and life skills. However,not much has been done towards achieving this target. This may be because educationand health are often seen as separated issues; it is difficult to regard them as one
cross-sectional issue.

■Expansion of Life Skills in “the Dakar Framework for Action”“The Dakar Framework for Action,” adapted at the World Education Forum in 2000,
expressly advocated the expansion of life skills. Although the relationship between childeducation and health was noted, how health education should be practiced has not been
discussed enough.

There is not even an agreed concept for "life skills."■Life Skills Developed from Discussion about ＥＦＡ
This manual focuses on HIV/AIDS based on past discussions about education and health.
Moreover, this manual will discuss life skills that were developed from EFA as a concept ofa bridge between international education and health.

Life skills will play an importantrole in an international society aiming to achieve the Millennium Development Goals andthe UN Millennium Declaration adopted at the UN Millennium Summit.

8

2．Impacts of HIV/AIDS on Education

HIV/AIDS negatively impacts the education system from the aspect of not only the supply
side of education (teachers) but also the demand side of education (pupils and students).
In addition to Africa, these negative impacts are expanding in other continents.

2-1. Children miss education opportunities
due to loss of teachersʼ lives■Loss of Teachersʼ Lives
One research study shows numbers and ratios that indicate that more teachers are dying
due to HIV/AIDS.
For example, in Zambia, 20% of teachers are infected by HIV (Kelly 2000). Moreover,
one study shows that more than 30% of teachers are infected by HIV in some areas in
Malawi and Uganda (Coombe 2000). The loss of teachers from HIV/AIDS may cause
missed educational opportunities for students.
In this situation, schools need to hire and train new teachers.

However, the cost of thiscan become a heavy burden for the education sector. For instance, in Swaziland, theestimated cost of replacement teachers for those lost to HIV/AIDS by 2016 is estimated atabout 233 million USD （Kelly 2000）.

This is above its national budget; making

complete implementation impossible.

■Frequent Work Absence and Interrupted Lessons
Even before the actual losses of teachers to HIV/AIDS, infected teachers are frequently
absent from schools, and teachers often have to leave in the middle of their class schedule.
This results in a decrease of the amount of time for education, which negatively affects
quantity and quality of education. At least three reasons cause teachers’ frequent workabsence (World Bank 2002).
Firstly, teachers with HIV are absent from schools more and more as their sickness from
HIV/AIDS worsens.
Secondly, when teachers have family members with HIV/AIDS, they need to take time
off work in order to take care of them or prepare for funerals.
Thirdly, the psychological effects from HIV/AIDS cause work absence. When teachersor their family members suffer from HIV/AIDS, the costs of treatment or funerals
financially damage the teachers. Also, repeatedly sad incidences cause major trauma tothem. Loneliness and fear hinder teachers from continuing effective educational activities.

■Infants lose their lives.
Although it is agreed that HIV/AIDS causes problems to educational supply, its impact

9

on educational demand is not clear.
It is believed that population of the infants is decreased due to HIV/AIDS, due totransmission from mother to child. However, the population of school-aged children has
generally increased.

Moreover, HIV/AIDS is not directly related to the death ofschool-aged children.

The main infection route for infants is from mothers, and infants

lose their lives. Only less than half of infants with HIV/AIDS reach to schooling age.
Therefore, the number of children with HIV/AIDS aged 5 to 14 years tends to be smaller
than that of other age groups.

■Ages 5 to 14 years is the most important time for HIV/AIDS prevention.
When the youth enter puberty and have sexual desire, the infection rate of HIV/AIDS isincreased. Among children aged from 15 to 24 years in Africa, the number of girls with
HIV/AIDS is twice as high as the one of boys. This shows that women are more vulnerable
than men (UNICEF, UNAIDS & WHO 2002）.

In this sense, ages 5 to 14 years is themost important time for the HIV/AIDS prevention.
It is difficult to show trends in the number of school-aged children. However, theirenrollment rates tend to be decreased, especially among poor households.

Due toHIV/AIDS, more households became poorer. This sometimes causes missed educational
opportunities for children (UNFPA 2005).

■HIV/AIDS Orphans without Opportunities for Education
The increased number of HIV/AIDS orphans is one of the negative causes foreducational demand. Even if children are not directly affected by HIV/AIDS, infection of
their parent(s) impacts their lives.

The number of children under 18 years old who havelost their parent(s) to HIV/AIDS, reached to 15 million in 2003; eight out of ten children
are from Sub-Saharan Africa. The number of HIV/AIDS orphans in Africa is estimated atover 18 million by 2010 (UNFPA 2005).
A recent survey showed that the attendance rate of HIV/AIDS orphans aged 10 to 14
years who had lost both parents was lower than that of those who had lost one（UNICEF
2004 ） .

This survey empirically indicates the fact that HIV/AIDS orphans lose

opportunities for education.

2-2. Several international agencies support educationfor HIV/AIDS prevention.
The serious impact of HIV/AIDS on education has heightened a sense of urgency fordevelopment education workers. At the same time, the importance of education has beenrecognized in fighting against HIV/AIDS problems.
In March 2004, Global Initiatives on HIV/AIDS and Education was established byorganizations, consisting of the Joint United Nations Programme on HIV/AIDS(UNAIDS): United Nations High Commissioner for Refugees（UNHCR）, United Nations

10

Children's Fund（UNICEF）, World Food Programme（WFP）, （WFP）, United Nations
Development Programme（UNDP）, United Nations Population Fund （UNFPA）, United
Nations Office on Drugs and Crime（UNODC）, International Labour Organization（ILO）,
United Nations Educational, Scientific and Cultural Organization （UNESCO）, World
Health Organization （WHO）, and World Bank. Its main aim is to support governments
to implement education programs for HIV/AIDS prevention.

3．Suggestions for Life Skills from the Dakar Framework for Action

This chapter briefly addresses international approaches towards school health with a focus
on health education.

The Dakar Framework for Action includes the importance of life skills in its targets 3 and6. It also suggests creating “safe, healthy, inclusive and equitably resourced educational
environments” as a strategy for achieving the educational development targets (Strategy 8).
Educational environments include “adequate water and sanitation facilities,” “access toor linkages with health and nutrition services,” “policies and codes of conduct that enhance
the physical, psycho-social and emotional health of teachers and learners,” and “education
content and practices leading to knowledge, attitudes, values, and life skills needed for
self-esteem, good health, and personal safety.” （World Education Forum 2000）.
Regarding Strategy 8 in the Dakar Framework for Action towards the achievement of
EFA, Focusing Resources on Effective School Health (FRESH) is worthy to mention as aninternational approach.

3-1.

Skills-based Health Education

At the World Education Forum held in 2000, WHO, UNESCO, UNICEF and the WorldBank agreed to promote an effective school health program together. This is FRESH,
including four core frameworks for action.
These are: (1) health-related school policies, (2) provision of safe water and sanitation
towards a healthy physical and learning environment, (3) skill- based health education, and(4) school-based health and nutrition services.

In order to strengthen these four

frameworks, these three points are mentioned: (1) effective partnerships between teachersand health workers and between the education and health sectors, (2) effective community
partnerships, and (3) pupil awareness and participation.

11

■Education through the development of knowledge, attitudes and skills
The third framework of FRESH is skills based on health education. Education herearemeans to create and maintain healthy lifestyles and environment through the development

knowledge andof knowledge, attitudes and skills. Knowledge here means information and understanding

attitudes?

of it.

What

Moreover, attitudes here mean personal bias and preference.

Skills are classified into life skills and “other skills”.

Life skills are defined by WHO as “abilities for adaptive and positive behavior thatenable individuals to deal effectively with the demands and challenges of everyday life

What

are

（ UNICEF, WHO, et. al. 2003, p.13 ） .”The main components of life skills are

psychosocial attitudes and interpersonal skills. These skills help people make decisions

life skills?

based on enough information, solve problems, think critically and creatively, communicate
effectively, build healthy relationships, empathize with others, and healthily andproductively manage their lives.

What

are

other skills?

“Other skills” mean practical skills in other areas, including hygiene control by washinghands.

3-2. Life Skills for Health Education■Knowledge, Attitudes and Skills for Healthy Action
When you plan health education, four steps (goals, targets, components, methods) need
to be considered.

Goals, which give positive influences to health and other related social issues, will beshown generally by words.

For instance, a goal can be solving health problems ofpregnant women and children infected by malaria.

Towards this kind of general goals,

targets impact attitudes and situations more specifically. For the prevention from malaria
infections, advising pregnant women and children to sleep in mosquito nets is a target.
Another example of targets is to create an environment in which people infected by malaria
can receive appropriate treatments.

Health education consists of specific knowledge, attitudes and skills, which help more
people act healthily and create a healthy environment.
For instance, it is important to let people know that malaria is transmitted through thebites of infected mosquitoes (Anopheles). Then, we can give information how to properly
use mosquito nets for avoiding bites from mosquitoes. In addition, we can encourage
people to learn attitudes for protecting pregnant women and children at high risk.

12Four Steps of Health education and “Knowledge,” “Attitudes,” “Skills”( Examples)
Goal
TargetTo prevent being infectedwith malaria
Use mosquito nets

Knowledge (information,

Attitudes

SkillsInfection through bites ofPeople prefer not to be

Interpersonal skills,

mosquitoes

infected by malaria.

comprehension of emotion, etc.

Understand how to use

People hope to protect

Try to promote the use of

mosquito nets

everyoneʼs health.

mosquito nets

understanding)Components

Life Skills

Other Skills

Participatory Lessons

Methods“Child-to-Child” approach■Importance of Sharing Messages for Promoting Knowledge and Attitudes
among the Involved Parties
For promotion of certain knowledge and attitudes, it is important to share focusedmessages among parties involved in health education.

As an international attempt

towards an agreement on t common messages, “Facts for Life,” published by UNICEF、WHO、UNESCO in 1989, is essential. This book, which contains “information to live,”
simply organizes knowledge for protecting health of children and women as the main
messages in each section (HIV/AIDS, malaria, immunization, injury, disaster, urgency,etc).

One of the features is that each section has only five to nine messages, because too

many messages would make it difficult to understand.

”Facts for Life”■Life skills change behavior.
The following knowledge, attitudes, skills are the other components of health education.
As mentioned before, skills are classified into cross-sector al life skills and other practicalskills in each sector. In the case of malaria, life skills are for decision making andproblem solving, such as a campaign for the promotion of mosquito net use for theprevention of malaria in the area.

13

Classification of life skills has many ways. Although Katsuma (2005a) classified skills
into three areas, a classification into five skills is introduced here.

These are: (1)decision making and problem solving, (2) critical thinking and creative thinking, (3)communication and interpersonal relationships, (4) self-understanding and empathy, and(5) dealing with stress and emotions.
The reason why life skills are important is because it is difficult to change behavior only
through knowledge and attitudes.

Even if people had knowledge about HIV/AIDS, theknowledge could not be used properly without attitudes for the promotion of health.
Moreover, even if people have knowledge and attitudes, it is difficult to expect behavioral
change without skills. Of course, “other skills,” such as how to access condoms and how
to use them, are important. However, before that, it is important to have life skills ofinterpersonal relationships, for example, where people can effectively express opinions andpolitely refuse sexual intercourse if they do not want it.

The above-mentioned fiveclassifications of life skills will be explained later
using examples of HIV/AIDS (p14).

４．Health Education against of HIV Infection
In addition to sexual transmission by sexual intercourse, blood infection andmother-infant transmission and other infection routes for HIV. Blood infection includes
sharing equipment and needles among drug addicts. Of course, it is important to deal witheach infection route. However, since about three-fourths of the HIV infections are causedby sexual transmission, the most urgent need is to deal with sexual transmission throughhealth education.

■Transition from emphasizing knowledge to emphasizing Life Skills against HIV/AIDS
Generally speaking, it is expected that the higher level of education people receive, thelower the rate of HIV infection. However, when examining the individual educational
levels in each country, the higher the level of education people receive, the higher rate of
HIV infection. This is not necessarily evidence of a direct relationship between educationand HIV infection.

Rather, it can be explained that since people with higher education

tend to have high income and expand their activity range, it results in an increased numberof sexual intercourse with multiple partners.
Moreover, although we can expect behavioral change through education, some people
believe that discussion on the relationship between education and the prevention of
HIV/AIDS should not be based on research studies from the 1980s and 1990s. In fact,
respondents for these research studies were infected with HIV before HIV/AIDS became
known （Kelly 2000）.

14

Moreover, the content of HIV/AIDS education in schools wasgeneral and placed emphasis on knowledge, which was far from the practical measures toprevent from HIV infection through sexual intercourses.
Therefore, it is assumed that HIV/AIDS education at the time did not change their
behavior.

It is against this background that health education based on life skills iscurrently needed.

■ Knowledge and Messages Agreed upon by Several International Agencies
UNFPA was involved in the second edition of “Facts for Life” in 1993, and UNDP,
UNAIDS, WFP and the World Bank were also involved in the third edition in 2001. Thismeans that “Facts for Life” was promoted by the agreement of eight internationalorganizations in total （UNICEF, WHO, et al. 2002）. It was also translated into 215
languages, and over 15 million copies are published in over 200 countries. This book hasnine important messages about HIV/AIDS for all families and communities （UNICEF,
WHO, et al. 2002）.

The significance of the popularization of “Facts for Life” is the formation of aninternational agreement on minimum required knowledge and attitudes about HIV/AIDS(and other health sectors) for the public.

This standardizes contents of international

education.
Of course, we have to avoid simply practicing the uniform health education in different
environments.

However, we have to welcome this agreement as a start point for

discussion among different actors (international NGOs, government, Ministry of Education,
Ministry of Health, NGOs, teachers, medical workers etc.) to work for health education
cross-sectorally.

15

Nine Important Messages for All Families and Communities
1. HIV/AIDS is a incurable disease, and a preventable disease.
HIV causing AIDS is transmitted by (1) unsafe sex (sexual intercourses without condoms), (2)transfusion of blood without examination, (3) use of contaminated needles and injective equipments,and (4 ) transmission from an infected mother to her baby in pregnancy, during delivery andlactation.
●
２． Everyone, including children, faces the danger of HIV/AIDS.
Everyone needs information and education on HIV/AIDS as well as access to condoms to preventfrom HIV/AIDS infection.
●
３． If you have a possibility of the HIV infection, you should contact either medical workers or a
HIV/AIDS center to have private counseling and examinations.
●４． The chance of the HIV infection through sexual intercourse can be reduced by the following
ways:(1) not performing sexual intercourses, (2) reducing the number of sexual partners, (3) keeping thesame sexual uninfected partner, (4) performing safe sex (consistent use of condoms can prevent
HIV and save lives. ).
●５． Girls are especially vulnerable to HIV infection and need support to avoid any unwanted sexualintercourses and unsafe sex.
●
６．Parents and teachers can support youth for prevention of HIV/AIDS.
Parents and teachers can teach how to avoid sickness and stop spreading it.

Teaching

appropriate usage of male and female condoms is one example.
●
７．HIV is transmitted from an infected mother to her baby in pregnancy, during delivery andlactation.
If a pregnant woman or new mother might be infected with HIV infection, she should consult
licensed medical workers for counseling and examinations.
●
８． HIV can be transmitted by using contaminated needles and injective equipments. Using usedrazor blades, knives, equipment, which cut or pierce the skin, have a danger of the HIV prevalence.
●
９． People with sexually transmitted diseases are more likely to be infected by HIV and more likely
to transmit HIV to others. Those who have sexually transmitted diseases should receive treatment
immediately as well as avoid sexual intercourse or have safe sexual relations (sexual relations
without sexual intercourse or sexual intercourse with condoms).

16Life Skills Application to HIV/AIDS
Characteristics of a life skill [1]Examples of Life Skills
at the Individual Level[2]Decision making

It helps to make constructive decision
about daily life

Discuss and decide how to help friends
who cannot come to school because
they take care of HIV infected parents.

Problem solving

It enables to cope with problems in their
daily life positively.

One senior boy’s group yelled at a girland threatened her. She thought about
how to deal with the same situation in

It enables to analyze information andexperiences objectively.

When a girl was walking alone, astranger offered her a ride. She thought
this was dangerous and declined it.

It enables to think of several possibilities
for problems and to make simulation
Creative thinking before making a decision and finding asolution.

HIV-positive boys carefully think
about their job options and consider
what they should do to gain jobs in the
future.

It helps to express themselves with either
words or attitude, considering thebackground of the situation.

A child is afraid that her uncle is HIV
positive. She was able to discuss her
fear with her parents and brother.

It helps to communicate with others in apreferable way.

A friend asked me to go to a nightclub
and drink there on the weekend.
Although I knew that she would teaseme if I declined it, I said “no”.

It helps people to know about themselves,
their own personal character, own strong
and weak points, desire and dislike.

Girls recognize their sexual desire andare afraid that they cannot makerational decisions. This kind ofrecognition helps them avoid thedanger of unsafe sexual relations.

It enables people to understand and shareother person ’ s feelings, even when they
have completely different lifestyle fromtheirs.

Children’s groups think about how tohelp HIV/AIDS orphans.

Componentsof Life skill

Critical thinking

Communication

Interpersonal

Self-awarenessEmpathy

Helps to identify the causes of stress indaily life, to find out its influence and to
Managing Stress control it.

and Feelings

A girl learns how to deal with anger
against her father who sexually abuses
her. Children in similar situations share
their experiences and deal with theirpain. They set their goals to live
positively.

[1] “WHO Life Skill Education Program” WHO (1997), translation by Tetsuro Kawabata, et al.,Taishukan Publishing Co., Ltd. p.13-15[2]based on Hanbury & Carnegie 2005, p.31

This table shows examples of life skills at the individual level. However, we have to notethat relationships with adults, those of the same generation as the individual, and local
communities do affect the behavior of the person. Moreover, we cannot think in the same
way about societies where there is strong individualism and societies with strong
collectivism.

17

“Child-to-Child” Approach■ Health Education with participation by Children
Participatory approaches are desirable for health education in order for children to attainknowledge, attitudes to live healthily, and life skills.

For instance, children are able toexperience “central players” on HIV/AIDS by simulations through games and role-plays.
Proactive behavioral change for children is expected.

■Children are “Change Agents”
Among participatory approaches to health education, the “Child-to-Child” approach especiallyattracts attention. This is suggested by education and health specialists who monitored the role ofchildren as change agents in 1979, the International Year of the Child.

At that time, they

expected to improve care of younger brothers and sister by elder children. However, it was
found out that elder children can change the behavior of not only younger children but also theirpeers in the same age group.

Moreover, they can also impact their parents, relatives andcommunities.

■ Attainment of Skills by Participation and Involvement of Families and Communities
As the idea of the “Child-to-Child” approach is developed, children as “change agents” areexpected to educationally impact not only younger children but also larger groups of people.
Education here is different from traditional health education in schools.

The “Child-to-Child” approach expects children’s participation at the stages of planning
activities. And they relate what they learn to what they face in practice.
their families and communities to solve

certain problems.

Then, they encourage

This helps children have more

knowledge about the problems and attain life skills through the proactive learning process（Hanbury & Carnegie 2005）. These “Child-to-Child” activities are not limited in terms of time.
They are continuous. These activities are followed with involving families and communities
outside the schools.

18

To practice the “Child-to-Child” approach, a model consisting of six steps is suggested.
Each step will be done by intercommunicating learning area (e.g. schools, health centers)
and living areas (e.g. villages, towns). In each step, different life skills will be attained（Child-to-Child Trust 2005）.

Six Steps of the “Child-to-Child” Approach
Step 1

Choose one health issue with high preference and understand it well.
→ Creative Thinking, Decision Making, Communication,
Problem Solving

Step 2

Research how the problem impacts your family and community.
→ Communication, Creative Thinking, Empathy

Step 3

Discuss what you learn after the research, and plan what you can do (either individual
or collective actions).
→ Communication, Decision Making, Creative Thinking

Step 4

Get into Action.
→ Communication, Interpersonal Relations, Problem Solving

Step 5

Discuss your actions and think about whether they are effective.
→ Critical Thinking, Dealing with Stress

Step 6

Learn lessons from the experiences, and consider more effective ways for next time.
→ Problem Solving, Decision Making, Communication

19

For Behavioral Change
Adding skills to knowledge and attitudes often leads to behavioral
change.

However, the cultural and social environment, the power

structure and emotions of the individual sometimes make behavioral
change difficult.
In order to awaken people and deepen their understanding, we have to
use games and role plays, train peer educators, and increase theirmotivation.
When children do presentations, they can encourage parents tounderstand life skills and strengthen their knowledge and attitudes.
Moreover, children can march in demonstrations on AIDS Day as an
advocacy activity in a community.
In addition, communities need to know how positive People Living
With HIV/AIDS (PLWHA) are in their life.

One good example is

HIV/AIDS learning sessions with PLWHA as instructors or speakers.

Example of Participatory HIV/AIDS education for Youth

ASIA.
ininAsia

Youth learn how to use condoms andcheck
Youth group doing self-assessment

theirunderstandingof

HIV/AIDS with their friends.

on AIDS competence, Thailand
photo：SHARE(Service for Health in Asian & African Regions)20

５．Practice of the “Child-to-Child” approach needs partnership between
education and health sectors.
“The Millennium Development Goals,” which international society aims to achieve by 2014,
includes both international education and health.

The international education goal has two targets: (1) achievement of universal primaryeducation (Goal 2), and (2) promotion of gender equality and empowerment of women(elimination of gender disparity in education) (Goal 3).
The international health goal has four targets: (1) reduction of child mortality (Target 4),(2) improvement of maternal health (Goal 5), (3) combat against HIV/AIDS, malaria andother diseases (Goal 6), and (4) sustainable access to safe drinking water (Goal 7, Target 10).

FRESH established by several international organizations and health education placed
within FRESH show a common direction in international policies at the global level.
Moreover, life skills developed from discussions on EFA play an important role to connect
international education to international health.

How do these global movements translate into local movements?
As the FRESH approach, it is essential to develop relationships between the education andhealth sectors for promoting health education.

Partnerships between the Ministry of

Education and the Ministry of Health at the national level and partnerships between teachersand medical health workers are also important. The significant challenge is to incorporate
the education and health sectors in the framework of aid coordination in each country.
Efforts to localize the “Global Initiative on Education and HIV/AIDS” are needed.

As for the content of education, educational specialists and health specialists need todevelop partnerships between the education and health sectors, then search for how to utilize
the “Facts for Life,” which standardize knowledge to deliver. The content of education
should be not only transmission of knowledge, but also encouragement for children to haveattitudes about how to live healthily.

And it is also important to consider the culture ofeach region and country.

It is difficult to change children’s behavior.

Based on past experiences, the participatory“Child-to-Child” approach is regarded as an effective method.

For practicing this,partnerships between teachers and medical health workers need to be strengthened.
Striving towards the global international development goals, international society has tomake an effort to empower children at the local level, as well as strengthen capacities ofteachers and medical health workers.

21

Part2 The Possibilities
HIV/AIDS education as Life Skills Education

1. Keys to Effective HIV/AIDS Measures: Participation and Cooperation

Before thinking about HIV/AIDS education, this section first briefly examines
HIV/AIDS measures.
Four HIV/AIDS measures are currently taken: advocacy including campaigns for
HIV/AIDS prevention, voluntary examination, treatment and care.

1-1. Three Points for Effective HIV/AIDS Measures Learned from
Policies
The following three points are important for effective HIV/AIDS measures based ongood practices from different countries.

● Leadership by Governments .
When HIV/AIDS is regarded as an issue only for people with HIV/AIDS, proper
knowledge and information cannot be transferred and that will cause discrimination andprejudice against people with HIV/AIDS. This may result in the breakdown of society as awhole.

Therefore, it is important to recognize HIV/AIDS issues as a national challenge

and to form new policies. In Uganda, the government took initiatives to solve problems
on HIV/AIDS, worked on them, and had consistent policies. This led to the reduction of theinfection rate of HIV/AIDS.
Political involvement is necessary, especially for removing discrimination and prejudiceagainst people with HIV/AIDS, and for maintaining an environment to fight against the
problem in the whole society.

●Participation of those with HIV/AIDS and others around them
HIV/AIDS issues are related not only to the central parties (people with HIV/AIDS), butalso various people around them, including their families, schools, medical institutions,communities, religious associations, governments and companies. Through the involvementof various people, social and comprehensive HIV/AIDS policies can be formed.

22

The most important thing is the involvement of people with HIV/AIDS as main actors in
the planning of policies and advocacy for prevention.
This situation is the same with children with HIV/AIDS.
know and suggestions from children are valuable.

Children have the right toMoreover, it is expected that children

encourage other children (“Child-to-Child” approach).
t is pointed out that involvement by people with HIV/AIDS leads to their zest for life andmotivation, as well as avoids loneliness through the increaseof contacts in society.

● Cooperation of Each Activity
Activities for “prevention and advocacy”, “voluntary counseling and testing”,“treatments” and “support for care” cannot be carried out separately.

They needcomprehensive practices with the involvement of each activity.
For instance, through advocacy, although many people recognize the importance ofvoluntary examination, they would not take an examination if they had ies about thefacilities and skills of examination. However, if the skills and facilities are of good quality,
more people will undergo examinations.
In a society where advocacy on HIV/AIDS is not enough and the community has
prejudices and discrimination, people with HIV/AIDS cannot express themselves.

Inthese cases, it is difficult for them to have support from care services even if the services
are organized well.

Important Points for the Practice of HIV/AIDS Policies●Leadership by Governments●Participation of Various Parties●Cooperation ofEach Activity

Voluntary

Prevention and
AdvocacyCounseling and Testing

Treatments

Care and Support(VCT)

Life Skills Education: knowledge affecting attitudes, attainmentof skills, and translating into action
Practicable in various situations (at schools, communities, hospitals, etc. )Important Points for Practice◆Attainment of Skills Matching Situations,◆ Involvement of Various Concerned People◆ Cooperation of Education and Medical Health

23

1-2.

Life Skills education is necessary and can be utilized
in all phases, from prevention to treatment.

For the effective processes of prevention, advocacy, treatment and care, various
concerned people and specialists have to attain appropriate knowledge and special skills. In
addition, they also need to have attitudes to face HIV/AIDS issues, appropriate
interpersonal skills, and self-management skills.

Life skills education lets people have these skills and knowledge in various situations for
HIV/AIDS measures. Schools, international NGOs, local NGOs, community organizations
and medical institutions are expected to be leaders for life skills education. To practicelife skills education, partnerships and coordination between the education and healthadministration offices are essential.

1-3.

Three Keywords for Life Skills Education on HIV/AIDS

In addition to the above-mentioned points, the following three points are key to thepractice of life skills education.

1 Involvement of Various Concerned

People with HIV/AIDS, Families, Schools, Hospitals,

PeopleCommunity Organizations, NGOs, Governments
Moreover, participation of those who produce

educational materials, specialists and artists encourages people to become involved in life
skills education.
Collaboration of voluntary testing, treatment, and2

Cooperation of Education andMedical Health3

Attainment of Skills Matching

Situations

support for care and HIV/AIDS education based on
its results and challenges

Attainment of skills matching various activities for
HIV/AIDS measures●In advocacy for prevention, not only appropriate HIV/AIDS knowledge, but appropriate
attitudes are important.
●In order for people (with HIV/AIDS) to come for voluntary testing, not only a good
medical environment of medical institutions and health administrative offices, but
consideration of people with HIV/AIDS and safe system for them are essential.
●In support for care, it is necessary to learn how to behave in the same class as people
with HIV/AIDS●When someone is orphaned in a community, it is necessary to share concrete skills,
knowledge and attitudes to live with him/her in the community.

24

2．The Possibilities of HIV/AIDS Education

Teachers, children and community neighbors are all people concerned about HIV/AIDS
issues. Through life skills education, what kind of results and challenges does each actor
bring? What about governments and NGOs?

This section will examine each possibility

and challenge.

OutsideChildrenof school
SchoolCommunity

Teachers

Governments

2-1.

NGOs

Expectations for Teachers■Appropriate Attitudes about HIV/AIDS Issues that Teachers Should Attain
In order for children to learn about HIV/AIDS as life skills, teachers need to haveappropriate attitude on HIV/AIDS issues.
Otherwise, children would learn only superficial knowledge and classes would be basedon the discrimination and prejudice of teachers. This would result in the possibility thatchildren would not attain any understanding or attitudes regarding HIV/AIDS issues.
However, HIV/AIDS education was very recently placed in the educational policy andmany teachers do not undertake teaching methods for HIV/AIDS education in the teacher
training process.
Therefore, it is important for teachers to attain a consciousness of and teaching methods
for the importance of children’s life skills.

Desired Abilities
in Teachers
To teach children the appropriate social HIV/AIDS issues●Understanding of customs, rules, sexual attitudes, social relations (including
discrimination), and gender relations in the community● Ability to plan lessons based on social environment and children’s
understanding25

①Expectation of Teachers with Accurate Knowledge about HIV/AIDS
HIV/AIDS education is a new area for teachers. They can teach without any problems
by attaining biological knowledge on HIV/AIDS and understanding problems of
unsupported myths.
Teachers can objectively see prejudice against people with HIV/AIDS by understandingsocial and regional situations and human and children’s rights.
Therefore, the improvement of teachers’ life skills will also lead to the improvement ofchildren’s life skills.

◆Challenges
Examples of obstacles to practicing appropriate HIV/AIDS education at school:●The teacher is also a religious leader in the community and HIV/AIDS issues at school
are completely different from what he/she teaches based on religious beliefs.
●The teacher strongly believe that teaching sexuality will encourage children to havesexual intercourse.
●Influential parents are against teaching sexuality to children and give the teacher pressure.
The teacher is afraid of receiving pressure from them.
●The teachers is afraid of practicing HIV/AIDS education because of community norms
on HIV/AIDS issues.

②Expectation of Teachers with Appropriate Attitude and “Mainstreaming”
of HIV/AIDS
Attaining teaching attitudes about human and children’s rights and coexistence helps
teachers avoid superficial teaching and discriminatory lessons about HIV/AIDS. This is
expected for children to improve their life skills.
Moreover, in the situation where many children drop out of school, the “mainstreaming”
of HIV/AIDS is important for all children to learn HIV/AIDS education. This is because“mainstreaming” of HIV/AIDS does not limit grades, subjects and lessons, and deals withvarious aspects of HIV/AIDS issues. Kenya is one successful example of mainstreaming
HIV/AIDS education as a policy.

◆Challenges
The following are examples of obstacles to practices of HIV/AIDS education, even if
teachers attain appropriate attitudes and t HIV/AIDS education is mainstreamed.
●Parents are negative about HIV/AIDS education and sex education.
●The community has a strongly-rooted prejudice against HIV/AIDS.
●The school principal is negative about HIV/AIDS education.

26

③The Possibility of Lessons about the “Child-to-Child” Approach
Peer education (whereby children teach each other) can lead to behavioral change ofchildren through activities of their own.
Moreover, adoption of child-centered teaching helps students understand and creates anenvironment for children to ask questions comfortably.

◆Challenges● Peer education can be limited for lower grade children since peer pressure (pressure
among children) is not so strong yet.
●If training of peer educators fail, peer activities do now work well. Moreover, even if
peer education works well at school, its activities tend to deteriorate after thegraduation of the core peer educators.
●Peer education does not work well in a society tolerant about adults’ sexual abuses
against children.
●Teachers may only focus on child-centered teaching and forget about the content.

④The Possibility of “Teacher-to-Child” Lessons
Children can attain appropriate knowledge and bases of peer education.
Teachers can teach community problems and human rights education in relation to
HIV/AIDS education at school , which are harder issues for children to deal with.

◆Challenges● When school education cannot deal with condoms in government policy, teachers
cannot teach appropriate knowledge on protection for children.
●“Teacher-to-Child” lessons are difficult to practice when they are set apart from thecurrent situation of t society. For instance, although girls would learn to refuse
unwanted sexual intercourses as a right, they cannot say, “No.”. Another example iswhen a society has customs whereby women cannot refuse men, and children cannot
refuse adults.

● When an influential principal does not allow HIV/AIDS education at school,
HIV/AIDS education from teachers to students is difficult to practice. (Peereducation is also difficult in this situation.)27

2−2． Expectations for ChildrenChildren are important actors in spreading messages and desirable behaviors to theirfriends, siblings and parents, not only now, but also in the future, when they become adults（UNICEF 2005）.

The following points are important in nurturing these important actors■Realize desirable behaviors
In order to realize desirable behaviors, people need to understand them properly and havemotivations to attain these behaviors.

To do this, it is effective to show a concrete model.

One practical example in textbooks is the invitation by an adult male on the way to or
home from school. In this case, the desirable action is to decline the invitation.

However,the following two points are necessary.
① To know the words for declining. (“No thank you,” “I need to go. I have something
to do.”)② To understand these words and how to say and use them.
To practice the two points above, it is important to show how:
① Teach the words for declining.
② Have the children actually say and use these words in role plays etc. (interactive
learning)
Children can change these words and attitudes to fit their situation.

Knowledge from messages, including emotions, attitudes and social values, changes
consciousness and behavior.

For instance, in order to decline an invitation, in some places,

ignorance is the most effective way, but elsewhere, ignorance is the rudest way. It is
important to behave desirably, matching the cultural and social background in the area.
The following are important points for appropriate behavior:
・What is the easiest way for children to make themselves understood with their words,
way of saying them and attitudes?
・What way will avoid a negative reaction from adults?

What kind of attitude or

response is expected from adults?

Adults need to suggest appropriate behavior for children by exchanging opinions withthem through interactive learning. The appropriate behavior resulting from this process
conveys the message to the children of what behavior is desirable.

Depending on age, gender, group size, literacy level, understanding ability and languagesof the targeted children, it is important to choose the right words, structure and content for
their messages to be efficient.

28

■Home is a good place for reaffirmation of what one has learned.
Home is the first place for children to practice what they have learned at school. Talking
about what they learned with parents and siblings becomes a reaffirmation for children.
Moreover, sharing with reliable others encourages children to attain desirable behaviors.
On the other hand, some families cannot discuss these things openly. One researchstudy says that these cases often depend on the attitude of the adults （Child to Child Trust,2005）.
■Promotion of Parentsʼ Understanding about HIV/AIDS
Practice of HIV/AIDS education at school highly depends on whether parents understandand support it. The actual behavior for infection and prevention of HIV/AIDS will beattained by support from families and communities （UNICEF, 2005）.

■Start HIV/AIDS Education in the Early School Years.
In order to spread knowledge to more community neighbors, it is desirable tostart HIV/AIDS education in the early school years （ActionAid, 2003）. In
addition to the attainment of skills for children, improvement of the environment
to practice such skills is also important for learning behaviors.
Lessons on HIV/AIDS■Utilize teaching materials and supplementary materials that are appealing

Education at Primary

to five senses.

School (Uganda)

In order for children to understand the meaning of the messages properly, creativity inteaching, such as in making materials appealing to five senses including eyesight isimportant. It is essential to reflect the daily lives of children and to regard the HIV/AIDS
issues as familiar problems by showing a “model” for practical applications.

Furthermore, games and role plays are utilized for promotion of realization
and understanding which lead to behavioral change.
manuals for these participatory activities.

There are many

Please refer to them.

■Promote learning among peer groups.
Learning among peer groups of the same gender and same age is effective forbehavioral change （ActionAid, 2003）.

This helps children learn what their groups wantto know and discuss issues openly in equal relationships. This also promotes the sharing
clarification, and removal of problems and challenges. To do so, training of students
taking the lead (peer educators) is essential.

■Improvement of environment to practice what one has learned
Involvements of communities effectively and sustainably change behaviors （ActionAid,
2003）.

It is essential that messages from teachers who are trusted by communities,

religious leaders and community leaders are consistent.
In a community with customs and culture against desirable behavior for HIV/AIDS, it is29necessary to form workshops with communities in considering specific situations in thearea, practice advocacy activities and form systems to collect information .
Effective advocacy for families without children is possible by giving them chances tocollect information. It is desirable that adults (teachers etc.) in communities play a rolemodel as messengers for children.

①Expectations from Attaining Accurate Knowledge about HIV/AIDS●Deep understanding about infection routes and prevention●Sharing information by children who have learned at school with parents, siblings andcommunities encourage people to have accurate knowledge.
●Accurate knowledge motivates the attainment of behavior for prevention against the
HIV infection●Sharing motivations with others helps people to form peer groups for leaning about
HIV/AIDS.

Although children do not listen to theirparents, they are sensitive about theirpeer’s words and actions.

◆Challenges●Knowledge about HIV/AIDS stays only temporarily and is not utilized effectively.
●Children should be a source of accurate knowledge. However, the level of understanding,maturity of children, as well as level of understanding of parents and siblings, prevent the
spread of accurate knowledge.
●In a society where it is difficult for children to express themselves,parents and adults do not take their comments seriously.
●Knowledge that is taught falls behind the rapid development of medical skills andtreatments.

30

②The Possibility of Children’s Behavioral Changes
Through the messages, including emotions, attitudes and social values, new knowledgechanges consciousness and forms motivations to behave effectively for prevention against
HIV infections.
These motivations promote the reduction of dangerous behavior, which cause HIV
infection, and the avoidance of infection.
This is the reconstruction of personal relationships, which means that people need tojudge various issues in their daily lives and express themselves to others. As a result, people
attain life skills and methods of communication matching situations and places.
These experiences help people become confident and active.

By sharing messages, including emotions, attitudes and social values with others, more
people are interested in HIV/AIDS and form study groups.

Merging the messages andknowledge changes people’s consciousness and motivates people to attain efficient
behavior for t HIV prevention.
Moreover, the forming and sharing of new messages for different age groups encourage
more people to become interested in HIV/AIDS issues and communicate actively.

This

also prevents wrong understanding and knowledge about HIV/AIDS and reduces
discrimination and prejudice.

◆Challenges●Knowledge may last only temporarily and may be not utilized effectively. This willlead to unexpected behavior or problems.
●HIV/AIDS issues are not regarded as their own problems due to social customs (othersocial influences, wrong information).
●HIV/AIDS issues are ignored in a society where children and women cannot express
themselves freely.
●Even if people attain and practice life skills, the community does not understand themand prevents people from practicing the life skills.

31

2-3.

Community―Expectations for Parents and Communities■Community with Contradictory Information
In some communities, people are confused due to contradictory information.

For instance, the following two types of information are spread in Kenya: “Condoms are
effective for prevention against HIV/AIDS,” and “Condoms are meaningless since an HIV
virus is smaller than the density of a condom skin.”Wrong information or myths are believed in some communities. For instance,“HIV/AIDS was made for destructing the African people.”Moreover, people sometimes

only know that HIV/AIDS is transmitted by sexual intercourses, and they do not know
other dangerous behavior that can cause HIV/AIDS infections.

Moreover, due to the understanding of HIV infections only through “immoral” sexualintercourses some people believe that people with HIV/AIDS have immoral behavior.
Also, some people believe that HIV/AIDS can be transmitted in any way, so people try to
remove HIV/AIDS-related people in the society.

■Creating opportunities for people in the community to attain accurate knowledge on
HIV/AIDS
In order for people in the community to attain standard biological knowledge on
HIV/AIDS, creating lessons outside of school is an effective way.

However, there is no guarantee that the community as a whole changes their behavior.
Therefore, it is important to have opportunities to talk about how to teach children about
HIV/AIDS and how to protect children from HIV/AIDS in the community.

32

Potential after Adults come to Understand HIV/AIDS

By attaining accurate knowledge about HIV/AIDS, adults can protect themselves and theirchildren from HIV/AIDS and learn attitudes for living together with people with HIV/AIDS.
Also, it promotes change in the attitudes of adults. For instance, adults can discuss
HIV/AIDS at home and in the community and protect children from HIV/AIDS.

It is possible for adults to teach outside of schools things that school cannot offer. For
instance, in a country where condoms as a method of the HIV prevention cannot be taught
at school, parents and the community can teach them this outside of schools.

Moreover,through discussions between the community and teachers, it is expected that the practiceand quality of HIV/AIDS education will be accepted in the community.

These are important points for children to attain appropriate life skills. Moreover, theygive opportunities to reaffirm the importance of education within the family and community,
which have not been recently evaluated.

◆Challenges
In order to tackle the completed HIV/AIDS issues by communities, it is essential for thecommunity to have consensus.

To do this, a high consciousness about HIV/AIDS issues

in the community is important.

2-4. Expectations for Partnerships between Government and NGOs
Involvement of the government in HIV/AIDS issues is very important for sustaining
HIV/AIDS education and preventing the limiting of HIV/AIDS issues to individual
problems.

When NGOs promote HIV/AIDS education as life skills education,

partnerships between them and government are essential.

■General Administration
Expectation for Advocacy to Citizens
I t is expected that wrong beliefs and the delivery of distorted information in society will becorrected through standard information from public officers and official bulletins throughpublic policy.
Partnerships between the government and NGOs help them avoid redundant training
activities in the same area.
If NGOs support the governmental policy on the HIV/AIDS education, the sustainabilityof HIV/AIDS education is expected.

33

◆Challenges
Since it is difficult to give HIV/AIDS education to frontline officials, there is thepossibility that the content of HIV/AIDS advocacy is superficial and that simple slogans are
just repeated.
When officials superficially understand HIV/AIDS issues, or they are strongly affectedby wrong beliefs or distorted information, HIV/AIDS education for officials is required
before partnerships are made.

■Educational Administration
Expectations for the Introduction of HIV/AIDS Education to School Curriculum
Guidelines
By placing HIV/AIDS education as a method of improving life skills in the school
curriculum guidelines, HIV/AIDS education is promoted.
At the same time, this idea helps outside aid agencies such as NGOs gain at least
superficial agreements from the concerned people.

◆Challenges
Even if HIV/AIDS education is included in school curriculum guidelines, challenges
regarding its daily practice in schools still remain, such as

the production and spread of

appropriate textbooks and training of teaching methods to teachers.
Teachers officially say that they teach HIV/AIDS education for the improvement of life
skills. However, there are possibilities that they do not teach it due to various obstacles orteach it only superficially.

It is difficult to check the actual situation in schools.

Also, when there is a lack of teachers and a large number of students per class, practicesof HIV/AIDS education leading to the improvement of life skills is difficult.

■Health Administration
In caring for people with HIV/AIDS, medical examinations and appropriate treatments
are necessary as with other diseases.
However, HIV/AIDS is often perceived as a special disease due to prejudices anddiscrimination against its infection routes and symptoms after its outset. These lead to
new forms of discrimination.

Generally, advocacy activities on HIV/AIDS are the responsibility of the Ministry of
Education because these activities are done in schools. However, HIV infection tests andtreatments are the responsibility of other sectors （ActionAid, 2003）. Therefore, even if
many people find out about their infection through advocacy activities in schools, medical
systems for treatments as the next step are not well organized. This also causes wrong

34

perceptions about HIV/AIDS.
Rural areas in developing countries especially do not have enough medical systems evenfor many other prevalent diseases. Although there are many advocacy activities about
HIV infection and prevention in many places, there is a big gap between rural and city areas
regarding the structure of treatments and care for HIV/AIDS (Institute of Development
Economies 2005). Moreover, it is pointed out that there is a close relationship between
HIV infection, AIDS outset and poverty in rural areas (The Institute of Developing
Economies 2005). New social problems such as loss of working population and increaseof orphans are reported.

For effective HIV/AIDS measures, medical systems at the national level are essential.
At the same time, strategic expansion of cross-sectoral programs with the cooperation ofNGOs and civil organizations is needed.

Expectations for the Medical System
For activating HIV/AIDS measures at the regional and national levels, governments need tosupport Voluntary Counseling and Testing (VCT) and medical institutions financially, anddevelop systems for appropriate care in needy areas.

Moreover, governments need to promote the hiring medical staff, counselors and social
workers that match the needs of each area. Moreover, they need to promote collaboration
on HIV/AIDS among concerned organizations, such as ministries of education and social
affairs, and exchange personnel among them.

Governments also need to improve systems

for protection and management of personal information of people with HIV/AIDS and theirfamilies at the national level.

◆Challenges
In addition to dealing with other general diseases, planning only for HIV/AIDS within alimited budget is difficult.

This may cause uniform planning based on the central

government’s decisions in the center.

Rural areas face many challenges. For instance,

training appropriate medical staff is difficult in rural areas. Moreover, they do not haveenough financial budget for human resources, and there is no industrial infrastructure inrural areas.

35

Part3 PracticePart3-1

Preliminary Survey for Implementationof HIV/AIDS Education

Important Points of Survey for Understanding the Situation of Regions and Teachers
for Effective HIV/AIDS Education

We have seen, in Parts 1 and 2, that HIV/AIDS education with knowledge, attitudes and life
skills, including interpersonal skills, leads to high quality results.

In forming HIV/AIDS

education, understanding the situation of teachers, as those in positions of responsibility,
and communities is essential. This section first examines an example of a preliminary
survey on school health by an NGO.

1-1.

Before starting HIV/AIDS Education

Preliminary surveys are essential for avoiding whimsical speculations and useful forunderstanding the starting point situation and evaluating programs later.

Moreover,preliminary surveys are done with people in the community, so they can also play a role in
the preparation and orientation of the program.

People have expectations regarding surveys.

If a field survey is done broadly at an

uncertain stage of project implementation and the project ends up unimplemented, people
will feel betrayed.

This results in that implementers lose trust from people in thecommunity.

Therefore, surveys need to be carefully done, watching and talking with people in thecommunity while implementing other projects. This part examines a feasibility study in
Nuu Division, Mwingi District, Kenya by CanDo. The main researcher was Japanese andher assistant was Kenyan.

36

1-2.

Understanding the areaand seeking to enforce HIV/AIDS education
Schedule／Week
Steps of Survey

1

2

3

4

5

6

7

8

（Example of CanDo）
9

10

11

12

13

14

Literature Review, Data Collection
Preparation for Interviews
Completing Research Design
Determination of Methodologies for the Survey
Training of Research Assistants
Determination of the Research Questions
Interview Surveys - Preparation
Implementation
Surveys by Questionnaires - Preparation
Implementation
Analysis of the Results
Reporting

1．Literature Review and Data Collection
A review of literature, including governmental policies on education and health and data
regarding the country and project sites (statistics by governments and the United Nations).

2．Completing Research Designs
First, clarify the goal of the survey. At the stage of the feasibility survey, this example first
set two goals in considering school health broadly.

HIV/AIDS was a part of them.

(1). Clarify what situation the community is in, and what kind of knowledge, attitudes andunderstanding on health issues (including HIV/AIDS) the community has.
(2). Investigate how (1) above affects HIV/AIDS education in schools in rural areas, and seek ways
for strengthening HIV/AIDS education.

3．Determination of Methodologies for Survey
Surveys are classified into quantitative and qualitative surveys. Methodologies are two:interview and questionnaire. This example took (1) qualitative surveys by interviews, and(2) quantitative surveys by questionnaires with the presence of researchers.

37

15 〜〜 30

31

32

①Qualitative Surveys/Interviews●For Teachers: Group Interviews (5 primary schools, 30 respondents)●For Parents: Group Interviews (4 primary schools, about 100 respondents)●For Teachers; Interviews to Focus Groups (2 primary schools, 15 respondents)●For Education Officers: In-depth Interviews (2 respondents)●For Female Parents: In-depth Interviews about female genital mutilations (FGM)(1 primary school, 3 respondents) *(Numbers in the brackets show the number of respondents.)

PointsSurvey methods depend on survey content
and the situation of the field◆CanDo divided female and male parents for interview surveys in order for them tohonestly answer questions about sexuality. When the number of female teachers isextremely small, interviews were done with female and male teachers together.
◆CanDo determined whether or not to inform about the survey in advance depending on
the survey content.
◆ Interviews with teachers and education officers were done in English (English is one ofthe official languages in Kenya).

Interviews with parents were done in English andindigenous languages. The research assistant was from the targeted area.

Refer to “Questioning Route” p.40, 41 for survey components.

38

②Quantitative Surveys/ Questionnaires

CanDo conducted questionnaire surveys with teachers in all primary schools (28 schools) in
the Nuu Division.
The research team (composed of 2-3 people) visited primary schools, asked all teachers tofill in the questionnaire, and collected them.

The questionnaire surveys were conductedunder condition of anonymity in order for the respondents to answer honestly. When ateacher was absent or not able to leave class, the researcher left a questionnaire with thedirector to collect later. In this survey, researchers collected 167 answers from 202 teachers.
The collection rate was 82.7%.

PointsTo understand the situation more precisely

Conducting a survey
at school.

The reason why the research team visits schools is because they are able to understandthe teachers’ knowledge more precisely by watching how they answer the questionnaires.
Also, researchers are able to make sure that teachers answer the questionnaires without
consulting with their colleagues. This helps researchers understand the situation more
precisely.

On the other hand, there is another way by which researchers send questionnaires toschools; teachers answer the questionnaires in their free time and return them to theresearchers.

One must choose the best way after considering research goal, cost

(personnel, time, financial costs) and collection rates.

Refer research questions p.105 for the research contents

39

4．Determination of Questions① Qualitative Surveys/ Interviews
If a researcher prepares points of questions and questioning routes, he/she is able tocollect the right information through interviews.

On the other hand, when questions are

decided in too much detail, respondents are not able to answer freely.

This may result in

the respondentsʼ ideas reaching the researchers. CanDo conducted a semi-structured
survey and formed questioning routes.

Qualitative Survey <Focus Groups Group Interviews for Teachers>
Questioning RouteOpening Question“Please tell us about health problems in this area or school. Maybe you could begin bytelling us what the biggest health problems are for each of you.”↓
Introductory Questions“How do you deal with these health problems in this school?”“Could you explain about health education in this school? Do you have school curriculumon health education in any means?”↓
Transition Questions“In your opinion, what would you really say is of particular importance to you in healtheducation?”↓
Key Questions“What do you think of AIDS education in primary schools? Who should be involved in
AIDS education planning?”“Could you tell us anything you know about HIV/AIDS? (knowledge, situation in thecommunity) How did you get that information?”“What would you think is the biggest challenge for teachers to deal with AIDS issues?
Do you think the community members feel confident or comfortable in talking about
AIDS?”↓

40

↓Ending Questions“ Are there any other issues relating to AIDS in your school?”“Would you say that a workshop on AIDS could help you to deal with AIDS in yourclass?”“Feel free to tell us if there is anything you think we left out that we should talked
about”
Other questions
Access to materials on HIV/AIDS education

Refer to the

Expected support from the community when conducting AIDS education

appendix 1,

Teachers’ knowledge on AIDS and other health related issues

p.105 for the

Early marriages in the area

original

School-drop out in relation to early marriage

questions.

In-depth Interviews for Parents Questioning Route●General questions on health in the community“Could you tell us about health problems in this area?”“What are the challenges people that have in the area when they are sick?”“How do people treat their diseases? (Going to the hospital, Wanganga, traditional
medicine)”●HIV/AIDS related questions“What are the recurring sicknesses?”“What do people feel towards people who die of untreatable diseases?”“Could you tell us anything you know about untreatable diseases (AIDS) (infection,
cure, prevention, risky behavior)”?
“Do community members feel comfortable when talking about AIDS? What are the
obstacles to this, if any?”●FGM related issues“What is the average age of girls to get married in the community? Why? Are they

Refer to theforced or willing?”

appendix 2,“How are the girls prepared for marriage?”p.106 for the“Is there any traditional ritual for a girl to get married? If any, what and why?”

original
questions.

41

②Quantitative Surveys/ Questionnaires

Questionnaires allow you to collect many answers in a relatively short time andunderstand the community situation. The list of questions from the questionnaire by
CanDo is below.

< Questions from Questionnaire for Feasibility Study of
School Health Project in Nuu>
●Respondent Attributes
Gender, age, religion●Knowledge about HIV/AIDS
・Infection routes, difference between HIV and AIDS
・Information sources about HIV/AIDS●Practice of Health Education Activities
・Subjects in moral education class, percentage of health education inschool・Participation in workshops about health・Topics about health for workshops●Knowledge about HIV/AIDS
・Important traditions
・Knowledge about people with HIV/AIDS
・Vulnerability of children against sexually transmitted diseases andHIV infection
・Vulnerability of adults against sexually transmitted diseases andHIV infection

Refer to the appendix 3, p.107
for the original questions.

5．Preparation of Surveys
Gain permission from the district education officers and give schools documentary noticeabout the surveys.

6．Conducting Surveys
Conduct surveys based on the prepared questions.
Every time you record interviews, you need to gain permission from the respondents.

42

7． Analysis of results from the Survey
Results of the Qualitative Survey●Kenyan Government Policy for Health Education and Perception in Schools
・HIV/AIDS education by the Kenyan Government: Textbooks
・Mainstreaming HIV/AIDS education into academic subjects
・Challenges of HIV/AIDS education in classrooms: Lack of knowledge by teachers, Issues ofcondoms・Involvement of health officers in health education in schools: Gaps between their public stance andreality. (Although the government encourages health and education officers to manage events on
health education, they do not collaborate with each other.)●Health Problems
・Common health problems in the area: Malaria, Typhoid fever, skin infections, common colds,
diarrhea
・Treatment: Health facilities and traditional herbs
・Challenges when people are sick: long distance from health facilities, lack of financial resources topay fees, lack of information on diseases, and shortage or lack of medicine in health facilities,●HIV/AIDS
・Recognition and perception of HIV/AIDS in the community: a lack of sense of crises and accurate
knowledge on HIV/AIDS
・Information sources on HIV/AIDS: Village meetings, churches, radios, newspapers, handouts fromworkshops
・Myths and misinformation on HIV/AIDS: Relation to witchcraft, social taboos, immoral life styles
・Situation of HIV/AIDS: Perception of HIV/AIDS as a real threat・ Customs and sexual behavior in the community: Polygamy, early marriages, FGM, Kwate(women-women marriage)
・Activities on HIV/AIDS in the community：-Village meetings: Messages without explanation. ”We need to talk about HIV/AIDS.” “Usecondoms.”-Workshops by a Community Based Organizations-Seminars for teachers by the Education Office: Emphasis on integration of HIV/AIDS Education
into academic subjects-Challenges of seminars held in the Nuu Division: limited participants, accuracy of information,
and acceptance of information
・Perception of HIV/AIDS in the community and preventive action: apathy and a sense of crisis, nopreventive action by the community, environment in which condoms cannot be used, and doubts
about effectiveness of condoms●Health Education and HIV/AIDS Education in Schools
・Understanding the necessity of this education, and desire for workshops by NGOs.

43

Four Challenges
about the Communityand HIV/AIDS Education

１．Absolute lack of knowledge on HIV/AIDS including preventive measures
２．Serious lack of participation in seminars and workshops by males
３．Traditions and customs encouraging spread of HIV/AIDS: difficulty of interventions byoutsiders to stop these practices
４．Limitation of school education on HIV/AIDS: necessity of involvement by parents and thecommunity in HIV/AIDS education

Results of the Quantitative Surveys
・The more accurate knowledge teachers have, the more often health education ispracticed in schools.
・Teachers who practice health education in schools tend to regard sexual transmitted diseases
and HIV/AIS as immoral diseases.
・Teachers who notice vulnerability of children to sexual transmitted diseases and HIV/AIDS also
tend to notice vulnerability of adults. However, vulnerability of adults is normally seen as
stronger than vulnerability of children.
・Teachers who notice vulnerability of adults to sexual transmitted diseases and HIV/AIDS tend to
be positive about working with people with HIV/AIDS.
・Teachers who notice vulnerability of adults and children to sexual transmitted diseases and
HIV/AIDS tend to be positive about telling children about condoms.
・Teachers who think that condoms are effective for HIV prevention tend to think children need tohave knowledge about condoms.
・Teachers who have accurate knowledge about HIV/AIDS tend to be highly concerned withvulnerability of adults and children to sexual transmitted disease and HIV/AIDS.
・There is no relationship between participation in workshops and knowledge and perception of
HIV/AIDS

Findings about Teachers related to
HIV/AIDS

44

１． Teachers do not have enough accurate knowledge about HIV/AIDS
２．Teachers do not have enough opportunities to gain information and knowledge
about HIV/AIDS
３ ． Teachersʼ perception of HIV/AIDS depends on knowledge about condoms,
HIV/AIDS, and vulnerability of people with HIV/AIDS.
However, Christians do not necessarily have little knowledge about HIV/AIDS.

1-3.

Strengthening HIV/AIDS Education

The analysis of the survey resulted in the following points for feasibility of HIV/AIDS
activities. Roles of the community and teachers and the importance of their coordination
are indicated. Moreover, life skills education is a necessity to gaining knowledge, as well
as overcoming traditional perceptions and customs.

While encouraging males to be involved in HIV/AIDS

Outsideactivities, the provision of accurate information is important.

of school

Children

Parents and teachers should hold workshops on HIV/AIDS
in schools.

Community

SchoolTeachers play an important role in giving children knowledge
about HIV/AIDS. Trainings workshops for teachers to plan

Agreement

the health education, including HIV/AIDS, is needed.
Teachers need to gain knowledge about HIV/AIDS.

Cooperation of parents for HIV/AIDS education for children is essential.

It isimportant for parents and teachers to discuss sexually transmitted diseases and
HIV/AIDS and agree on what to teach.

45

Teachers

Part3 PracticePart3-2

Life Skills for HIV/AIDS Educationin Primary Schools

Points and Approaches for Attitudes and Actions against HIV/AIDS

1．Practices for Appropriate and Effective HIV/AIDS Education

Practices of HIV/AIDS education in primary schools face various obstacles. Even if
the strucure is nationally formed, practices may be difficult due to social and cultural
factors, as well as a lack of knowledge and the perceptions of teachers and directors.
Moroever, even if HIV/AIDS education is conducted, children cannot gain appropriate
knowledge, attitudes and actions witout teachers’ approapriate knowledge and attitudes.
The survey also revealed that community participation and cooperation are essential.
In this situation, life skills play an important role for practicing appropriate HIV/AIDS
education. Part 3-2 suggests important points, including approaches of life skills, byusing the example of the preliminary survey in Part 3-1.

Group discussion among teachers from various schools within the district
The woman standing is a facilitator and monitors the discussion.

46

＜HIV/AIDS Education Project ‒ an example of a project by CanDO＞●For Appropriate Practice of HIV/AIDS Education in Primary Schools
The following four activities were implemented.
Teacher Training
Training for teachers was implemented in order for them to practice HIV/AIDS
education in class.
After the training, teachers practiced HIV/AIDS education in their schools.

Open Class
Teachers presented what they learned from the training.

At the same time,other teachers leaned from them, and untrained teachers were also motivatedto practice HIV/AIDS education.

Child Presentation Day (CPD)Children presented what they learned in class.
This ensured the actual practice of the HIV/AIDS education in schools.
Their parents also participated in CPD and were also expected to gain knowledge
about HIV/AIDS.

Parent Meetings
Teachers and parents discussed what they should do to protect children.
●To Encourage the Community to Face HIV/AIDS Issues
AIDS Learning Workshop
CanDo gave the community knowledge about HIV/AIDS in primary schools and discussedchanges in adult sexual behavior with the community.

This project was implemented in the Nuu division, Mwingi district, Kenya. The AIDS learning
workshops were first started in 2004. In 2005, teacher training sessions, open classes, CPD at
the school cluster level and stakeholders meetings were held in all 28 primary schools in the
district. In 2006, CanDo selected highly motivated schools and conducted teacher training,open classes, CPD and parent meetings only in these schools.

47

2．HIV/AIDS Education in Primary Schools,
and Parent Participation and Involvement
2-1. Teacher Training【Goal: To Practice lessons for the improvement of life skills】
In Kenya, the syllabus was renewed and HIV/AIDS education mainstreamed into eachsubject.

The rules for HIV/AIDS education in classes were officially set.

However, the preliminary survey revealed that many teachers do not have enough basic
What

is

mainstreaming

theknowledge, perception and understanding about HIV/AIDS to teach students; they do notofhave any opportunity to gain teaching methods.

HIV/AIDS

Therefore, teacher training aims not only to tell students about superficial knowledge, but

Education?

to also improve the life skills of students in order for them to live with people affected by
HIV/AIDS at different levels, including prevention.

To

deal

with

Improvement of Desired Life Skills

HIV/AIDS education

Children are able to prevent HIV infection

not within a certain
academicand live with people affected by HIV/AIDS.

year,

subject, or unit, but
in various academic
years, subjects andunits, depending on【Preparation/Planning Details】
Project coordinators and education and health consultants, who teach in the training

understanding

session, shared goals and important points of the project based on situation analysis andlevel of the children.

experiences. Throughout the discussion, they planned details of the project. For instance,Inthe following points were discussed.

the

these

lessons,children are able tolearn holistically and★ Scientific knowledge helps teachers gain confidence and noticerepeatedly

discrimination and prejudice

about

HIV/AIDS issues.

Observations revealed that teachers were not able to do lessons with confidence since
they did not have enough knowledge.

Teachers were not able to answer students’questions or told students the wrong information.
Teachers need to have not only partial knowledge, such as infection routes, but also
knowledge based on scientific facts. This helps them answer various questions precisely.
With broader knowledge, the anxiety of teachers can be decreased; their motivations are
increased.

Moreover, scientific knowledge helps teachers notice discrimination andprejudice.
Although teachers are more interested in the infection routes and AIDS symptoms, it isimportant to have knowledge of symptoms before the onset of AIDS.
◆Decide the Content of Trainings◆
In addition to scientific knowledge, understanding of children and human rights need to48

be considered.

Sexual abuse of children and discrimination against people with

HIV/AIDS in the community also need to be analyzed. Practices of planning lessons
based on syllabus, mock lessons in groups, and methods of open lessons are included in thecontent.

★Discuss aims to deal with knowledge
Related to the stages of HIV/AIDS, as well as care and support, preclinical people withHIV need to be considered. It is important for learning that infection does not equal todeath.

Also, it must be known that care and support for preclinical people with HIV are

not only physical but psychological.
In training sessions, some people may say, “Care and support cannot be given to people
without any symptoms,” or “It is important to know the infection status (HIV positive or
negative).” At the stage of AIDS onset, people with HIV/AIDS are not always visible fromthe outside. Therefore, before knowing whether they are HIV positive or not, rumors
spread; people with HIV/AIDS are discriminated.
One of the aims of dealing with knowledge is to discuss how participants think with theknowledge attained.

◆Think based on knowledge.◆
Training by which people know social facts as knowledge and discuss what to teachchildren is desirable.

Consultants and coordinators also need to share this beforehand.

★Gain and utilize opinions from participating teachers.
When training reflects opinions from participating teachers, teachers can learn more.
Although consultants as facilitators listen to the participants, they sometimes proceed basedon what they prepare. This is because consultants have problems of facilitating trainings(fracilitation ability) or are not able to consider what participants suggest enough. In casethe consultant does not have enough skills for facilitation, including in regards to his/hermanner of speaking and expression, the coordinator must talk with the consultant
beforehand.

◆Think of social factors of HIV/AIDS by making teaching plans.◆
Coordinators need to have explained to them about the content of facilitation by
consultants beforehand in order to respond to participating teachers’ ideas, thoughts, andopinions.
Making the syllabus and searching for messages are good chances to have various
opinions. Rather than simply making syllabus that include HIV/AIDS, it is important fortraining to allow participants to face actual HIV/AIDS issues and children’s environmentand share social aspects of HIV/AIDS by making syllabus.

49

Points
Avoid a situation
where motivated participants cannot participate in discussions.
In the example project in this chapter, teacher trainings were conducted in only motivatedschools which applied for CanDo in the second year of the project.
It was assumed that applications were dependent on the headteachers, and somemotivated teachers were not able to participate in training. Therefore, apart from theselected schools, the same teacher training was conducted during the school holidays forteachers in the district.

【Schedule of Teachers Training】＜Voluntary Teachers Trainings on HIV/AIDS Education＞
Day 1
Session① Meanings and Significance of HIV/AIDS Education (Group Work)
9:00-13:00

Session② Model Lesson (Natural Science)
Session③ How to find a message (Group Work)

13:00-14:00 Lunch
14:00-17:00

Session④ Basic Knowledge on HIV/AIDS
Session⑤ Discriminatory Expressions (Group Work)
Day 2
Session⑥ Model Lesson (Religious Education)

9:00-13:00

Session⑦ Searching for units which can be integrated with HIV/AIDS issues
Session⑧ Making a teaching plan (Group Work)

13:00-14:00 Lunch
14:00-16:00 Session⑨ Improvement of the Education Approach (Group Discussion)
16:00-17:00 Session⑩ Future Activity Planning50

Day 1
Session① Meanings and Significance of HIV/AIDS Education (Group Work)In this session, teachers understand the importance of gaining practical ability for
HIV/AIDS education in order for children to live in a society with HIV/AIDS. Participatingteachers are divided into groups and express their opinions.

Examples ofOpinions in theGroup Work

＜Importance of HIV/AIDS Education＞
Teachers give knowledge on HIV/AIDS to students.
Teachers encourage students to be aware of HIV/AIDS
Teachers let students learn the importance of health.
Students learn methods of HIV/AIDS prevention
Students learn about HIV infection routes
Students become aware of symptoms of HIV/AIDS

Students learn how to prevent HIV infection when treating people with HIV/AIDS
Teachers change students’ attitudes towards HIV/AIDS
Teachers illustrate misunderstandings about HIV/AIDS and culture.
Students are able to learn information regarding HIV/AIDS and share it to the community.
Students learn how victims of HIV/AIDS live and how to take care of them.
Students are able to take care of people with HIV/AIDS.
(* These are from actual opinions in Group Work)

Refer to Session⑤ for “Victims of HIV/AIDS”■Evaluation and summarization of group presentations
Facilitators (education consultants) give sum-up comments based on the grouppresentations.
In the presentation, the facilitator highly evaluated the fact that participating teachers did
not regard the HIV/AIDS education as a factor in the improvement of the academic grades.
She evaluated that participating teachers understand the importance of HIV/AIDS
education itself.
However, this evaluation is not enough. This is because some teachers might think that
HIV/AIDS education is not related to the improvement of academic abilities.

If teachers

think like this, they might not be motivated to practice HIV/AIDS education.
Therefore, the coordinator added that improvement of academic abilities as one of thegoals of HIV/AIDS should not be denied and it is more important that children need tochange their life.
For sum-up, the facilitator emphasized that children need to protect themselves or othersfrom HIV infection and judge based on knowledge in order to live with people with
HIV/AIDS.
The coordinator has to play a role to understand the aims of the training, and add andadjust discussions if necessary. This is very important for achieving the aims of the project.

51

Session② Model Lesson (Natural Science)
Before the lesson, the facilitator told participating teachers about the importance of
HIV/AIDS education in a society with HIV/AIDS. Also, she discussed with participatingteachers what to teach children through theImportance of HIV/AIDS Education●Students gain not only knowledge but also attitudes to protect
themselves from HIV infection●Students are aware of living with people with HIV/AIDS and notsocially discriminating themlesson, what teachers should consider. Then,sheuniquecommunity

situations children face every day withteachers.

Moreover,thefacilitator

the assumptions of attendance of children●Understanding of the community situation that children face
●Practicing lesson on the assumptions of attendance of children
affected by HIV/AIDS

affected by HIV/AIDS like orphans.
Based on these, the facilitator (education
consultant) started a model lesson.
In Kenya, HIV/AIDS is dealt with innatural science, education and Swahili classes.

p.72 for the example oftheemphasized the importance of the lesson on

Points of an HIV/AIDS lesson

Refer open class p.69 anddiscussed

In natural science class, HIV infection

routes are studied. After the lesson, participating teachers expressed their opinions andthe facilitator reported the targets of this lesson and the process of the lesson planning.

science class.

■Responding to practical questions and removing teachersʼ anxieties about lessons
In addition, the facilitator talked with teachers about various challenges in practicing
HIV/AIDS education.

The following conversation is one example.

Teacher : If children do not want to share things with a child with HIV/AIDS, what should I do as
teacher?
Facilitator : Children have the right to share things. What will you do in order to avoid hurting thechild with HIV/AIDS ?
Teacher : I would gently tell the other children to play with the child with HIV/AIDS in.
Facilitator : If you give the child with HIV/AIDS a special thing, other children may prejudge theBeforechild.

training

Other Teacher : When brothers share things, although one of them is seriously sick, how should I
advise them ?
Facilitator : You have to take care of both children. I think you have to think about how you can takecare of them in order for them to protect themselves from infection and toavoid being rejected by

Organizers of training
sessions,

NGOs

and

facilitators

need

to

prepare for responding
to practical questions
from teachers, which
are not in textbooks.

prejudice and fear.

**

The facilitator summed up by saying, “These are not in the textbooks, but these things
can happen. Therefore, teachers should consider them well and deal with different
situations.”
When a facilitator understands teachers’ anxieties and fears and appropriately responds tothem, teachers are able to practice HIV/AIDS education.

Therefore, facilitators andcoordinators need to prepare for possible fears and anxieties of teachers.

52

Session③ How to find a message (Group Work)

Divide participating teachers into groups, select units for each, and think about whatchildren should learn and what kind of messages should be told to children in class.
For instance, the following messages are possible when a natural science unit is selected
for training and when a health education unit is selected for teaching infection routes.

“Actions that do not lead to HIV infection”
When students understand HIV infection routes, they learn that they do not need to beafraid of people with HIV/AIDS. By removing their fears, students can take care or
people with HIV/AIDS properly.

“Steps of AIDS Outset”
People who look healthy might be HIV positive.

Moreover, even if someone has

symptoms known for HIV/AIDS, she is not necessarily HIV positive.

Rather thanguessing, students need to have attitudes for prevention from HIV infection.

“Care and Support”
When people talk about care and support, it is limited to physical support to people affectedby HIV/AIDS. However, “care and support” have broader concepts; and they should not
be regarded as support for “vulnerable people”. In the concept of “care and support,”
people with HIV/AIDS should be treated equally with non-HIV infected people.

Teachers passionately discuss making messages from units.

53

Session④ Basic Knowledge on HIV/AIDS■Knowledge for Appropriate Judgment
This session aims for teachers to obtain knowledge as a basis of judgment in order tojudge and respond to children’s questions on HIV/AIDS.

Facilitators are healthconsultants.
For instance, when teachers understand that excretory substances do not have HIV,teachers can judge that people are not infected with HIV by sweat, tears and urine.
Regarding infection routes, people are not infected with HIV just by sharing cutting tools.
HIV infection is caused by the mixture of bloods when sharing cutting tools. There arepossibilities of HIV infection when coming into contact with blood or body fluid. Whenteachers understand these infection routes, they can understand what kind of activities
cause HIV infection.

■Important points which tend to be disregarded
The teachers’ attitudes and opinions revealed that teachers do not understand the needs ofsocial care and support for the preclinical stage (time period from HIV infection until AIDS
outset).
In training, the facilitator emphasized care at the preclinical stage for delaying AIDS
outset and having a longer life.

Moreover, she emphasized that appropriate care at the

preclinical stage can prevent themselves and others from re-infection.

＜Examples of Training Components＞●Infection Routes●Preclinical Stage and Danger of Infection to others during this Stage●Care and Support for People Affected by HIV/AIDS (Especially, people with HIV at the preclinical stage)

Questions from
Teachers andPerspectives ofLife Skills
Education“Until they tell us…”
Teacher: Since we do not know who are infected with HIV until they tell us, we cannot
support them.
Facilitator: In many cases, someone, who wants to know whether people are
infected with HIV may intend to reject people with HIV/AIDS.

**

If someone confesses that she is infected, she might face rejection from others. If so, shewould not tell the truth. However, others do not understand these feelings of people
with HIV/AIDS sometimes. Training needs to include not only medical and scientificaspects of HIV/AIDS, but also social aspects in the community, which teachers might
not notice.

54

This is an important approach for life skills education.

Session⑤ Discriminatory Expressions (Group Work)

This session aims for teachers to think of (1) situations where people talk about
HIV/AIDS, (2) words and expressions often used in schools, and (3) their impact on people
with HIV/AIDS.
Textbooks often have explanations with pictures and photos.

And there are often somepictures of thin people as people with HIV/AIDS. If a teacher shows these pictures bysaying, “Let’s see what people with HIV/AIDS are like,” what would children understand?
These issues are discussed; teachers realize their perceptions of discrimination andprejudices as well as discriminatory expressions.
The participating teachers were divided into three groups; they discussed the following
two issues.

“Does fear help students protect themselves?”“What is wrong with asking students whether they have seen people
with HIV/AIDS before? ”

Questions from
Teachers andPerspectives of Life
Skills Education“I think children find out about people with HIV/AIDS by learning thesymptoms of HIV/AIDS.”“I think children can protect themselves by being afraid of HIV/AIDS.”

These reactions are often seen, and the method of giving children fears is popular.
However, the facilitator (health consultant) pointed out, “When children who areafraid of HIV/AIDS see symptoms of HIV/AIDS from someone, they might avoid
that person,” and “Children can live with people with HIV/AIDS by understanding
the infection routes and ways of prevention.”“Can we call people with HIV/AIDS “victims”?”
One teacher said, “If calling people with HIV/AIDS “victims” is not
appropriate, how should we call them?” Other teachers suggested that they
can call people with HIV/AIDS “clients” or “those suffering from HIV.”The facilitator suggested that “the infected” may be appropriate since it does nothave any discrimination.

55

Experiences
Prejudice and Discrimination against HIV/AIDS

Teachers must understand prejudice against HIV/AIDS.

in Asia

If they do not understand it, there is the possibility that they

will encourage children to be prejudiced and discriminate against people with HIV/AIDS and their families.

Examples of Activities in Teacher Trainings●How to Proceed:
1. Divide participants into three groups and show them the pictures below. Each group chooses one of the pictures.
2. Each group discusses the issues below.
① What is shown in the picture?
② How does this picture show prejudice?
③ How is the prejudice expressed and what does it cause?
3．Discuss prejudice and discrimination against HIV/AIDS＃1●Explanation:
Each picture shows a situation described below and illustrates prejudiceat different levels, including the individual, family and community levels.
＃1：A man sits and eats alone, separately from his family.

＃2＃2：A man on a bus sits alone. Other people get along with each other,and some look at him.

＃3

＃3：A man sits alone on a crude bed.

Prejudice causes loneliness, a sense of inferiority, misery, lack of confidence, hopelessness, depression, self-hatred,
guilt, feelings of being abandoned, ignorance and fear. Prejudice appears in indirect ways, such as being avoided on thebus in picture #2, and in direct ways, such as eating separately from one’s family, like in the picture #1.

Moreover,prejudices are also found in schools, houses and safe places such as hospitals.

The definition of prejudice in as follows.
・Prejudice is rooted in peopleʼs minds, and discrimination is the actual behavior based on prejudice.
・People with prejudice think that certain people are different from “ordinary” people.
・Prejudice grows in the social process, and represents tensions and conflicts of relationships in social groups.

Prejudice isstructural and cultural, and relates to authority.

What does prejudice against HIV/AIDS cause?
・Fear・Since many people do not understand the issue of HIV infections well, they feel safe by condemning people with HIV/AIDS.
・Forced HIV/AIDS examinations and the identification of groups with HIV/AIDS structuralize prejudices.
source：”Workshop Report: HIV/AIDS - Role of the Education Sector in Dealing with the Stigma and Discrimination”, ASPBAE et al. 2006

56

When teachers discuss every
question one by one, they are
able

to

have

variousperspectives on HIV/AIDS.

When a person confess that she is HIV positive,
can society accept her?

Coordinator: “How would you feel if someone close to you had HIV/AIDS symptoms and you are
asked if you have seen people with HIV/AIDS? ”
Teacher A: “I would feel uncomfortable.”
Teacher B: “I would wonder how to respond.”
Facilitator (Health Consultant): “The question whether children have seen people with HIV/AIDS
makes children imagine sick people and leads to misunderstanding.”***

Teacher A: “How can we know if someone is HIV positive or not?”Facilitator: “We would not know until the person tells us. Many people are not able to tell us in thecurrent society.

With this situation, what do you think we can do?”Teacher A: “Give them time to tell us.”Teacher B: “It takes time for them to tell us.

The person needs to have examinations and she has toprepare herself gradually.”
Facilitator: “The person needs to change herself by taking counseling and accepting her situation(infection).”
Coordinator: “This is not about individuals but about the society.

I think that how people in society

think about HIV/AIDS is a serious concern. Therefore, I think there is no meaning in only people
with HIV/AIDS trying to change themselves. Society needs to be ready to accept people with
HIV/AIDS.

What do you think about this?”***

The participating teachers nodded deeply to opinions by the coordinator, and strengthened theirperspectives of the social situations for people with HIV/AIDS.

57

Day 2
Session⑥ Model Lesson (Religious Education)■Including HIV/AIDS Education into Religious Education.

The above-mentioned “Session ② Model Lesson (Natural Science) ” is a subject which
deal with HIV/AIDS directly.

This Session selects subjects and units integrated with

HIV/AIDS education, and expands knowledge and perception on HIV/AIDS.

These

lessons need high ability on the part of teachers. An example of a unit integrated with
HIV/AIDS education is “Growing up in Christ” in religious education.
According to the syllabus, in the unit of “Growing up in Christ” for 5th grade, teachers
have to mention pregnancy, sexual transmitted diseases, HIV/AIDS, child abuse anddropout by irresponsible relationships among teenagers.

In the model lesson in the

training session, the facilitator talked about children in poverty who were abused by adults
to get something. By this lesson, the teachers understood the social aspects of HIV/AIDS
issues in reality.

Unit integrated with HIV/AIDS

Subtitle:

Perspectives in reality“Growing up in Christ”

Facing the reality where children in“Results

poverty are abused by adults

fromirresponsible

relationships between boys and girls”
HIV/AIDS is regarded only as a result

Connections

from irresponsible behavior.

To have perspectives on the social aspects of HIV/AIDS issues in reality

58

■Is HIV/AIDS the result of irresponsible behavior ?
In the natural science class, students learn about the causal connection from infection routes
to actual infection. On the other hand, in the religious education class, HIV/AIDS is theresult of irresponsible behavior. This may give children a fixed idea that “ HIV/AIDS
equals to irresponsibility,” and encourage them to have discrimination and prejudice against
people with HIV/AIDS and their families. These issues are pointed out in the training andfacilitators explain the importance of understanding various infection routes.
Like Session ②, the facilitator checked what kind of messages the participating teachers
received and told them the meanings and messages of the model lesson after the lesson.
One participating teacher said, “Parents promote these abuses to their children. Whatshould we do in these situations?”
The facilitator suggested, “It is important to emphasize that child sexual abuse by adults iswrong even if they give things or money to children. I think these situations will be better
through discussions with the parents.”
Teachers should be concerned about social aspects of HIV/AIDS issues for practicing
HIV/AIDS education as the next step to teaching simply based on textbooks.
Implementors of training need to prepare well beforehand in order to point out whennecessary in training.

Refer Refer to Appendix 4 (p.110) for an example of a lesson plan for“Growing up in Christ” integrated with HIV/AIDS education.

59

Session⑦ Searching for units which can be integrated with HIV/AIDS issues
The participating teachers were divided, and the syllabus for religous education and social
studies were distributed to the teachers. They selected units that may deal with HIV/AIDS
and discussed what kinds of HIV/AIDS issues were included in these units.

Thefollowings are some examples.

●Religious Education (higher grades)
Unit

Potential Content

New life for Christianity

Prevention against HIV/AIDSHow Christians share talents and abilities with others

Care for people with HIV/AIDS

Challenges for living a new life

Child abuses

Christians support people with special needs.

Infection/Prevention/Care●Social Studies (higher grades)
Unit
PeoplePopulation
Social relations and cultural

Potential Content
Immigration and Migration (cause and impact of HIV/AIDS)
Population Census (impact of HIV/AIDS)
Cultural aspects (Sharing cutting knives, HIV infection routes)

behavior●Social Studies (lower grades)
Subtitle: Various routes to the school
On foot: Avoid walking with a stranger
By bicycle: Refuse when a stranger offers you a ride
Safe way to use roads: When you help someone who has had an accident,
you have to touch the person using a plastic bag.
Danger of talking with a stranger or following a stranger: rape, drugs, inducement, abductions

A participating teacher said, “It is difficult to teach students in the lower grades. For

Pointsinstance, when I explain that a boy and a girl go on a trip and they are infected, I would
only tell them that the girl touched the boy’s wounds or body fluid. What should I do? ”
The facilitator said, “When you teach HIV/AID issues, you have to consider thechildren’s level of understanding; however, you should not avoid explaining about sexualintercourses. You have to teach them gradually.”

She also said “Even little children facesexual intercourse in society. They know about it to some extent.”
When teachers actually conduct HIV/AIDS education, they often face these problems.
Facilitators need to prepare how to respond and answer them beforehand. Otherwise,
they might lose the trust of particiating teachers.

60Session⑧ Making a teaching plan (Group Work)
Each group makes a teaching plan and teaching notebook for the unit integrated with
HIV/AIDS education, and representatives from each group presents their model lesson.
Other teachers play the role of students. They compare the messages that students receivewith the actual planned messages of the lessons.

■For steady integration of HIV/AIDS education
When the facilitator does not give appropriate instructions, participating teachers cannot
Moreover, the integration ofRefer to appendix 5

HIV/AIDS into a lesson would not work well. In these situations, when participants(p.113) for an example

almost finish making the teaching plan and lesson notebook, the facilitator needs toof the lesson

understand the meaning of making the teaching plan.

encourage participants to rethink how the HIV/AIDS approach is integrated in structured
lessons.

Facilitators have to listen to discussions of each group and work with thesituation.

■The Expression “Suffering from HIV/AIDS”
One group used the expression “suffering from HIV/AIDS”.
The facilitator asked if people with HIV/AIDS were suffering or not. She said that theexpression “suffering from HIV/AIDS” was coming from prejudice against people with
HIV/AIDS (by feeling pity for people with HIV/AIDS). She added that many people with
HIV/AIDS live positively.

Before the actual model lesson, expressions leading todiscrimination were discussed. However, this will not change teachers’ perceptions andremove all the discriminatory expressions completely. It is important for facilitators tolisten to participants and repeatedly point it out, like in this example.

Questions from
Teachers andPerspectives ofLife Skills
Education

For Children in the Lower Grades
Discussions from a quesion on HIV/AIDS and sexual intercourse
from a teacher who played the role of student.
Facilitator: When you teach children in the lower grades about HIV/AIDS,
what kind of explanations and teaching ways should we use?
Teacher A: We can explain with easy words.
Teacher B: Do you think we can say, “Please cover wounds since there are diseases which are transmitted
by blood?”
Facilitator: Even children in the lower grades have heard and know about HIV/AIDS in their daily lives.
Teacher A: What children in the lower grades understand through poems is that “HIV/AIDS is scary”.
Teacher B : Children know that many people die due to HIV/AIDS.
Teacher A : Although children know the word “HIV/AIDS”, they do not know what HIV/AIDS is and its
infection routes.
Facilitator : No, they don’t.

We need to think about what we teach children by considering their situationand level of knowledge.

61Session⑨ Improvement of the Education Approach (Group Discussion)■Discussion about giving fear to children
This group session is aimed at discussing the approach of giving fear of HIV/AIDS tochildren.

Thissessionhelps

students

avoid

unnecessary

fear,

prejudiceandmisunderstandings by HIV/AIDS education.
Students with unnecessary fear of HIV/AIDS may perceive that HIV/AIDS is
uncontrolled. This causes relying on traditional medicine, losing perceptions of practicalprevention and care, and avoiding HIV/AIDS issues.

The participating teachers discussed

these issues in this session.
Question
The expressions “HIV/AIDS leads to death.” or “incurable disease” increase fear forchildren. Why is this a problem for children when they have HIV/AIDS education?

Opinions from the Teachers・

When children are scared of HIV/AIDS, they avoid listening to HIV/AIDS issues.

・When you explain that HIVAIDS is an incurable disease, children believe that people with
HIV/AIDS die soon.

・When children think that people with HIV/AIDS die soon, they do not dare take care ofpeople with HIV/AIDS.

・Children will not ask people with HIV/AIDS why those people are infected with HIV.

・

If children have a relative with HIV/AIDS, they might avoid the person.

・

Misunderstandings about HIV/AIDS are left without being corrected.

Suggestions from the Facilitator“Giving children fear covers the truth.

Fear of HIV/AIDS may lead to misunderstanding of

HIV/AIDS (e.g. HIV/AIDS is uncontrollable.) and resignation. And this will spread HIV
infections and prejudice against people with HIV/AIDS.”（To Next Page）

62

Improvement Plans by Teachers・

Teachers should not relate HIV/AIDS issues to death・Teachers should perceive that HIV/AIDS is a real disease, and emphasize that
HIV/AIDS is dealt with like other diseases

・

Teachers should tell the truth of HIV/AIDS with careful words.

・

Teachers should tell students that HIV/AIDS, as well as other diseases, causes deaths.
At the same time, they should explain that HIV/AIDS is not the only disease thatcauses deaths. Malaria and typhoid also cause deaths without proper care.

・Teachers should explain about prevention and treatment methods for HIV/AIDS as
they explain about other diseases and sanitation. This helps children prevent
HIV/AIDS like other diseases.

・

Teachers should explain not only that HIV/AIDS causes deaths and does not have a
medical cure, but also that HIV/AIDS is preventable and manageable.

・Teachers should invite someone who knows about HIV/AIDS very well and ask
him/her to explain how to deal with HIV/AIDS.

Should we call a resource person

Discussion(including the people with HIV/AIDS)?

Teacher A: If we invite a person with HIV/AIDS and ask her to talk in class, children might
have psychological prejudices.
Teacher B: However, children are able to understand real HIV/AIDS by listening to stories
by a person with HIV/AIDS.
Facilitator: Inviting a person with HIV/AIDS for class is meaningful if we avoid theenvironment where children have prejudices and discriminations against people with
HIV/AIDS.
Teacher B: I heard KENEPOTE (one group consisted of teachers with HIV/AIDS) will senda teacher who can talk in class.
Coordinator: If children are ready to understand a talk by a person with HIV/AIDS, having
someone with HIV/AIDS in class may be meaningful. However, inviting a personwith HIV/AIDS once does not change the mindset of children about the HIV/AIDS
issues immediately.

Teachers need to think what they can do for children.

Teacher A: It is important for us to teach about HIVAIDS in our daily classes.

63Session⑩ Future Activity Planning■The training is not the end. Think about ways to promote HIV/AIDS education. The
NGO that implemented the training suggested that the participating teachers hold “openclasses” and “Child Presentation Day”.
School teachers who experienced Child Presentation Day, said, “Adults were able tolearn through the presentation by children,” and “Children change their behavior by gaining
knowledge about HIV/AIDS.”

For instance, when a child played alone and was injured,

other children took care of her by avoiding touching her wound directly and using paper.
Teachers should discuss, plan and make sure to hold future activities with NGOs. Thisguarantees that they will practice what they learn in the training in classes.

■Teachers and parents should have time to discuss.
After Child Presentation Day, someone reported that everyone had agreed that all parents
needed to talk to children with responsibility.
Teachers and Parents should discuss and agree on the importance of HIV/AIDS
education.

By understanding the content of HIV/AIDS education, what teachers learnedin training will be practiced in class.
In general, teachers tend to avoid talking with parents. Therefore, it is important for
facilitators to point out the necessity of their discussion with parents for promoting
HIV/AIDS education.

Refer to “Parents Meeting”, p.80 for discussion with parents.

■NGOs should give information to communities with multiple perspectives
The NGO told participating teachers that they were ready for AIDS learning workshops
for parents if parents want to attain basic knowledge on HIV/AIDS.
Multiple work with schools and communities towards HIV/AIDS are necessary.
Therefore, NGOS need to give communities information by planning activities withmultiple perspectives.

Refer to “AIDS Learning Workshops”, p.84.

64

【Evaluation of Teacher Training】
The following is the evaluation of the teacher training.

◆Teachers thought about what they can do in class
For instance, there are some teachers positive about talking about sexuality. Someteachers were negative in explaining about sexuality to children in the lower grades.

Onthe other hand, one teacher said that the problem is that teachers are embarrassed to explain
about it. She added that teachers need to have caution and confidence.

Although there are

not many teachers who are positive about talking about sexuality, their impact on theparticipating teachers is big.

◆ Think of realistic measures against HIV/AIDS and motivate otherteachers.
When children in the lower and higher grades are together and teachers cannot teachthem equally, someone suggested that special lessons for children in the higher grades
should be conducted.

Sharing realistic measures and efforts motivate other teachers.

◆Teachers do not have the confidence to answer to detailed questions inclass.
A mock teacher training session found out that teachers do not have the confidence toanswer detailed questions. This is because of a lack of holistic knowledge. Moreover, inthe evaluation session of the mock lessons, many people criticized certain individuals;
some teachers lost their confidence.

◆ Someteachingways

causing

discrimination,

prejudice,andmisunderstanding
Teachers learned the importance of teaching necessary knowledge and skills for children
to live, as well as the importance of co-existence in a society with HIV/AIDS through thediscussion.

Moreover, they considered situations for children and understood theimportance of telling them social messages.

However, these ideas could not be connectedwith the actual messages in class. Some teaching ways had possibilities of leading todiscrimination, prejudice and misunderstanding.

◆Lesson planning in order for children to think and judge in society is still
incomplete.
Another significance of HIV/AIDS education is that children will be able to think andjudge by themselves in society based on the knowledge and skills they learned. However,the facilitator did not get into that point enough.

Therefore, teachers were not able toplan lessons in order for children to think and judge their real situations.

65

Summary for the Teachers Training

１） Training content needs to be modified all the time.
It is very important for the coordinator to understand training content and orientation, and modify
training based on the situation. This leads to the success of the project. The coordinator needs torespect the facilitator, and listen to discussions in the group work. When necessary, the coordinatorintervenes in the training.

２） Preparation for responding to teachersʼ anxieties and questions.
The facilitator and coordinator have to notice and respond to questions and anxieties of teachers. This
helps teachers learn how to practice HIV/AIDS education in class. If the facilitator is not able torespond to anxiety and questions often asked, he/she might lose the trust of the teachers. The facilitatorand coordinator need to prepare for responding to possible anxieties and questions.

Moreover, in casethe consultant does not have enough capability for facilitation, the coordinator must talk with theconsultant beforehand.

３） Integration of the social aspects of HIV/AIDS into training.
The coordinator integrates the social aspects of HIV /AIDS issues, which teachers do not notice, intotraining. This affects the quality of HIV/AIDS education as life skills education.
Since teachers have not thought of the social aspects of HIV/AIDS (e.g. discriminatory expressions)
before, they cannot change their perceptions immediately.

Implementers of the program listen to theparticipating teachers and point out these issues repeatedly.

４） Think of different methods
Many people think that giving children fear about HIV/AIDS can protect children. By pointing out that
this teaching way reproduces social discrimination against HIV/AIDS, the quality of HIV/AIDS
education as life skills education will be higher.

５） To guarantee the practice in class
Having discussion time after the research and making sure for future planning can guarantee that what
they learned in the training will be practiced in class.

６） Multiple approaches, such as information sharing with the community
For dealing with HIV/AIDS issues, which need multiple approaches, thinking activities with multiple
approaches, as well as giving information to the community, are important.

66

2-2.

Open Class【Goal: To have confidence and motivation for practicing HIV/AIDS education】
Open class is aimed for teachers to understand the importance and meaning of what theylearn in training, as well as motivate participating teachers to practice it.
The internal goals for NGOs as implementers are the followings:

1.

To give teachers high confidence and motivation for practicing HIV/AIDS education. (Toencourage them to participate in the next training session during school holidays.)2.

To realize HIV/AIDS education which does not produce discrimination, prejudice andmisunderstandings. (Teachers understand the importance of thinking, judging andexplaining. (Enforcement of knowledge and understanding will be done in the next
training, session)3.

To re-understand and share the significance of HIV/AIDS education with other teachers
To plan lessons based on the significance of HIV/AIDS education, as well as share how
to think. (To judge how much you can expect by examining the response from schools
and teachers. The highest preference is to understand the significance of HIV/AIDS
education.)

4.

To improve the quality of HIV/AIDS education through discussion of HIV/AIDS
education among teachers.

【Preparation: Detailed planning, coordination with schools which hold open class】
Implementers plan details of open class based on evaluation of the teachers training, andcoordinate it with the school.
The schedule of open class is the following:（1） The teachers participate in the training practice lessons in their schools; other teachers
look at the lessons.
（2） After each lesson, teachers and NGOs discuss the content of the lesson.

If people evaluate the open class in discussion after the lesson, the representing teacher may
shrink back (lessons learnt from evaluation of the teachers training in the previous section).
Therefore, the discussion is aimed at talking about the significance and practice of
HIV/AIDS education with teachers.

■Expectation to teachers participating in teacher training to play leading roles in
discussion
The implementers expect that the teachers participating in the teacher training play aleading role, such as sharing how they plan the lesson, based on what kind of ideas.
Through this, the implementers expect other teachers to learn effectively.

67

In order for the host school and representing teachers to have Child Presentation Day(CPD) based on the results of open class, discussion about planning of CPD at the end of
the discussion session was internally scheduled beforehand.

■ The role and involvement methods for NGOs
Regarding the participation of an NGO in open class and the discussion session, roles andinvolvement methods for NGOs were decided as follows:◆Role of the NGO in discussion
・To en sure that teachers are motivated and improving their confidence towards the practiceof HIV/AIDS education
・To suggest discussion on the realization of HIV/AIDS education without discrimination,
prejudice, misunderstandings, and planning lessons based on the significance of
HIV/AIDS education and sharing ideas.
◆Intervention of NGOs in discussion
As much as possible, an education consultant, not coordinator, will facilitate it. Particularly
when an NGO critically intervenes, the educational consultant, who has a good
relationship with teachers, should facilitate the discussion; she has to be careful not to lose
the teachers’ motivation and confidence.
◆Wrap-up meeting by the host school after the lesson
The NGO should respect procedure orders for the meeting and initiative by the school. The
NGO can expect that information will be shared within the school, and the school has an
initiative of HIV/AIDS education, which results in continuous discussions on HIV/AIDS
education.

■Role of the education consultant
The role of the education consultant, who play the role of facilitator, is the following:
When there is wrong information or information leading to misunderstandings in openclass, the education consultant should not correct those points directly. Rather, she should
encourage participants to discuss the misunderstanding, and to have questions andperceptions.
By emphasizing good points, the education consultant helps teachers have confidence.
In order for participants to perceive the important points, the consultant leads discussion
on purpose.

■The way to hold open class
The participating teachers gave various opinions for good and wrong points about themodel lesson in the teacher training before open class.
talk about them.

Therefore, the implementers decided to make sure the above-mentioned

points were considered beforehand.

68

However, the facilitator did notOn the other hand, the implementers judged that it is difficult for the facilitator to point out
the problems with opinions, and avoid being negative to the teachers for a short time.
Therefore, the coordinator participated in the discussion between teachers and the facilitatorand intervened in the discussion, in order for teachers not to miss points from the teacher
training.

【Open Class】Good Examples with High Quality

Participants: 8 teachers in the host school (9 teachers in total), coordinator, education consultant,and health consultant
Content of Open Class: Presentation ① Natural Science for 5th grade (HIV infection routes, HIVprevention, classification of the HIV stages)
Presentation ② Natural Science for 7th grade (care and support forpeople with HIV/AIDS and those affected)＊

The primary school system in Kenya is for 8 years, from the age of 6 years.

＊

Each presentation took about one hour.

Presentation ① Natural Science for 5th grade (HIV infection routes,
Safe routes for HIV, classification of the HIV stages)

Firstly, the definition of HIV/AIDS was explained in the lesson.

----HIV Infection Routes---The teacher explained that HIV is transmitted by contacting body fluids such as blood,
saliva and seminal fluid. She asked students about HIV infection routes and explained
details regarding sexual intercourse and blood transfusion, wounds, kissing, mother-child
infection, and sharing cutting knives as HIV/AIDS infection routes. For instance, sexualintercourse transmits sperm through seminal fluid; kissing is dangerous for HIV infection
by saliva, especially with a wound or sore in mouth; HIV is transmitted to the baby fromher mother by blood and a wound of the mother during delivery and lactation.
Moreover, the teacher emphasized that HIV is transmitted when infected body fluid goes
into the blood of someone else.

She added sharing cutting knives and traditional

circumcisions as examples.

--- Safe Routes for HIV--The teacher stated that no one needs to be afraid of contacting others. She explained insect
bites, playing together, sharing toilets, hand shaking, hugging, sitting down beside a personwith HIV/AIDS, and living together are examples of safe routes for HIV.

69

The teacher did not just explain these examples, she also explained that there are somepossibilities of HIV infection by contacting body fluid when playing or living together.
She emphasized that students need to be careful about contacting body fluid and blood.

Natural Science for 7th Grade. Female and male mixed class.

----Classification of the HIV Stages----

The teacher explained that HIV has stages, from infection to death, although HIV is
incurable. She explained that when a blood test shows HIV positive, there are possibilitiesof transmitting HIV to others in the first stage. And she added that people with HIV inthis stage look healthy.
She explained that the second stage is still a symptomless period for about 6 weeks to a
maximum of about 12 years from infection.

Although people in this stage are HIV

positive in the test, they can live healthily.
The teacher explained that various symptoms are seen in the third stage, and symptoms
become very serious in the AIDS stage as the fourth stage.

Moreover, the teacher

mentioned Voluntary Counseling and Testing (VCT) and how people with HIV/AIDS aretreated at VCT centers. Also, she added that people are able to seek advice about HIV
prevention methods there.

70Presentation ② Natural Science for 7th grade(care and support for people with HIV/AIDS and those affected)

In this lesson, the teacher started from the definitions of “the infected” and “the affected”.
She defined “the affected” as relatives of people who died by HIV/AIDS. Like the naturalscience class for 5th grade, the teacher emphasized that people are able to live with people
with HIV/AIDS, since HIV is not infected by living together.

She also explained how we

can care for and support people with HIV/AIDS.
One student said, “We can share time with people with HIV/AIDS.” And the teacher
responded, “We should not exclude them. We have to take care of them so they can feelthey are part of the family and society. And these attitudes show love to them.”
The teacher also asked the children how they can care for people affected by HIV/AIDS
other than by financial support.

Evaluations after the Lesson ･ What teachers learned

Education consultant— “What do you think children learned from the lessons?”
Teacher (Presenter): “Children learned the importance of accepting people with HIV/AIDS andthose affected with care and support. Also, they learned the importance of respecting life andliving together with people affected by HIV/AIDS.”

Female teacher (without teacher training): “By learning the infection routes and the prevention
methods, children are able to protect and take care of themselves.”
Other female teacher: “I myself did not know that the HIV infection has
different stages and that there are symptomless periods.”
Teacher (Presenter): “I was able to correct misunderstanding by pointing out that infection will
be found only through examinations in the lesson.”
Teacher (with teacher training): “When people with HIV/AIDS are cared for byothers, they are able to feel that they are accepted by society and are able tocontinue their lives.”
Coordinator: “I think the children thought by relating this to their actual lives,
since the explanation was done based on their situation in the lessons.”
Female Teacher: “I think we should show affection for people with HIV/AIDS
and shake hands with them normally. However, if the person with HIV/AIDS
is injured in her hand, should we still shake hands with her?

”

Teacher (Presenter): “I always emphasize that there is no infection without contacting body
fluid.”
Coordinator: When children understand the structure of the infection and importance of careand support, they can decide their actions depending on the situation.

71

【Open Class】Examples of Failure to Provide Appropriate Intervention

Participants: 11 teachers in the host school (12 teachers in total), a teacher from a neighboring
school (who had participated in the teachersʼ training), a coordinator, education consultant,health consultant, and field assistantContent of Open Class:Presentation ① Natural Science for 5th Grade (Infection routes, care and support)
Presentation ② Natural Science for 7th Grade (Infection routes, care and support)＊ Students were a mixed class of 7th and 8th grades

Presentation ① Natural Science for 5th Grade(Infection routes, care and support)

The lesson started by asking children about the meaning of HIV/AIDS, its infection
routes and prevention methods. The teacher clearly mentioned that HIV is infected bybody fluid, including sexual discharge from reproductive organs.
Mainly children discussed the infection routes and prevention methods, and the teacher
did not add explanations very much.

This resulted in that the lesson had little substance.

The teacher showed pictures with symptoms of skin diseases, diarrhea and vomiting as
examples of HIV/AIDS symptoms.

She intended to show symptoms and explain whatkind of care and support for people with HIV/AIDS is needed. However, the pictures ofdiarrhea and vomiting lead to laughter from children, as well as mockery from someteachers.
The teacher also showed another picture indicating the response of people with
HIV/AIDS. This picture showed a person with HIV/AIDS first finding out about her
infection with shock, experiencing anger, sorrow, confusion and loneliness, and finallyaccepting her infection and living positively.

Presentation ② Natural Science for 7th Grade(Infection routes, care and support)

The teacher started with a supplemental explanation on infection routes, which was not
explained in the lesson for 5th grade.
Regarding the difference between “the infected” and “the affected,” most of the teachers
in the teacher training misunderstood “the infected” as sick people. In this lesson, theteacher clearly explained “the infected” are people who have HIV. However, she was
confused while she explained it.

She was also confused by the meanings of HIV andAIDS.
The teacher asked the children what kind of support and care they can provide, andresponded to their questions. She also explained that people with HIV/AIDS should not72

be isolated and should be accepted as part of society. She showed pictures in whichpeople are having meals and living together with people with HIV/AIDS.
Children asked the teacher some questions, such as the origin of HIV/AIDS, why HIV istransmitted only among humans, and drug treatments for people with HIV/AIDS. The
teacher was not able to answer them and asked the health consultant for the answers.

Evaluations after the Lesson –Perceptions of Teachers
The teacher who presented shared messages she wanted to deliver with other teachers.
However, one teacher just read the lesson book made by the education consultant for theteacher training.
***

A teacher from a neighboring school pointed out, “The explanation of circumcision as an
example of tan infection route was not enough. The teacher should have explained whatcauses the infection.” Although the chairperson of the evaluation meeting accepted thisopinion, he was not able to elaborate on it in discussion.
Since some teachers asked for NGO opinions, the education consultant explained thesignificance of HIV/AIDS education and how to think of it.

When teachers were asked

their opinions after that, they just repeated what the education consultant explained.
***

Regarding using pictures, the coordinator asked teachers, “In the class where there might bechildren affected by HIV/AIDS, when children laugh about pictures of people with
HIV/AIDS, how should teachers react?” The teachers responded, “We do not have children
affected by HIV/AIDS.” and “There is no problem since we can control children.”
The coordinator said, “As there are children in various family and social situations andthere are some who know someone with HIV/AIDS symptoms, how do they feel?

Howshould teachers respond to this?”
Teachers answered, “I will explain clearly.” and “I will explain various infection routes.”
However, there was no discussion about consideration for people with HIV/AIDS andpeople affected by HIV/AIDS.

The discussion was ended by talking about the importanceof thinking about children’s situations.
***

A teacher said, “It is difficult to teach about sexuality to children in the lower grades. If wemention about sexuality, children will have curiosity.”
The education consult indicated, “If we do not teach them properly, children might gain
wrong information from other sources. Therefore, it is important for teachers to teachchildren by considering their age. ”

73

【Evaluation: Failure example without proper intervention】◆The education consultant talked like she would in her lecture.
Since the education consultant talked about the significance of HIV/AIDS education andhow to plan lessons like in a lecture, teachers lost chances to think for themselves and share
information from the teachers who participated in the teacher training. On the other hand,since the education consultant made good relationships with the teachers, her comments
seem to be thought-provoking for many teachers.

This shows that the participatingteachers at least shared the important points for having HIV/AIDS education.

◆Comments from a teacher was not elaborated in discussion.
In the meeting, although one teacher pointed out that the explanation of infection routes
was not enough, the issue was not elaborated in discussion.

Therefore, teachers lost the

chance to think about how and what they should explain.

◆Visual aids were not used for a point of discussion.
Although there were many evaluative points in the presentation, they were not pointed
out and the teachers did not discuss them.

Therefore, teachers were not able to haveconcrete images and think of approaches for children’s needs. The teacher showed a picture
indicating the response of people with HIV/AIDS. This picture showed a person with
HIV/AIDS who first finds out her infection with shock, experiences anger, sorrow,confusion and loneliness, and finally accepts her infection and lives positively.

These

visual aids can be used as an effective way of teaching if teachers properly explain aboutthem.

However, the teachers did not have any chance to discuss it. Only the negative

impacts of visual aids were pointed out, as they encourage people to have prejudice against
people with HIV/AIDS.

Open Class --- Summary of the Points（1）Do not provide too much information.
If implementers give a lot of information, teachers would lose opportunities to thinkand share information with other teachers.
（2）Elaborate opinions in discussions.
The coordinator needs to elaborate good points for discussion into actual
discussion.
（3）Do not forget to evaluate good points.
When implementers evaluate good points adequately, teachers will have images ofgood examples.

74

This also leads to confidence of teachers.

2-3. Child Presentation Day
For making sure that HIV/AIDS education is practiced innormal lessons, schools hold “Child Presentation Day” onwhich children present what they learn.
When we say “presentation” for children, plays, songs, andpoems are often used.

However, in presentation for

HIV/AIDS education, children sometimes do presentations
by using diagrams on large sheets of paper. In either case,teachers need to understand HIV/AIDS issues holisticallyand assist children in the preparation of presentations.

【Goal: To share perception of HIV/AIDS issues with teachers and the community】
Internal purposes for the NGO, who organized the program, as well as external purposes forsharing with teachers and the community were set.

●Internal Purposes
Understand the significance of the roles of teachers and the community
Teachers and parents think about how to protect children in a society with HIV/AIDS; they
are motivated to deal with the HIV/AIDS issues as a community.

It is important for the

NGO to understand the significance of teaching about the roles of teacher and community.
To make a good environment for practicing HIV/AIDS education
Having meetings for teachers and parents to talk about HIV/AIDS education willencourage them to work for HIV/AIDS education as a community and practice HIV/AIDS
education in schools.
Adults think about their behavior.
Through the presentations by children, adults think about their behavior (perceptions of
HIV infection risks, child sexual abuse, HIV prevention, and living with HIV/AIDS).
Teachers have confidence.
Teachers are motivated to learn the HIV/AIDS education, gain confidence,and understand the HIV/AIDS education deeply.
The community works on HIV/AIDS issues.
Through the presentation about HIV/AIDS education in primary schools, the community
has a chance to think about HIV/AIDS issues and understand the significance of working
on HIV/AIDS issues.

●External Purposes
Teachers and parents think of important issues for children to live in society with.
Parents (the community) learn about HIV/AIDS.
Parents have information on HIV/AIDS and understand how to think about HIV/AIDS.

75

Teachers practice HIV/AIDS education.
Teachers practice HIV/AIDS education with the aspect of how children can live in society.
Children learn about HIV/AIDS.
Through the presentations, children gain more knowledge on HIV/AIDS. They also attainaspects and ways of thinking about living with HIV/AIDS.
Children play a roleChildren play a role in advocacy activities for participating parents (the community),.

【Preparation】
Those involved (e.g. education officers, teachers) understand and agree that Child
Presentation Day (CPD) is aimed for children to present outcomes of HIV/AIDS
education in the lessons.

Teachers prepare for practicing HIV/AIDS education.

■From teacher training to Child Presentation Day
This program consists of Teacher Training → Open Class → Child Presentation Day→ Parent meeting .

Teacher training is for teachers to practice HIV/AIDS education. In

the future planning session of the training, teachers agree to have CPD in each school.
Through discussion with teachers, the following points are agreed upon regarding Child
Presentation Day.
◆School will be the host for Child Presentation Day.
◆To clarify what to deliver through the presentation◆The influence of CPD should be considered■Child Presentation Day with proactive involvement by school
Presentations can be done either by using existing items or by making unique items byteachers or students. The NGO respects what each school plans and prepares; the NGO’sintervention should be minimum. This results in that schools regard Child Presentation Day
as their own activity, and work towards HIV/AIDS education proactively. This also helps
schools become motivated to continue their work, as well as creates a school structure forit.

■ To prevent the creation of misunderstandings about and discrimination against
HIV/AIDS
If only the schools are involved in preparations for Child Presentation Day, there arepossibilities for presentations that are discriminatory regarding HIV/AIDS and people with
HIV/AIDS.
It is essential for the presentations not to have misunderstanding and discrimination
against HIV/AIDS.

This is a minimum requirement for the presentations. In the actual

project, teachers shared ideas about human rights and living with HIV/AIDS and talked
about them in the teachers training.

76

Moreover, open class encouraged teachers tounderstand the fear about and influence of their unconscious actions that can create
misunderstandings or lead to discrimination. .
■Coordination with the Divisional Education Office
The NGO reached an agreement with the Divisional Education Office regarding Child
Presentation Day (CPD). Each school also coordinated with them when they decided
guests for CPD.

【Child Presentation Day】
Students and parents are invited for Child Presentation Day.

In Kenya, primary school isthfor eight years, and many student presenters are older than 4 grade. What students learn
about HIV/AIDS is presented through poems, songs, plays and conversations.

★Example of a Play★
Play of doctor interviews on TV or radio program: It gives audiences knowledge
about HIV/AIDS, its infection routes and safe actions against HIV/AIDS. Also, it
includes what people with HIV/AIDS need and what are important points for caring
for people with HIV/AIDS.

*

*

*

Explanation of opportunistic infections; Children, who play the role of immunity,
make a circle and protect people inside of the circle from children who play the roleof bacteria. However, through HIV infection, the immunity circle is broken and thechildren inside it are attacked by bacteria.

★Examples of Songs and Poems★
“Sugar Daddy and Sugar Mummy” shows child sexual abuse by adults in exchange
for money and things. This has messages to adults for the protection of children who
are still young.

Child Presentation Day helps playing children, as well as watching children, understand
HIV/AIDS well.

77Moreover, inviting parents also impacts adults in the community.

When the means of

instruction in schools is different from their mother tongue, teachers need to explain thecontent of the presentations in their mother tongue.
Meeting with teachers, parents and adults in the community after CPD is useful in orderfor parents and adults to use this opportunity in facing HIV/AIDS issues. In meetings,
they can discuss how to protect children from HIV/AIDS and teach HIV/AIDS to children.

In order to not promote discrimination and prejudice,teachers need to improve their life skills.
Songs and poems may be repeated with the same slogan, such as “HIV/AIDS brings
death” or “sexual intercourse causes the HIV infection and children need to listen to
parents.” Plays may reflect only superficial understanding about HIV/AIDS issues, suchas that HIV is transmitted by immoral acts such as extramarital sex, and that HIV causes
death.
These activities not only prevent students and audiences from learning about HIV/AIDS
issues, but also promote and strengthen discrimination and prejudice against HIV/AIDS.
CPD reflects understanding and attitudes of teachers, who play a supervising role.
Therefore, enough training to teachers and the improvement of life skills for teachers arenecessary before CPD.

Refer to “Parent Meeting”, p.80.

78

Points

【Evaluation: Day 1 and 2 of Child Presentation Day】
Through this project, CanDo conducted CPD in each school cluster for all 28 schools inthe division in 2005.

Moreover, CanDo separately conducted CPD in six active schools in2006 (some CPD included neighboring schools).

The following are evaluations fromtheses two years.

◆From Competition to Maintaining Quality
In the first year, all primary schools in the division participated in CPD and t competed
each other. The focus of CPD became acting, and some content of plays werediscriminatory.

The quality of CPD was lower than the minimum level.

Since CanDo criticized this situation, the number of participating schools drasticallybecame small.

However, the quality of plays became higher. Factors of competition

became less and schools were able to focus on the content of their plays.

Also,participation by six primary schools that understand the significance of HIV/AIDS
education led to the improvement ofquality.

Moreover, in the second year, human rights and social aspects of HIV/AIDS were
promoted in the stage of teacher training.

Therefore, the presentations required quality.

◆Continue cooperation among teachers for broader impact
By expanding knowledge and attitudes on HIV/AIDS from active teachers to otherteachers, it was expected that the practice of HIV/AIDS education is expanded in the wholedivision.

However, its impacts were only in limited schools

By conducting training for teachers repeatedly, implementers need to look for active
teachers and continue cooperation among teachers who have a broad impact.

PointsTo have a high quality of presentation content●Discuss social aspects of HIV/AIDS and living together with people with
HIV/AIDS in the stages of teacher training and open class.
●Reduce competition and ceremony, and focus on the content.

79

2-4. Parent Meeting
After CPD, teachers and the community (audiences of CPD) discuss HIV/AIDS
education. In the project by CanDo, meetings for people related to the school clusters(especially influencial people in the area), including some parents, were held in 2005. In
2006, when CPD was held in individual schools, CanDO held meetings for all parents andconcened individuals in the community.

【Goal: For teachers and adults in the community to work with HIV/AIDS issues】
Implementers have to understand the significance of working with HIV/AIDS issues in
the area (thinking about children’s living). The parent meeting is aimed at the actual
practice of HIV/AIDS education, as well as behavioral change of adults in the community.

【Preparation: meetings for all the parents】
In order to think about how to hold parent meetings, the siutation was analyzed
beforehand.
This project consists of Teacher Training →Open Class →Child Presentation Day→Parent meeting for HIV/AIDS education in schools, and AIDS Learning Workshop
for the community.

Refer to “AIDS Learning
Workshop”, p.84.

In the stage of teacher training, some teachers said, “It is difficult to practice HIV/AIDS
education in schools when we think of the reaction of parents.” The implementation of
AIDS learning workshops for teachers and parents were limited to a few schools.
In order to work with HIV/AIDS issues, the community as a whole needs to work
together. However, parents do not coordinate with teachers in some schools. Therefore,
parent meetings were not limited to influential people in the area, and were open to allparents. After watching CPD in schools, parents discussed how children live in a society
with HIV/AIDS based on the children’s presentations. It is expected that the community
has an agreement to practice HIV/AIDS education.
On the other hand, there was the possibility that meeting open to all parents might resultin superficial discussions.
CanDo.

80

However, professional consultation was possible throughP
PointsWho should we consult with before CPD?――
Headteachers negative about HIV/AIDS education

In a school, the coordinator repeatedly talked about having a parents meeting with its
headteachers. However, on the day, the headteacher suddenly cancelled a parent meeting
after CPD.
As seen in this example, headteachers in some schools are negative about HIV/AIDS
education.

The reason is because some headteachers are also religious leaders, who do nothave enough knowledge about HIV/AIDS and condoms. These headteachers tend to avoid
talking with the community about HIV/AIDS.
To have CPD and parent meetings, the coordinator needs to discuss it not only withheadteachers, but also responsible teachers.

【Content of Parent Meeting: Discussion among teachers and parents --- example ofteacher with low perceptions】
CPD was held in six primary schools that are positive about the HIV/AIDS education.
However, parent meetings were held only in two schools.

The following shows thediscussion in the parent meetings.

What they learned from CPD

Deputy headtecher: What did you learn through the poems, dances and plays today?
Female Parent A: I learned that people with HIV/AIDS should not be isolated.
Female Parent B: If a relative is infected, we should take care of her.
Male Parent: HIV/AIDS is not a disease from the gods.
Children also need to learn about this.

People have to accept HIV/AIDS.

We need to protect children as well as tellchildren about this.
Parent: I learned that we should not share sharp objects.

To prevent children from infection
Deputy headtecher: What did you learn about the prevention of HIV infection for children?
Male Parent A: Since blades are used by barbers for everyone , we need to becareful with haircuts. I did not know that this could transmit HIV. For instance,
we can buy a blade only for our child and cut their hair at home.

Deputy headtecher: The parent can go to barber shop with his/her child.

81

Female Parent: I learned that HIV can be anywhere around us. We need to advise children what to
do for HIV prevention.
Teacher: How will you advise children to avoid HIV infection? What did you learn from thepresentations by children?
Parents: Sharing blades, sexual intercourse.

Deputy headtecher: What about traditional customs? For example, what is done to girls every
August?
Male Parent B: These customs can transmit HIV. (1)Male Parent A: Parents need to advise and teach children.

Deputy headtecher; Parents also have a role in protecting children from theinfection.

(1) This implies female genital mutilation (FGM). With FGM, the wound takes time to heal
and it makes people bleed unexpectedly.

Although FGM is prohibited by law, it ispracticed in every August, over the long holidays.

Where should we learn about condoms?
Teacher A: Sexual intercourse causes HIV infection.

Parents should understand that children havesex.

If your child is close to a person of the opposite sex, what would you do? They might havesex.

Will you tell them not to have sex?

Parent A: I am not ready to tell them.
Teacher A: If you are not able to tell the children, they might become infected. What do children
understand about the meaning of sexual intercourse? If they knew that HIV is infected throughsexual intercourse, they would not do it.
Parent B: Why don’t they check if their partner is infected or not, when they have sexual intercourse?
Teacher A: I think they should check themselves when they have sexual intercourse.
Teacher B: What can parents do if they do not know about the sexual intercourse of their children?
What about talking with children openly at first?

I think this is important to change behavior.

Female Parent: I learned that the use of condoms is one of the methods for HIV
prevention.
Teacher B: Children should not learn about condoms in schools (2). However,they learn about how to use condoms after school. This is because they havesexual intercourse.
Teacher A: I think someone can teach them about condoms after the children finish school.
(2) Teachers have different opinions about teaching about condoms in schools. Some teachers thinkthat they should teach about it based on the reality of sexual intercourse by children.

On the other

hand, some teachers think that teaching about condoms leads to acceptance of children’s sexualintercourse.

In Kenya, teaching about condoms is not mentioned in the education policy. Also, it

is not included in textbooks.

82

【Evaluation: To have discussions with parents.】
CanDo implemented parent meetings in the second year (in 2006) of the project after
finishing CPD in each school. In the first year (in 2005) when CPD was held for eachschool cluster, the parent meeting was not implemented.

Instead, meetings only for

influential people in the area were held. The following are what CanDo learned fromthese experiences over two years.
●In order for teachers and parents to talk about the issues of each school and school area,
an event for multiple schools was not appropriate. When multiple schools are together inthe meeting, they think of competition and entertaining. This does not lead to practical
discussions. In the second year, only one school invited teachers, parents and students fromthe neighboring schools.

By inviting the neighboring schools, CPD ended up in like aceremony, and it was difficult to have practical discussions among teachers and parents.
●Teachers tend to avoid discussions with parents, especially when teachers do not thinkthey can gain the upper hand by discussing it with them.
When teachers have chances like CPD to show their outcomes and discuss their results,
they tend to feel they have an upper hand over the parents and to have meetings withparents more easily.

832-5. AIDS Learning Workshops【 Goal: The community attains knowledge and skills regarding confusing
information, and discusses behavioral change. 】
In the targeted area, different information on HIV/AIDS was supplied from religious
people, traditional medicine men, politicians, administrative officers, medical workers andothers.

The preliminary survey revealed that the community did not know which

information is true.
Therefore, basic knowledge and skills for HIV/AIDS were supplied for parents and thecommunity.

CanDo also had held learning workshops with teachers in primary schools.

This workshop was regarded as a good chance to teach HIV/AIDS to children and discuss
sexual behavioral change for adults.

【Preparation】■Making teaching materials and facilitation notes
The health consultant made teaching materials in English based on reference materials, andtranslated them in the indigenous language. Since she played the role of facilitator, shealso prepared facilitation notes and planned the content of the AIDS learning workshopswith the coordinator.

■Venue: Classrooms in schools
The AIDS learning workshops were held in classrooms of the targeted primary schools.
Educational activities for the community are often held under a big tree or in the market
where many people gather. However, CanDo chose classrooms with desks and chairs inorder to create an atmosphere for learning.

■The headteacher and school management committee submit an application form
reflecting opinions from the community.
CanDo suggested the AIDS learning workshops at teachers’ meetings forheadteachers and school management committees. When they are willingto have the workshops, they first discuss the needs of the AIDS learning
workshops with parents.

Then, the headteacher and school management

committee submit an application form with signatures of the headteacher andschool management committee.

The application form has a part indicating

what they discuss with parents (e.g. what they want to learn).

CanDo staff displayed
the flyer at shops in thecommunity.

■Keep everyone in the community informed about the AIDS learning workshop
If only some people have information about holding a workshop, the workshop might bedisturbed on purpose.

CanDo has experienced that people did not come to the workshops

many times before. Therefore, when CanDo visited schools for other purposes, such as

84

school construction projects, they had permission from the schools and tried to informmany parents about the AIDS learning workshops. CanDo made flyers and passed themout at the schools. If the flyers were not displayed, CanDo displayed them at places where
people gather to collect water and markets in the community.
Even if people in the community have a high interest in HIV/AIDS and strongly hoped
for the AIDS learning workshop, there is a possibility that the AIDS learning workshop was
not held due to a power balance in the community.

It is important for implementers toanalyze what the obstacles are to holding an AIDS learning workshop and think about how
they can remove these obstacles.

【The Program of the AIDS Learning Workshop】
The AIDS learning workshop was planned as a half-day program.
used after the lower grade students left.

Classrooms were

CanDo considered that the workshop did not

disturb school lessons and that the burden of school was small.

Time
14:00-14:30

Contents
Fill in questionnaires
Orientation

14:30-15:00

Background Information
Difference

between

HIV

and

to

use

AIDS
HIV infection routes
15:00-15:30

Prevention(howcondoms)
15:30-16:00

Methods for delaying the AIDS
outsetParents who participated in an AIDS learning workshop

To live positively
16:00-17:00

Practice of using condoms
Discussion (group work)85

＜Standard Biological Knowledge on HIV/AIDS (Lecture)＞
The participants received teaching materials entitled “Basic Information on HIV/AIDS.”
The facilitator taught about HIV/AIDS issues based on the facilitation notes prepared
beforehand.

The following shows the big picture of the content.

◆Background Information
E.g. national disaster declaration by the president in 1999, more than 700 deaths per day, reasons forhigh infection rates among young women◆Difference between HIV and AIDS

Human immunodeficiency virus (HIV) causes AIDS. By destroying cells, HIV makes immunity
lower.
AIDS is a status of low resistance against infection. Opportunistic infection.
◆HIV Infection Routes HIV
Body fluid with HIV, excretory substances which do not include HIV
Danger of wounds and sharing cutting knives (e.g. needles, knives ‒ circumcision, tattoo, tooth
extraction, pierced earrings)
Mother-child infection ‒ Prevention of mother-child infection in medical institutions◆Prevention (how to use condoms)
Safe sexual intercourse, how to use condoms properly◆Methods for delaying the AIDS outset
To know the status (HIV positive or negative)-

The role of VCT (voluntary counseling, examinations)

Acceptance, living positively, open disclosure
Disclosure and last will to close people (challenges for people with HIV/AIDS)
Removal of prejudice and discrimination against HIV/AIDS (challenges for society)HIV is preventable, and we can live with HIV
Existence of groups of people with HIV/AIDS
Nutrition ‒ balanced meals, foods obtained in the community, keeping body clean, public healthResponse to opportunistic infection
Refer to Appendix 6,

ARV ‒ not curative medicine, expensive, must take for life, side-effects

p.114 for the AIDS

Safe sexual intercourse

Learning Workshops

Support, care and understanding of family and the community◆Children and sexual intercourse
Voluntarily sexual intercourse
Irresponsible sexual relationships by adults (sexual relationships between adults and children)
Sexual aggression ‒ rape, sexual abuse◆Customs, taboos, perception about HIV/AIDS
Sexual intercourse with children (Children not infected with HIV, HIV is curable bysexual intercourse with a virgin.)
To separate HIV/AIDS from traditional medicine and immorality86

＜Practice of Using Condoms＞
In order for condoms to be effectively used as a prevention method against HIV, it isimportant for condoms to be used properly. In the program, the facilitator showed how to
use condoms properly and the participants practiced using it.
Points are the following:・

Check the expiration date of condoms

・Do not bite away the packaging of condoms

・Make sure the condom is the right side out.

・Gently press out air at the tip of the condom before putting it on.

・Unroll the condom over the entire length of the erect penis.

・After ejaculation, avoid touching the semen inside and tie the condom closed.

■Decide whether co-gender or single-gender practice
Depending on the participants, the coordinator decides whether the practice of using
condoms is done in co-gender or single gender groups.
If the coordinator feels that men might make fun of the practice, groups are separated bygender to keep a good learning environment, even if someone says that it should be done byco-gender groups.
On the other hand, when male and female participants think that they should discuss
HIV/AIDS issues and practice using condoms together, co-gender groups are applied.
These decisions are made by the coordinator.

Practice of using condoms. The two pictures show the co-gender practice.

87

＜Discussion (group work)＞
The discussion points are the following:

Discussion Point 1“HIV/AIDS prevailed beyond generations. Some human behaviors andcustoms promote HIV infection.

Please indicate examples of thesebehaviors and customs and discuss how we can stop the spread of
HIV/AIDS. ”“Also, please explain why people do not want to use condoms.”

Discussion Point 2“Is it important for children to attain proper knowledge about HIV/AIDS?

If you thinkthat it is important, how will you teach about HIV/AIDS without shyness?

If you thinkthat it is not important, please explain why you think like that. What kind of information
on HIV/AIDS do you think children should have?”

Discussion Point 3“Even if you have proper knowledge on HIV/AIDS, you cannot tell them
due to shyness and difficulty sometimes. What are the difficulties? And
how should we remove these difficulties? ”

What do outsiders (NGOs) do regarding customs that are a danger for HIV infection?

Discussion point 1 aims to ask about dangerous behaviors and customs with thepossibility of infection. These behaviors and customs include traditional customs, such as
polygamy and women of a certain status who have sexual intercourse with multiple men.
CanDo gave lectures and facilitated discussions by not encouraging people to stop certain
sexual customs.

CanDo, as an outsider, provided holistic information on HIV/AIDS

issues and showed options leading to prevention against HIV infection and about livingwith people with HIV/AIDS.

Moreover, CanDo gave opportunities for the community to

discuss and promoted self-sustained problem-solving by the community.

88【Evaluation of the AIDS Learning Workshops】
CanDo implemented the AIDS learning workshops from 2004 and evaluated them asfollows.
Even if the community hoped to have the AIDS learning workshop, there are many cases
whereby headteachers disturbed holding the workshops.

CanDo used to talk withheadteachers and asked them to talk with parents and people in the community. However,when CanDo relied on only the schools, people in the community did not know about theworkshops. Without community understanding, it is difficult to have workshops.
The AIDS learning workshops are also aimed at having opportunities for teachers andparents to protect children. However, this did not happen in many cases. This is because
many teachers were absent from the AIDS learning workshops, or workshops were not held.
Implementers need to make sure that the AIDS learning workshops are held. And rather
than opportunities for discussion, learning opportunities for the community should beprioritized.
Summary of Points for the AIDS Learning Workshops

１） Importance of analysis of obstacles and appropriate responses
Even if people in the community have a high interest in HIV/AIDS and strongly desire
the AIDS learning workshop, there is a possibility that the workshop is not held due tovarious factors and the power balance in the community. Appropriate analysis of thecurrent situation and principles for response are needed for examining what factors disturb
having the workshop and how these factors are removed. For instance, when only somepeople have information on the AIDS learning workshop and its information is not sharedwith others, the workshop is disturbed on purpose. It is important for implementers to tellmany parents directly on various opportunities, and communication methods need to bechosen depending on situation.

２） Importance of Judgment by the Coordinator
When participants are not ready to learn about HIV/AIDS, male participants mightmake fun of talking about sexuality. In these cases, the coordinator needs to judge
and deal with it in order to keep a good learning environment, such as practicing using
condoms in single-gender groups.

The coordinator needs to judge whether aco-gender group is possible or not.

３） Understanding of Customs in the Community
CanDo, as an outsider, provided holistic information on HIV/AIDS issues, gave
opportunities for the community to discuss them, and promoted self-sustained problem-solving for dangerous customs that lead to HIV infection by the community.

89Part3 PracticePart3-3

HIV/AIDS Activities Engaged by Community
For living together by various peopleʼs participation
We have seen that HIV/AIDS education in schools is strongly related to community
engagement in HIV/AIDS in the previous chapters.

Part 3-3 examines community

engagements for HIV/AIDS.
World Vision implements Area Development Programs (ADP) in order to care for people
with HIV/AIDS and organize “Community Care Coalition” for support for HIV/AIDS
orphans. This chapter examines, through an example, how NGOs work with the communityand create activities, as well as what kind of challenges they face.

1．Organization of Community Groups for Care
In order for the community to care for people with HIV/AIDS, resources in thecommunity (e.g. human resources, social systems) need to be used effectively.

NGOs

need to make an organization and form activities based on characteristics of the community.

1-1.

Understanding the Current Situation

The community, which is the main body of the organization, and the NGO, which supports
the community, understand the characteristics, current medical services, social rules, andsituation of HIV/AIDS in the community.

①･ What kind of area?
To understand characteristics of the area, including population census, population distribution,industry, education/literacy levels, ethnicity, language, dietary pattern and religions.
②How is the social system, including medical services?
●When people in the community receive medical services, what kind of system is working
and what kind of services do people receive?
・the number of public and private medical institutions in the community
・transportation methods and distance to each medical institution
・medical costs, necessary cost for medical services
・the number of staff in each health center, the number of medical goods in stock・What kind of treatments and care HIV/AIDS people in the community are able to receive●How laws and social rules are formed③HIV/AIDS situation in the community
Collect date from literature and listen to people in the community and public officials, who areresponsible for the health sector, about the current situation.

90

1-2.

Forming a Community Organization

In order to form a community organization, the NGO clarifies its goal and encourages
people who can be responsible for activities.

Aims for Forming a Community Organization (An example of World Vision)●To understand the HIV/AIDS situation and proactively participate in activities for prevention.
●To care for people with HIV/AIDS and HIV/AIDS orphans who need support from someone.
To consider long distance areas that the government cannot reach.
●To find and teach human resources for people in the community to work for activities proactively.
To form an administrative structure for the sustainability of activities of the project＜Steps for Forming a Community Organization＞①

Decide on the people to be given responsibility
Based on the collected information, make an activity plan whichmeets the needs of the community. Moreover, decide on thepeople who will be mainly responsible, who can lead thecommunity.

For example:

・People who socially play a leader role in the community.
→ Their opinions are easily accepted in the community.
・ Opinion leaders who have a big impact on society.
→ Their opinions are easily accepted in the community.

Workshops about forming a community
organization for leaders in the area.
(Kenya)・Targeted people who are impacted by HIV/AIDS→ Their awareness of the HIV/AIDS issue is high.
・People who work for schools or health centers in the existing social system.
→ They know the characteristics of the area and can cover them.
② Secure a public place (e.g. school, public hall) to have workshops with 20 to 30 people③ Share the current situation and aims of the organization
Representatives, who were decided in stage①, hold a workshop to share the current situation,awareness of HIV/AIDS issues and aims of activities with others.
④ Participants in the workshop hold other workshops for the community in their activity
areas.
⑤ Form a care team in each area, mainly by advocates⑥ Form a regional or community organization, which includes representatives of care teams
in each area and specialists of different sectors as a parent organization for every care
team.

91

By World Vision――
World Vision decided that representatives of the church/mosque, which strongly
influence social/moral values in the area, should be the main responsible body for thecommunity organization because of the trust of information and sustainability of activities.
Each care team was also formed mainly by the church.
Moreover, local administrative bodies, politicians, and representatives from different
areas (e.g. private sector) are involved in care teams.

Through the usage of publicresources and existing systems, effective advocacy education and care for people with
HIV/AIDS and HIV/AIDS orphans are expected.

Invite people in the community to the meeting and decideto form a community organization. (Kenya)

1-3.

Deciding Components of Activities①Understanding and mapping the situation of HIV/AIDS orphans and people with
HIV/AIDS in the area.
Statistical data・・ Accumulation and management of data and results of survey
Questionnaires
for survey p.106

by visiting house holds②Understand the needs in the area based on
the above-mentioned results.
③Decide activities based on the needs.

＜Four Activities by Community Care Coalition＞
The following are responsible for each activity:◆Preventive Education ・・・ teachers who do extracurricular activities (2)children (4), youth (2)◆Care・・・social workers in the community (2)◆Treatment by collaboration of VCT (Voluntary Counseling and Testing) and health centers・・・staff of the health center in the area (1), health volunteer(1)*Numbers in the brackets show the number of people◆Advocacy activities for the whole area

92

Church/Mosque

Politicians
Private Sector

Opinion Leaders
Local Government

NGOs
Specialists

Community Care Coalition
Care Team

Care Team

Care Team

VCT

Prevention

Advocacy Activities

Care
Visiting Care

Students

Parents/Families

Home Care

Orphans①Each care team forms responsible teams consisting of 4 to 5 people for each activity.
②Each responsible team forms activity teams, including people in the community, andmakes a structure that allows them to move more easily in a broader area.
③Each team plans activities and implements its plan.
④Care teams have a regular meeting every month and ensures the activity process andaims of activities.

If necessary, activity aims and plans are modified for further activities

that meet the needs in the community.
Regular coordination meetingby a church/mosque

Workshops for leadersof churches and mosques
Formation of activity team for removing
prejudice and discriminations against HIV/AIDS

Workshops on HIV/AIDS mainly forbelievers of churches/mosques

Care
Team

Care Care
Team Team

Formation of
a Community Organization

NGOs

PrivateSector

Local
Government

Specialists

Formation ofa Group Care Association
Care
Team

Care Care
Team Team

Care

Examination/Treatment

Prevention

Home,
MedicalInstitutions

VCT,
HealthCenters,
Hospitals

Schools,
Public Hall

Home Care, Orphans

Students, Parents

Advocacy Activities for People in the Community

93

OpinionLeaders
Politicians

2．HIV/AIDS Activities by Community

2-1. Preventive Education●Targeted peopleChildren, their parents and people in society●Implementing Bodies
・Care Group members・・・teachers who do extracurricular activities (2)Training in Kenya

children (4), youth (2) *Numbers in the bracket shows the number of people

・Care team members formed in each area
・Activity teams consisted of people in the community (care team members
mainly organize this.)・People in the community who attended workshops and training sessions about HIV/AIDS●Facilitator
・ People in the community who attended workshops and training sessions about HIV/AIDS(including care members)・Specialists in the health centers and local administrative offices in the area
Teachers and volunteers in the area, who received training about basic sanitation including
the HIV prevention organized by the Areal Development Program or local government, teachchildren in the area.

●Teaching Materials
Some countries have their own textbooks for HIV/AIDS education and provide schools andhealth centers with them.
NGOs.

There are many textbooks issued by the United Nations and local

Teaching materials with pictures are suitable for the area with low literacy rates.

Teaching Materials by World Vision94

Students read (left), sing songs (below) and perform a play about HIV/AIDS (right).

Points◆Secure a public place (e.g. school, public hall) to haveworkshops with 30 to 50 people◆ Sessions on preventive education should beorganized as extracurricular activities by using lunch
time and after school time. This is easier for children
to gather.
◆When knowledge on basic sanitation (e.g. washing hands before meals, how to wash body, how tobrush teeth) are included in the HIV/AIDS prevention, parents tend to accept it.
◆When presenting what students learn by playing, reading poems and singing in a school play,students can use learning topics in textbooks.
◆When children create the content of their presentation, staff or teachers have to teach preventive
education.

By leaving textbooks and including original material, the children’s level ofunderstanding is examined.
◆By opening a school play for the community, illiterate people canenjoy it and learn about health issues◆To families without students and people who live far from schools
and health centers:●Care teams visit and open workshops there●With the coordination of local administrative bodies, facilitators

Mobile HIV/AIDS learning workshop

or people who can be responsible for care team activities visit and form care teams.
●With the coordination of leaders of churches/mosques and community elders, implementers work
for more people in the community by using time after plays in churches/mosques and through women’s
associations in the area.
These activities cannot be done without coordination with religious bodies, opinion leaders, local
governments, politicians, and the private sector. Care groups need to have representatives from eachsector, exchange information in regular meetings, and build cooperative relationships.

95

2-2. Care

●Targeted People
People who need support to live, such as orphans, one-parent families and poor families.
By survey through questionnaire, staff understand the targeted people.

●Implementing Bodies
・Care team members in each area
・Activity teams, consisting of people in the community, formed by care team members
・People in the community who have attended workshops and training sessions about
HIV/AIDS・Specialists who belong to health centers and local governments in the area

●Activity Plan
Activity teams regularly visit families, and make sure support provided meet each situation.
Based on this, the teams think about and decide on the following points:
・

Budget ( cost for activities, financial resources )・

Number of people (number of people a member can care for)・Necessary materials (e.g. disposable gloves, antiseptic solution)

Staff visits each family and listen to them.

By World Vision――
The care group checks the budget plan made by each care team and applies the budget for
the Area Development Program.

The care group has two social workers who know about

price and care methods. In order for people in the community to manage activities andfinance, Would Vision holds workshops for program management, including budget
planning and implementation, and forms the organization structure.

96

2-3.

Utilization of VCT and Health Centers

People in the community can receive examinations and treatments for HIV/AIDS at
Voluntary Counseling and Testing (VCT) centers, public and private hospitals and healthcenters in the area.
At VCT centers, various services specifically for HIV/AIDS, including checking theinfection and giving people prevention methods, are expected to be available.

However,

HIV infection routes are closely related to privacy and many people believe that visitors of
VCT centers are people with HIV/AIDS or “sinners.” Therefore, it is difficult for people
just to visit a VCT center; VCT centers are not utilized enough. The structure by whichpeople can use VCT centers like other medical institutions is essential.

■Components of Activities
Training for People in the Community/Health Education・Facilitators (staff of VCT and health centers) give training and health education to nursing
volunteers in the community.

They provide knowledge about simple sterilization,

treatment for bruises and bedsores, and how to hold patients, as well as new information
about HIV/AIDS treatments, to improve information necessary for visiting care.

Finely-tuned Response to Needs
・When representatives of VCT centers and health centers become members of care groups,
they try to respond to various needs.

Regularly Sharing Information
・Through the regular care group meetings, information about people whoneed medical support is shared, and support which meets needs becomes
possible.
By closely exchanging information among administrative bodies andhealth institutions in the community, administrative bodies are able tounderstand the current situation. And they may be encouraged to use
public finances and resources in cooperation with other bodies, as well as toPeople waiting for clinical examination

secure necessary stocks of medial goods and medical staff. Opinions andat a health center in the area

consultations from families during home visits are reflected in these meetings.

By World Vision――
World Vision introduces institutions that meet the needs of the people who needexamination for HIV infection.

World Vision closely coordinates with VCT centers,

public health centers, hospitals and health posts. Staff of the health centers and healthvolunteers also work as care group members.

97

＜Potentials and Challenges of VCT centers＞
VCT centers need to improve VCT functions and coordinate with other sectors in working
on problems that needs other sectors’ support. (e.g. preventive education, advocacy
activities)

Expectation (potentials)
VCT staff members need to clearly explain the procedures, from concrete examination toresults notification, to visitors and people who are interested in VCT. Follow-up after
results notification in particular need to be explained well.

VCT staff members give

advice for their lives if they are HIV positive.
VCT centers have proper management structures not to reveal private information,
including information about people who undertake examinations.

Moreover, it isimportant for VCT centers to coordinate with churches and mosques that are influential in
the area, and to gain trust of VCT staff from them, since VCT centers have highly private
information.
Staff in the VCTsection of a public

Challenges (Limitations)

hospital

HV/AIDS has a series of issues, including preventive education, advocacy activities, HIVblood testing, follow-up after results notification, and care for people with HIV/AIDS.
Among these issues, VCT centers deal with a part of it. Therefore, only VCT centers andactivities at VCT centers are focused, and there is a possibility that VCT centers are isolated
in the community. For effective preventive activities, it is important for VCT centers tocoordinate with other departments and institutions that do other activities.

Staff at a VCT center in a district hospital98

【Example 1: Activities of Care Teams】

2004

Hold meetings for all priests in area.

World Vision invited about 50 people from nine different religious schools to participate in themeetings.
Purpose：① To understand the situation of HIV/AIDS in the area, organize one groupconsisting of different religious schools and religions and do advocacy activities.
② To train and educate local people engaged in the activities

2005③ To form concrete active plans for a desirable society
35 people formed a care group association.
26 out of 35 people then created 26 care teams using the church as a base
The care teams started home visits to understand the current situation and began life skills training.

2006

The representatives of the care teams got together periodically and formed a regionalgroup care association with specialists and regional leaders.
The care union held its first workshop.

orphans
andandpeoplewithwith
HIV/AIDSin theinarea.
2007onwards
onwards ★To★To understandunderstandHIV/AIDS
HIV/AIDS
orphans
people
HIV/AIDS
the area.
2007
Dividedhouseholds
in theproject
areasareas
into 4 into
regions
and assigned
members members
do home visits.
Dividedthe
the2,900
2,900
households
in theproject
4 regionsand assigned
do homevisits.practice advocacy activities for prevention at school★To
Club” (referto 101 activitiespage) has afor
meeting
every atweek
after school.
“Health★To practiceadvocacy
prevention
school★To
reduceand discriminations
againstevery
HIV/AIDS“HealthClub”prejudice(refer to100page)
has a meeting
week after school.
Aftermembers
visitedandthediscriminations
homes of peopleagainstwith HIV/AIDS,
people started talking about HIV/AIDS.
★To thereduceprejudice
HIV/AIDSThis contributed to a decrease in prejudice and discrimination.

After the members visited the homes of people with HIV/AIDS, people started talking about★Events
Advocacy
HIV/AIDS.forThis
contributed to a decrease in prejudice and discrimination.

Holding football matches, which is popular in the area, and using these opportunities for advocacy.

★Events for Advocacy★Suggestions to the local government

Holding football matches, which is popular in the area, and using these opportunities for advocacy.

For better activities against HIV/AIDS, care teams collaborate with the Ministries of Education and★Suggestions
to thelocal using
government
Healthand promote
activities
existing public facilities and specialists.

For better activities against HIV/AIDS, care teams collaborate with the Ministries of Education and
Health and promote activities using existing public facilities and specialists.

Results：＊ Local administrative officers and heads from the districts and villages started participating in the training
unofficially and officially. They positively learned many things and used that in policy making..
＊ A support group for people with HIV/AIDS was formed, and it received funds from local governments.
＊People from the central government visited the program areas, observed the activities,
and introduced the experience in the area to other regions as examples.

Members of Care Activities

Regional Group Care Association

Roles
Technical Support/Specialist Advice

Local Administrative Officers
Representatives of Specialists from Different Sectors
Politicians, Opinion Leaders
Representatives from Different Religions and Religious Groups
Representatives from each NGO/CBO in the area
Representatives from Home Visiting Care Staff of Care Teams
Representatives of Orphans
Representatives of People with Chronic Diseases and HIV/AIDS

Representatives from Different Groups

Representatives of Beneficiaries
Care Team
Members
Religious Leader（Priests, Board member）

5

Male Villager

2

Female Villager

6

Youth Group Member

2

Primary School Teacher

2Social Worker

2

Church Member
Representatives of Children

3
4

Total

26

Teams
Prevention
Care Support
Treatment
Advocacy
Total

7
7
5
7
26

99

【Example 2: Health Club】
On the basis of the counseling sessions for individual guidance in 2003, a health clubwas formed in 2004. The member students were 68 at the time. The number of members
increased to 149 students out of 221total students in 2006. This is about 67 percent of thetotal number of students at the school. All responsible teachers finished one of the
HIV/AIDS trainers seminars run by the Kenyan Ministry of Education, World Vision
Regional Development Program or other NGOs.
Date and Time：About one hour, every Tuesday after school
Qualification of Participants：Students aged 13 years old and above who are interested in
Health Club activities. No participation fee. (We allow children aged 10 years old andabove to participate in the club, since they have enough ability to understand.)Content：We study the issues below using textbooks.
▽HIV/AIDS−prevention of HIV infections, attainment of life skills, advocacy of issues about
HIV/AIDS, care for people with HIV/AIDS (home care)▽Environmental Sanitation −suggestions of concrete ways to make living environments clean▽Basic Sanitation − how to keep clean and how to protect ourselves from danger▽Essay Writing − write thoughts about what has been learned in the clubs and submit them.

◆Question Box−Students can write about what they are unsure of and questions from the class.
▻This question box helps teachers grasp the level of understanding of students.

This

gives feedback opportunities to students.
◆Guest Speakers−On the basis of questions in the question box, teachers invite appropriate specialists andtrainers and ask them to answer students’ questions.
▻ Parents can also listen to guest speakers.

These opportunities help parents understandthe activities and encourage them to cooperate with the club.
◆Presentation Day−Presentation Day is held once in three to six months on the bases on the learning content.
▻ Presentation Day is open to the community, so that Illiterate children, people withoutchildren, and children not attending school can effectively access information and share thecontent of the class.

Results：＊Children started accepting HIV/AIDS issues naturally and talking about HIV/AIDS
openly.
＊The community shared information which was used to be only for doctors and nurses.
And people in the community started supporting and understanding each other.

100

【Example 3: Training of Peer Educators 】▽Students aged 13 years old and above with recommendation by teachers canbecome candidates for peer educator.
▽ Teachers recommend one student from each class based on academic
performance and personality, but in many cases, class representatives arechosen.
Peer educators help teachers who are responsible for the health club and theygain more knowledge by learning of the process of health club activities.
Moreover, peer educators partly teach classes, explain the content of the classand answer questions. Also, they sometimes answer questions in the question
box when they are asked to by teachers.
Peer Educators:：＊Prepare classes for Health Club（Health Club）＊Support teachers in classes＊Explain the content of the class−Teach one session＊Counsel other students＊Provide support for events about HIV/AIDS and health organized outside of school

Twenty peer educators have been trained so far, and eight of them stopped
their activities after leaving school.

How to influence the community by

utilizing the experience of peer educators after graduation is a challenging
issues.

【Example 4: Care for Orphans and People with HIV/AIDS】

World Vision classifies the situation of orphans into three groups andspecifies priority orders for assistance.
Priority

Classification of Orphans

1① No Parent

2② One Female Parent

3

One Male Parent

4

No. of People
15③ One Female Parent in Poverty
Total

51
86
152

On the basis of hearings from care team members’ home visits, World Vision
supports the healthy growth of children from three perspectives; education,
nutrition and periodical monthly visits by members.

101①-1. A girl with no Parent
The girl knows about HIV/AIDS since a doctor told her grandmother that her mother’s
death was caused by AIDS. She has four siblings. After her parents died, all of themwere adopted into different families. She lives with her grandmother now. However, thecrude house is badly ventilated and she has eye troubles due to the bare mud floor. They
sleep on cloth bags which do not keep them warm enough.

She has only one unclean

clothes. They eat food from the two-acre plots that her grandmother cultivates. They eat
only twice a day and share the food that is supposed to be only for her grandmother.
Therefore, the food is not enough for two people.
World Vision supports this HIV/AIDS orphan by providing her with an education andclothes.

①-2. A Woman who lives with seven grandchildren who have no parents
She lived with her son, son’s wife and four grandchildren.
her son and his wife went mad anddied.

However,

After one year,

her daughter lost her husband, got sick, and came to her with threechildren.

Her health became worse, and she went mad and died, too.

The seven grandchildren were left, and they share food from s two-acre plot in thegarden.

Although the room is not big enough for eight people, they share a few rushmats and blankets.

The bare mud floor is unsanitary and one of the grandchildren got

bacteria from a toenail, which caused edema in his left foot.
One World Vision staff who started activities in the village heard about the situation andidentified that these seven children are HIV/AIDS orphans.

She registered the family toreceive support. This family will receive an education and clothes from World Vision.
They are also currently registered as a candidate family for house construction support.

②One Female Parent (The mother is the income earner.)
She has three children who go to school. She cultivates a 1.5-acre plot and has four
cows, four sheep and four goats.

Since she has asthma strokes when the climate changes,

it is difficult for her to do physical work.
Children started going to school with the support of World Vision. Moreover, they arealso on the waiting list for clothes support since their clothes are damaged and unclean.
Periodical care team visits are kept short (within one hour) because the mother is busy withwork.

③Female Income Earner
She raises five children as a single mother.
woods and sells it for a living.

She gathers charcoal for fire in the

There is not enough food and her children arealways hungry. They are often absent from school since they do not have physicalstrength. They do not have enough money to buy school uniforms and stationary. Even if

102they can go to school, it is difficult for them to catch up with other students. Although
they discuss their future sometimes, they are busy trying to surviving each day.
World Vision gave the three children educational support and gave the family a goat for
nutrition. They can gain nutrition by drinking goat milk. Also, they can promote thegoat to mate with other goats and sell the offspring at the market. They can gain animal
protein by eating goat meat.
When World Vision judges that the unsanitary environment hurts health conditions, it
provides corrugated iron and wood for a roof and renovates the house with care teammembers and communities. It also provides support for the treatment and examination feesof people with HIV/AIDS based on their needs, which meet the criteria set by the caregroup association and their activity plan.

A bus which takes people to the hospital for treatment andexamination every week
World Vision covers the transportation fee for going to hospitals.
More recently, since income generation programs for people withchronic diseases (goat raising, job training etc.) help people pay fortransportation fee, the support from World Vision is decreasing.

4 Children who lost their parents to AIDS live in this house.
Their neighbors who know World Vision activities reported them to World Vision. The two elder
brothers stopped going to school in order to work for living.

However, they could not get work

because they are still young (one of them is only 14 years old). They just helped their neighbors to
get some food, and share it among them.
World Vision renovated their house, supported the three children in getting an education, andBeforeRenovation

gave the eldest brother training in wooden furniture making.

【Example 5: When an activity plan is formed…. 】
We need to know the uniqueness of the area, including the main cause of infections, inorder to do effective advocacy activities. The ordinary routes of infections are, of course,
written in the existing manuals. However, infection routes are sometimes rooted in uniqueAfterculture, custom and practices in the area.
In one program area in which 98 percent of people are Masai, people live with theirtraditional customs and practices.

Among various customs, female genital mutilation(FGM), which is one of the possible factors of HIV infections, is normally practiced in thearea. People in the area need time to understand that what they normally practice as theirtraditional custom has a danger of HIV infection.

In the program, World Vision does

advocacy activities for HIV/AIDS prevention. However, World Vision needs to change
each villager’s idea about FGM in order to do effective advocacy activities.

103

Renovation

For instance, although FGM is banned in Kenya, people still practice it in the program
areas. Denying FGM means not only denying marriage with Masai men but also leaving
Masai society for women.

They have to move to other area. Therefore, mothers whopracticed FGM force their daughters to do it. Even if mothers know the negative effects
from FGM, it is difficult for women to deny FGM in Masai society.
In this situation, World Vision started advocacy activities against FGM this year. It
shows the community how FGM damages girls’ lives and the negative effects that FGM
might cause in their lifetimes on the bases of rights of children and women. World Vision
implements programs which bring behavioral change, including the prevention of HIV
infections.

【Example 6:

Utilization of VCT Centers 】

We need to not only impart knowledge about the prevention of HIV infection, but also
act against actual infections for effective advocacy activities.

To do so, each villager has

to take an examination, understand his/her condition, and do appropriate actions based on
the result of the examination.
VCT centers provide examinations for HIV infections and their aftercare (treatment,
counseling). However, in some areas, centers are not accepted before they can properly
function in this way.

Even if a center has quality medical staff and the necessary medical

equipment, people in the community sometimes think that a visit to the VCT center meansthat there is a HIV/AIDS infection involved or that the person going there is “someone who
did something risky for infections. Although these people understand the importance of
VCT centers, they cannot utilize them due to their underlying emotions.
This also relates to discrimination and prejudice against HIV/AIDS in the area.
Moreover, in the areas where many children and villagers die from diarrhea, malaria, andother infectious diseases, including tuberculosis, VCT centers, which only deal with
HIV/AIDS, sometimes provoke antipathy with discrimination against HIV/AIDS.
In this area, there are few people who have officially died from HIV/AIDS. However,there are many villagers who went mad before they died. Therefore, regional health centersestimate that many people died from AIDS. People cannot accept that their family member
died because of AIDS since they will be discriminated in the area.
In order to deal with this situation, World Vision forms VCT sections in the existingregional medical centers or health centers, or health posts which also provide treatment forordinary diseases.
The care group association and care teams periodically hold meetings and try to do
support activities which meets the actual needs based on the reports from responsible staff.

104

Part4 Appendix

Appendix 1：Focus Group Interviews for Teachers Questioning Route

Focus Group Interviews for Teachers Questioning RouteOpening Question
1. Please tell us about health problems in this area or school.
May be you could begin by telling us what are the biggest health problems for each of you.
Introductory Questions
2. How do you deal with those health problems in this school?
3. Could you explain about health education in this school?
Do you have school curriculum on health education in any means?
Transition Questions
4. In your opinion, what would you really say is of particular importance to you in healtheducation?
Key Questions
5. What do you think of AIDS education in primary schools?
Who should be involved in AIDS education planning?
6. Could you tell us anything you know about HIV/AIDS? (knowledge, situation in the community)
How did you get that information?
7. What would you think is the biggest challenge for teachers to deal with AIDS issues?
Do you think the community members feel confident or comfortable in talking about AIDS?
Ending Questions
8. Is there any other issues relating AIDS in your school?
9. Could you say that a workshop on AIDS could help you to deal with AIDS in your class?
10. Feel free to tell us if there is anything you think we left out that we should talked about?
Other questions
Access to materials on HIV/AIDS education
Expected support from the community when conducting AIDS education
Teachers’ knowledge on AIDS and other health related issues
Early marriages in the area.
School-drop out in relation to early marriage

105

Appendix 2：Questionnaire for a Feasibility Study of School Health Project in Nuu

In-depth Interviews for Parents Questioning RouteGeneral questions on health in the community
1. Could you tell us about health problems in this area?
2. What are the challenges people have in the area when they are sick?
3. How do people treat their diseases?
Hospital,
Wanganga,
Traditional medicine
HIV/AIDS related questions
4. What are the recurring sicknesses?
5. What do people fell towards people who die of untreatable diseases?
6. Could you tell us anything you know about untreatable diseases (AIDS)?
Infection, Cure, Prevention, Risky behaviour
7. Do the community members feel comfortable when talking about AIDS?
What are the obstacles, if any?
FGM related issues
8. What is the average age of girls to get married in the community?
Why?
Forced or willingly
9. How are the girls ready for marriage?

10. Is there any traditional ritual to be taken for a girl to get married? If any, what and why

11. What do you think is the danger of early marriages/FG

106

Appendix 3：Questionnaire for a Feasibility Study of School Health Project in Nuu

Questionnaire for a Feasibility Study of School Health Project in Nuu
Please fill in this form and put it in a bag. There is no need to give your name.
1.

Are you(2.

) a manor() a woman?

() In the thirties

How old are you?
(3.

) In the twenties() In the forties() Over fifty

What is your religion?
(

4.

) Catholic() Protestant() Muslim() None() Others []In Guidance and Counselling, which topics have you dealt with in your class or school?
(Choose as many answers as you like.)

5.

() Girls’ education() Morality() Environment activities and conservation() Career guidance() HIV/AIDS() Children’s rights and act() Drugs and smoking() None() Others []How much information on health issues do you cover in your class?
() As much as a syllabus requires(() a little less than a syllabus requires) Add more information than a syllabus requires() None6.

What health activities do you practice in your class or your school?

7.

On what topics do you want to get information in a workshop with CanDo?
(Choose as many answers as you like.)

8.

() Nutrition() Sanitation and hygiene() First aid) Ordinary diseases and their preventive measures(() HIV/AIDS and its preventive measures) Others []Have you ever attended seminars or workshops dealing with health issues?
(

9.

(

) None() Once() Twice() More than twice

In your opinion, which practices should be retained as tradition in the community?
(Choose as many answers as you like.)() Early marriages() Kaweto() Female circumcision() Male circumcision() Polygamy() Traditional medicine() Wife inheritance () Wanganga() Others [107]

Appendix 3：Questionnaire for a Feasibility Study of School Health Project in Nuu

10. In general, how can HIV be transmitted? (Choose as many answers as you like.)() Toilets() Kissing() Sexual intercourse() Mosquitoes() Blood transfusion() Sharing needles and blades() Breast feeding() Shaking hands() Sharing cups and spoons() In the womb(

) Others []11. If someone is infected with HIV, which of these statements is true?
(Choose as many answers as you like.)() He or she has AIDS.

() He or she may not have AIDS yet, but will almost certainly develop AIDS.

() He or she could stay healthy for a long time.

() He or she can pass HIV to other people only when he or she is sick.

() He or she could pass HIV to other people.

12. In general, do you think that people who have sexually transmitted infections have been immoral?
1. Definitely 2. Very likely

3. Likely

4. Perhaps

5. Not likely

13. If you knew that one of your community members was infected with HIV, would you feel happy tocontinue working with him or her?
1. Definitely

2. Very likely

3. Likely

4. Perhaps

5. Not likely

14. In general, do you think that children in your school are vulnerable to sexually transmitted infectionsand HIV?
1. Definitely

2. Very likely

3. Likely

4. Perhaps

5. Not likely

15. In general, do you think that adults in the community are vulnerable to sexually transmitted
infections and HIV?
1. Definitely

2. Very likely

3. Likely

4. Perhaps

5. Not likely

16. Which one of the following statements is closest to how you feel?
( ) AIDS is mainly about morals. Religious leaders and organisations must convince people oftheneed to protect themselves from AIDS.
() AIDS is mainly a health issue, so workers in the health sector are mainly responsible forresponding to AIDS(

) All the members in the community are responsible for working together to prevent HIV infection
and to stop AIDS.

() AIDS is mainly an issue of education. Workers in the education sector have to protect the next
generation from HIV infection.

() AIDS is mainly an issue of individual behaviours. Parents are mainly responsible for providing

108Appendix 3：Questionnaire for a Feasibility Study of School Health Project in Nuu

enough knowledge to protect their children from HIV infection.
17. Through which means do you have access to the updated information of HIV/AIDS?
(Choose as many answers as you like.)() Radios() church workshops() Newspapers() None(() VCT centres() Barazas) Others []18. Which one of the statements is closest to how you feel?
() The knowledge of condom use should not be passed on to pupils because it would encourage
immorality.

() The knowledge of condom use should be passed on to pupils at school to protect themselves,depending on the age of pupils.

() The knowledge of condom use is necessary for pupils but should be passed on to pupils by theirparents.

() The knowledge of condom use is necessary for pupils but should be passed on to pupils by thecommunity rather than the school.

19. Which one of the statements is closest to how you feel about the effectiveness of condoms inpreventing infectious diseases?
() I believe the effectiveness of condoms and use them in practice.

() I believe the effectiveness of condoms but find it difficult to use them in practice.

() I have some doubts on the effectiveness of condoms.

() I don’t believe the effectiveness of condoms at all.

() I don’t have accurate knowledge of condoms and can not judge their effectiveness.

20. What kind of difficulties would you worry about in having a workshop on health issues together withparents at school?

21. Any other comments to CanDo?

Thank you very much for co-operation.
June, 2004
Yuki Nakamura,

CanDo Nairo（Reference of the appendix 1 to 3: Yuki Nakamura, “A Feasibility Study For a School Health Project In
Nuu Division, Mwingi District, Kenya”, CanDo, Oct 2004.）

109Appendix 4：A Sample Lesson Plan and Lesson Note (for facilitation)/ Religious Education for 5th GradeA SAMPLE LESSON PLAN
Class
Std 5
Subject
C.R.E.
Topic
Growing up in Christ
Subtopic Effects of irresponsible boy/girl relationships
Objective
By the end of the lesson, the learners should be able to know that being responsible in their relationships can savethem a lot of pain, regrets and sufferings
References Primary C.R.E. teachers guide pages 6-7
Primary C.R.E. pupils book 5 pages 10-12
The Bible: 1 Corinthians 6:12-20
Teaching/Learning Resources
The bible, Pupils books page 10-12,
Presentation
TEACHERSʼ ACTIVITY
STEP I

Through asking oral questions and discussions,

PUPILSʼ ACTIVITY
Give oral answers from the previous lesson.

teacher connects the lesson to the previous one
or boy/girl relationships

STEP II・Teacher guides learners to act a

・Act the drama and discuss somedrama to elicit a discussion on

points they learnt from it.

effects of irresponsible behaviour,.

and from which, brings out othereffects like school drop out,
sexually transmitted infections.
・Teacher reads 1 Corinthians 6 and advises
learners on how to use their bodies. Asks the・Listen to the Bible reading and say
how they think bodies can be misused.

learners, to say how bodies can be misused.
STEP III

Teacher infuses emerging issues by sensitizing

Mention some responsible behaviours regarding

learners on HIV/AIDS and child abuse throughHIV/AIDS and some child abuses they know.

explanation and discussion
STEP IV

Teachers assigns learners to answer questions

Answer questions to bring out the main points ofon Page 12 of their books to summarize thethe lesson.

lesson.
CONCLUSION

Teacher marks pupils work giving corrections
where necessary.

REMARKS110

Do corrections appropriately.

Appendix 4：A Sample Lesson Plan and Lesson Note (for facilitation)/ Religious Education for 5th Grade

Lesson Note (for facilitation)
EFFECTS OF IRRESPONSIBLE BOY/GIRL RELATIONSHIPS

StepⅡ
Objective:• learners to learn/acquire attitude to be responsible for themselves, respect their bodies and othersʼ bodies.
(i) Explain the importance of being responsible for their bodies as one matures and coexists with others in various activities-God designed bodies in his image and likeness and are meant to be holy as they are the temple of the holy spirit-As one matures there is need to have self acceptance, be responsible for his/her behaviour to avoid any serious effects.
Question: what is one supposed to do to make his/her body the temple of the holy spirit?
Message: One needs to be responsible, have respect for his/her body.
(ii) Explain what irresponsible behaviours are and their effects
These include(a) ・Irresponsible sexual behaviour which may lead to teenage pregnancy leading to school drop out.
・One needs to have a baby when they are mature enough and can take good care of it(b) ・Sexually transmitted infections like syphilis, gonorrhoea, chlamydia and herpes.
・This is sinning against the body ‒ 1 Corinthians 6: 12-20.
Question: What is the impact of irresponsible relationships between boys and girls?
Message: Need to have responsible relationships for they complement each other invarious s activities in school or society to avoid contracting STIs, and continuelearning.
StepⅢ(iii) Responsible behaviour regarding HIV/AIDS
Objectives:• not just telling modes of transmission of HIV as emerging issue but need connecting the issue of HIV with responsible
behaviour which is the main theme of this topic.
• By knowing other ways of transmission of HIV, learners to learn all the responsible behaviour as well as sexual behaviour.
(Review knowledge of HIV/AIDS transmission)
・There is need for one to be honest and faithful to their partner
・Blood transmission-need thorough screening
・Sharing sharps with infected persons
Message:・One needs proper knowledge to avoid the risk of infectious for living in an HIV/AIDS society.
・Irresponsible sexual behaviour is not the only way through which HIV is transmitted
・Be able to give positive influence and direction to the society
・Be responsible on their behaviour regarding others and respect others.

(iv) Responsible behaviour regarding Child abuse
Objectives:• Learners to learn how child can be abused sexually and acquire skills to defence themselves from abuse and be assertive to
avoid the situation which may cause misuse.
Explain what child abuse is.
・Children can be abused by grown-ups sexually through:・Rape・Being lured into prostitution
・Incest・Children learn to be assertive and say no to what is not right for them to do.
・Adults need to change attitudes towards children
Question: what is the importance of children getting information on child abuse?

111

Appendix 4：A Sample Lesson Plan and Lesson Note (for facilitation)/ Religious Education for 5th Grade
Message:・Should have the proper information to avoid situations leading to abuse and report any
cases of any form of sexual abuse by adults to any relevant authority
・Childsʼ rights should be upheld by all in the society they live in.

ELABORATION ON RESPONSIBLE BEHAVIOUR REGARDING HIV/AIDS
(i)
-

(ii)
-

Responsible behaviour to protect themselves and others from HIV infection (including other modes of transmission)
Be able to explain that irresponsible sexual behavior is not the only way the HIV is transmitted
Be able to use sharps responsibly and be able to advise others on the same to avoid HIV infections especially those who carry out
some traditional practices in the society they live in.
Covering wounds properly to avoid infection of HIV through them in case they come into conduct with infected blood
Use protective materials when assisting an injured person
Boys/girls to respect each others bodies by not engaging in sexual activities and avoid inadequate behaviour.
Should be able to say no if one suggests some form of irresponsible behaviors
Children not to allow adults to misuse themselves sexually

Responsibility for living in the society with HIV/AIDS including other people
Should interact freely and responsibly, respecting each others ideas and status, as they perform various activities both at school andthe society they live in
Discuss and share information on various modes of HIV transmission and precautions to take to prevent the transmission
To give positive influence and direction to society towards protective (prevention?)of HIV/AIDS infections
Make an impact in the society by being a role model(Influence )Adults to have appropriate attitudes towards children(iii)
INCLUDING OTHER POINTS FROM OTHER STEPSChilds rights to be observed by adults for not abusing them sexuallyChildren to be assertive enough and say no to what is not adequate for them to do. In case they are forced, they should report
immediately to the relevant authority.
Avoid situation which might bad to sexual abuse.
Encourage self acceptance regardless of ones situation (be confidence enough in their situation so that can stay away from risks
caused for their wants.

112

Appendix 5：A Sample Lesson Plan and Lesson Note (for facilitation)/Social studies for 5th GradeGroup A-1
CLASS: STANDARD 5
SUBJECT: SOCIAL STUDIESTOPIC: INTERACTION
SUB-TOPIC: SOCIAL RELATIONSHIP IN THE NEIGHBOURHOODOBJECTIVES:
By the end of the lesson pupils should be able to;▷State at east five ways in which people interact

REFERENCE:▷

Social Studies Pupils Book 5 Pg 68-69

PRESENTATIONSTEPTEACHERʼS ACTIVITY

PUPILS ACTIVITYI

Ask oral questions to review previous learnt

Answer orally in turns

lesson e.g. what is interaction? How did
people in the past interact?
II

Lead a discussion on the social relationships

Participate actively in the discussion by giving examples onin the neighborhood

the questions e.g. youth groups, religious groups

Infuse HIV/AIDS as an emerging issue inGive examples of irresponsible behaviors which can beevery group mentioned

brought about by the groups

IV

Give notes in form of blank spaces

Write notes and fill the blank spaces

CONCLUSIONMark and give corrections where necessary

Do correction appropriately

III

Lesson notes
Introduction
How did people interact in the past?
▷

Trade

▷

Inter-marriage▷

Games and sports▷

Sharing of foodDiscussion
Social relationships (explain)▷

Are things done by people living in the same area either in rural areas or urban centers•

Religious groups e.g. evening fellowships, choir, youth camps etc. Guidance and counseling (visiting the infected and affected)•

Youth groups e.g. football clubs. Engaging the youth to avoid idleness; allowing members without discrimination against theinfected•

Welfare societies e.g. funeral societies. Assisting and caring for the affected e.g. orphans•

Co operatives e.g. harambees/fundraising towards care of the HIV/AIDS affected•

Women groups e.g. discussing on modes of HIV/AIDS transmission, Prevention, care of the HIV/AIDS infected and affected.
Contributions towards assisting HIV/AIDS infected/affected mem

113

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops

BASIC INFORMATION ON HIV/AIDS~Handout for HIV/AIDS Training in Mwingi District~
2nd Edition, May 2005

14
12
10
8
6
4
2
0
15
-1
9
20
-2
4
25
-2
9
30
-3
4
35
-3
9
40
-4
4
45
-4
9

Already it has been declared a national disaster in ourcountry in 1999. Adult HIV prevalence rose from 5.3%
in 1990 to 13.1% in 1999 [NACC 2000].

HI V P r e vale n c e by Age gr o u p an d S e x
Percentage HIV Positive

1. BACKGROUND
HIV/AIDS is now a serious issue that has increased
mobility and mortality among the people in many parts of
the world, especially in Sub – Saharan Africa.
In Kenya, HIV/AIDS is a very serious matter among otherparts of Africa as a whole.

women menIn the year 2004, the prevalence rate was announced toAge
be 6.7% according to Kenya Demographic and Health
Survey 2003, it doesn’t necessarily mean that the prevalence has dropped because the methodology ofdata collection is different. Also it is important to note that the rates differ from male to female. 700
Kenyans were said to be dying from the disease each day [NACC 2003].

Mwingi District is not left out, and therefore, the importance of incorporating the HIV/AIDS basic facts tothe teachers and the school communities, given the fact that, the community should have the facts so as tochange the risk behaviour in the society as well as to pass them to the youth.
2. WHAT IS HIV/AIDS?
HIV is the virus that causes AIDS. HIV is short for Human Immunodeficiency Virus.
Human
the people/persons
Immuneresistance against diseases
Deficiency lack of resistance to infections
Virus
smallest organism that cause diseases* HIV causes AIDS by reducing the ability of the body to defend itself against infection.
AIDS stands for Acquired Immune Deficiency Syndrome.
Acquired something you get (not born with)
Immunethe resistance against infections
Deficiency
lack of - in this context, lack of protection against infections
Syndromea group of or patterns of signs symptoms
3. HOW IS HIV TRANSMITTED?
As it has been seen, a person can get HIV infection through several ways.
3 major modes of transmission of HIV are:(1) Sexual intercourse
Penetrative sex always carries risk of HIV infection. In addition, some ofthe sexual practices have higher risk of transmitting the virus because ofincreased possibility of breakages of skin.
Anal sex (sexual intercourse using anus)“Dry” sex – when the vagina is or gets dry, the friction
can lead to bruises or abrasion.
When either of the partner has STIs.

- 114

-

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops(2) Contact with blood or other body fluids- blood transfusion from a person who has HIV- practices by sharing contaminated instruments (needles, syringes and knives)* These include circumcision ofboth males and females, skinpiercing, scarification, traditional
healing like tattooing and others.
- birth attending- burial practices where the bodycome to contact.

fluidsmay(3)
Mother to child– in the womb, during birth, and breast feeding
4. HOW ONE CANNOT GET HIV?
HIV is not transmitted through casual contact with another person.
This includes holding hands, hugging, kissing, sharing food or drink.
HIV cannot be transmitted by mosquitoes or biting insects.
YOU CAN’T GET HIV FROM:• Mosquitoes, flies or other insects• Sharing latrine or toilet• Sharing food, drink or cooking utensils• Holding hands, shaking hands or hugging• Dancing, swimming• Coughing or breathing• Living together

It is important toshow normal care
and affection topeople living withHIV and AIDS.

We can work, study or live with a person with HIV/AIDS
without getting too much concerned, if we are fully awareof how HIV can be transmitted and how it cannot betransmitted in our daily lives.
5. HOW THE INFECTION OCCURS?
When the HIV virus enters the body, then the person becomes “HIV infected” or “has HIV.” For a few
weeks to months, it’s difficult to detect even in a laboratory. This is called the “window period.”
We should be able to know that one can get infected through the above listed ways and that once a
person becomes infected, he/she will always remain with the virus in the body.
The immune system tries to fight the HIV infection with antibodies, but they cannot eliminate the virus
because it hides inside the cell and becomes part of that cell of the body.
So once a person is HIV infected, they cannot be cured of the virus unless the cell is destroyed andtherefore the person.
The antibodies that people who are HIV infected produce are used to test for HIV. Those who have HIV
antibodies are then referred to as “HIV positive” to describe someone who has HIV, and “HIV negative”
to describe someone who does not have HIV virus or the antibodies.
A person may be infected for many years before showing the serious symptomsof AIDS. But it is said that the virus will multiply and bring about full blown
AIDS case at one time. To slow down this process, one has to know his/her
HIV status, as early as possible. Therefore people are encouraged to getcounseled and tested for the HIV status.
During this time the virus is multiplying but the immune system is able to- 115

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops
control the amount of the virus. We say that the virus load is low, but the
How to use condom
person can still infect another person with HIV through sex, from mother to theirinfants, or through contact of blood or other body fluids.

6. HOW TO PREVENT SPREAD OF HIV?
In the earlier stages of infection, an HIV positive person has minimal or no signsof diseases and therefore looks as healthy as before. But the person is capableof passing the HIV to anyone.

“Open the condom package
carefully. Don’t open itwith your teeth.”

Practice of Safer Sex
Penetrative sex always carries risk of getting the virus from or passing thevirus to the partner. If you decide to have any sex, you can reduce the risk ofinfection by practicing safer sex.
Safer sex is any sexual practice that reduces the risk of passing (transmitting)
HIV from one person to another. The best protection is obtained by choosing
sexual activities that do not allow semen, vaginal fluids or blood to enter themouth, anus or the vagina, or to touch the skin of the partner where there isan open cut or sore.
Safer sex practices include:• staying in a mutually faithful relationship where both partners are confirmed
to be HIV negative.
• using condom (as demonstrated) properly and systematically (one newcondom for every sexual intercourse) and for all types of sexual intercourse(oral or vaginal).

“Put the condom on theerect penis; be careful no toscratch it with your nails”“Check if the condom
is put on with correctside, not inside out.”* HIV/AIDS and STIs have correlations in the following ways:•
STIs (Sexually Transmitted Infections) increase the chances of getting
HIV infection.
•
HIV makes it difficult to treat STIs effectively.
Prevention of Mother to Child Transmission
There is risk for a HIV positive woman to transmit HIV to her baby, but there isalso possibility for her to deliver a baby free from HIV infection. First of all, it
is important for a pregnant woman to go for counseling and testing before
giving birth. If you are found HIV positive, it is necessary for you to consult aqualified health worker in order to have enough information on necessary
considerations not to pass HIV to your unborn baby.
7. AIDS STAGE
This occurs when the body immune system has been reduced to very low levels.
Opportunistic infections:This is a condition in which the person infected with HIV develops signs ofrepeated, often prolonged illnesses as a result of the lowered immune system(ability to defend against diseases).

“Unroll the condom tothe end of the penis;
leave a teat at the top.”“Remove the condom
after the sexual act.”

These prolonged and serious illnesses due to the lowered immune system mayoccur after someone has had HIV for two, three or more years. Some cases
have been known to take as long as 10 or 15 years for someone to develop AIDS.
It is emphasized that if these infections do occur, then the person should seek
treatment at the earliest possible time. Treatment should be given by aqualified health worker, and at no one time should self-medication bepracticed.

- 116“Tie a knot to avoid
spilling the semen
when disposing.”

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops

COMMON SYMPTOMS AND CONDITIONS OF AIDSThe symptoms of AIDS differ from one person to another.
Some of the symptomatic AIDS related illnesses and major action to be taken:
General•General malaise (need treatment andnutritional support)•
Loss of weight (need nutritional support)•
Pain (need pain killer)•
Swollen glands (need treatment)•
Swelling of limbs (need treatment)•
Hair loss (need treatment)
Skin and hair•
Itching (need treatment)•
Boils (need treatment)•
Rashes/ skin lesions, ulcerations,wounds (need treatment)•
Fungal infection (need anti-fungal
treatment)•
Thinning of hair (need nutritional
support)•Hair change (need nutritional support)
Chest•
Fever, cough (need treatment)•
Chest pain (need treatment)•
Difficulty in breathing (need treatment)•
TB (need treatment)

Gastroenteritis track•
Diarrhoea (need fluid replacement)•
Difficulty in swallowing (need treatment)•
Poor appetite (need fruit juice)•
Sore mouth (need treatment)•
Nausea and vomiting (need fluid
replacement)•
Abdominal pain (need treatment)
Nervous system•
Headache (need treatment)•
Memory loss and confusion (needsupport & treatment)•
Tingling and numbness of limbs (needtreatment)•
Anxiety and depression (need counselingand emotional support)•
lack of sleep (need emotional support)•
Herpes zoster (need treatment)

Ways to delay the multiplication of the HIV virus leading to AIDS caseNutrition
Good nutrition is extremely important for a person with HIV virus. A well-balanced diet will help
the person to stay healthy longer by providing the nutrients the body needs to fight diseases.

Requirements and sources for good nutrition:[0]• Energy-giving foods: maize, sorghum, cassava, rice, millet, potatoes, avocadosand lemons• Protective foods:
papaya, oranges, mangoes, bananas, green vegetables,
pumpkin, cabbage, carrots and tomatoes• Body-building foods: meat (all), fish, eggs, milk, beans, peas (all) andgroundnuts* As much as possible select locally available foods and ensure that the 3 foodgroups above are covered in everyday meals.
Safer sex
For a person with HIV/AIDS, it is important to use condom every time s/he decides to have sexualintercourse. It can prevent new infection to the partner, and it can also reduce the risk forre-infection from the partner who also has HIV. If a person with HIV gets re-infection, it promotes
the virus to multiply, leading to AIDS stage due to added virus that damages the immune system.
Hygiene and sanitation
These include keeping the house and compound clean. It is very important especially for thehousehold which has a member who is infected with HIV to ensure that the living quarters areclean, safe and pleasant to support physical and emotional health, because a person with the HIV- 117

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops
tends to have weaker immune system compared to the uninfected person, which means s/he ismore susceptible to diseases.

••

House cleaning
Since family members are in close contact with each other, it is very easy to spread
germs and illnesses to the whole family. It is more important to keep the houseclean when there is a sick person because sickness reduces the body’s ability toprotect itself from ordinary illnesses.
This is done to maintain good hygiene to prevent infections and the spread of thesame.
Cleaning the compound
Weeds, rubbish and leftover food can attract rats, flies, mosquitoes and otherpests that carry germs.
The environment should be maintained clean so as to minimize the spread of
diseases and make it a pleasant place to live in.

8. ANTIRETROVIRAL DRUGS (NOT FOR TREATMENT)
Antiretroviral drugs inhibit important enzymes that are needed for HIV to replicate or multiply. By
doing this, ARVs slow down the replication of HIV, leading to maintain strong immune system. ARVs
are not a cure to HIV/AIDS.
They have some advantages and some serious disadvantages.
ADVANTAGES• Restore immune function or slow
the decline of immune system.
• Prolong life and improve quality oflife.
• Improve symptoms of AIDS.
• Decrease risk of illness andhospitalization.
• Improve health and strength;
patients may return to work.

DISADVANTAGES• ARVs are not a cure and may raise false hopes.
• They must be taken for the rest remainder of apatient’s life.
• At least 3 drugs must be taken together to beeffective.
• Most of the regimens have complicated schedules
to be strictly followed.
• Some side effects may impair quality of life.
• If resistance develops, the drugs no longer work
effectively.
• ARVs are expensive medicines.

9. IMPORTANCE OF COUNSELLING AND TESTING FOR HIV
Counseling helps persons to understand HIV and AIDS, to get information to prevent the spread of HIV,and to help those who were found positive to cope and live in a more resourceful way.
Every time a person is going to have an HIV test there should be counseling by a trained HIV counselor
or a medical personnel.
Some other diseases like cancer, TB or malnutrition can look similar to AIDS, and require different
treatment approach than HIV/AIDS. People should be tested to confirm their symptoms are due to
AIDS or to some other diseases. When a person has proper information about HIV/AIDS, it is quite
important to get tested to establish your status, and therefore know how to take care of oneself.
Counseling and the tests can be done in health facilities and in the available voluntary counseling andtesting centres (VCT). In VCT centres, the testing is usually done anonymously.
10. WHAT IS IMPORTANT FOR PEOPLE LIVING WITH HIV/AIDS?
Persons living with HIV/AIDS, in most cases, need special considerations. It is the responsibility of
everyone in the community to understand their needs and to support them, so that the persons with- 118

Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops
HIV/AIDS can enhance quality of their lives in supportive environment.

Support from the family and community members
Persons with HIV/AIDS needs support from the family members as well as from the community
members, socially, emotionally and sometime even materially. Stigmatization involves very
negative connotations or discrimination towards persons with HIV/AIDS, which could bearticulated through verbal or non-verbal communications such as careless remarks and uncaring
behaviour. When there is a lot of stigmatization towards persons with HIV/AIDS, they tend to feel
isolated or neglected, and in worse cases, they feel discriminated. It is our responsibility not tostigmatize persons with HIV/AIDS in the society, so that they can live positively and takenecessary actions to manage the diseases caused by the virus.
It is important to remember the following points when dealing with persons with HIV/AIDS in thecommunity:✻ understand their needs and difficulties they have✻ being understanding, supportive, gentle and responsive✻ maintain usual/normal relationshipIf someone in your family gets infected with HIV, it is necessary for you to make sure that you
protect yourself from coming to contact with the blood or body fluids of the family member who has
HIV, so as to avoid another casualty in your family. Especially when the person with HIV develops
AIDS symptoms, other family members would need to provide intensive care for him/her, which iscalled Home-Based Care. The detailed information on how to take care of the person with
HIV/AIDS can be obtained from the health facilities or VCT centres.
Living positively with HIV/AIDS
Positive living for the persons with HIV/AIDS is very important for them to be able to cope with thesituations and enhance the quality of life as well as to delay the multiplication of HIV and progress of
AIDS.
Positive living involves the following aspects:✻ to accept your status as HIV positive✻ to disclose your status to a person whom you can trust✻ to eat well balanced diet with nutritious foods✻ to seek for medical advice and treatment for opportunistic infections andother AIDS related diseases and conditions as soon as possible✻ to adhere to the prescriptions for taking ARVs when appropriate and available✻ to keep good hygiene and sanitation✻ to avoid certain lifestyles such as smoking, drinking, taking addictive drugs (as they weaken yourbody immune system) and getting stress✻ to do simple exercises✻ to have enough rest and sleep✻ to join or form a support group for persons with HIV/AIDS to share experiences,
information,
views and problems, so as to support each other in many aspects through networking.

Networking:[0]A networking is a group of individuals or organizations that on voluntary basis
exchanges information or undertakes joint activities in a way that strengthens andextends the individual capacity of each member. Networking and coordination are aprocess that promote information exchange, builds alliances, and facilitates thecreation of complementary programs. Networking provides learning atmosphere and it
improves ability to address complex problems.

- 119Appendix 6：Basic Information on HIV/AIDS for AIDS Learning Workshops
11. SEXUAL ENCOUNTERS FOR CHILDREN
It is very sad that some of the adults in our society are sexually exploiting our children despite the factthat they are supposed to be care takers of our children. Such cases include irresponsible sexual
relationship between adult and a child called “Sugar Daddy” or “Sugar Mammy.”

As parents, we can communicate with our children in a way that enables them to tell us if anything
unusual happens, so that we may take the appropriate steps.
From a very young age we can train our children:• Not to go with strangers.
• To stay away from secluded places.
• To report to us any older person offers them gifts or sweets.
In addition, we need to address the social injustice for the fact that some of the sexual aggressions aretargeting our children. They include:• Sexual harassment• Rape• Defilement• Sexual abuse
Also in Kenya today, many youths are becoming infected with HIV/AIDS by the time they are ten years
old. This means that they are playing sex that early, either because they decide for themselves or
because other people influence them. It is collective responsibility of the community to give
appropriate information to the children before they start engaging in sexual activities without knowing
the possible negative consequences.
12. HIV/AIDS PERCEPTION, CUSTOMS AND TABOOS
Some people in Kenya today are intentionally having sex with a very young child as a way of making
sure that they themselves will not get infected with HIV/AIDS.
Many people wrongly believe that sex with a virgin or a young child is a cure for sexually transmitted
infections including HIV/AIDS. It is important for the community to have the correct information andto reach to a consensus on changing a certain social behaviour and practices of the society.

Reference:
1. What Can We Tell Our Children? – A Parent’s Guide To Growing Up and STD/HIV/AIDS. NASCOP[Kenya], Ministry of Health [Kenya] 1997
2. The Kenya National HIV/AIDS Strategic Plan 2000-2005. NACC [Kenya] 2000
3. Home Care Handbook – A Reference Manual for Home-based Care for People Living with HIV/AIDS in
Kenya. NASCOP [Kenya], Ministry of Health [Kenya] 2002
4. National Programme Guidelines on Orphans and Other Children Made Vulnerable by HIV/AIDS.
Ministry of Home Affairs [Kenya] and NACC [Kenya] 2003
5. Kenya Demographic & Health Survey 2003. Central Bureau of Statistics [Kenya], Ministry of Health[Kenya] and ORC Macro 2004

- 120

Appendix 7：Questionnaire 1 – Households of OVC

121

Appendix 7：Questionnaire 1 – Households of OVC

122Appendix 7：Questionnaire 1 – Households of OVC

123

Appendix 7：Questionnaire 1 – Households of OVC

124

Appendix 7：Questionnaire 1 – Households of OVC

125

Appendix 7：Questionnaire 1 – Households of OVC

126

Appendix 7：Questionnaire 1 – Households of OVC

127

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Michael J. (2000). Planning for education in the context of HIV/AIDS. UNESCO.
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UNICEF, UNAIDS & WHO (2002). Young people and HIV/AIDS: Opportunity in crisis. UNICEF, UNAIDS & WHO.
UNICEF, WHO, et al. (2003). Skills for health: Skills-based health education including life skills---An important component of achild-friendly/health-promoting school. WHO.
UNICEF, WHO, et al. (2002). Facts for life (3rd edition). UNICEF.
WHO, UNESCO, UNICEF & World Bank (2000). “Focusing resources on effective school health: A FRESH start to enhancing thequality and equity of education.” World Education Forum, Dakar, 26-28 April.
World Bank (2002). Education and HIV/AIDS: A window of hope. World Bank.
World Education Forum (2000), The Dakar Framework for Action, Education for All: Meeting our Collective Commitments, World
Education Forum, Dakar, 26-28 April, UNESCO.

Part2
1: ActionAid (2003) The sound of silence: difficulties in communicating on HIV/AIDS in schools
2: Child-to-Child Trust (2005) Child-to-Child Approaches to HIV and AIDS: A Manual for teachers, health workers and facilitators ofchildren and young people,
3:Child-to-Child Trust (2005) Children for Health: CHILDREN AS PARTNERS IN
HEALTH PROMOTION second edition, Macmillan Publishers Limited.
4: Dr. Bhagbanprakash (2006)

A Training Guide for Young people: YUVA (Youth Unite for Victory on AIDS) Project, Ministry ofYouth Affairs & Sports, Government of INDIA
5: Inaba, Masaki and Todokoro, Emi(2005)“Dai 3 sho Kenya 0 seihu no taisaku bosoku wo oginai, danretu shita shakai wo hougoku

suru toujisya/NGO no torikumi (Chapter 3: Kenya – People and NGOs that support the governmental policy and reform collapsed
society)” AIDS seisaku no tankan to Africa shokoku no genjyo –houkatsuteki approach ni mukete (Diversion of AIDS policy and thesituation of African countries – towards a holistic approach)Institute of Development Economies, Japan External Trade Organization

6: Health Actions for Ethiopian Youth! (2004) Youth and HIV/AIDS MESSAGE GUIDE Working Draft
7: UNICEF/IRC (2005) Water, Sanitation and Hygiene Education for Schools: Roundtable Proceedings and Framework for Action,
UNICEF/IRC
8: World Vision International (2003) Children’s Discovery, Family Impact

128Japan NGO Network for Education

http://jnne.org/