Appraisal report Title of material: Helping pupils to stay safe, a handbook for teachers (P5 P7) Technical information Type of material: Teacher handbook Year of publication: 2004 Target of material: Primary school learners grades P5 P7 Country: The Republic of Uganda Author/publisher: Ministry of Education and Sports Number of pages: 180 Abstract The teacher's handbook 'Helping pupils to stay safe' for grades P5 - P7 was developed in the framework of the 'Presidential Initiative on AIDS Strategy for Communication to Youth' (PIASCY), which is spearheaded by the Ministry of Education and Sports, in cooperation with among others, the Ministry of Health, Labour, Gender and Social Development. The handbook was developed to support teachers to be 'change agents... to safeguard pupils from AIDS' (p. iv). The manual is composed of ten (10) chapters addressing: 1. Helping pupils to choose to abstain 2. Ethics, morals and cultural values 3. Teaching reproductive health and HIV 4. Understanding HIV/AIDS in Uganda 5. Gender, children s rights and responsibilities 6. Reproductive health 7. STIs, HIV and AIDS 8. Life skills 9. Guidance and counselling, and 10. Messages for assemblies, clubs and classes. The manual addresses topics such as how HIV is transmitted, how to protect oneself from infection and how to treat people with AIDS with dignity and respect. Since many Ugandan primary school pupils are in their mid to late teens, the manual also contains basic information on reproductive health, the importance of safer sex, condom use, being faithful, and getting an HIV test. The manual provides information on how to teach learners life skills such as how to say no to sex, avoid sexual violence and maintain good sexual hygiene. The first chapter of the manual Helping pupils to choose to abstain provides an outline of the PIASCY programme, why teachers need to be involved in education on HIV and AIDS and briefly describes how to use the manual. Chapter 2 is designed to give the teacher the moral, ethical and cultural background on HIV/AIDS and sexuality in Uganda. The third chapter should help the teacher to feel comfortable about teaching reproductive health and HIV/AIDS, whilst chapter 4 is designed to give the fact about HIV and children in Uganda. The fifth chapter is designed to help teachers to understand how gender and children s rights affect children and the risks of getting HIV/AIDS. Chapters 6 and 7 provide information on reproductive health, STIs, HIV and AIDS and should serve as a resource to the teacher as a professional and as a sexual person in [his/her] own right. The chapters 8 and 9 explore life skills and guidance and counselling and each topic is approached with the question what do pupils need to know so that they can choose to delay sex or stop?. All chapters include a range of 1
(active learning) activities and samples of letters from pupils. These letters are designed to give the teacher a clear idea of the tough situations [Ugandan] pupils face. The final chapter of the handbook contains 26 messages for assemblies, clubs and classes, designed to provide (head)teachers with messages to pass to pupils during assemblies, in clubs and class. Each message has a main theme and is backed up by supporting information. It is suggested that teachers cover two to three messages a month. The handbook ends by providing a glossary of the main terminology used in the handbook and a bibliography. Overview of the appraisal [insert overview diagram] Helping pupils to stay safe is evaluated relatively positively on criteria 3 10, and relatively less strong on criteria 1 and 2 as shown in figure 1 above. Please refer to the attached excel worksheets for details. Strengths Criterion 3: Goals, objectives and target group The purpose of the material is clear and is linked to HIV and AIDS education, as are the objectives of the different chapters and topics (in each chapter). The target group of the material is specified, namely learners in grades 5, 6 and 7 of primary school. Criterion 4: Basic information for protecting and promoting health The information provided in the material is clear and comprehensive, dealing with a variety of relevant topics including bodily changes in boys and girls, cultural practices which can increase the risk of HIV transmission, children's rights, (the effects of) sexual abuse, STIs and TB. The information on VCT is provided in the sections dealing with STIs, HIV and AIDS and one of the key messages. The manual also addresses signs and symptoms of HIV, as well as the impact of HIV on a persons' health and on children, be they infected themselves or taking care of infected relatives/ guardians. Some information is provided on the treatment of HIV and AIDS. Myths and misconceptions regarding the transmission and prevention of HIV, sexual and reproductive health as well as TB are discussed. Criterion 5: Me, my emotions and others There is a brief section in the chapter on life skills that explains what self esteem and self confidence are and encourages the teacher to encourage learners to value themselves. The same applies to coping with stress; i.e. teachers are encouraged to talk with learners about issues which they find stressful. How teachers and learners can care to someone who is affected by HIV (including myths surrounding the care for people living with HIV) or to cope loss is discussed (mainly in the sense of needing to support and respect one another), including in the key messages. Learners are warned that alcohol and drugs such as marijuana can be very dangerous. 2
The manual explains strategies to prevent 'bad touches' and provides learners with tips on how to avoid risky situations which might lead to unwanted sexual intercourse. Condom use, abstinence and faithfulness are all addressed as methods to prevent the transmission of HIV, with a focus on encouraging learners to abstain from having (further) sex until marriage (and the need to do HIV tests once one starts having sex with one's regular partner). The topic of peer pressure is mainly deal with in the chapter on life skills. This chapter contains activities to learn to say what you want, to define good friends, to clarify that being kind to members of the opposite sex does not require having sex with them, etc. Finally, the manual explores getting support when having been (sexually) assaulted or threatened, providing a list of organisations which can provide assistance to both learners and teachers. Criterion 6: Addressing gender issues One specific chapter deals with gender, along side children's rights and responsibilities. In this chapter information is provided to sensitize teachers to gender roles, gender stereotypes and 'harmful gender relations', and the effect these can have on the spread of HIV. The chapter includes one activity aimed at helping learners to understand about gender roles and role models. Respect between boys and girls is promoted throughout the manual and the different exercises, e.g. aiming to raise awareness of learners that bodily changes that each experiences are normal and that learners should not ridicule other learners (because of the changes they experience). A number of the key messages at the end of the book also deal with gender. These are the messages on: 'culture and HIV infection' (discussing the ill effects of e.g. early marriage), 'respect between boys and girls is healthy' (equality between genders, encouraging boys and girls to accept a 'no', encouraging them not to accept gifts, etc.). Power relations are primarily discussed in relation to sexual abuse and harassment. The message of the manual is that children have rights and that they can and should say no to 'bad touches'. Criterion 7: Promoting human rights, overcoming stigma and discrimination A direct linkage is made between (the violation of) children's rights and the spread of HIV. The manual pays attention to children's rights (UN Convention, the Ugandan Children's Statute and the Ugandan constitution) and general reproductive rights (which it clarifies also apply to children). The topics sexual harassment and abuse are entered into in some detail, as according to the manual '[sexual] violence is prevalent'. The manual contains a number of messages that deal with e.g. 'bad touches'; how to avoid risky situations; that sex for gifts is wrong; and that (sexual) violence is a violation of a child's right. The manual encourages learners to report anyone who tries to hurt or threatens to hurt them. A list of referral sites is provided to the teacher should s/he feel a child needs further, professional support. The message on HIV and AIDS is that it can affect anyone, whether they have had sex or not (e.g. transmission from mother to child). The messages in the manual are aimed at encouraging learners to empathize with people who are affected by HIV, including other learners/classmates. Though there are no activities or sections dealing explicitly with strategies to combat prejudices or how to avoid stigmatizing, the manual does appear aimed at teaching learners to respect other people. The language used is generally gender sensitive and non-judgemental (even though abstinence and virginity is promoted, the manual also underlines the need not to moralize and/or judge learners who have had sex). 3
Criterion 8: Community and culture The material is designed for teachers and learners in Uganda and the language, pictures and examples used appear appropriate in relation to the context. Religious and cultural values as well as practices regarding sexuality, growing up etc. are explored and positive/protective elements are highlighted. At the same time, cultural/ traditional practices that can increase the risk of HIV transmission are explored, such as early marriage. The manual includes exercises which involve visiting the local health centre and visiting people in the community affected by HIV. Teachers are encouraged to invite health workers to come and speak to learners on specific topics. The handbook explores silence and stigma regarding HIV and SRH. Criterion 9: Teaching methods and strategies, and teacher guidance A range of teaching-learning methods and activities are used to explore the different topics in the manual. Exercises are often accompanied by 'follow up activities', which will allow teachers and learners to return to a topic explored before. The objectives of each chapter and activities are clarified. How to teach about the topic is explained, including the activities to do. The description of the activities oftentimes includes some information on what kinds of materials will be needed. The manual also includes a glossary of key terms, and contains several chapters on how to teach and counsel young people on issues relating to sexual and reproductive health (SRH) and lists sources of support a teacher (and learners) can make use of. The manual gives instructions on how to teach about the different topics addressed in the manual. Criterion 10: Lay out and packaging The material is simple but attractive. Almost each page contains an illustration and/or a text box with a question from a child or a story. Weaknesses and suggestions for improvement Criterion 1: Material development and inclusion in prescribed curriculum The material was developed in the framework of the Presidential Initiative on AIDS Strategy for Communication to Youth, which is spearheaded by the Ministry of Education and Sports. It is not clear, however, whether the material was developed as part of a HIV and AIDS and education policy. Nor is it clarified how teaching about HIV and AIDS is integrated within the regular curriculum. What also remains unclear is how the material was developed. It is mentioned that the material was developed with the inputs of a wide range of actors, e.g. the Uganda AIDS Commission and the Ministry of Health. It is not very clear whether learners, community members and/or teachers were involved in the development of the materials, however. It is also not clarified on what basis the manual was developed, e.g. needs assessment among learners/teachers and/or assessment of existing constraints and resources, or what the underlying assumptions regarding teaching and behavioural change are. It is mentioned that the manual was pre-tested and revised as a result, so some input from learners and teachers may be presumed (but what kind of input was received and how this was used in the revision of the document is not made clear). 4
It would be helpful if the handbook contained more information on the (policy) context in which it was developed. More specifically, more information on the PIASCY programme would be useful and how this relates to the national policy on education. As mentioned above, it is not clear how teaching and learning about Sexual and reproductive health (SRH), HIV and AIDS are integrated within the regular curriculum and therefore, in what kind of set up the teacher handbook is to be used. It would be useful if it were made clear in for example, an introductory section, how the PIASCY teaching fits in the overall curriculum for grades P5 P7 and whether the subject is officially timetabled. With regard to the development of the material it would be helpful if more information was provided on the development process; who were involved, on what basis was the material developed (learner needs assessment, analysis of existing constraints and resources, etc.), how was pre-testing carried out and how were the results used in the finalisation of the handbook? Criterion 2: Time frame and assessment The manual does not clarify how long each lesson/topic is estimated to take, nor how many topics (and which) should be organised across the three years of primary school (i.e. P5 - P7). It is, therefore, not possible to assess whether the number of lessons defined for certain (school) period is realistic. In some chapters activities are described which could be used to assess learner progress (e.g. false/true exercises and follow up activities), but the handbook does not provide the teacher with specific guidance on to how to do assessment of teaching and learning. It would be helpful to if more information was given on how much time should be reserved for a particular lesson or chapter, as well as the different steps (including the activities) in such a lesson. The manual would also be stronger if it provided the user with specific assessment tools and methods, for assessing prior knowledge, skills and attitudes as well as learners progress in these domains following completion of lessons/activities. Criterion 3: Goals, objectives and target group The objectives of the different chapters and activities are fairly clear (or in the case of the activities, can be deducted from e.g. the description of the activity), but they could be made more specific and measurable so as to facilitate assessment of teaching and learning. As mentioned the target group is learners in grades 5, 6 and 7 of primary school, and the age range is estimated to be between 10-13 years. The differences in development between learners in this relatively broad age group can be significant, and the relevance of the contents to learners can vary. As it is not clear how the contents are to be divided across these three years of primary school, it is difficult to gain insight into the relevance and appropriateness of the teaching-learning contents for the different sub-cohorts within this relatively broad age group. It would be useful it the objectives of the chapters and activities were consistently made clear, and the existing ones made more specific and measurable, stating e.g. to identify 2 cultural practices that may promote the spread of HIV (instead of to identify cultural practices that may promote ). 5
In addition, clarifying which contents of the handbook should be taught in what grade /to which age group would help to clarify the question into the relevance of the contents for the sub-cohorts and how to divide the lessons across the three of years of schooling. Although the contents are considered to be relevant to the broader age group of 10-13 years, it may be that older learners require more information on sexual and reproductive health than the learners of 10 years do. Criterion 4: Basic information for protecting and promoting health The information in the handbook on sexual and reproductive health is fairly comprehensive, but the handbook is less clear on the meaning of the terms sexuality and sex. 'Sexuality' is defined as 'being male or female' (which is in fact a definition of the term 'sex'), and in terms of reproduction. Further on sexuality is described as a 'life time experience'. The handbook provides only some information on the treatment of HIV and AIDS. This is also reflected in the information on the myths regarding the treatment of HIV, i.e. only one myth is addressed regarding treatment, namely that having sex with a virgin will cure HIV. The handbook also does not explore the impact HIV and AIDS have in much detail. The information on sexuality can be improved upon by using the more common and comprehensive WHO working definitions of 'sex' and 'sexuality'. The handbook would also be stronger if it addressed the topic of treatment of HIV and AIDS in more detail, including what kind of treatment exists, when it can be taken, what side effects it can have, how a person can access treatment, as well as the different kinds of myths that surround the treatment of HIV. Another improvement to the material would be if it dealt with the impact HIV and AIDS in greater detail. Criterion 5: Me, my emotions and others The PIASCY handbook for grades P5 - P7 does not deal with the topic self-esteem and self-confidence in great depth (N.B. the PIASCY teacher handbook for P3-P4 deals with this topic in more detail). The same applies to coping with stress, i.e. it is only briefly addressed. The handbook contains messages on the danger of alcohol and/or drugs (along with other risky situations that contribute to the spread of HIV, e.g. going to discos or taking gifts you cannot show to you parents of friends), but does not contain any activities which allow learners to explore how alcohol or drugs (or the other risky situations ) may contribute to heightened vulnerability. It would be useful if the handbook included more (explicit) information on the concepts of self-esteem and self-confidence and how a teacher can create a safe environment for learners to develop these matters. Including more activities that would allow learners to explore (factors which influence) risk and vulnerability to the spread and impact of HIV and AIDS would also be useful. Criterion 7: Promoting human rights, overcoming stigma and discrimination The material does not address universal human rights. Though the messages in the manual are aimed at encouraging learners to empathize with people who are affected by HIV, there are no activities or sections dealing explicitly with strategies to combat prejudices or how to avoid stigmatizing. 6
The material would be stronger if, next to children s rights, more attention were paid to universal human rights - in connection with the spread and impact of HIV and AIDS. The sections on stigma and discrimination could also be improved upon, by providing more activities that enable learners to explore the concepts of stigma and discrimination, how these affect people (living with HIV), how these can be countered, how a person can respond to stigma and so forth. Criterion 9: Teaching methods and strategies, and teacher guidance Though the objectives of a chapter are made clear, the specific objectives of an exercise quite often are not clarified. In addition, the handbook does not clarify how much time should be reserved for the different chapters and activities. The manual gives instructions on how to teach about the different topics addressed in the manual, but does seem to assume teachers are already relatively skilled (trained?) in facilitating e.g. role play and comfortable discussing sexuality with learners. Though it generally should be possible to deduct the objectives of an activity from the preceding text and/or the description of the activity, it would be useful - particularly for assessment purposes - if the objectives were specified. Similarly, it would be useful it the time required to complete a lesson/topic was consistently clarified. It would be helpful if it was made clear whether the handbook was for use by specifically trained teachers or whether all Ugandan teachers are expected to be able to apply the different lessons and strategies. Criterion 10: Lay out and packaging The manual could be reproduced quite economically, but the binding will make photocopying slightly difficult. A simple change to the lay out of the text may make reproduction of the handbook easier to do, e.g. increasing the inner margins of the pages (i.e. those close to the binding of the book). Internal consistency Both language and images are gender sensitive. Generally, the manual promotes acceptance that learners in the final grades of primary school will start to explore their sexuality and sex. The manual states however, that homosexuality is 'morally unacceptable behaviour (for adolescents)', making it clear that it is only acceptable if learners (in these final grades) explore certain forms of sexuality, i.e. heterosexuality. Also worth noting is the information provided on the possible reasons for certain negative behaviour patterns that children may display (in the chapter on guidance and counselling). For the 'behaviours' 'rude or lonely' a possible explanation according to the manual is that the child has a single parent (mother) and that this mother may be overbeating (sic) the child. Not only is having a single parent not necessarily linked to 7
rude behaviour by a child, seeing as the manual discusses the importance of child rights and physical integrity, it would seem that it should promote condemning beating all together. Another inconsistency in the manual is the structuring of the chapters. Each chapter covers a range of topics, which are explored through various activities. Each activity is accompanied by teacher instructions. However, where some chapters and topics include a brief introduction and background information for the teacher, others do not. Transferability and usefulness for developing own material The material is designed for formal education, but different themes / lessons could also be used in non-formal settings. The manual addresses topics that are relevant to young learners in Uganda, describing e.g. which traditional practices can increase the risk of HIV transmission and supporting learners to explore traditional practices and beliefs they can be proud of. It deals with the topic of sugar daddies and mommies and the prevalence of sexual abuse/harassment quite extensively and in an open manner. Topics such as these are not only relevant to young people in Uganda and educators in other countries/regions in Africa may well find the manual provides useful examples of lessons and activities. It is important to note however, that the PIASCY material has a strong moral and religious basis and conveys strong messages regarding what good and bad morals are (regarding sexuality). For example, in chapter 2 ( Ethics, morals and cultural values ) it is stated that religious teachings [in Uganda] all promote the understanding of sex as a gift from God that must be protected and respected and consider sex outside marriage as sinful and dishonouring God, the creator. Not all educators will consider these kinds of messages as being conducive to the development of a sexually healthy person. Special features/additional comments The manual contains one chapter on guidance and counselling, aimed at the teacher. This chapter gives a description of what guidance and counselling are and the kinds of skills an effective counsellor needs. The chapter deals with the need to provide counselling to learners living with HIV and/or are caring for sick relatives or are orphaned. The different steps in counselling a learner are outlined and reasons for certain negative behaviour are given to help a teacher understand behaviour. The chapter on guidance and counselling concludes with a section on referral centres for guidance, counselling and reproductive health services (including telephone help lines), which are said to offer 'friendly care to adolescents and help to teachers'. In the chapter dealing with teaching about reproductive health and HIV, attention is devoted to the impact of HIV on teachers and some of the common concerns teachers have regarding teaching about sexuality and HIV. The material therefore, not only serves as a handbook for teaching itself, but also provides information that can be helpful to teachers as sexual beings in their own right (N.B. as is also stated in the section outlining the different chapters). 8