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Evaluation report

2010 Jamaica: Evaluation of the Health and Family Life Education in Jamaica



Author: Jimmy Kazaara Tindigarukayo (Ph.D.). Institution: Univestity of West Indies, Mona, Kingston. Partners: Minstry of Education, National HIV/AIDS Programme, UNESCO

Executive summary

 

“With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System". Within this system, an external independent company reviews and rates all evaluation reports. Please ensure that you check the quality of this evaluation report, whether it is “Outstanding”, “Good”, “Almost Satisfactory” or “Unsatisfactory” before using it. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report.”

Background:

The revised Health and Family Life Education (HFLE) Program in Jamaica since 2007, has incorporated a life-skills based approach to teaching and the use of interactive teaching methods in the overall delivery of the program. Four thematic areas are covered in the Jamaica HFLE curricula for grade 1-6 and 7-9:
• Self and Interpersonal Relationships
• Managing the environment
• Sexuality and Sexual Health
• Eating and Fitness
These revised HFLE Curricula are currently being implemented in all government and independent schools, on a phased basis up to 2012. The initial roll out commenced in September 2007 with 223 schools. In September 2008 the programme was scaled up to include an additional 234 schools across the island. The intention is to eventually cover all schools from early childhood through to Secondary

Purpose/Objective:

The main objective of this study was to evaluate the progress and the impact of the implementation of the Health and Family Life Education (HFLE) curricula in primary and secondary schools in Jamaica, paying special attention to the following: (i) the impact of life skill teaching on the knowledge, attitudes, behaviours and practices of adolescents exposed to the revised curriculum; (ii) the quality and effectiveness of teacher training and performance in the delivery of the life skills methodology in teaching the program; (iii) the extent to which HFLE has been incorporated into the school's academic structure, especially as it relates to time-tabling and the assignment of classroom teachers to the subject; and (iv) acceptability of HFLE among students, teachers and parents.

Methodology:

In order to fully address the above mentioned objectives, the following methods of data collection were implemented: (i) Secondary data analysis: This involved critical review of documents and reports relating to the HFLE Programme, including: curricula guides, training manuals, teaching aides for various grade levels, monitoring and evaluation instruments, reports from HPEOs, project documents, and other relevant studies and reports; (ii) A survey of students: This was based on a comparison of data collected from schools that were implementing all four themes of the programme, and data collected from schools that were not implementing any theme of the programme. Two separate survey instruments were utilized in the students’ survey: an instrument for grade six students (Appendix 2), and an instrument for grade nine students (Appendix 3). (iii) A survey of teachers: All teachers surveyed, from both HFLE and Non-HFLE schools, were asked to indicate (a) their level of preparedness and comfort in teaching some topics relating to HFLE; (b) teaching techniques they utilized, and (c) their perceptions on challenges to HFLE implementation in Jamaican schools (see Appendix 4 for teachers’ questionnaire) (iv) A survey of Principals: This survey sought information from school Principals on: types, sources and adequacy of resource materials for HFLE delivery at their schools; main factors supporting the delivery of the HFLE programme; challenges to the delivery of the programme; and suggestions on how to overcome those challenges (see Appendix 5 for the principals’ questionnaire). (v) Focus group discussions: Twelve Focus Group Discussions (FGDs) were held across the island, targeting two types of groups: students and teachers who had been exposed to the HFLE Programme. The objectives of those FGDs were two-fold: (i) to collect information on successes and challenges the studied groups may have had with the HFLE programme; and (ii) to solicit suggestions for gaining programme support. Six days of meetings were held, one in each of the six MOE regional centers. (vi) Elite interviews: In-depth interviews, relating to clarification on some findings resulting from the other methods of data collection mentioned above, were conducted with various stakeholders at two levels: (i) school level (teachers, principals, and parents); and (ii) at Ministry of Education level (Health Promotion Education Officers).

Findings and Conclusions:

Survey of Grade 6 Students 2.1 Background to the survey: The survey was conducted in nine schools fully implementing the HFLE program, which were matched with nine Non-HFLE schools across Jamaica. The survey sought to establish the extent to which the implementation of the HFLE program had changed the knowledge, attitude, behaviors, and practices of the students to whom it had been exposed, when compared with equivalent students that were not exposed to the HFLE program. 2.2: information on respondents: There were more male than female respondents in both HFLE (52%, n=273) and Non-HFLE (56%, n=228) schools. The modal age in both HFLE (48%) and Non-HFLE (54%) was 12 years. 2.3 Respondents’ attachment to their schools:
• Feelings of respondents from both HFLE and Non-HFLE schools towards their respective schools were high and similar.
2.4 Use of drugs including alcohol, marijuana, cigarettes, etc:
• The life time use of drugs by respondents from both the HFLE and Non-HFLE schools were generally similar. However, results on short time drug use (within the past 30 days leading to the survey) indicated that Non-HFLE students were more likely to use drugs than HFLE students, 100% of the time.
• Female respondents reported much less drug use than male respondents in both HFLE (75%) and Non-HFLE (88%) schools.
2.5 Respondents’ Knowledge about HIV/AIDS:
• Respondents from HFLE Schools had by far superior knowledge about HIV/AIDS (94%) than respondents from Non-HFLE Schools. All this implies that the HFLE program has had a remarkable impact on its Grade Six recipients in relation to knowledge about HIV/AIDS.
• Female respondents were more knowledgeable about HIV/AIDS than male respondents in both HFLE (88%) and Non-HFLE (69%) schools.
2.6 Physical Fights (involving hitting, kicking, or pushing):
• Respondents from both HFLE and Non-HFLE schools scored equally (50% each) on items measuring students’ opinions and attitudes on physical fights.
• Male respondents were more supportive of violence attitudes than females in both HFLE (75%) and Non-HFLE (75%) schools.
2.7 Involvement in Physical Fight and Carrying Weapons:
• Students from Non-HFLE schools were slightly more likely to get involved in both physical fights and carrying weapons than students from HFLE schools.
• Male students were more likely than females to get involved in physical fights and carrying a weapon in both HFLE (100%) and Non-HFLE (80%) schools.
2.8 Perception on Life Style Choices:
• HFLE students were slightly more likely (50%) than Non-HFLE (25%) students to practice life style choices
• Among HFLE students, females were more likely than male to practice life style choices, 75% of the time. However, among Non-HFLE students, the opposite was the case; male students were more likely than female students to practice life style choices, 75% of the time.
2.9 Perception on Eating and Fitness:
• Non-HFLE students were 100% more likely than HFLE students to practice appropriate requirements for eating and fitness.
• Female respondents were better informed than male respondents on appropriate eating and fitness habits in both HFLE (80%) and Non-HFLE (60%) schools.
2.10 Perception on Managing the Environment:
• Non-HFLE students were more likely than HFLE students to practice requirements for managing the environment, 67% of the time.
• Among HFLE students, females were 100% more likely than males to protect the environment. Among Non-HFLE students, however, there were no gender differences in environmental management, since both males and females scored 50% each on items measuring environmental management.
2.11 Skills for Everyday Living:
• Non-HFLE students were more likely than HFLE students to practice skills for everyday living, 82% of the time.
• Female students demonstrated superior skills for everyday living than male students in both HFLE (77%) and Non-HFLE (77%) schools
Survey of Grade 9 Students 3.1 Background to the survey: The survey was conducted in seven schools fully implementing the HFLE program, which were matched with seven Non-HFLE schools across Jamaica (see Appendix 1 for the schools studied and potential respondents expected from each school for both grades six and nine). 3.2 Information on Respondents: There were more female students in HFLE schools studied (54%, n=245) and more male students in Non-HFLE Schools (56% n=233). The modal age category was 15-16 years in both HFLE (54%) and Non-HFLE (55%) schools. 3.3 Attachment of Students to their Schools:
• Respondents’ feelings towards their respective schools were more or less similarly positive, among HFLE and Non-HFLE schools, on all items.
3.4 Life time use of drugs including alcohol, marijuana, cigarettes, etc:
• The use of drugs by respondents was generally similar between HFLE and Non-HFLE grade nine students.
3.5 Drug use within Past 30 days:
• Non-HFLE students reported slightly lower levels of drug use than HFLE students on every item measured; which contrasts sharply with results from the grade six survey, indicating slightly higher level of drug use by Non-HFLE than HFLE students.
• Male students were more likely than females to use drugs in HFLE (100%) schools. However, among Non-HFLE students, both males and female scored 50% each, implying that there was no difference in the use of drugs between female and male respondents 3.6 Knowledge and attitudes about HIV/AIDS:
• There were no differences between HFLE and Non-HFLE grade nine students on their knowledge and attitudes on HIV/AIDS. These findings are less definitive than those of grade six students in which HFLE students had much more superior knowledge on HIV/AIDS than Non-HFLE students
• Overall, female students were more knowledgeable than their male counterparts about HIV/AIDS in both HFLE (56%) and Non-HFLE (89%) schools.
3.7 Sexual Risk-Taking:
• Non-HFLE students were more likely than HFLE students to engage in risky sexual behaviours.
• Male respondents were more likely than females to get involved in risky sexual behaviours in both HFLE (83%) and Non-HFLE (67%) schools.
3.8 Refusal Skills Relating to Sexual Behavior:
• HFLE students were more likely than Non-HFLE students to practice sexual refusal skills.
• Female students from both HFLE and Non-HFLE schools were much more likely than their male counterparts to refuse risky sex.
3.9 Physical Fights (involving hitting, kicking, or pushing):
• HFLE students were slightly more likely than Non-HFLE students to get involved in both physical fights and in carrying weapons.
• Male respondents from both the HFLE and Non-HFLE schools reported higher scores on physical fights than females on all five items measured (or 100%), implying that males were more prone to physical fights and to use weapons than females.
3.10 Refusal Skills Relating to Physical Fights:
• The scores on refusal skills in relation to physical fights were equal (50% each) between HFLE and Non-HFLE students, implying no difference.
• Among Non-HFLE students, female were 67% more likely than males to refuse fighting. However, among HFLE students, there were no gender differences.
3.11 Perception on life style choices:
• Non-HFLE students were more likely than HFLE students to practice life style choices.
• Female respondents scored higher than males on life styles choices in both HFLE (86%) and Non-HFLE (71) schools.
3.12 Perception on eating and fitness:
• Non-HFLE students scored slightly higher than HFLE students on items measuring eating and fitness.
• Female students scored slightly higher than males on items measuring eating and fitness in both HFLE (57%) and Non-HFLE (also 57%) schools.
3.13 Perception on managing the environment:
• Non-HFLE respondents scored slightly higher than HFLE students on items measuring the management of the environment.
• Male students from HFLE schools scored 75% higher than females on items measuring the management of environment. On the other hand, female students from Non-HFLE schools scored 100% higher than males on the same items.
3.14 Skills for Everyday Living:
• HFLE students scored 67% higher than Non-HFLE students on items measuring skills for everyday living.
• Female students scored higher than males on items measuring skills for everyday living in both HFLE (71%) and Non-HFLE (67%) schools. Survey of Grade 9 Students 3.1 Background to the survey: The survey was conducted in seven schools fully implementing the HFLE program, which were matched with seven Non-HFLE schools across Jamaica (see Appendix 1 for the schools studied and potential respondents expected from each school for both grades six and nine). 3.2 Information on Respondents: There were more female students in HFLE schools studied (54%, n=245) and more male students in Non-HFLE Schools (56% n=233). The modal age category was 15-16 years in both HFLE (54%) and Non-HFLE (55%) schools. 3.3 Attachment of Students to their Schools:
• Respondents’ feelings towards their respective schools were more or less similarly positive, among HFLE and Non-HFLE schools, on all items.
3.4 Life time use of drugs including alcohol, marijuana, cigarettes, etc:
• The use of drugs by respondents was generally similar between HFLE and Non-HFLE grade nine students.
3.5 Drug use within Past 30 days:
• Non-HFLE students reported slightly lower levels of drug use than HFLE students on every item measured; which contrasts sharply with results from the grade six survey, indicating slightly higher level of drug use by Non-HFLE than HFLE students.
• Male students were more likely than females to use drugs in HFLE (100%) schools. However, among Non-HFLE students, both males and female scored 50% each, implying that there was no difference in the use of drugs between female and male respondents 3.6 Knowledge and attitudes about HIV/AIDS:
• There were no differences between HFLE and Non-HFLE grade nine students on their knowledge and attitudes on HIV/AIDS. These findings are less definitive than those of grade six students in which HFLE students had much more superior knowledge on HIV/AIDS than Non-HFLE students
• Overall, female students were more knowledgeable than their male counterparts about HIV/AIDS in both HFLE (56%) and Non-HFLE (89%) schools.
3.7 Sexual Risk-Taking:
• Non-HFLE students were more likely than HFLE students to engage in risky sexual behaviours.
• Male respondents were more likely than females to get involved in risky sexual behaviours in both HFLE (83%) and Non-HFLE (67%) schools.
3.8 Refusal Skills Relating to Sexual Behavior:
• HFLE students were more likely than Non-HFLE students to practice sexual refusal skills.
• Female students from both HFLE and Non-HFLE schools were much more likely than their male counterparts to refuse risky sex.
3.9 Physical Fights (involving hitting, kicking, or pushing):
• HFLE students were slightly more likely than Non-HFLE students to get involved in both physical fights and in carrying weapons.
• Male respondents from both the HFLE and Non-HFLE schools reported higher scores on physical fights than females on all five items measured (or 100%), implying that males were more prone to physical fights and to use weapons than females.
3.10 Refusal Skills Relating to Physical Fights:
• The scores on refusal skills in relation to physical fights were equal (50% each) between HFLE and Non-HFLE students, implying no difference.
• Among Non-HFLE students, female were 67% more likely than males to refuse fighting. However, among HFLE students, there were no gender differences.
3.11 Perception on life style choices:
• Non-HFLE students were more likely than HFLE students to practice life style choices.
• Female respondents scored higher than males on life styles choices in both HFLE (86%) and Non-HFLE (71) schools.
3.12 Perception on eating and fitness:
• Non-HFLE students scored slightly higher than HFLE students on items measuring eating and fitness.
• Female students scored slightly higher than males on items measuring eating and fitness in both HFLE (57%) and Non-HFLE (also 57%) schools.
3.13 Perception on managing the environment:
• Non-HFLE respondents scored slightly higher than HFLE students on items measuring the management of the environment.
• Male students from HFLE schools scored 75% higher than females on items measuring the management of environment. On the other hand, female students from Non-HFLE schools scored 100% higher than males on the same items.
3.14 Skills for Everyday Living:
• HFLE students scored 67% higher than Non-HFLE students on items measuring skills for everyday living.
• Female students scored higher than males on items measuring skills for everyday living in both HFLE (71%) and Non-HFLE (67%) schools. A Survey for Principals 5.1: Information on Principals’ Survey: The survey was conducted in 14 schools fully implementing the HFLE program, which were matched with 14 Non-HFLE schools across Jamaica. The numbers of Principals who completed the questionnaire (see Appendix 5 for Principals’ instrument) were 14 from HFLE schools and 14 from Non-HFLE schools. 5.2: Principals’ Rating on Levels of Adequacy in teaching HFLE Indicators in Schools:
• Principals reporting that the teaching of the HFLE was either “adequate” or “very adequate” in relation to HFLE indicators came only from HFLE schools, and ranged from 55% to 92% for the 8 indicators rated. 5.3: Principals’ Evaluations of Factors Supporting HFLE in their Schools:
• Of the four factors rated, the scoring on them was split half (50% each) between HFLE and Non-HFLE Principals.
5.4: Principals’ Evaluation of Challenges to the Delivery of HFLE Program:
• The biggest challenge shared by both HFLE and Non-HFLE schools was lack of sufficient trained HFLE staff.
5.5: Principals’ Levels of Perception on Challenges to Implementing HFLE:
• Principals from Non-HFLE schools rated 6 of the 10 (or 60%) challenges higher than Principals from HFLE schools.

Recommendations:

Recommendations: The recommendations arising from this study are mainly four-fold, based on results from surveys, focus group discussions and elite interviews conducted for this study. Recommendation 1: Monitoring of the HFLE Programme: The under-performance of some HFLE schools on HFLE indicators, as discussed above, raises issues relating to the implementation of the HFLE programme in Jamaican schools. The HFLE schools that under-performed were either non compliant or lacked necessary resources to implement the programme. In either case, this calls for serious efforts in monitoring the implementation of the programme by the MOE to ensure effective delivery of the programme. More human resources are needed for the implementation of the HFLE curriculum. The HPEOs are stretched to provide adequate monitoring, as reflected in their reports. Each region consists of three to four parishes with numerous schools not necessarily in close proximity, especially in the rural areas. According to one of the HPEOs during the elite interview, “monitoring will always be a challenge. The HPEO to number of schools ratio is too wide. HPEOs are stretched. Increase the number of HPEOs.” Monitoring and evaluation mechanisms and tools should be reviewed and adjusted to provide useful and qualitative reports that reflect targets and relate to measurable indicators. Moreover, the MOE needs to implement sanctions against non compliant schools. Recommendation 2: Supply of Resource materials: As indicated in teachers’ focus group discussions, a number of teachers complained about lack of materials to enable them teach different themes of the HFLE programme. The shortage of resource materials should be relieved to enhance proper implementation and to provide a supportive environment for the delivery of the curriculum. Suitable materials and resources should also be developed for children with special needs. Recommendation 3: Education campaign for HFLE teaching policies: During the teachers’ focus group discussion, many participants were not aware of any policies from the MOE that speak to the teaching of HFLE. Moreover, those who were aware were not specific about particulars relating to those policies. Thus, there is a need to involve principals, teachers and school boards in the dissemination of policies relating to the teaching of HFLE within the school system. This becomes even more critical as some of the HPEOs expect principals to monitor the HFLE programme at the school level. According to one of HPEO during the elite interview, “monitoring is at the principal level because HPEOs have a great deal of schools to visit”. HPEOs implement and the principals should monitor”. Recommendation 4: Training for teaching the HFLE programme: It is recommended that this should be done at the Teachers’ Training Colleges. There are three main reasons to support this recommendation, collected mainly from the teachers’ focus group discussions for this study. First, in the present system, some teachers believe that teaching HFLE is an added burden, for which they are not rewarded financially. Second, some teachers are uncomfortable in teaching some aspects of the curriculum, especially older teachers. Thirdly, some teachers are uncomfortable knowing that they do not possess sufficient skills to deliver the programme, their refresher training notwithstanding. If HFLE training was offered at teachers’ training colleges, all the above misgivings among HFLE teachers would be eliminated. This policy would also enhance the aspiration of the MOE to implement the HFLE programme to all schools in Jamaica by 2012. Moreover, training HFLE teachers at Teachers’ Training College would enhance a level of sensitivity about gender imbalance in schools and its impact on male students.



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