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PROGRAMMES
Programmes to prevent HIV/AIDS
Overview
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1. Nature of the Issue:

There are two important aspects to understand -

(i) HIV/AIDS can have an enormous impact on education in the most HIV/AIDS affected countries

(ii) At the same time, education can have an enormous impact on HIV/AIDS prevention, care and support, especially when supported by other strategies and other sectors

2. HIV/AIDS Education and Lifeskills

(i) The impact of HIV/AIDS on education

HIV/AIDS has had an impact on the education sector primarily by affecting the:

a) demand for education,

b) the supply and quality of education, and

c) management of education systems.

 

Mr. Chikanga, a health worker from the small health clinic in Nyakomba, Zimbabwe, teaches students at the local Chatindo Primary School about HIV infection and AIDS

a) Impact on demand

  • Since the epidemic began, 3.8 million children have already been infected with HIV, and over two-thirds have died, and the epidemic has already reversed gains in infant and child mortality rates and overall life expectancy in the worst affected areas.
  • As HIV/AIDS incidence has increased, the most affected areas are beginning to witness a decrease in the overall demand for education in terms of basic education enrolment rates, vocational and adult education, and tertiary education facilities.
  • Drop-out has increased and access has been limited or denied to many young people due to additional HIV/AIDS-related demands; e.g. coping with personal illness, caring for family members, trauma related to illness and death in the family, discrimination and stigma, reduced family income and income-generating needs, and/or declining financial support from parents. A high percentage of these drop-outs will likely be orphans, street kids and working youth with very limited resources and few clear incentives for entering the education system.
  • For marginalised young people such as girls, orphans, street kids, out-of-school youth and working youth, the impact of HIV/AIDS is exacerbated.
  • HIV/AIDS can reverse achievements in gender equality in education – girls tend to bear a greater burden in terms of care-taking responsibilities, in addition to domestic chores and the tradition favouring education towards boys. Moreover, infection rates among girls as young as 13 have risen, thereby reducing their likelihood of benefiting from, or completing, their basic education. Pessimism about the value of education can emerge where public confidence in the quality of education is low and the strain of poverty favours income generating skills over schooling, especially as HIV/AIDS adds to the economic burden of families providing for orphans from other relatives, or of child-headed households.

 

b) Impact on supply and quality

  • HIV/AIDS has caused greater inconsistency in the supply of quality educational services where teachers are in poor health, caring for others, or not well trained. Irregular teacher attendance, and the depletion of trained teachers directly related to HIV/AIDS, have been a source of great aggravation to already struggling education systems.
  • The quality of education decreases in terms of both teaching processes and content, where trained teachers are in short supply
  • The epidemic has highlighted inadequacies in curricula which are not designed in content or delivery to address the many sensitive issues surrounding HIV/AIDS. Consequently, the introduction of essential life skills critical for students to handle HIV risk contexts has often been inhibited, and in some cases prohibited.
  • Where HIV/AIDS has appeared in curricula, it has tended to be inadequately addressed with an over-emphasis on information and a marked under-emphasis on attitudes, values, and skills, particularly those related to human sexuality and social norms, including gender issues.

c) Impact on management

  • In general, AIDS has not been factored into educational planning. In some cases existing policies and practices reinforce discrimination, neglect human rights and personal safety, and fail to improve poor working and learning conditions. In some cases human resource management policies and practices may undermine the health or welfare of staff, especially those related to recruitment, training, and compensation, which may overlook factors such as the need to be close to family or medical services.
  • The emergence of HIV/AIDS has diminished the value of long-term sectoral planning, and existing management practices and budgets have struggled to cope with the additional demands imposed by HIV/AIDS due to high turnover and diminished capacity of staff.

(ii) The impact of education on HIV/AIDS

  • HIV/AIDS prevention programmes work with young people, especially where they are reinforced and supported by other strategies and other sectors.
  • Well implemented programmes can not only delay the start of sexual activity but also reduce the number of sexual partners and raise contraceptive use among those who become sexually active.
  • Although exceptions exist, HIV/AIDS-specific education has been disappointing in developing countries due to a lack of comprehensive strategies, including: an over-emphasis on information and a lack of skills based education linking knowledge, attitudes, values and psycho-social skills; a lack of teacher training and ongoing support; and inadequate policy and structures to support consistent and high quality coverage.

2. UNICEF Policy: To promote effective HIV/AIDS prevention through education

  • Children and young people are a priority for HIV/AIDS prevention. The majority of this group is HIV-free.
  • HIV/AIDS prevention needs to be a component of all quality education programmes.
  • HIV/AIDS needs to be addressed within the context of other issues relevant to children and young people, such as human rights, discrimination, healthy lifestyle, relationships, reproduction and other sexually transmitted diseases.
  • HIV/AIDS programmes need to focus on ‘prevention’ and need to be skills-based - with a balance of life skills, attitudes and values, and information - which is age-appropriate and relevant to children and young people
  • Teaching and learning about HIV/AIDS prevention needs to be highly interactive with broad participation of young people, teachers, and surrounding communities.
  • HIV/AIDS prevention programmes work best where they are supported by other strategies - such as policies and health services - and reinforced by other sectors.
  • Alternative strategies for reaching the many children and young people not attending school regularly must be a priority within education systems, and across sectors.

3. Measures Adopted UNICEF is working across agencies to maximise progress on preventing HIV/AIDS and reducing the impact of HIV/AIDS, especially through the strengths UNICEF has in education.

Education for All Increasing school attendance and completion must be a priority to increase the number of students benefiting from school-based HIV/AIDS prevention programs.
Child Friendly Schools All environments for children need to be ‘friendly’ – inclusive, effective, healthy and protective, and gender-sensitive. Encouraging UNICEF country programmes to adopt a wide-ranging approach to school improvement processes, which is inclusive of the needs of those affected by HIV/AIDS, will contribute to a rights-based, child-friendly school, and ultimately more effective teaching and learning.
Focusing Resources for Effective School Health: A ‘FRESH’ Start Strengthening School Health programmes will provide a strong foundation for HIV/AIDS prevention programmes. The FRESH approach focuses on prevention through skills-based HIV/AIDS prevention education, supportive policies, and related health services.
Skills-based HIV/AIDS education Supporting the improvement in quality of teaching and learning processes through more widespread training and implementation of skills-based approaches will enhance the effectiveness of HIV/AIDS prevention programmes. Adequate training and ongoing support of teachers and other facilitators, as well as the improvement of teaching and learning materials will be required to maximise effectiveness.

4. Selected outcomes:

  • School based HIV/AIDS and life skills lessons conducted across Zambia, Zimbabwe, Uganda, Caribbean, Sri Lanka, Viet Nam.
  • Evidence that young people in Senegal, Zambia, Thailand, and Uganda show increasing HIV/AIDS knowledge, more positive attitudes and some behavioural change and risk reduction.
  • National curriculum reform in South Africa including addressing teacher HIV/AIDS risk, as well as teacher training and support for students.

5. Further Steps:

  • Further increase quality and coverage of skills-based HIV/AIDS prevention programmes in and out of school to achieve national scale – including improving the way that HIV/AIDS is handled within curriculum, and especially through the training and support of teachers and other facilitators.
  • Increase intersectoral collaboration to reinforce and supplement the reach and quality of education strategies.
  • Increase multi-strategy support to education programs, especially through intersectoral action, such as through the use of concurrent media strategies and policy support.
  • Strengthen evaluation and monitoring in quality and quantity of programme evaluations, and disseminate findings widely.