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Evaluation report

2004 Rep. of Turkmenistan: Evaluation of Life Skills Education Implementation



Author: Babadjanov, A.

Executive summary

Background:

Life skills based health education (LSE) is one of the strategies UNICEF employs in HIV prevention among young people. In Turkmenistan, activities for introducing LSE in formal and informal education system started in late 2001 in the frame of Young People’s Wellbeing programme (Healthy Lifestyle and Youth Participation project) of the UNICEF-supported Country Programme for 2000-2004. The national Youth Union has been the leading partner from the very beginning, with the Ministry of Education joining the process of LSE implementation in 2004. The evaluation was initiated by UNICEF in the last year of programme
cycle with the aim of more precise programming of HIV prevention in the new country programme (2005-2009).

Purpose/Objective:

The goal was to measure the relevance and effectiveness of the chosen approaches for introduction of LSE in the country and sustainability of implemented interventions. The objectives were to assess:
· proportion of trained master trainers who actually provide training of trainers (ToT) or cascade trainings for educators and young people
· coverage of young people in school and out-of-school
· gained level of knowledge and skills for HIV prevention by the covered mainstream and vulnerable groups of young people costs of different types of implemented activities

Methodology:

The main methods used were:
1) a desk review of the consultancy reports, workshops and trainings reports, pre- and post-training testing questionnaires, relevant financial documents of UNICEF;
2) a mini-survey of the trained trainers. Questionnaires used for the pre- and post-training testing and the mini-survey were developed by the author based on the available UNICEF and WHO methodological materials/questionnaires.

Findings and Conclusions:

Over three years, two batches of master trainers were trained (140) with 70 per cent of them actually engaged in further ToT and/or cascade trainings of young people.

About 18,000 of mainstream youth of 12-24 years old, 2,600 military servicemen of 17- 24 year old and about 900 intravenous drug users (IDU’s) had access to LSE focused on HIV prevention tailored to their age and specific needs

A comparison of pre- and post-training level of knowledge of HIV transmission and means of protection measured during health education sessions for military servicemen and IDU’s showed an average 7-fold increase of correct responses; no measurement of knowledge and skills of mainstream in-school and out-of-school young people was possible as LSE had been introduced unevenly in all project sites.

In general, cost of publication of information materials comprised 4 per cent, locally developed methodological materials - 9 per cent, trainings - 69  per cent, international consultancies -17  per cent, monitoring - 2 per cent.

Per capita gross cost of master trainers was progressively decreasing from $US2,342 for the batch, to $US330 for the second batch and $US9.6 for trainers who provided direct LSE for young people; 7-fold and 34-fold less respectively. The coverage of end-users (young people) had no direct cost for UNICEF.

Health education courses for drug users in treatment were the easiest to institutionalise in hospitals in comparison with LSE courses in schools and military camps. Hospital administration appreciated the improved relationships between patients and medical staff and general “warming” of psychological atmosphere in the treatment facility.

The evaluation showed that ToT on LSE when using culturally adjusted education and methodological materials is a cost-effective approach to building professional capacity of national educators. On the other hand, sustainability of LSE was dependent on the understanding of benefits (short-term and long-term), involvement and commitment of the decision makers, be it the Ministry of Education, local authority, school principal, military commander or head of drug addiction treatment centre. The more structured, regular and intensive intervention, was the quicker results were perceived as positive and the intervention supported by decision makers.

Recommendations:

To make LSE more efficient and sustainable, the strategy should be introduced in higher education institutions responsible for preparing teachers, doctors, nurses and military commanders. This can also consequently upgrade the institutions’ curricula. At the same time, to maintain LSE in schools, informal youth settings, in military and health care system, a network of information reference centres should be established/supported at local level, youth-friendly services among them. The impact of LSE will depend on the overall development of youth and HIV-related policies



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