2001 UKR: Young People's Health and Development Programme Evaluation 1997-2001
Author: Yaremenko, O.O. et al
The programme's main objective is to develop pilot models (subprojects) demonstrating a new approach oriented at co-operation with local agencies and young people's management, as well as securing the right of youth to health and development. These projects are reviewed in the following categories:
- youth participation
- youth-friendly environments
- youth-friendly health care services
- mass-media mobilisation
- HIV prevention among youth and adolescents
- HIV/AIDS prevention among young injecting drug users
Purpose / Objective
This publication summarises the implementation experience of the Young People's Health and Development (YPHD) Programme in Ukraine and represents the evaluation results of the projects realised with UNICEF support in 1997-2001.
Program evaluation objectives:
- Identify the programme's key achievements
- Analyse obstacles in the way of programme realisation
- Identify the best practices in programme implementation
- Study the ways of programme development and further implementation
Each project has a different methodology consistent with its goals, objectives and implementation techniques. Most involved a combination of:
- pre-program and post-program questionnaires
- holding focus-group discussions with target youth categories before and after project implementation
- expert interviews with program executors
- interviewing volunteers participating in these change-detection programs
Key Findings and Conclusions
Shaping government policies regarding young people's health support and development:
The following sociological research has been conducted, aimed at shaping government policies regarding young people's health support and development:
- Ukrainian Opinion Poll Survey «Children on their Rights», 2000
- Children and Youth Regional Survey «Young Voices», 2001
- Surveys within the framework of «Youth Barometer", 1999
* among «Youth for Health» gathering participants
* among clients of Social Services for Youth in Kyiv
* «Kyiv Youth-99»
* among Kyiv city and district councils deputies
* Social Services Fair visitors, etc.
- Survey among Southern Region adolescents and young adults within the framework of subproject «Preventing HIV Transmission Among Young People», 2001
- Survey «Knowledge, attitudes, behaviours» among young injecting drug users, 2001
The research has as its long-term objective providing government officials with the information necessary for decision-making, as well as raising public awareness with regard to children's and young people's rights, their health and development. For this reason, the important thing is not only to obtain objective research results, but also to make appropriate use of them. The findings of the research conducted within the framework of the YPHD Programme were disseminated in the following ways: 1) research findings have been presented to government officials and mass media representatives during launching events and Social Projects Fairs; 2) research-generated materials were used in presentations made at conferences, workshops and round table discussions; 3) a number of information kits for mass media are based on the research-generated data.
In addition to the positive effect it had on specific programme implementation, active support for UNICEF projects in Kyiv has also substantially affected the city's social policies. Over the period of project implementation, the Head of Kyiv City State Administration has issued the following directives:
- «On Supporting Voluntary, Socially Useful Activities by Kyiv Young People» (February 6, 1998)
- «On Conducting Social Preventive Activities among Adolescents, Young Adults and Families in the Streets of Kyiv «Social Pedagogues in the Street» (March 3, 1998)
- «On Constructing and Operating Sports and Children's Playgrounds in Neighbourhoods and Involving Adolescents and Young People in Negative Development Prevention in Youth Environment» (July 23, 1999)
- «On Conducting Assembly-March of Children and Kyiv Youth Organisations and Voluntary Detachments «Youth for Healthy Life Styles» (April 3, 2000)
- «On Conducting the Meeting for Ukrainian Cities' Mayors «Mayors for Youth Friendly Cities» (May 26, 2000)
- «On Measures Aimed at Preventing Negative Developments in Youth Environment and Setting Up Mobile Centres for Street Social Work» (July 5, 2000)
- «On Setting Up Special Social Services for Young People «Mobile Centres for Street Social Work» run by Social Service for Young People under Kyiv City State Administration (October 18, 2000)
- «On Setting Up Specialised Social Youth Services «Youth Friendly Clinic» (November 29, 2000)
- «On Holding the Second Children's Municipal Assembly «My City -- My Concern» to Celebrate the International Volunteer Day» (December 5, 2000) and others.
The policies pursued by the Kyiv local government set a model for other Ukrainian cities' authorities. On November 5, 1999, Mr. Oleksandr Omelchenko, Mayor of the capital of Ukraine, made public his Appeal on initiating «Mayors for Child Rights» movement. The initiative was supported by twelve Ukrainian cities' Mayors, as well as by delegates at the Children Municipal Assembly «My City -- My Concern».
Kyiv authorities' initiative towards shaping youth-friendly policies had its follow-up in the First All-Ukrainian Mayors' Meeting «Mayors for Youth Friendly Cities». In the course of the Meeting, Heads of City Administrations, mass media representatives, Social Services Centres for Young People and NGO staff from 28 cities were exposed to principles of shaping children and youth friendly policies and with Kyiv's best practices in this area.
In 1998, UNICEF made the first and rather successful attempt at training Deputy Heads of Kyiv and Odessa City Administrations, focusing on harmful habits prevention among youth. Now that substantial positive experience has been piled up within the UNICEF Programme on YPHD, it is advisable to conduct a series of seminars and training courses aimed at exposing government decision-making officials to philosophy, techniques, and, first and foremost, efficiency of the developed projects.
Creating a favourable environment:
Taking into consideration the strong influence exerted by mass media upon young people, considerable attention in the programme was given to working with the press, radio and television: thematic workshops, conferences and contests were held for journalists; they provided coverage on social actions, etc. One indisputable result is that young people's health and development issues found much broader mass media coverage in UNICEF projects' target cities.
Nevertheless, in-depth understanding of youth problems still leaves much to be desired. As contests showed, it is not infrequently that the journalists only see superficial signs of children's and young people's problems without in-depth penetration into their core. It might be due to the fact that one-time seminars or training courses cannot have a lasting effect upon many journalists' vision of the world. In order to achieve positive changes, targeted efforts towards this goal are required, especially in the light of massive advertising running contrary to healthy life style ideas.
Projects aiming at youth activities information support on «peer to peer» basis are more efficient in terms of accomplishing the goal of creating a favourable social environment. The basic tenet is that youth tends to treat the information provided by their peers with great confidence, and even greater if the information is generated by young people. A considerable number of young people who studied, internalised and succeeded in getting across to their peers the need for a healthy life style, made their input into their development.
Technical support provided by UNICEF for printing valeology handbooks in large amount for parents of elementary, junior and high school children can also be regarded as a tangible contribution to creating a favourable social environment (the handbook has been designed within the framework of Ukrainian-Canadian project «Youth for Health»). The handbook will come in handy in creating favourable conditions for young people's health and development in the family environment. Systemic approach to child raising in Ukraine is still a very acute problem. Working with the family as the social environment where a child is moulded should figure more prominently in subsequent UNICEF projects.
Discussing positive social environment creation, it is noteworthy that there are five major factors affecting a young person's socialisation process: 1) government social policies; 2) community; 3) school (or other educational establishment); 4) family; and 5) peers. The analysis of implemented UNICEF projects within the framework of the YPHD programme shows that the advisable courses of action involve cooperation with educational agencies and more intensive work with families.
Developing personal and professional skills:
One of the major problems we are facing today is the lack of sufficient numbers of trained national trainers - practitioners who would be able not only to talk about the idea and convince the audience of its usefulness, but also train in implementing a specific programme from its inception to sum-up evaluation. Special training courses and teaching aids are required for training national trainers. These teaching aids could be used by pedagogical students and professional social workers. The first aid developed in 2000 is the Youth Participation Handbook, which contains materials that both professionals and young people need.
Reorienting health care services:
One of the major accomplishments of the YPHD Programme is developing collaboration between health care services, Social Services Centres for Youth and NGOs based on mutual realisation of the fact that a considerable portion of young people's health problems is caused by social and age factors.
An important model was set by the first Ukrainian youth friendly clinic (YFC), which was set up on the basis of Kyiv Children's Polyclinic #6 in the former Starokyivsky District. No less important was the decision of setting up youth friendly clinics in the other four Kyiv districts, and Children, Adolescents and Youth Reproductive Health Centre affiliated with the Donetsk Regional Centre for Mother and Child Care. There is no doubt that best practices should be disseminated in the Ukrainian regions.
There is an obstacle here, however, caused by the lack of compliance of certain youth friendly clinics' operation principles with the Ministry of Health's standards (in particular, anonymity and confidentiality issues in case of STIs treatment). Young people identified the confidentiality (72%) and friendly approach (61%) as the major factors to visit Youth Friendly Clinic. The integrated approach and synergism of medical and social care services are the basis for the adequate, effective response to young people's needs. It is the right moment for the development of the national policy and state health-care standards for adolescents' medicine that contributes to the new quality and positive changes in the health of young people.
To sum up, the conclusion can be made that the programme Young People's Health and Development is being implemented in Ukraine in conformity to UNICEF rules, and meets international approaches to healthy life style promotion. The following steps are advisable to improve these activities:
- Provide more attention to working with government decision-making officials, to their training in particular
- Design a training course in the evaluation of specific social projects' implementation for project executors (both governmental and NGOs)
- Conduct specific projects' evaluation on a regular basis, followed by best practices documentation
- Train a national trainers' team aimed at disseminating acquired expertise in other regions of Ukraine
- Disseminate expertise acquired in the course of YPHD implementation in all the regions of Ukraine, drawing upon available governmental and non-governmental organizations' networks
- Provide broader support to projects focusing on pre-school and educational establishments, and working with parents; focus special attention on the development of life skills education in schools and out of schools to reduce the risk and vulnerability of children and young people to HIV infection and STIs
- Provide assistance in the reform of the state health care system through the development of national policy and standards towards health care services for children and adolescents
- Study, summarise and disseminate 'best practices' accumulated by national and international organizations in the course of implementing programmes aimed at promoting healthy lifestyles
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