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Base de datos de evaluación

Evaluation report

MYN 1998/001: Participatory Qualitative Evaluation of Life Skills and HIV/AIDS Training for Youth and Women

Author: Population Council (Thailand)

Executive summary


The Myanmar Maternal and Child Welfare Association (MMCWA) and Myanmar Red Cross Society (MRCS), with technical and financial support from the United Nations Children's Fund (UNICEF), conducted life skills and HIV/AIDS training for married women and youths in 27 townships from December 1994 to mid-1997. A total of 17,280 (urban/rural) married women and 17,280 (urban/rural) youths between the ages of 20 to 40 (married women) and 15 to 25 (youth) participated in the two-day training course in their respective townships. Recognizing the need to assess the effectiveness of introducing innovative training activities in Myanmar, in mid-1996 the implementing agencies MMCWA, MRCS and UNICEF prepared a participatory qualitative evaluation program, with technical assistance from the Population Council of Thailand.

Purpose / Objective

The objectives of the qualitative evaluation were as follows:
- To assess the impact of the life skills training among the target population, the married women and youth
- To assess the multiplier effect of the training amongst the non-trained population in the project areas
- To assess the capacity building processes of local counterparts and their understanding of the ongoing programs (both training and evaluation)


It was decided to use a particpatory aproach where stakeholders defined the key areas for assessment during a participatory workshop. The participatory evaluation used a qualitative approach based on focus group discussions (FGDs) and in-depth interviews (IDIs). To assess the multiplier effect, the non-trained participants were defined as participants from the project township who were family members or friends of the trained participants who may have received further spread of accurate information from the trained youth and married women. Control groups came from non-project township.

Eight project townships were identifed as evaluation project areas and one township without training was selected as a control township. The subjects chosen from particpants in MRCS program were: 83 trained urban youth, 70 non-trained urban youth, 78 trained rural youth, 9 non-trained rural youth, 10 control urban youth and 12 control rural youth, totalling 262 participants. For the MMCWA: 96 trained urban, 88 non-trained urban, 96 trained rural, 8 non-trained rural, 12 urban control adn 12 rural control, totaling 312 participants. Results for the two organizations are presented together.

Key Findings and Conclusions

Substantial evidence indicates that the training was effective and knowledge of HIV/AIDS, its transmission, prevention, and care and counseling improved in both Youth and Women participants. The general findings of the evaluation showed that the trained youths and married women had internalized the life skills concepts and were applying them in daily life. The training helped the youths and married women to differentiate between characteristics of a good spouse, 'good' and 'bad' friends, risky and healthy behavior, as well as enabling them to identify the skills necessary to promote positive behavior among themselves, family members and their friends. Through practical and positive discussions on the messages of life skills such as good decision-making, friend-to-friend education, community-based counseling and happy healthy living, it seems that they were well received by the participants. The trained youths gained confidence and were able to discuss important matters in their lives with their parents/elders. The trained married women showed that their knowledge of birth spacing and reproductive health improved and was applied in real life situations, reportedly preventing unwanted pregnancies and abortions in the community! Evidence suggests that both the trained youths and married women are now able to follow the correct steps toward sensible decision-making and problem solving.

Overall knowledge of Sexually Transmitted Diseases (STDs), their features, transmission and prevention, was very high among trained youths compared to the married women. There were also indications that the trained youth disseminated the messages to their friends who were not directly involved in the training. All youth respondents were aware of the seriousness of HIV/AIDS infection and expressed their concern throughout the survey. Knowledge of HIV infection, its transmission, blood testing and prevention were very high among the trained youths/women and satisfactory among most of their friends/family members. The overall STD knowledge of married women improved especially among the trained groups. However, some misconceptions on the clinical features of STDs, its transmission and prevention remain.

There were still misconceptions and some confusion surrounding STDs amongst all youths. The importance of seeking medical care, taking a full course of treatment and notifying partners in case of STD infection were not discussed, nor was the connection between STDs and HIV/AIDS. The most dangerous misconception was the use of antibiotics (both oral and by injection) to prevent STD just before or after intercourse with Commercial Sex Workers (CSWs), as this can lead to drug resistance and complicated STD cases. This was most common in the Control Township.

Only a few youth respondents admitted that they had ever used condoms, and the majority of the youths would not disclose their practices or personal feelings. Although all respondents were aware that condoms prevent infection and unwanted pregnancies, they were reluctant to talk about it. Condom use is almost non-existent among married couples since it is stigmatized with unfaithfulness and visiting CSWs.

A sizeable portion of youth (male respondents) admitted that pre-marital sex was common among youths and over half of the encounters were with CSWs. Less than half said sex was with girlfriends. It was not considered 'proper' to have pre-marital sex, even though it was generally accepted by the youths as an act of maturity. Most girls (youth) said they would not accept pre-marital sex, although some had consented. Reasons given by female youth respondents were: as proof of their love, being weaker in negotiating skills and blind faith in their boyfriends. MMCWA evaluation showed that the sexual decision-making remains dominated by husbands, thus wives rarely discussed about sexual matters with their spouses. The cultural, traditional and religious factors are preventing the married women from discussing sexual matters with their husbands though there was frequent mention of men visiting CSWs and alcohol-related sexual risk behaviors among married men.

Attitudes towards people infected with HIV/AIDS were very positive among youths and married women except those from the Control Township. It was obvious that attitudes had improved as a result of the training and its multiplier effects on youths and married women in the community. The understanding of the course of the disease, its transmission and life skills helped people not to discriminate against or socially disregard people living with HIV/AIDS (PLWHA). It has been shown that the life skills training provided a lot of information on care and counseling for those trained youths and married women ready to give a helping hand in the community. Friend-to-friend education was also reported as contributing to a reduction in risk behaviors and practices among youths and married women.

It was evident that non-trained participants had received some critical messages through friend-to-friend education. They demonstrated greater knowledge of HIV/AIDS and STDs, their features, transmission, prevention, care and counseling compared to participants from the Control Township of both organizations. The non-trained respondents said that their trained friends/family members positively enhanced their attitudes, removing fear stigmas, and encouraged care and counseling. Therefore, it is believed that a substantial multiplier effect has been achieved, with some critical messages disseminated by trained youths and married women to their non-trained friends/family members in project townships.

There is no doubt that the capacity of local youths and married women, especially the township facilitators, has been enhanced throughout the training and evaluation process. Over three years, they demonstrated their capability to organize and conduct quality training. Most of the township youth and women facilitators are now being utilized by other international NGOs involved in related areas of work due to their improved training and communication skills.

Despite the positive findings, some areas still need to be strengthened. Misconceptions regarding STD infection, the low-acceptance of condom use, risk-taking sexual behavior of youths (especially males) and married men, their sense of responsibility, attitudes revealing double standards between men and women regarding pre-marital and extra-marital sex, and sexual decision-making dominated by husbands are areas requiring further attention. The following set of recommendations were identified during the study to improve the life-skills training activities.


General recommendations to improve life skills and HIV/AIDS training of both married women and youth (MMCW A and MRCS):
- To extend this training activity to new townships
- Reassess the training manuals, materials and training process
- Develop a built-in monitoring and regular feedback system
- Promote condom use among married couples and youths for birth spacing, prevention of unwanted pregnancy as well as STD infections
- Experience sharing workshops for township level trainers of both MMCWA and MRCS
- More involvement by MMCWA and MRCS in planning and strategy formulation

Specific recommendations to improve life skills training for married women (MMCWA):
- To find ways for participation of both husband and wife in understanding gender issue and gender roles
- To find ways to incorporate married men into life skills training
- Involvement of young married women in life skills training since they are also vulnerable to infection

Specific recommendations to improve life skills training for youth (MRCS):
- Promote religious values and teachings
- Discuss the possibility of incorporating one-page behavioral questionnaires in life-skills training sessions with the National AIDS Program (NAP)
- Publish youth-friendly literature, TV dramas and video movies based on life-skills training and HIV/AIDS

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Report information





HIV/AIDS - Young People

Myanmar Red Cross Society, Myanmar Maternal and Child Welfare Association


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