Aids community

Umesh Chandra Gaur, Confederation of Community Based Organizations of India, New Delhi

Adolescence can be defined in numerous ways, considering such factors as physical, social, and cognitive development, apart from age. Though adolescence refers to an age range, chronological age is just one way of defining adolescence. For the purpose of this discussion, the term adolescent is used for all individuals in the age group of 10-19 years, based on the definition followed by World Health Organization (WHO). It may also be defined as a phase in human life that begins with the onset of puberty and ends with reproductive maturation.

Despite the negative portrayals that sometimes seem so prevalent, the picture of adolescents today is largely a positive one. Most adolescents in fact do fairly well in school, are attached to their families and their communities, and emerge from their teen years without experiencing serious problems such as substance abuse or involvement in violence. With all of the attention given to the negative images of adolescents, however, the positive aspects of adolescents can be overlooked.

Educationists and teachers can play an important role in shifting perceptions of adolescents to the positive. The truth is that adolescents need adults to be part of their lives, as they can nurture, teach, guide, and protect them on the journey to adulthood. Directing the courage and creativity of normal adolescents into healthy pursuits is thus a crucial role that teachers can play. This facilitator’s role constitutes a significant part of what successfully counselling, teaching, or mentoring an adolescent is all about.

Dr. Abhay Nirgude, Kamineni Institute of Medical sciences, Andhra Pradesh

We have undertaken Adolescence Education Programme in three rural and one urban school of Nalgonda District in Andhra Pradesh. We have observed that students participate actively in the training sessions. They ask many questions at the end of each session. Following are some of the elements in our approach that helped us in gaining positive response from teachers and students:

1. 
   Having a comprehensive programme; which include education not just on Sexual and Reproductive Health (SRH), but also on all other relevant issues of adolescents like nutrition and hygiene.
   
2. 
   Training teachers to use participatory teaching-learning tools.
   
3. 
   Using interactive methodologies; for example, role plays were very useful in showing the effect of peer pressure.
   

Dr. Rajesh Garg, Government Medical College, Uttrakhand

In reference to the Life Skills Education (LSE) debate, one has to keep in mind the ground-level realities of Indian villages. In most of the schools, there are only five or six teachers. Besides, many of them will be quite frequently involved in election duty, pulse polio immunisation duty, census enumeration, education board meetings or other meetings with senior authorities. The remaining teachers are so much over-burdened that LSE remains just a formality for them. Things could be worse in schools having only male teachers left for handling LSE.

The challenges faced by LSE need much more attention as they are very complex and not just an issue of morality. The language in which LSE is going to be imparted is one such challenge. The vernacular words are sometimes too much awkward to be used. In villages, one of the important reasons for drop out, particularly after class eight, is the uncomfortable environment in schools and teasing of school girls by their own class mates and seniors.

K. L. Khanna, Nehru Yuva Kendra Sangathan (NYKS), New Delhi

I have been officer in-charge of adolescent development programme for a very long time at the headquarters of Nehru Yuva Kendra Sangathan (NYKS), a body of the Ministry of Youth Affairs and Sports. Since 2006, we have been running a project in 128 Community Development (CD) blocks of 64 districts, in collaboration with the United Nations Population Fund (UNFPA). Presently in my capacity as Joint Director, I am looking after programmes and projects sanctioned for NYKS by the Ministry, under its National Programme for Youth and Adolescent Development (NPYAD).

Through NPYAD, this year NYKS will organise 512 camps of seven days each in these 128 CD Blocks. These camps will carry forward the work on Life Skills Education (LSE) and Adolescent Reproductive and Sexual Health (ARSH). We have been holding such camps in the past several years mainly for out-of-school adolescents, though such camps included school students too.

Some of the strategies that we have been using since 2006 along with some of our learning and observations are shared here:

1. 
   Our strategies were always made for the "adolescent in community" rather than the "adolescent in school". There is a continuum between school-going and non-school-going situation of many adolescents in our universe of work. In addition, the area of our work lies outside the educational institutions. Hence, we take the community as the substratum for organising and educating the adolescents. Even if our camps are organised in a village school, our strategy remains community-centric as different from a school-based, extra-curricular or curricular education. Since peer education is the common denominator in both approaches, it forms an integral component of our strategy.
   
2. 
   The "adolescent in community" approach recognises adolescent as an important member of the nuclear family that s/he belongs to. Hence, a space is created for the common education of the mother and the girl, and the father and the son. In other words, there are sessions in the seven days' training when fathers and their sons sit for the main theme education for ARSH. Similarly, there are common sessions for the mothers and their daughters. The LSE sessions are conducted in the first three or four days when even the parents are invited to join as observers, whenever it is possible for them.
   
3. 
   We bought several copies of Panchtantra and distributed them among the Project Officers with the advice that LSE should be laced with the Panchtantra stories. Stories of Panchtantra or of well-known authors in the local language should be told to the adolescents, which the parents must also hear. Thus, a message goes into the community that LSE is learning from the old as well from the new ways of life. As per the legend, Panchtantra by Vishnu Sharma was after all a pristine book of ethics prepared to teach princes the basic life skills and ethics.
   
4. 
   Main objections to the teaching of ARSH, when it comes from a community, are usually in view of the girl participants – both as school students or as community members. Hence, we put in our protocol that there should be joint sessions of mothers and daughters with a doctor in the initial stages of ARSH lessons to know from them their anxieties about health. Many mothers undergo almost the same level of anxiety around menopause, like many girls undergo at the time of menarche. Quite often, they happen almost at the same time too. Joint sessions involving parents solve the problem of acceptance of the educational themes within the community.
   
5. 
   It is interesting to note the feedback we receive from parents after the camps on LSE and ARSH. They may not say that their wards learnt well the lessons of ARSH. However, they often say that the programme was good or very good for their children, because their children became "more obedient" or "more respectful to the elders in the community" or they "have started carrying good values". These statements provide a perception of a traditional society through which they see the socialisation of their children becoming more complete - the completion of the missing link which they failed to fill up. The adolescent may have learnt to cope with life in a better way, or s/he may have learnt also to say "no" to the unwanted, but the parents may say that s/he has become more useful to the family and in that, "s/he has started doing better in the family affairs". The best thing that such perception statements say is that the parents have accepted the programme and that they find it useful for their adolescents.
   
6. 
   In all the above, the programme is carried as a matter of socialisation, more than a formal peer-led education. We, being the non-school operators of ARSH and LSE, have wished and produced this programme as a socialisation programme in the community. Thus, our programme becomes a part of learning of ethics and values, and promotes an environment where the family becomes the hub of socialisation of adolescents more dynamically.
   

Hanumanthayya, Aasare Social Service Society, Shimoga

Life skills are the basic, everyday skills that we need in order to get through in life. Even though it appears like common knowledge, diverse challenges of adolescence make it necessary that Life Skills Education (LSE) require special attention. However, most of our NGOs and Government programmes are target-oriented and time-bound. Hence, it is still a challenge and a concern on how to reach all those who are in need.

I would like to share some experiences and observations based on my field level work in Shimoga district:

• 
  In my experience I felt that there is a need of Community Trainers to implement LSE among adolescents. Sexual and Reproductive Health (SRH) components are especially very sensitive, and are surrounded by taboos too. Hence, outsiders who are involved with LSE will face even more resistance.
  
• 
  Our programmes should focus on the teachers. From my experience in villages, most of the teachers are not very open with the SRH component. They hesitate to speak and listen on these topics. Thus some teachers end up misguiding the students not to attend these classes.
  
• 
  Parents should not be physically present with adolescent children in LSE programmes at all stages. It is better to involve parents only in the final sessions. Often, parents do not feel comfortable in sessions where SRH issues are discussed with children. Preliminary sessions should in any case be separate.
  
• 
  Most of the times, we are directly addressing SRH issues. It is not effective among adolescents. Moral Stories and Case Studies will help to create the proper awareness among them.
  

It is good to see programmes like Sarva Sikshan Abhiyan trying to incorporate LSE in their subjects. Today, adolescents and their thinking levels are entirely different. I have observed quite often that during LSE sessions, they are asking questions that are sometimes beyond the scope of LSE curriculum. Such students get misguided through internet and other media. Parents’ responsibility is hence to encourage and provide them with healthy books and other reliable sources.

Padmavathi. B. S., Karnataka Knowledge Commission, Bengaluru

I presume Life Skills Education (LSE) for adolescents is not confined to sex education. If this is the case I would like to share with you all that the Karnataka Vocational Training and Skill Development Corporation Limited (KVTSDC), a Government of Karnataka Undertaking, is offering vocational skill training to youth of Karnataka. They are focusing on drop-outs in the rural areas. Even though they do not work like NGOs, any NGO working in a particular region can facilitate youth to get in touch with KVTSDC. Vocational skill training to youth being their mandate, they would be glad to help the adolescents to learn skills and they would also facilitate in getting jobs. For more information kindly contact KVTSDC by phone - 080 40621149, 40621122.

Naina Kapur, Advocate and Equality Consultant, Gurgaon

Aarathi’s questions are so valid and it is great to hear about their work on Life Skills Education (LSE). In my history of working on sexual violence and equality issues, there has been no doubt that the language of sexuality is critical to addressing a number of issues arising amongst young people in dealing with sexual health and related issues. Too much garnish exists around these topics. Moreover, today I see an increasing number of women in the workforce and both genders unable to address the dynamics of relating with the opposite sex. The result is a complicated mess.

I can invite you to please take a look at "Senses and Soul - a Sexuality Handbook” produced by Sakshi which provides some detailed experiential exercises on addressing sexual health issues. In addition, please take a look at "Mirror-Mirror on the Wall... Who am I After All". It is a documentary film - a creative exploration of the segregation and integration of self and sexuality as experienced by the students and teachers of an all-girls-school pursuing the pathway to sexual awareness. For more details please visit - http://www.synclinefilmstore.com/movies/movie_detail/67

Given that you are addressing village level students and school drop-outs, there is much that can be done through experiential processes. Language is critical but so are issues of self-esteem and confidence. Sexuality needs to be addressed at a physical, emotional, mental and spiritual level and outside of jargon. Until it is made as natural as coconut water, the "taboo" element will continue to complicate life for young people. A space needs to exist to encourage young people to ask ANYTHING; otherwise they will act out. If you go to a local cinema today, you still experience the whistles and cat-calls as soon as a scene becomes near to intimate. That is a sign of ignorance, and lack of knowledge leading to immaturity. It is not the fault of these adolescents. They do not know anything better because they are exposed to our own discomfort and moral taboos. We have a responsibility to discard our own discomfort around this issue first and arrive at unconditional acceptance and a non-judgmental space. That calls for deep self-reflection and questioning our own selves as to what is it about sex and sexuality that makes "me" uncomfortable first?

S. Samraj, Christian AIDS/HIV National Alliance (CANA), New Delhi

I am pleased to read Aarathi’s query on Life Skills Education (LSE) posted to the AIDS and MCH communities of Solution Exchange. I too have gained much through the discussions and feedback of other members who have responded to the query.

I take this opportunity to share some of my experiences, as the Christian AIDS National Alliance (CANA) over the years has been involved in this area through our extensive networks. Three years ago we had pilot programmes launched in north eastern states like Manipur and Nagaland, which got further expanded to Chattisgarh. We are working on the scale up of this programme in Bihar, Uttar Pradesh, New Delhi and Uttrakhand in the coming years.

When we started this programme, one of the detailed discussions we had was on how to roll it out on the ground, considering the experiences and setbacks of various models through the School AIDS Education Programme (SAEP) and the Adolescent Education Programme (AEP). In many places, the feedback from parents, and teachers was that even though the name changes, “they still come to children with Sex Education”. When CANA introduced our programmes to schools, we went with a clear emphasis on providing inputs to children on importance of maintaining the moral standards and the expected level of value systems. We shared this as Value Based Education (VBE) and took time to work with Principals, Teachers, and Parent Teacher Associations (PTAs) to make them confident with the content of the modules.

We started our pilot trainings with school teachers as our trainers. Three major reasons made us to shift from teachers to external youth-friendly trainers or youth leaders:

1. 
   Teachers are pre-occupied with routine curriculum, and VBE is always considered to be something out of the curriculum and hence less important.
   
2. 
   Teenage students are not comfortable and free to share their problems and sensitive issues to their teachers and also feared that sharing may have other consequences and judgments on them.
   
3. 
   Teachers and schools are not in a position to scale up the programmes.
   

I can recall some experiences from my earlier employment with Pathfinder as well. We felt that in the Indian rural context with limited literacy, we have to go through a series of processes to attain a saturation of reach. We need to demarcate areas clearly, enrol all the population in villages to cover, undertake detailed household surveys, list stakeholders and beneficiaries, and with the support of NGO Intervention Partners (NIPs) and NGO Training Partners (NTPs) go for community-based programmes instead of school-based programmes. Even though the latter will give easy access and be convenient, community-based approach would provide the acceptance of parents, key community influencers and opinion leaders. They will provide a supportive and facilitative environment.

I wish you and your team all success in your efforts in bringing positive change among adolescents, who are crucial to the society at-large.

Dr. Udita Ghosh Sarkar, GfK MODE, Kolkatta

I am personally very much impressed with the concept of 'Learning Games' being an educational component of Reach India. We had the opportunity of assessing the programme in West Bengal as well as across the states of Bihar, Orissa, Jharkhand, Assam and Orissa. Being part of GfK Mode, an in-depth study and quantitative assessment were done for Sri Mayapur Vikas Sangha (SMVS), Nadia and the results were very impressive in terms of adaptability and learning as well. The group approach of 'Learning Games' and its ripple effect in the community calls for similar programme for the adolescent boys too as was shared by various stakeholders of the programme during our study.

The Mid-term and End-line evaluation amongst the 2300 adolescent girls in Nadia district of West Bengal indicated positive results though few concerns were mentioned by their respective mothers. But overall, the programme with its 8 important components is an explicit example of Life Skill programme whereby improvement in health, social and financial empowerment of the adolescent girls were reflected in the studies conducted by us in 2009.

GfK Mode is part of the GfK group being the 5th largest research organization worldwide. Gfk-Mode has the skill, expertise as well as the experience of planning, monitoring, implementing and facilitating developing projects in all parts of the country. We would be very happy to be part of similar and interesting project in any part of the country. Please visit our website to know more - http://www.gfk-mode.com/

Gourab Chakraborty, Reach India Service Center, Bardhaman

We have found a very high impact of 'Learning Games for Girls’ at Sri Mayapur Vikas Sangha (SMVS), an organisation run by International Society for Krishna Consciousness (ISKCON), Mayapur, West Bengal. 40 female volunteers were trained by us to implement Life Skills Education (LSE) among 1000 girls and mothers through this learning game methodology.

It is a very new approach of learning life skill among rural girls as often they have no access of right information after a certain age in rural Bengal. Due to lack of information and health education, there is high incidence of early marriage and early pregnancy. We have found very positive impact of HIV education given through these learning games where people even thought that pronouncing the word AIDS by one’s mouth is a sin when we started. It was one of the big programmes we had, and it lasted for 3 years including base-line survey and impact study of LSE of adolescent girls.

Subhi Quraishi, ZMQ Software Systems, Delhi

ZMQ Software Systems has developed an initiative on HIV awareness using computer and mobile phone games. These games are useful tools to educate adolescents and young people. It is a non-profit initiative of ZMQ Software Systems in its contribution to the HIV response. Please visit the website www.freedomhivaids.in to see details about these desktop and mobile games on HIV awareness.

Please contact us if you are interested in these games for young people.

N. Ramakrishnan, Ideosync Media Combine, Faridabad

It is wonderful to see such a variety of initiatives on life skills and sexuality education now in existence. Our organisation, Ideosync Media Combine, is a communication for development organisation that works to develop communication strategies and plans, especially relating to Behaviour Change Communication (BCC). We develop different communication tools including print, audio and audiovisual material. Ideosync also does training and capacity building programmes for NGOs and communities on how to harness low-cost communication technologies to address their communication needs and voice their concerns.

Ideosync has been working on issues around young people's Sexual and Reproductive Health (SRH), and HIV awareness for more than seven years now. One of our primary objectives has been to encourage the incorporation of SRH and sexuality education in schools, and to make it part of regular interactions and outreach by NGOs working with groups of young people. To facilitate this process, we have developed a series of video-based discussion modules on issues ranging from reproductive anatomy, puberty and adolescence, sexual attraction, contraception, STIs and HIV, and sexual choices. These modules are:

1. 
   Growing Up - 3 films in English, directed at 9 -14 year old children,
   
2. 
   The Time of Our Lives - 3 films in English, for 15 - 19 year old, and
   
3. 
   Badhte Hum  - the 9-14 year olds' trilogy, in Hindi
   

All these are in wide use by several NGOs and schools across the country, and have become a model for similar initiatives in Bangladesh and other South Asian countries. Various components of the modules have been supported by DFID - India, BBC World Service Trust, Ford Foundation, UNAIDS and the MacArthur Foundation.

Each of the modules is supported by facilitators' material, which carry detailed directions on how to use the informational content of the films to expand and adapt the modules to the needs of specific groups. The modules themselves are meant to form the core of long term interventions with young people's groups. All the modules have been developed through an extensive participatory process where young people from various schools and youth groups have come together to develop and participate in the creation of the content with our team, as well as comment on preliminary versions of the modules.

Since 2005, we have also been conducting a series of training and capacity building workshops for NGOs and schools in various states. Participants of these programmes have been trained in the development of SRH interventions for young people. Using our modules as a foundation, we supported the participants with additional advisory and material inputs during the process. Many of those trained have gone on to implement full scale interventions with groups of young people. For some of these NGOs we were able to help them access funding support from different agencies. The process helped in creating a pool of trained NGO members and teaching professionals in states like Jharkhand, Uttar Pradesh (UP), and Madhya Pradesh (MP). We are in the process of expanding these initiatives to include more stakeholder groups and states.

Ideosync has also been training young people as peer educators directly as part of a collaborative intervention with the British Council's Beyond Borders project, where young people have been trained to conduct facilitated sessions with their peers using material and session plans they themselves have developed. This initiative, running since the beginning of 2006, has also resulted in a pool of trained young people with experience in conducting SRH, gender and sexuality related programmes with other young people.

These two projects, and the tremendous response they have received from young people universally, demonstrate the need for sexuality education to be user friendly, responsive, and adaptable to the needs of individuals and specific groups. Above all, it needs to be presented in ways that combine information, fun, practical life skills, and a participatory process that gives young people a voice and a stake in the intervention.

For more information on the materials and the projects, please write to [e-mail] or visit our website at www.ideosyncmedia.org.