Aids community
Dr. Madan Mani Dhakal, Government Health Service, Sikkim
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- Bu səhifədəki naviqasiya:
- Prof. Suneeta Mittal, All India Institute of Medical Sciences (AIIMS), New Delhi
- Dr. Amol Patil, Government Medical College, Dhule
- Dr. Avnish Jolly, Butterfly Nature Club of India (BNCI), Chandigarh
- Dr. Koen Van Rompay, Sahaya International, California; and Durai Selvam , READ India, Perambalur
- Empowering the people: Development of an HIV peer education model for low literacy rural communities in India
- Kunwar Viqar Naseem, Hindustan Latex Family Planning Promotion Trust (HLFPPT), Noida
- Dr. Ravishwar P. Sinha, Independent Consultant, New Delhi
- Ranjana Shrivastava, Independent Consultant, New Delhi
- Dr. Charulatha Banerjee, Terre des Hommes Foundation, Kolkata
- Life Skills Education in Andaman Islands
- Life Skills Education for Adolescent Trafficked Girls Returning to Rural Areas
- Manju George, Evangelical Social Action Forum (ESAF), Bengaluru
- Islam Hussain, Pahal Institute for Community Empowerment and Micro Finance, Nainital
- Dr. Ashwini Narasannavar, J. N. Medical College, Belgaum
- Divya Krishna, M/s Sivan Siva Associates, Bangaluru
- Swati, Community Development Foundation(CDF), Bengaluru
- Role of Parents Parents can teach LSE to children in very effective manner. They can help children in the following ways: Basic Anatomy
Dr. Madan Mani Dhakal, Government Health Service, Sikkim I am from the rural background and have interacted with rural boys and girls on issues related to Sexual and Reproductive Health (SRH). I find that the level of sexual activity and the issues related to it among adolescents are alarming. It is hence the need of the hour to systematically undertake research to know about their exact sexual behaviour. A recent news article from Tamil Nadu published by the Times of India points to this fact. The article available at http://timesofindia.indiatimes.com/city/chennai/HIV-Housewives-professionals-at-high-risk-now/articleshow/6263505.cms, says that HIV infection rate among people aged 15-29 years is on the rise, in spite of the state’s success in controlling infection rate among populations classified as Most-At-Risk. However, I have not seen such studies or statistics from Sikkim, even though several pointers are there among adolescents indicating to such a trend. As mentioned in the response from Ragini Pasricha, evidence from research is very crucial for valid and concrete decision-making. Interventions including Life Skills Education (LSE) need to be based on evidence from behavioural patterns and cultural characteristics of adolescents in the different rural areas. I am interested to work further on this issue and request help from members of Solution Exchange to conduct research in this area.
Aarathi has raised a very relevant issue. Educating adolescents is going to go a long way for improving overall health status in the country. We had launched an initiative for correcting adolescent anaemia and increasing their nutrition and iron awareness called 12 by 12 initiative. It aims to achieve at least 12 g% of Haemoglobin by 12 years of age. Being implemented across the country by several members of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), will soon be a part of the National Rural Health Mission (NRHM). Please find more information about this initiative and implementation strategy by visiting the website www.12by12initiative.com
Before thinking about universalising Life Skills Education (LSE), we should have our cent percent efforts towards basic education for all children up to class 10. There is increasing dropout from schools in some rural areas, which needs to be addressed hand-in-hand. Among some rural communities, there is negative perception about education. For example, the rising unemployment even after getting education is one such factor. Such negative perceptions about education should be removed from the community. Educated and successful role models in villages could help in this effort. Dr. Avnish Jolly, Butterfly Nature Club of India (BNCI), Chandigarh I reckon the efforts of Nehru Yuva Kendra Sangathan (NYKS) in providing services similar in scope to what Aarathi raised in her query. As a resource person of some of the programmes organized by NYKS, I got opportunities to interact with out-of-school students. Even though these children miss out on formal education, they had learnt some essential lessons in growing-up through NYKS programmes. Through their service many girls now can cope better with the issues of entering womanhood - physical and emotional. They learn how to maintain menstrual hygiene, how to communicate better and how to prevent Sexually Transmitted Infections (STI) including HIV. They came to know all this and much more by interacting with other young people of her age and by becoming a part of a Youth Information Centre (YIC), located in the premises of the locally-elected village council or Gram Panchayat office in their respective villages. The programme is being implemented in collaboration with the Panchayats system which is part of a structure for local self-governance and decentralisation of power to people at the grassroots level. In fact NYKS plays a pivotal role in partnership with Panchayats in many parts of the country for the holistic development of villages. Equipping young people with knowledge and life skills helps preventing HIV transmission, in building self confidence and thereby building a better tomorrow. Under the mandate of NYKS we talked about addressing the issue of HIV prevention in a holistic manner, along with other issues of adolescence. The concept of peer educators is well knit in the initiatives of NYKS. A peer educator is a youth from the village who is nominated by the community, and who undergoes training on topics like governance, life skills, reproductive health, and HIV prevention. Each village has Teen Clubs for girls and boys separately who act as peer educators. The peer educators further conduct at least eight hours of session among their friends who dropped out from the school and are most at risk to make them aware about their vulnerability to contracting HIV and how to protect themselves. In fact many members would recall the consultation initiated by Mr. K. L. Khanna on the draft guidelines for Teen Clubs. Taking part in the discussion, members of Solution Exchange had appreciated Teen Clubs as an excellent initiative for the development and empowerment of adolescents. The Consolidated Reply of this consultation can be downloaded from ftp://solutionexchange.net.in/public/aids/cr/cr-se-aids-06040901-public.pdf (PDF, Size: 212 KB). Some common meeting places called Youth Information Centres (YICs), Panchyat Dharm Shala, and religious places are the centers for the purpose of facilitating interaction between peer educators and young people. YICs are usually located at Gram Panchayat offices, youth clubs and other existing structures. Here young people interact with one another, learn about life skills through various games and educational material that incorporate key messages on Sexual and Reproductive Health (SRH), HIV, and substance abuse. In addition, large-scale sensitisation and orientations to involve elders, parents, members of the locally elected village councils and religious leaders are being carried out in the districts. The impact of the intervention is already visible in terms of creating an enabling environment in the districts. However, I feel we are lacking in consistent follow-ups in the projects and scale-up of successful ones.
In a rural HIV peer education programme implemented a few years ago in Tamil Nadu by the NGO Rural Education and Action Development (READ), we had trained leaders of women’s self-help groups and barbers as peer educators to reach women and men, respectively. Cartoon-based flipcharts and booklets were developed. These programmes can also reach adolescents who are not in school. In this programme, we observed that many students came to talk to the peer educators and pick up the booklets, because the information that they were receiving in schools was often not sufficient or did not solve many of their doubts. Many teachers are hesitant to discuss these issues, and students are also afraid to ask sensitive questions to their teachers. Please have a look at the paper - Empowering the people: Development of an HIV peer education model for low literacy rural communities in India, published in the journal Human Resources for Health. It is available at: http://dx.doi.org/10.1186/1478-4491-6-6 All the cartoon-based books, flip charts and other Information Education Communication (IEC) material can be downloaded from http://www.sahaya.org/iec-materials.html
Let me share my experiences of working with adolescents in the slums of Delhi when I worked with the Gender Training Institute. We found that most of the male adolescents were aware about sex. They do get this information through TV, Peers, friends and magazines. However, they do not know the correct information which then leads to other problems. We conducted trainings and we found that, adolescents suffer from low self-esteem, confusion, and those who are out of school do not know how to get engaged in life as they are without adequate education. Hence I believe that it is better to give them guidance on employment opportunities along with the other components of Life Skills Education (LSE). The biggest problem of adolescents is lack of guidance at an appropriate time. Specifically coming to your third sub-question about out-of-school adolescents, I would like to share from some of our experiences in Rajasthan and Orissa. During the implementation of a project on HIV we reached out to school drop-outs through youth groups and workplaces like automobile workshops, mechanics shops, brassware workshops and tea shops. Even though we were able to reach out to a good number of them through this approach, I acknowledge that it is a challenge in rural areas. Another option to reach out is through organising rural sports. With prudence and perseverance, I am sure that you will see some good results. Dr. Ravishwar P. Sinha, Independent Consultant, New Delhi Aarathi and her organisation deserve compliments for the nice work they are doing. Posting this query on Solution Exchange is a most welcome. I had been following the diverse and rich views and experiences shared so far and find them very educative. Here, I would like to add a relevant experience where the difficulties outlined in the query had been overcome. Francois-Xavier Bagnoud (FXB) colleagues in Kolkata took me to a number of school health programmes, when I had the privilege to be the Country Director of FXB in India. These schools were in the middle class locality. I had discussions with the teachers and students and also attended the training sessions and looked at the post training evaluation answers. During this visit, I too had the same concerns raised by Aarathi in the back of my mind. Indeed during my discussions I did probe these issues with them. The experiences they shared were rather encouraging. Initially there was resistance from family members and some teachers. What overcame this was transparency and sensitivity. The dissenters were invited to the first such course exclusively and were asked to evaluate it. The mindset changed after these sessions. Discussion with the children, who were all adolescents, in the presence of faculty and parents and the opinion of students came out strongly in favour. The youngsters described this course as very useful. Schools were requesting and were in queue with my esteemed Kolkata colleagues. Transparency, perseverance and sensitivity shown by them were exemplary. Through inputs from other members so far, I am happy to note that there are many such institutions and individuals whose numbers are increasing, doing the noble duties to our future citizens.
Presently, I am associated as a Consultant with an NGO called Swati in New Delhi for their ‘Health, Gender and HIV’ project in one of the slums of Delhi. The direct beneficiaries of the programme are adolescents, youth, children and women. The main objective of the project is to educate the beneficiaries and to sensitise them on the above mentioned issues in their life. One such activity is Life Skills Education (LSE) for the community children who include both school-going and out-of-school children, community youth, and women from the community. For this, different kind of audio-visual methods are being implemented. Though the query is for rural adolescents, in fact it is relevant for urban or semi-urban areas as well. The responses to this query filled with experiences and relevant resources, especially the videos of National Institute of Open Schooling (NIOS) shared by Asheema Singh, will help us a lot in our current project. The other components of the project are street plays, quiz competitions, in house painting competitions, screening video films and counselling sessions to women, youth, children and adolescents on education, gender, health, HIV and matters related to daily life. These activities helped us a lot in not only sensitising the direct beneficiaries, but also in getting on board the entire community to appreciate the importance of Life Skills Education. In all, the Counselling session is the most effective one because it covers all the aspect of LSE like their questions and views on reproductive health issues, menstruation, gender as a hurdle in education and career building, sex and sexuality, and higher education. Dr. Charulatha Banerjee, Terre des Hommes Foundation, Kolkata I have been following the responses to this query with great interest and look forward to the Consolidated Reply (CR), which will give me a list of all organisations and resources on the subject. My experiences with Life Skills Education (LSE) for adolescents are largely similar to what has been discussed so far. Nevertheless, I would like to share two specific experiences here. Life Skills Education in Andaman Islands LSE when it touches upon long-standing practices and beliefs in the community often gives rise to confusion in the youngsters’ mind. Many a times, statements in LSE programmes are directive and prescriptive. We should be providing them with facts and information. Along with presenting all available alternatives and options to adolescents, we must simultaneously build their skills and confidence to choose the right options. We must not forget the skills component of this education process - which is the most important one and what makes LSE different from just information dissemination. In our project, with in-school and out-of-school adolescents on the island of little Andaman, we use a module adapted from various existing modules such as the WHO Skills for Life module, Peace Corps module, and the UNICEF modules. Our realisation has been that youngsters are most attracted to sessions where we incorporate the information with skill building activities. We conduct trainings for the school going and out-of-school adolescents, initially focussing on knowing oneself, gender roles, values and beliefs, emotions and coping strategies, peer pressure, decision making, adolescence and puberty followed by the Sexual and Reproductive Health (SRH) issues much later. It is difficult to actually segregate SRH issues from other Life skills sessions. Personalising skills to life requires conducting role plays that are centred around SRH, when it comes to decision making and coping with emotions and negative influence of peers.
For adolescents who are out of school and are already struggling to earn a living and support for their families, these sessions must be coupled with a practical life skills curriculum. The same applies to girls who return to rural environments after a long time in institutions like those for trafficked and rescued girls. Such children need very special inputs that will help them cope with the challenges of facing the community and making decisions for a healthy life. Terre des hommes Foundation works with such girls in partnership with Sanlaap through a European Union supported project titled 'Protection and Quality of Care Action' (PAQCA). Trafficked children as young as 11 years after being withdrawn from commercial sexual exploitation are rehabilitated in a receiving facility for a maximum of three months before being moved to alternative care which often is their families or group homes in rural areas. These children have special health vulnerabilities especially STIs and HIV, in addition to the entire spectrum of under-nutrition. In this period of three months, we try to provide as much information as possible to them in terms of life skills especially related to health. We start with the basics within the framework of protection. We have developed a grid which ensures that a child who stays with us for even 1 week goes back with some information which could enable the adolescent to protect herself from further health risks. The grid is available at ftp://solutionexchange.net.in/public/aids/resource/res19071003.pdf (PDF, Size: 58.2 KB). After going through the grid, please feel free to give us suggestions or feedback so that we can make it more effective. In addition, I take this opportunity to recommend few materials developed by other agencies, which we have used successfully:
Manju George, Evangelical Social Action Forum (ESAF), Bengaluru The National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru had published a series of programme manuals for conducting workshops on Life Skills for school children of all classes. You may check their website http://www.nimhans.kar.nic.in/ for contact details of faculty members who could be of help. I would suggest you to contact people like Dr. Shekhar P. Seshadri and Dr. Srikala Bharath of the Department of Psychiatry, and Dr. H. Uma of the Department of Mental Health and Social Psychology. Dr. R. Parthasarathy and Dr. V. Indiramma of the Department of Psychiatric Social Work would be able to further guide you in working with out-of-school children as they do have many community health programmes.
I would like to share information regarding the initiatives of an organisation named Pardada Pardadi Educational Society (PPES) near Anupshahar in Bulandshar District of Uttar Pradesh (UP). PPES is an organisation working since 2000 and is providing free education to girl students. PPES have Life Skills Education (LSE) integrated in their programme. Interestingly, PPES deposits ` 10 (ten Indian Rupees) for every day’s attendance to the bank accounts of these girl students. Hence, apart from the other benefits of education, these girls will have a considerable amount of savings by the time they complete their education. PPES has integrated vocational training and has several livelihood initiatives attached to it. The organisation is also trying to link health and livelihood services to students through unique projects like the ‘Rags to Pads’, which provides sanitary napkin facility to girls and women. There are many such initiatives about which you can get a brief idea from the document at ftp://solutionexchange.net.in/public/aids/resource/res19071004.pdf (PDF, Size: 29 KB). You can also visit the PPES website - www.education4change.org or contact them at the following address: Mr. Preeti Dhaka
Dr. Ashwini Narasannavar, J. N. Medical College, Belgaum One of my students did a study on the knowledge, attitude and practice regarding menstrual hygiene in a rural setup. The results showed that most of the adolescent girls did not have adequate knowledge about menstrual hygiene and also the further consequences related with it. Even when basic education is improving through different government schemes and other programmes, most of the girls in these rural areas are not educated on Sexual and Reproductive Health (SRH). People working at the grass root level should join hands with basic school teachers to take forward Life Skills Education including SRH.
Thank you for sharing your concern. I believe that education relating to life skills can be imparted more effectively by screening of educative short films, documentaries and street plays keeping in mind the social set up of the village. You can get locals of the village to contribute and participate in the street plays. Such screening must be kept open to not only existing students and dropouts but also for the general public. It would be an additional advantage if you get a leader of the village to speak about the issues. Such people are likely to attract more audience. I would also suggest an interactive session after the screening where the students may clarify their doubts. However, I understand that, they might not be forthcoming to speak up about certain issues. In such cases, I suggest anonymous written communication whereby the students may write their questions without revealing their identity or organise individual sessions for clarifications which are to be held in complete confidentiality. I hope you find these suggestions useful. Swati, Community Development Foundation(CDF), Bengaluru Life Skills Education (LSE) includes necessary skills that a child needs to be successful in society. In rural areas children need to learn the essential life skills. They need to learn about personal hygiene, anatomy and physiology of human body, reproductive organs, understanding the basic social rules and how to take decisions under different circumstances. Knowledge on these can be given in different manner. I feel sex education should not be seen as separate and should be considered as important as other things. For teaching components of life skills education, equal cooperation of teacher and parents is required.
Role of Parents Parents can teach LSE to children in very effective manner. They can help children in the following ways:
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