Efficacy of school-based HIV and AIDS education in achieving behaviour change in Kenya: towards a contextual model
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Date
2011-08-03
Authors
Lengewa, Mesianto Catherine
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Abstract
In an effort to address the problems generated by HIV and AIDS and to avert further new infections among adolescents, a school-based intervention strategy has been widely recommended and implemented in many countries including Kenya. Nonetheless, a number of issues have been raised regarding the effectiveness of this approach. These issues revolve around the content of the HIV and AIDS education, its mode of delivery including the approaches, and the needs of HIV and AIDS educators. Critics are concerned that the technical components of the program are not supportive of the intended outcome. Very little systematic evaluation of the school-based HIV and AIDS intervention strategy is linked to the expected outcome of behaviour change. This study therefore sought to establish the effectiveness of the school-based HIV and Aids intervention strategy in relation to the translation of knowledge into behaviour change. The study also sought to provide recommendations on a school-based HIV and AIDS contextual model with a broader focus in addressing both the individual level phenomenon and a multi faceted range of influences that promote, reinforce and maintain the adolescent's protective behaviour towards HIV and AIDS.
The study employed cross-sectional study design, where both qualitative and quantitative data was generated to address the study objectives. Stratified random sampling was used to arrive at the eight selected public schools. Similarly, proportional and simple random sampling was used to select the 400 respondents. Five focus group discussions for adolescents, key in-depth interviews and structured observations for teachers were held. The population of study consisted of form one to four students in public secondary schools aged 15-19 years in Thika district. Quantitative data was analysed using SPPS and simple descriptive analysis used for qualitative data. The main findings indicate that school-going adolescents have high levels of HIV and AIDS knowledge. Only 10 percent displayed moderate level knowledge while 90% indicated high level. Although the knowledge level was high, they still engaged in risky sexual practices. It was noted that 74% of the sexually-active respondents reported not using condoms during their first sexual intercourse, while 45% of the sexually-active adolescents reported having been sexually-involved with two or more partners within the twelve months prior to the study. Majority of adolescents and teachers considered the school-based HIV and AIDS education content ineffective in changing adolescents' sexual behaviour. Similarly, the teachers of HIV and AIDS considered themselves not adequately trained to handle the subject. The result also indicated a clear dissonance between the education sector AIDS policy, the curriculum content and actual school-based HIV and AIDS education implementation. Based on these findings, there was among school-going adolescents an apparent gap between HIV and AIDS knowledge on the one hand and practice on the other. The study identified three broad factors that may be linked in an effort to address the problems generated by HIV and AIDS and to avert further new infections among adolescents; a school-based intervention strategy has been widely recommended and implemented in many countries including Kenya. Nonetheless, a number of issues have been raised regarding the effectiveness of this approach. These issues revolve around the content of the HIV and AIDS education, its mode of delivery including the approaches, and the needs of HIV and AIDS educators. Critics are concerned that the technical components of the program are not supportive of the intended outcome. Very little systematic evaluation of the school-based HIV and AIDS interventions strategy in relation to the translation of knowledge into behaviour change. The study also sought to provide recommendations on a school based HIV and AIDS contextual model with a broader focus in addressing both the individual level phenomenon and a multi faceted range of influences that promote, reinforce and maintain the adolescent's protective behaviour towards HIV and AIDS.
The study employed cross-sectional study design, where both qualitative and quantitative data was generated to address the study objectives. Stratified random sampling was used to arrive at the eight selected public schools. Similarly proportional and simple random sampling was used to selected public schools. Similarly, proportional and simple random sampling was used to select the 400 respondents. Five focus group discussions for adolescents, key in-depth interviews and structured observations for teachers were held. The population of study consisted of form one to four students in public secondary schools aged 15-19 years in Thika district. Quantitative data was analysed using SPSS and simple descriptive analysis used for qualitative data.
The main findings indicate that school-going adolescents have high levels of HIV and AIDS knowledge. Only 10 percent displayed moderate levels knowledge while 90% indicated high level. Although the knowledge level was high, they still engaged in risky sexual practices. It was noted that 74% of the sexually-active respondents reported not using condoms during their first sexual intercourse, while 45% of the sexually-active adolescents reported having been sexually-involved with two or more partners within the twelve months prior of the study. Majority of adolescents and teachers considered the school-based HIV and AIDS education content ineffective in changing adolescents' behaviour. Similarly, and teachers of HIV and AIDS considered themselves not adequately trained to handle the subject. The results also indicated a clear dissonance between the education sector AIDS policy, the curriculum content and actual school-based HIV and AIDS education implementation. Based on these findings, there was among school-going adolescence an apparent gap between HIV and AIDS knowledge on the one hand and practice on the other. The study identified three broad factors that may be linked to this gap and that play a role in influencing the HIV and AIDS behaviour change among school-going adolescents. These are policy and institutional framework, community participation and capacity building for both students and teachers. The study attempts to use these features to propose a school-based HIV and AIDS contextual model that takes into account both individual level phenomenon and environmental dynamics that influence the adolescents' sexual behaviour. The study recommends strengthening of the HIV and AIDS education policy implementation to bridge the gap between policy and practice. It also proposes a revision of the HIV and AIDS curriculum based on the proposed contextual model.
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