HIV/AIDS Prevention & Reproductive Health Project

HIV/AIDS 

Prevention & 

Reproductive 

Health Project 

LEARNING & CAPITALIZATION STUDY 

NEPAL RED CROSS SOCIETY 

Swiss Centre for 

International Health

Submitted to 

Nepal Red Cross Society & 

Swiss Agency for Development and 

Cooperation (SDC) 

Submitted by 

Ricarda Merkle 

Prakash Rimal 

With contributions from 

Bipul Neupane, Nepal Red Cross Society 

Bhojraj Thokar, Nepal Red Cross Society 

February 2007

Contents 

List of Abbreviations 

III Executive Summary 

IV Study Methodology 

1 Introduction 

4 Life Skills Development of 

Youth 

9 Teaching Sexual and 

Reproductive Health at 

Schools 

13 Involvement of Parents and 

the Community 

19 Gender Equity and Equality 

23 Coordination at District 

Level 

26 Summary of 

Recommendations 

Annex 

28 I - Newspaper extracts 

30 II - Question Guide 

36 III - Project Documents and 

Consulted Literature 

ART 

BCC 

CBOs 

CCM 

DACC 

DDC 

FGD 

HIV/AIDS 

HQ 

IDUs 

IEC 

IGA 

I/NGOs 

J/YRCC 

MoH 

NCASC 

NGOs 

NRCS 

PE 

PLWHA 

RH 

SDC 

SSI 

STI 

SRH 

UNAIDS 

UNDP 

VDC 

VCT 

Anti Retroviral Therapy 

Behaviour Change and Communication 

Community Based Organizations 

Country Co-ordination Mechanism 

District AIDS Co-ordination Committee 

District Development Committee 

Focus Group Discussions 

Human Immunodeficiency Virus/Acquired 

Immune Deficiency Syndrome 

Headquarters 

Injecting Drug Users 

Information, Education and Communication 

Income Generating Activities 

International/Non-Governmental 

Organizations 

Junior/Youth Red Cross Circle 

Ministry of Health 

National Centre for AIDS and STD Control 

Non-Governmental Organizations 

Nepal Red Cross Society 

Peer Educator 

People Living with HIV and AIDS 

Reproductive Health 

Swiss Agency for Development and Cooperation 

Semi-structured Interviews 

Sexually Transmitted Infection 

Sexual and Reproductive Health 

Joint United Nations Program on HIV and AIDS 

United Nations Development Programme 

Village Development Committee 

Voluntary Counselling and Testing 

The contents of this publication 

may be reproduced in whole or 

in part on condition that due 

acknowledgement is given to the 

publication.

Executive Summary 

The Nepal Red Cross Society in partnership 

with the Swiss Agency for Development and 

Cooperation (SDC) has been implementing 

an HIV/AIDS Prevention and Reproductive 

Health Project in six districts - Dolakha, 

Ramechhap, Sindhuli, Bhaktapur, Baglung 

and Parbat - since 2000. The project will 

continue until February 2007. 

Focusing first on working with youth and 

teachers at secondary schools, the 

programme has increasingly reached out to 

the wider community, mainly through 

facilitation of women groups and public IEC 

(Information, Education and Communication) 

events. Peer Educators (PEs), who are 

members of the Junior/Youth Red Cross 

Circles (J/YRCC), school teachers and 

women groups act as facilitators and change 

agents. Interpersonal communication 

channels, such as teaching in class rooms, 

group discussions, door-to-door 

interventions, folk song competitions and 

street drama are the main information 

vehicles. They are supported by IEC materials 

including a quarterly bulletin, Yuva Chautari, a 

Youth's Forum, posters and show books for 

(partly illiterate) women in the community. 

The project has contributed to open up 

attitudes and discussion among youth, 

teachers and the community on issues 

related to HIV and AIDS and Reproductive 

Health. Moreover, capacities of teachers and 

peer educators to provide lessons and 

interactive IEC interventions on Sexual and 

Reproductive Health have increased. Project 

interventions have served to further 

strengthen the respective NRCS institutions 

and facilitated implementation of HIV and 

AIDS prevention initiatives; in particular 

through NRCS youth circles, teacher 

volunteers and district offices. 

In all of the six districts the project was the 

first comprehensive initiative addressing HIV 

prevention and Reproductive Health for 

youth at schools. The project filled a gap and 

contributed to putting the "on paper only" 

curriculum of Sexual and Reproductive 

Health into practice. Those involved 

unanimously welcomed the initiative. 

Schools that could not be covered felt that 

they were missing out. All activities were 

implemented through existing institutions 

with the aim of enhancing sustainability. All 

districts intend to continue the project 

activities and some districts have already 

started to do so with their own resources. 

Nevertheless, the level of activity is likely to 

slow down. Important inputs of the project 

needed to sustain the momentum of 

activities include trainings and provision of 

IEC materials. 

CAPITALIZATION STUDY 

HIV/AIDS Prevention and Reproductive Health Project 

NRCS/SDC 2000-2007 

III

Study Methodology 

This capitalization document is primarily 

based on a qualitative study drawing on a 

number of participatory and exploratory 

techniques. As far as possible quantitative 

data was also investigated within the 

interviews to complement the analysis and 

expand the conclusion. The documenting 

process itself served for exchange and 

mutual learning for both the study teams and 

stakeholders at the district and central level. 

Project documentation and related literature 

was reviewed prior to the fieldwork and used 

as reference and for triangulation throughout 

the capitalization process. During the field 

visits additional documents and IEC 

materials relating to the project were 

gathered, reviewed and incorporated into the 

study. 

Prior to the fieldwork component, the team 

developed a question guide based on project 

documentation and the Terms of References. 

It included sections that were adapted for 

application to different stakeholder groups 

(Annex II). The question guide served the 

two teams to adopt a common methodology 

of semi-structured interviews (SSI) and 

open-ended stakeholder discussions. It was 

pre-tested in the first district that was jointly 

visited by the study team and then finalized. 

SSIs formed a major part of the field 

methodology, and were based on issues 

arising from pre-field meetings and 

documentation provided by the NRCS 

Headquarters (HQ). SSIs were used in key 

informant interviews and focus group 

discussions. Interactive interviews were 

conducted with NRCS district chapter, 

DACCs, DDC members, teachers, 

headmasters, peer educators and women 

group members in the six districts. All six 

SDC supported programme districts were 

visited for qualitative data collection. In each 

project district FGDs and SSI were held with 

2 groups of PEs, 2 women groups, 2 

teachers and the headmaster, NRCS district 

chapters including DACCs and DDC 

members. 

IV 



NRCS/SDC 2000-2007

Introduction 

since the detection of the first the general population is high because of 

AIDS case in Nepal in 1988, risks related to commercial sex, high 

Nepal has progressed from a rates of sexually transmitted diseases, 

"low-prevalence" country to low levels of condom use, pockets of 

one with a "concentrated 

intravenous drug users and low literacy 

epidemic" with relatively high prevalence rate. In 2005, a total of 959 AIDS cases 

in certain sub-groups of the population. and 5,828 cases of HIV infection were 

HIV prevalence is estimated at 17.3% reported to the Ministry of Health. 

among female sex workers, at 68% 

among injecting drug users and ranges Young people in Nepal constitute more 

from 4-10% among labor migrants to than one third of the population. Young 

India. The risk of an epidemic bridging to people are considered a priority group in 



NRCS/SDC 2000-2007 

1

the National HIV and AIDS Strategy. 

Young people in Nepal are becoming 

more vulnerable to HIV and AIDS 

because of an increase in pre-marital 

sexual intercourse. Moreover, young 

people also tend to make up a large 

proportion of particular high-risk subgroups 

such as migrants, female sex 

workers, injecting drug users, and men 

who have sex with men. Vulnerability is 

further fuelled by gaps in access to 

Sexual and Reproductive Health (SRH) 

knowledge, and skills and services. For 

young people to reduce their risk and 

vulnerability to HIV, they need a set of 

protective skills and to have access to 

appropriate services and products. They 

must also perceive their environments to 

be supportive of changing or maintaining 

safe behaviours. On their journey from 

childhood to adulthood youth are eager 

and perceptive to learn about SRH and 

thus bear high potential to apply 

protective skills and adapt their 

behaviour. Society-wide change is 

nevertheless a slow process. Changes 

achieved through Behaviour Change and 

Communication (BCC) will not be seen 

overnight. This is especially true when it 

comes to addressing HIV and AIDS 

which requires national and community 

discussions on sex and sexuality, risk, risk 

settings and risk behaviours and forces 

them to confront cultural ideals and the 

practices that clash with them. 

The NRCS started to address HIV and 

AIDS prevention for Youth in 1994 as one 

of the first main actors in this field in 

Nepal. The HIV and AIDS Prevention and 

Reproductive Health Project, funded 

through SDC, has adopted 

comprehensive approaches to address 

SRH education at schools. Today, NRCS 

promotes SRH at schools in 19 districts in 

Nepal, with support from SDC, 

Norwegian Red Cross (Norcross) and the 

UNDP. Altogether, the NRCS covers 54 

districts through HIV prevention 

activities. The programmes are 

implemented through the educational 

institutions which are closely linked with 

the NRCS network and reach down to the 

community level. The SRH youth 

programmes of the NRCS are embedded 

in the community development work of 

the NRCS; they are multi-sectoral in 

nature and contribute to a coordinated 

response through involvement of 

community members, leaders and other 

organizations. The programmes 

essentially built on the participation of 

youth, involvement of teachers and 

outreach to the community. Measures to 

address gender balance and social equity 

are an integral part of all programmes. 

2 



NRCS/SDC 2000-2007

The NRCS addresses HIV prevention and 

Reproductive Health through the 

adapted use of BCC as a multi-level tool 

for introducing and sustaining riskreducing 

behaviour change. This involves 

the promotion and reinforcement of 

tailored messages through a variety of 

communication channels. In Nepal as a 

first step towards behaviour change the 

general level of awareness on issues 

related to HIV has considerably 

increased. What is needed further is to 

reinforce the message and address 

beliefs and practices that lead to 

behaviour change. This includes 

stimulating discussion around cultural 

beliefs and practices; facilitating the life 

skills needed to reduce vulnerability and 

improving access to youth friendly 

services. It further implies reaching out 

to population groups with less access to 

information and reinforcing an 

information cascade among teachers, 

peer educators, their parents and peers 

followed by the community at large. 

This capitalization study presents the 

activities, outcomes and lessons learnt of 

the SDC funded programme on HIV and 

AIDS Prevention and Reproductive 

Health, implemented from 2000 until 

2007 in the districts of Dolakha, 

Ramechhap, Sindhuli, Bhaktapur, Baglung 

and Parbat. The study highlights the main 

common features of different initiatives in 

the six districts, presenting them as the 

main pillars of the NRCS approach to SRH 

with a focus on youth at schools. 



NRCS/SDC 2000-2007 

3

Life skills 

development 

of Youth 

Project activities 

Almost all of the Peer Educators (PE) that are 

trained in the frame of this project are part of 

Junior/Youth Red Cross Circles (J/YRCC), 

also called the "youth wing" of the NRCS. 

The J/YRCCs are widespread groups of 

youth volunteers; almost every school in 

Nepal is hosting one or more circles. 

Throughout Nepal there are over 4,020 

school youth circles with more than 

800,000 members. Each circle is tended by 

a teacher - who is also a NRCS volunteer - as 

a first reference and supporting contact. The 

circles develop their own yearly work plans, 

4 



NRCS/SDC 2000-2007

organize monthly meetings and submit 

quarterly short activity reports to the district 

chapters of the NRCS. Activities range from 

emergency response and environmental 

work to sanitation and social protection. 

Moreover, circles constitute an important 

communication link between communities, 

schools and district chapters of the NRCS. 

Often they are the first to inform the district 

chapters or respond to the upcoming social 

and emergency needs in the community. 

Between 2-4 students are selected for a three 

day core PE training. Teachers and core PEs 

then jointly organize a two-day PE training at 

their school for 20 selected students. Topics 

of the training include Reproductive Health 

and HIV and AIDS issues related to 

adolescence and life skills. PEs are expected 

to educate their peers in and out of school. 

Their role is to act as change agents, 

disseminating messages to their peers and 

the community. Usually some of the PEs 

trained 5-6 persons, take the lead and play a 

more active role. Interactive IEC initiatives to 

foster debate and youth participation include 

role plays, street drama and group 

discussions. Activities at schools usually take 

place once a week on a free afternoon. PEs 

may organize awareness sessions in 

different classes when teachers are absent. 

One school, for example, set a standard for 

every trained PE to hold at least one session 

after receiving training. 

Most activities are youth-initiated and based 

on shared decisions between youth and 

adults. The youth are involved in all steps of 

the programme; as participants in planning 

workshops, self-assessment exercises, when 

organizing and implementing 

communication events and through 

contributing to the production of IEC 

materials. They thus gain planning and 

organizational skills and learn to discuss and 

communicate plans to a wider audience. 

They are responsible for defining their 

working agenda, including monthly 

meetings, and for submitting quarterly 

reports to the district chapters of NRCS. 

Some of the IEC materials are completely 

designed by the youth; others are developed 

with their significant involvement. PEs, for 

example, contributed to compiling and pretesting 

a PE manual. It was developed through 

a rigorous one year process, has gained 

popularity and is today used by many other 

agencies in the country. One of the most 

popular IEC materials is a quarterly bulletin - 

Yuva Chautari - published at central level and 

distributed to all district chapters, schools and 

PEs. The bulletin is based on inputs from the 

youth who are invited to submit articles. On 

average submissions exceed the bulletins 

publishing capacity two or threefold! The 

bulletin includes a section where those 

questions are answered which schools and 

district chapters had difficulties to answer and 

which were therefore forward to the NRCS 

HQ. 

Project outcomes 

A main outcome of the project is that it 

considerably contributed to open up 

discussions among the youth about issues 

related to SRH and reducing the shyness 

surrounding them. As an example, people 

used to turn off the radio when HIV 

prevention messages were disseminated, 

boys and girls would strictly stick to the 

opposite benches and women used to hide 

their sanitary towels during menstruation. 

Parents and elders usually avoided 

pronouncing words perceived to have 

"sexual connotations" in front of young 

people. These expressions of shyness are 

gradually disappearing. Students increasingly 

ask questions - and the teachers appreciate 

this as it supports them to overcome their 

own difficulties in teaching SRH. 

The project has contributed to removing 

barriers that existed at all levels - within the 

family, at school and in the wider 



NRCS/SDC 2000-2007 

5

community. Sessions now include 

discussions on "intimate" issues such as 

menstruation, sterility, males' concern about 

masturbation, wet dreams, etc. Youth 

indicate that they are most of all interested in 

issues related to Reproductive Health and 

adolescence/life skills. This includes health 

issues such as hygiene, infection prevention 

and contraception which are relevant to the 

daily life of the youth. Hence, to capture the 

interest of the youth HIV needs to be 

integrated into the broader context of 

adolescence and Reproductive Health. 

Increased knowledge, new responsibilities 

and participation in activities all promote a 

set of life skills of PEs, including awareness, 

self-esteem and assertiveness. One youth 

commented that his main motivation to 

work as a PE is to challenge conservative 

attitudes. Being selected for the training is 

regarded as a privilege and other students 

would also like to receive the training. The 

project further enjoys popularity among the 

youth as it provides an open environment to 

exchange matters of their concern. Though 

many of the youth knew each other 

previously, the joint project activities 

intensified interaction and friendship among 

PEs. It is now noted to be relatively easy to 

gather the youth together for activities. The 

readiness to meet was further 

demonstrated when organizing focussed 

group discussions for this study. 

The project has resulted in an increased 

number of J/YRCCs and an increased level 

of their activity (one district, for example, 

had 8 new circles). Through the project 

activities J/YRCCs gained additional 

responsibilities that kept them more active, 

as expressed in an increased number of 

quarterly reports submitted by the youth 

circles to their NRCS district chapters. The 

project has thus played a catalytic role 

motivating youth to work as volunteers and 

to get involved in a range of community 

interventions and extra curricular activities 

that go beyond the issue of HIV. 

Although the NRCS is considerably successful 

with its volunteer based approach, incentives 

to keep the momentum of activities need also 

to be considered. Though the PEs do not 

receive any financial incentives, they have 

other incentives such as meeting peers and 

most importantly receiving trainings. 

Motivation though tends to slow down as the 

effect of the training fades away which often 

is the case approximately one year after the 

training. Also, youth request more in-depth 

knowledge on some issues - the module on 

life skills currently only covers 2 hours and 

many of the PEs find it to be very short. The 

yearly one-day refresher meetings are not 

considered to provide significant added value 

compared to the first trainings. Incentives are 

further related to belonging to the broader 

social movement of the NRCS. Activities are 

often integrated into the planning of J/ 

YRCCs, but not all schools have a system in 

place where PEs can meet with one another, 

follow up and update their knowledge 

regularly. 

Often the formal role as educators for HIV 

prevention is limited, given that PEs are 

unlikely to have sufficient level of HIV and 

teaching expertise after a few days of 

training. An important part of information 

sharing is on an informal basis with close 

peers. These interactions are most intensive 

after the training when friends are curious to 

ask PEs what they have learnt. For direct 

questions PEs prefer to consult close friends 

and others of the same gender. Most 

interactions are with friends at school. 

Nevertheless, examples include talking with 

out of school peers, sisters/ brothers and, in 

some cases, parents. Interactions with other 

youth and the community are easier if they 

are supported by questions from the query 

box to be answered, and event and role plays 

such as the street drama. 

6 



NRCS/SDC 2000-2007

A BOX TO ENCOURAGE QUESTIONS FROM YOUTH 

A tool that is often used to conduct discussions are questions 

submitted by the youth anonymously to a Query Box. Query 

boxes are put up at schools for youth to submit any questions 

they have regarding adolescence and sexuality. With a couple of 

questions being normally submitted per week, query boxes 

present a continuing demand and a tool to shape sessions. 

Questions submitted are looked at jointly by PEs and teachers 

who contribute to the cooperation between teachers and PEs. 

Answers may be published at school notice boards or discussed 

in classes or other discussion sessions. If PEs and teachers have 

difficulties to answer the questions, they are forwarded to the 

NRCS Headquarters in Kathmandu, which answers and publishes 

them in its quarterly newsletter, Yuva Chautari. Some schools 

noted a decrease in queries submitted to the query box which 

was mainly attributed to an increased openness of students to 

ask questions directly during sessions. 

EDUTAINMENT WITH STREET DRAMA 

Youth receive a four-day training on street drama as performers 

and facilitators. The drama teams usually perform during 

festivals and public gatherings, attracting masses of around 500 

people. One district has performed around 20 sessions, one team 

around 4 in one year. Performances are interactive; a moderator 

involves the public with questions during the play. Street drama 

teams are also mobilized by a range of other institutions and 

organizations such as the military service, other district offices 

as well as private companies including Coca Cola - Nepal, 

Nebico Biscuits, etc. One team received substantial support in 

terms of equipment through another agency that was impressed 

by its performance. 

NATIONAL EXCHANGE BETWEEN PEs 

In 2005 for the first time a three day PE conference was 

organized in Bhaktapur. Four PEs and one teacher from each 

district were invited. The PEs were asked to submit abstracts 

according to a list of topics based on which some were selected 

for presentations. Youth were the main actors throughout the 

conference, to the point that teachers complained they felt 

neglected. Participation in the conference was stated by several 

youth as a highlight within their work as PEs. It gave them the 

opportunity to share and learn form others on practical issues 

related to the work as a PE. 

A major challenge for the sustainability of PE 

approaches is that the turn over of PEs is 

usually high. Young people grow up, have 

rapidly changing interests and environments 

and often find themselves on the look out for 

opportunities to generate income - in part 

due to sheer financial necessity. The more 

active PEs are often the older ones and when 

they leave school the younger PEs are 

required to take up the initiative. This project 

reduced the risk of low sustainability by 

using the J/YRCC as a continuing 

institutional base that provides its own 

incentives. In the majority of districts 

reference teachers of the J/YRCCs are 

involved in supporting the continuity of 

activities and providing guidance to younger 

PEs. In other districts voices were less 

optimistic stating that "the training has just 

made us stand, we need more to help us 

make the move." Furthermore, it needs to be 

kept in mind that reaching out to the 

community and changing behaviour is a 

longer process. "If we critically analyse the 

questions in the query box we find most of 

the questions coming from students indicate 

that they are still shy." 

The general statement was that to keep the 

same level of activity it will need a minimum 

level of external support mainly in terms of 

further trainings and provision of IEC 

materials. Small incentives have a high 

effect but their reliability and continuity 

needs to be assured. Youth are discouraged 

if, despite their initiative, support in terms of 

answered questions and provision of IEC 

materials is lacking. To increase the 

capacities of PEs an option may be to 

provide further training and some additional 

incentives to a selection of active PEs (2-4 

per schools) which in turn have to initiate a 

certain set of activities. Ideally, these PEs are 

selected by the other youth/PEs and thus 

have the mandate and trustworthiness of 

youth to function as their representatives, 

counsellors and role models. 



NRCS/SDC 2000-2007 

7

Lessons learnt 

Adolescents have many questions and 

doubts about what happens to them when 

they grow up and mature, about their sexual 

feelings and sexual life. Prevention of HIV 

infection might be one area of interest, but it 

is neither the only nor the most important 

one. Perceptions about physical development 

and relationships, normality and abnormality, 

pregnancy, disease prevention, among 

others, all influence how girls and boys 

perceive their roles and options and influence 

how they behave. Initiatives therefore need to 

involve young people and take a broader 

perspective of their concerns related to 

reproductive health and sexuality instead of 

an HIV perspective only. Prevention 

information must be coupled with everyday 

skills to increase the likelihood that 

individuals will translate their knowledge into 

action. Life skills based approaches are 

designed to do this by developing young 

people's abilities such as negotiation, 

assertiveness, and ability to cope with peer 

pressure; attitudes such as compassion, selfesteem, 

and tolerance; and knowledge about 

HIV transmission. When implemented with 

community involvement and support, these 

programmes foster a positive social 

environment. For the community 

environment to be conducive to safe sexual 

choices, coordinated interventions are 

needed that target parents, community 

leaders, teachers, and others with positive 

messages about HIV prevention. 

Youth involvement is an essential approach 

to foster life skills. Youth involvement refers 

to the degree of empowerment and decisionmaking 

that youth are able to assume. It 

needs both adequate training and 

supervision to increase youths' decisionmaking 

skills and proficiency in carrying out 

their responsibilities. Youth-adult 

partnerships constitute an advanced stage of 

youth involvement which in itself is a success 

story. However it usually needs adult staff 

members to initiate and facilitate the process 

supporting direct youth involvement, open 

communication, trustworthiness and mutual 

respect. 

An important factor to motivate youth to 

become involved is the camaraderie and 

friendship developed in a youth group. A 

shared vision and commitment to the 

programme and its goals are strong 

motivators to join, be active, and remain in a 

programme. The cooperation through group 

activities significantly contributes to the selfesteem 

and social skills of involved youth. 

Lessons learnt from the project: 

• Peer education is effective to increase 

communication between peers. Face-to-face 

exchange mostly takes place between close 

peers. Dissemination of information to other 

youth mainly takes place indirectly through 

public IEC events. 

• Peer education does not contribute 

significantly to increase communication 

between youth and parents or other adults in 

the community. 

• An institutional base such as the youth 

volunteer circles decreases the usually high 

level of fluctuation of PEs. 

• Trained teachers and PEs support and 

complement each other. 

• Youth bear a high potential of motivation 

and creativity to implement IEC activities. 

• Continuous support and incentives are 

required. Important incentives include: 

training; IEC materials, HIV prevention tools; 

belonging to a group of peers and a broader 

movement. 

• For a majority of students the school 

classes on Reproductive Health are among 

their favourite classes at school. Youth are 

eager to learn about reproductive health and 

thus there is high potential to convey 

messages on HIV prevention. 

• HIV alone however does not suffice to 

keep the interest of youth; it needs 

integration with other issues of their 

concern. 

8 



NRCS/SDC 2000-2007

Teaching Sexual 

and Reproductive 

Health at schools 


Sexual and Reproductive Health (SRH) is part 

of the national curriculum on health, 

population and environment science and 

compulsory for the grades 9 and 10. The 

policy is currently to start teaching SRH from 

grade 6 onwards. Though the institutional 

frame to teach HIV at schools exists, it 

essentially lacks capacities to teach SRH and 

teachers find it often difficult to teach these 

issues. Furthermore, the national curriculum 

is lecture based, does not include teaching 

approaches and the contents on HIV is 

limited to just a few pages. There is no 



NRCS/SDC 2000-2007 

9

national system for distributing IEC 

materials on HIV prevention and RH at 

schools. The objective of the project is 

therefore to meet this gap and arm 

teachers with necessary skills to 

enhance teaching capacities with 

regard to SRH. 

The education sector has traditionally 

been a main coordinating partner of the 

NRCS. A majority of long term 

volunteers are teachers and many of 

the NRCS programmes use schools and 

J/YRCCs as a main link to the 

communities. J/YRCCs are often the 

first to report any incidences, needs 

and emergencies, within communities 

to the NRCS support teachers who then 

forward the information to the district 

chapters. 

The project implements most of its 

activities through this existing network 

of the NRCS and educational 

institutions. Schools are selected upon 

criteria including levels of vulnerability 

in the community and quality of 

cooperation with the NRCS. On average 

two teachers per school are trained for 

one week at the district headquarters. 

The teachers also receive a curriculum 

detailing different sessions for SRH 

including tools for interactive and 

participatory teaching approaches. One 

of the teachers selected for the training 

is usually the support teacher of the 

J/YRCCs. This increases the likelihood 

that the teacher has a social inclination 

and is trusted by the youth. 

The project also closely cooperates 

with the headmasters of schools. They 

receive a one day briefing workshop 

during the planning stage of the project 

and serve then as main reference 

persons. The project district chapters 

usually use the yearly district meetings for 

headmasters and add one day to brief and 

TRAINING GIVES A NEW START 

I am Amrita and work as a treasurer of Junior Red Cross Circle. I 

got an opportunity to participate in the peer education training 

organized by the HIV/AIDS Prevention and Reproductive Health 

Project. This training has changed my life. After the training I have 

started taking care of my health and also the cleanliness of 

reproductive organs. I have also explained the importance of 

cleanliness and disease prevention to my family, friends and to the 

people of my community. The training has also helped me in 

developing communication skills. These days I find myself confident 

in expressing myself in large gatherings. It has changed the way I 

look at myself. The training has motivated us to take responsibility 

and do something for other people. I as well as my friends discuss 

HIV and AIDS, STDs and RH with the help of the query box and the 

wall news paper. I am also thankful to Yuva Chautari for keeping us 

in touch with the updated information. 

A HUMAN CAUSE TO WORK FOR 

I am Meena Khadka. I am interested in social work and have helped 

before some old age people the way I can. I am pleased to get an 

opportunity to participate in the peer educators’ training. The 

training has helped me to understand more about HIV and 

reproductive health. As I found it very useful, I am disseminating the 

information among the people of the community. I also help the 

trainer of the district chapter in facilitating trainings. I have found 

people changing; those who were uncomfortable talking those 

sensitive issues now ask more questions. Today, people of the 

community, both male and female, are interested in reading Yuva 

Chautari. People who are illiterate ask other people to help them 

understand. 

Being involved with the Red Cross gave me the opportunity to learn 

many new things. I learned about HIV in general, how it transmits 

and how we can prevent ourselves from being infected. I also learned 

to take responsible decisions during the adolescent period. I believe 

that anybody who is involved in the Red Cross movement has 

motivation to serve for humanity. Being involved with the Red Cross, 

I have visited many places and made new friends. Now I can express 

my ideas fluently among friends, have overcome shyness, and I am 

committed to work for others. 

10 



NRCS/SDC 2000-2007

discuss the issue of teaching HIV and 

Reproductive Health. Headmasters are 

therefore involved from the beginning; they 

receive briefing on the objectives and 

approaches of the project. This cooperation 

continues throughout the project with yearly 

briefing meetings. 


As a response to the training teachers have 

begun to feel more comfortable about 

teaching issues around SRH. Other teachers 

seek their advice and they are asked to step in 

to teach SRH in other classes than their own. 

In one district the trained teachers upon 

demand also taught at other schools. 

The school sessions on Sexual and 

Reproductive Health (SRH) have become 

more lively with students forwarding 

questions openly including sensitive or 

intimate issues. For a majority of students the 

classes on Reproductive Health are their 

favourite classes at school. Still, when asked 

how the classes at schools 

compare to the trainings in most 

cases the training is more 

appreciated due to its higher level 

of interaction and open space for 

discussions. 

Teaching SRH remains a challenge 

and teachers openly describe how 

they try to deal with sensitive 

issues. Using questions submitted 

to the query box helps to 

introduce sensitive topics. 

Importantly, teachers value the 

support of the youth as they have 

become less shy to ask questions 

in and out of class. Teachers 

appreciate as PEs take the 

initiative to run classes on their 

own, sometimes even replacing 

an absentee teacher. 

Teachers are generally supportive and 

interested in the development of the youth. 

Ideally, youth are able to select the teacher 

they trust to talk about their concerns and 

more intimate issues. This is not feasible in 

the current setting. However, as teachers 

selected are also support teachers of the J/ 

YRCCs there is an increased likelihood that 

they teachers provide a set of social qualities. 

In most cases, these teachers have been 

NRCS volunteers for long and generally 

share some social values. Apart from 

teaching in the classroom, teachers 

supporting the 

J/YRCCs are involved in the joint extra 

curricular activities with the J/YRCCs. This 

role increases their trustworthiness in front 

of the youth and facilitates a more open 

dialogue on both sides. 

Overall, the programme has contributed to 

increasing interaction between teachers and 

students. The youth generally feel well 

supported by their reference teachers. In one 

case, for example, after the brother of a PE 

EXPERIENCES OF PES TO TEACH SRH 

PEs from Bhaktapur said they stand in for teachers who are 

absent and talk to their classmates about SRH and HIV and AIDS. 

They said they would try to make the session as interactive as 

possible. According to the PEs, this was difficult in the beginning 

because their class mates would feel shy, especially girls. Both 

boys and girls, however, started to accept discussions regarding 

sexual and reproductive health. 

"Earlier it was quite difficult to show face with opposite sex 

while teaching reproductive health and we often thought why 

this topic was taught in the class room? The peer educators 

program helped us to know about boys and girls' problems, 

reduce confusion and have more clarity on subject matter, how 

to care our body and maintain personal hygiene. Nowadays we 

realize the importance of this topic. This program equally helped 

us to solve problems and communicate with each other more 

confidently on difficult subject like sexuality and HIV and AIDS." 



NRCS/SDC 2000-2007 

11

forbade his sister to be involved in a street 

drama performance, the NRCS 

representative and the support teacher went 

to talk with the family of the PE. In most 

cases, teachers appreciate the support of PEs 

and encourage them to take the lead in 

organizing events. The example given at one 

school was that teachers would join as 

invitees while the youth stay in front of the 

event. A teacher admitted that PEs may have 

a better knowledge of life skills as they are 

closer to their peers in age. 


Given the sensitivities that surround sex, SRH 

teachers often find it difficult to discuss HIV 

and AIDS with their students. In addition, 

teachers may not be accustomed to 

interacting with students in the 

"participatory" methods, best suited for 

facilitating these subjects. This situation is 

made more difficult if teaching curricula and 

information materials take a knowledgeoriented 

and biomedical perspective, 

ignoring the kind of questions that are in the 

young people's minds. Life skills, in 

particular, are best learned through 

"experiential" and "learner-centered" 

methodologies designed to help young 

people examine attitudes and practise skills. 

Interactive teaching techniques allow 

discussion of social issues relating to 

relationships and opportunities to practise 

negotiation, communication, and own 

choices. 


• Trained teachers serve as resource 

persons for all issues related to teaching 

SRH. Other teachers and schools also seek 

their advice and support. 

• It is essential that teachers for SRH enjoy 

the trust of the young people involved. The 

project benefited from working with teachers 

who are also NRCS volunteers. In general 

these teachers had a greater social 

commitment and do greatly support youth 

volunteer circles at schools. 

• If supportive, teachers play an important 

role to facilitate the work of PEs. They can 

have a motivational effect as role models. 

• Teachers who are NRCS volunteers are 

often also involved in other fields of 

community development. They are therefore 

in a good position to create a link between 

HIV prevention in and out of school. 

• Teachers value the fact that the young 

people involved are increasingly asking 

questions as it helps them to discuss 

sensitive issues. Similarly, answering 

questions which youth submit anonymously 

to a query box helps teachers to address the 

concerns of youth. 

• Teachers appreciate that PEs take the 

initiative to run sessions. They admit that 

"for some issues PEs are better qualified to 

talk to the youth." 

• Using an existing institutional network 

increases sustainability and facilitates 

monitoring of project activities. 

12 



NRCS/SDC 2000-2007

Involvement of 

parents and the 

community 


In a preliminary phase the objective of the 

project was to use PEs at schools to also 

reach out to the communities. Support of the 

community to the PEs was 

however limited, their work 

was misunderstood and it 

was regarded as inappropriate 

for youth to talk about issues 

related to HIV and SRH to 

their seniors and elders at 

home or other older people in 

the community. Public IEC 

events such as street drama 

contributed to removing some barriers. 

Another approach was to directly include the 

community and shift the responsibility of 

sensitizing other adult community members 

to women groups. 



NRCS/SDC 2000-2007 

13

PEs disseminate messages related to HIV 

and Reproductive Health to the wider 

communities mainly through public IEC 

events - street drama or folk song 

competitions. Some interventions specifically 

target vulnerable population groups 

including dissemination of IEC materials to 

transport workers and sending letters on 

HIV and AIDS to migrant workers. Youth 

perform interactive street drama sessions 

not only in the community but also on the 

roadside, truck and bus halting places. 

To gain parental support the project informs 

and involves parents through information 

sessions and distribution of IEC materials, 

for example, at parents' days. Parents are 

invited to public activities of PEs. There 

appears to be little resistance of parents 

regarding SRH education at schools. 

Opposing views are often related to the fear 

that teaching of SRH may increase 

promiscuity among the youth. Support 

teachers play a role to counter these fears. 

The project has increasingly made an effort to 

involve the People Living with HIV and AIDS 

(PLWHA). While in general PLWHA are 

increasingly coming out, in many communities 

they are still invisible and the majority of youth 

and community members involved in the 

project have not met anybody living with HIV 

and AIDS. Within the project, PLWHA are 

increasingly being referred to the NRCS for 

support. Three PLWHA were supported by the 

project when they publicly spoke out on the 

occasion of the condoms' day. 

In one district the project is supporting a self 

help group of 12 PLWHA. Members of the 

support group are in regular contact with the 

NRCS district office, they are invited to join 

the DACC meetings and receive small 

financial support mainly in terms of travel 

expenses to reach the treatment facilities in 

the next district, Kaski (Pokhara city). It is yet 

not widely known that treatment is available 

in Pokhara, even health facilities may not be 

aware of this. Dolakha, Ramechhap, Baglung, 

Parbat and Sindhuli districts until now do not 

have VCT facilities and people would need to 

travel to Kathmandu Valley for testing. The 

lack of close voluntary testing facilities 

appears to be a major deterrent to a 

comprehensive HIV response in the project 

districts. In one project district 7 people 

currently receive ART, 3 of them were 

referred by the project. They also receive 

support for travel expenses. 

Each district has constituted 10 women 

groups, each comprising 20 or more 

members. For each group 20 members are 

selected based on criteria including social 

status and vulnerability (e.g. wives of 

migrants working mainly in India). The 

women receive a 3-day training on HIV and 

AIDS, RH, and hygiene and sanitation. They 

meet once a month with a community-based 

facilitator to learn and discuss these issues. 

Occasionally, non-members also take part in 

these meetings as observers. Encouraged by 

the discussion and appreciative of the events 

organized by the women's groups, nonmembers 

have also expressed interest to join 

in as members. Many feel 'excluded' as their 

calls go unheeded. According to group 

members, however, larger groups are 

difficult to manage in the long run. Having to 

stay out of the group makes non-group 

members feel like 'lesser child of God,' 

particularly if they are Dalits. The project 

provides a small seed amount to set up a 

fund for social protection/IGA/emergency 

depending upon the modalities that are 

determined by the members. Though the 

funds are small and thus of limited scope, 

they contribute to a sense of membership 

and provide an incentive to meet regularly. In 

most cases members have used the funds to 

take loans. The number of women 

participating in the groups has increased 

steadily and some of the groups almost 

doubled in size. Demands are further issued 

14 



NRCS/SDC 2000-2007

y communities that are not 

included in the project and by 

men who also partly felt 

neglected. 

A common activity of women 

groups is to organize public 

events on occasions such as 

condoms' day and the World 

AIDS Day. Other popular 

activities are song competitions 

and street drama performances 

with different topics on HIV. 

One women group, mainly 

comprising Dalits, was proud to 

have won a prize in a song 

competition. Different groups 

had performed several street 

dramas in the last year. Most of 

the women who have their 

husband working outside of 

Nepal send a standardized letter 

on HIV prevention targeting 

migrant workers. One district 

alone sent around 300 letters to 

migrant workers throughout 

the project phase and received 

15 responses from the 

migrants. Initiatives of women 

with regard to face-to-face HIV 

prevention are more difficult. 

Women find it challenging to 

open discussions on these 

issues and in most cases appear 

to limit these talks to close 

friends. 

Project 

outcomes 

Generally, families and 

communities have become 

more open towards issues 

related to SRH. Moreover, 

support of the community with 

regard to the work of PEs has 

IMPRESSIONS OF YOUTH MEETING PLWHA 

A group of PE from Dolakha that met a positive person 

commented: "With his healthy and active looks he will probably 

live for 20 more years." "He shared with us his views about 

positive living and it was an amazing experience listening to him," 

said a PE from High School in Dolakha. "Getting to know about 

him and learn about how he was making himself a productive 

member of society was an inspiring story to listen to," the 10th 

grader said. "I got to learn from him that positive thinking is 

absolutely necessary once someone has been infected with HIV 

and that care and support would make a lot of difference in the 

lives of those who have been infected with HIV." 

RECOGNIZING SYMPTOMS OF HIV AND AIDS 

I am Sarita from Pang V.D.C. ward no. 2 in Parbat. I am a member 

of the women group. I have 12 members in my family. My husband 

worked for 8-9 years in Mumbai. When he returned he was very sick 

and died three years ago. During the training for the women group, I 

realized that my husband was HIV positive. When I talked to him, 

the trainer suggested me to visit the Voluntary Counselling and 

Testing centre in Kaski. I went there, received counselling and was 

tested. Thank God, it was negative! I realize now how much I was 

deprived of the information. There are many cases of death - like my 

husband - in my village. But there was nobody with whom we could 

talk. Therefore, we talk about HIV issues to our friends and the 

community and motivate people to participate in the activities like 

rallies, street drama shows, folk song competitions etc. organized 

by Mahila Samuha (Women Group). 

KNOWLEDGE SHARING BEYOND BORDERS 

I am Narahari from Parbat. Currently, I am working in Malaysia. My 

friends and I are thankful for receiving a letter from your 

organization, which contains message about HIV and AIDS and 

how it transmits, how we can avoid the transmission and how to 

behave with a person testing HIV positive. As we found this 

information important we have photocopied the letter and sent it to 

our other fellows working in different factories and cities across 

Malaysia. Sending the letter made me feel important contributing to 

the prevention of the disease in our country. 



NRCS/SDC 2000-2007 

15

increased. "We were accused of being 

shameless while performing drama on HIV 

and AIDS, but now our views are listened to 

and we are encouraged to continue the good 

work". "Before we were told that only bad 

girls and those who have AIDS provide peer 

education to others - but from our street 

drama we convinced them." Though youth 

recognize some changes, there are still many 

examples where the work of PEs is 

misunderstood, they are being teased or 

regarded as "shameless". For example, after 

a street drama performance where a girl 

played an HIV positive person, spectators 

went to her brother and told him his sister 

was an HIV positive. Indirect approaches 

such as the street drama are easier to 

implement, talking directly and individually to 

community members is more difficult. 

Moreover, increased direct communication 

between adults and youth on issues related 

to SRH is less likely to happen within such a 

short time frame. 

With regard to involving PLWHA, the project 

has reached PLWHA though their visibility in 

some districts remains limited. If PEs meet 

PLWHA this appears to have a direct and 

effective impact on their attitudes and 

effectively contributes to eliminate any 

stigmatizing prejudices that may have 

persisted (unconsciously) before. Members 

of a self-help group stated that 

discrimination especially in the district cities 

has decreased. Main reasons are that 

information on HIV is now being 

disseminated through different media which 

reduces misperceptions. Another important 

factor that decreases stigmatization is the 

availability of treatment. 

There are common features regarding the 

incentives needed to keep the interest of PEs 

and women groups: Integrating HIV into 

other issues related to Reproductive Health is 

essential to gain and keep the interest of the 

women. HIV as a stand alone issue is not 

sufficient to keep the interest and to fill the 

agenda of regular meetings in a longer term. 

Concerns of women are primarily related to 

other RH issues including family planning or 

the frequent problem of uterus prolapse. 

Also, the motivational effect of the training 

tends to fade away and it needs additional 

means to keep the interest up and the 

meetings busy. As one facilitator stated, she 

had told the women everything she learnt in 

the training and they would ask her for 

further information which she could not 

provide. One group used the quarterly 

bulletin to choose subjects for discussion. 

Another sets targets on activities for the next 

month and discusses them in the next 

meeting. Other incentives for the women 

groups to meet include collecting 

membership contribution for their funds and 

to have an open space to discuss common 

concerns and to meet up with "a reason for a 

break from work". These incentives enhance 

sustainability to some degree but are unlikely 

to suffice in the longer term. Women groups 

estimate that without additional incentives 

activities are likely to level out within 1-2 

years. 

Teaching or talking to others also requires a 

certain level of expertise that may not be 

assured through a few sessions. Members of 

a women group stated, for example, that they 

would teach their children but are not very 

sure regarding their level of knowledge. The 

women groups have contributed to create a 

more open environment on issues related to 

HIV, but often they have less potential to 

disseminate detailed technical knowledge. 

Self initiative of women to access 

knowledge has partly increased. Women, 

for example, approach health posts or the 

NRCS district offices to seek answer to their 

questions. Importantly, women gained 

awareness and skills to express issues 

16 



NRCS/SDC 2000-2007

elated to SRH. One group, for example, said 

that now, if they are blamed for not having a 

son they would turn this down saying that it 

is the men who determine the sex of the 

child. Many cases are described where 

women are now more open to discuss HIV 

with their husbands and other community 

members. Some women even described 

how they would convince their husbands to 

have a blood test or use protection. Some 

cases where women previously have 

suffered in silence, they now approach the 

trained group members and seek advice. 

Women group members provide them with 

the answer and when they are not sure 

themselves the advice-seeking women are 

referred to the health facilities. 

However, barriers are naturally prevailing. In 

general women still find it easier to talk to 

close friends on issues related to SRH as 

compared to their children or husbands. 

Taking protective measures is further 

inhibited as there are no VCT centres in the 

proximity. In the western districts the closest 

VCT centre is in Pokhara, in the eastern 

districts it is in Kathmandu. "How can we tell 

spouses who come back after years to go 

back to Kathmandu, have their blood tested 

and then return home with a clean chit 

before having sex?" 

Compared to the youth, women are in a 

better position to address issues related to 

SRH to other adults in the community. Youth 

usually discuss with closer friends and, in 

some cases, also with other peers of their 

age and sisters or brothers. They prefer not 

to be responsible for sensitizing their 

parents. The project took account of these 

realities by including the women as 

mediators to reach the adult population. The 

women groups clearly contributed to 

opening up the environment and also 

increasing acceptance and support to HIV 

prevention at schools and community 

initiatives of PEs. 

However, women groups do not have the 

same institutional links compared to the 

J/YRCCs and a main concern regards their 

level of sustainability. In more urban settings 

HIV prevention targeting the general adult 

population mostly focuses on mass media 

ideally combined with counselling at health 

facilities and work places. These approaches 

bear less potential in a rural setting and other 

more sustainable alternatives compared to 

the community initiatives may not be feasible 

or effective. Health posts and family planning 

volunteers provide information on HIV, but 

they contribute less to reducing barriers and 

stigma on issues related to HIV. Where 

women groups exist in the frame of other 

programmes they may be used to integrate 

the issue of HIV, provided that they bear a 

certain level of sustainability. 


Involvement of parents and senior/elder 

members of the community provides PEs the 

critical support that they need to spread 

awareness about HIV and AIDS and SRH. 

Proper understanding regarding HIV and 

AIDS, their symptoms and the modes of 

transmission also contributes to reducing 

stigma and discrimination attached to HIV 

and AIDS. 

Moreover, the project initiatives bear the 

potential to increase inter-generational 

communication and raise awareness and 

openness among parents and other adult 

peers on issues of HIV. However, parents 

may find it difficult and be reluctant to talk 

about relationships and sexuality with their 

children out of embarrassment, lack of 

accurate information, or fear that they will 

appear to condone adolescent sexual activity. 

Similarly, youth prefer friends of the same 

age and gender to discuss issues on SRH, 

followed by sisters or brothers. Inter 

generational talk about SRH in all societies is 

a challenge for both the youth and parents. 



NRCS/SDC 2000-2007 

17

Adults furthermore tend not to be very 

receptive to teaching by the young, regarding 

any subject but even more so with regard to 

SRH. These are social commonalities that 

exist in any country or culture and may be 

reduced over time but are unlikely to 

disappear altogether simply by reducing 

culturally bound barriers. 


• Compared to youth, women are in a better 

position to address issues related to SRH to 

other adults in the community. 

• After the short training many women still 

do not feel confident to disseminate detailed 

technical knowledge. A technical knowledge 

to teach others is unlikely to be achieved 

after a few days training 

• Women are most likely to talk to close 

friends and family members of the same age 

and gender regarding SRH. Increased 

communication between adults and youth on 

issues related to SRH is less likely to happen 

at all and more so within such a short time 

frame. 

• Indirect approaches such as the street 

drama are easier to implement, talking 

directly and individually to community 

members is more difficult. It needs "tools" 

and IEC materials to open up discussions. 

• Integrating HIV into other issues related to 

Reproductive Health is essential to gain and 

keep the interest of the women. HIV as a 

stand alone issue is not sufficient to keep the 

interest and fill regular meetings in a longer 

term. 

• The motivational effect of the training 

tends to fade away and it needs additional 

incentives to keep the interest up and fill the 

agenda of meetings. 

• If PEs meet PLWHA, this has a direct and 

effective impact on their attitudes and it 

effectively contributes to eliminate any 

stigmatizing prejudices that may have 

persisted (unconsciously) before. 

18 



NRCS/SDC 2000-2007

Gender equity 

and equality 


Gender attitudes in the project districts were 

examined during a mid-term evaluation of 

the project. Boys and girls generally do have 

a "sense of being equal." Nevertheless girls 

feel more restricted than boys with regard to 

their social and economic options. Girls 

seem to have a higher sense of responsibility 

and are more concerned about their future, 

while boys show a more carefree attitude 

and some feelings of superiority. There are 

certain places where girls feel unsafe (sex 

abuse, molestation) while this is not the case 

for boys. Likewise, free and single movement 



NRCS/SDC 2000-2007 

19

is not encouraged or allowed at all 

for girls. These examples show that 

even though boys and girls talk 

about "equality" and feeling "equal," 

their daily and future life is guided by 

culturally entrenched gender roles. 

The project addresses gender and 

social equity - though to a limited 

extent - during Teacher Sponsors 

training and PE training to students. 

The project trained an equal number 

of female PEs, increasing their 

number to almost 50%. This increase 

in the number of female PEs is 

important as naturally many girls feel 

shy to talk about SRH issues to a male 

teacher, and most of the support 

teachers are male. The project has 

further contributed to ensuring the 

gender balanced representation at the 

boards of J/YRCC. 

In general there is a very low 

representation of female teachers in 

schools. Throughout the project the 

number of female teachers for the 

training was increased. Trained 

female teachers account for 

approximately 20% of the total. At 

times when no female teacher was 

available at secondary level, one 

from primary level was chosen. 

THANKS TO THE RED CROSS PROGRAMME 

I am a young girl of 21 years. I live in Khurkot VDC ward no 7, of 

Sindhuli district. As I was studying in class 9 at Aambegudin 

secondary school, I was introduced to a local boy who was a bus 

driver. After my final examination, he proposed me to accompany 

him to go to Janakpur. My family and the neighbours were against 

this. To make things easier, we got married. In the fourth month of 

our marriage, a friend and I participated in the PE training. After 

the training I realized I had sexually transmitted infection. I shared 

this with my friend, who had a similar problem. She advised me to 

visit the health post for treatment. I talked to my husband and we 

both went to the health post for treatment. I have explained all 

things to the health worker. The health post referred us to district 

hospital for treatment of STIs. 

SENDING INFORMATION ON HIV TO MY HUSBAND 

I am Hira Nepali from Sindhuli district. Often I am too busy with my 

household activities, but sometimes I participate in the meetings 

organized by the Red Cross Mahila Samuha (Women Group) of our 

community. After hearing about issues related to HIV I visited the 

field coordinator to talk as my husband works in India. He provided 

me with additional information. After my return I asked the 

community mobilizer to give me the letter with information on HIV 

and AIDS, designed by NRCS. I wanted to send it to my husband 

along with the brochure containing information about how to 

prevent HIV. I also wrote the correct way of using condoms and its 

importance in the letter to my husband. 

The project uses selection criteria to 

prioritize women from Dalit castes to 

participate in the women groups. However, 

often this is difficult to fully implement in 

practice given that the women from the 

lower income groups generally have less 

time available. Most of the women groups 

include representatives from different caste 

groups, including Dalits and ethnic 

communities. In some groups however the 

majority of group members, and particularly 

those in the board, are from higher social 

classes. Dalit and ethnic women are largely 

'ordinary' members of the group. 


Project activities contributed to increase 

participation of girls in classes. Though 

generally boys still ask most of the questions, 

girls do so increasingly. Teachers and women 

note that interaction between boys and girls is 

increasing. One example given by a teacher is 

that girls and boys started to share the same 

benches what they never used to do before. 

They also welcome the opportunity in the 

mixed trainings to learn about the concerns of 

the opposite gender. 

20 



NRCS/SDC 2000-2007

CHANGE IN KALPANA 

I live in Tilahar village. My husband and I have a very good 

relationship but our economic condition is quite poor. He went to 

South Korea to earn money. He sent money home and I started to 

change my lifestyle, eating at the hotel, going to movies, etc. One 

day I met a boy called Rupak at a hotel. He's a policeman and he 

asked me to sleep with him. I heard later that he has had relations 

with other women in the past. One day, I got one HIV and AIDS 

booklet from Red Cross and I knew about HIV and AIDS and STIs. 

At the same time, I met one lady trainer of Red Cross, Meena, and I 

shared my story with her. Then I am afraid of having sex with 

unknown person, and I left that kind of relation. After meeting with 

that lady trainer I knew about how to manage conflict, how to say 

no, how to avoid sexual stress and build my decision making 

capacity. Now my life is very simple. I think this kind of problem will 

come with unknown people who have no knowledge about HIV and 

AIDS and STIs. That's why, I thought information regarding these 

issues should be given to the community women. Nowadays I am 

passing information about HIV and AIDS, and STIs to our 

community people. 

Opinions of girls whether they prefer female 

teachers for the reproductive health classes 

are mixed. In general though the majority of 

girls would prefer and benefit from a higher 

number of female teachers to address their 

concerns. A female teacher stated, for 

example, that she has become a counsellor for 

female students. For more private issues they 

usually approach her out of class. 

In general and increasingly, men regard the 

involvement of women as positive. 

Statements are that women receive an 

education they need and which also benefits 

men when women share their knowledge and 

are less embarrassed to talk about SRH 

issues. 

Nevertheless, barriers do persist. All women 

groups state that their husbands are often 

curious and also suspicious about the topics 

and discussions in the women groups. Men 

tease women asking if they are not shy talking 

about these issues. In one community men 

stated that if women spend their time 

on these activities it means they did 

not find any (seasonal) work. In 

another case, while women were 

trained, the male would make 

comments about the trainer who 

dares to talk about these issues to so 

many women. 

Cases where men are clearly against 

the activities of women groups do 

persist. "My husband, who was 

working as a tailor in Kathmandu, 

returned to the village recently. He 

drinks and stays home all day. He 

doesn't want me to go to the women's 

group because he has no good 

opinion of such groups. He often 

quarrels with me and even beats me 

up," said Manju Nepali, member, 

Devisthan, Women Group, 

Bhaluwajor Village Development 

Committee. 

Women see a need for men to be addressed 

by the HIV training. Women argue that men 

are at higher risk compared to themselves. On 

the other side, men felt excluded, expressing 

their interest to know more about HIV or even 

asking for "male groups." As it is the case 

with the youth, women also prefer the option 

to have a mixed training with men, given that 

this would contribute to a higher mutual 

understanding of the other gender's 

concerns. 

Understandably - though perceived as 

negative by men - women would not want the 

men to take part in the meetings. "Once we 

went to the meeting held by women but they 

did not talk about anything seeing us there but 

when we left the place they resumed their 

discussion." 

In some project districts unwanted and early 

pregnancy often followed by early marriage 

reduced over the last years. The increase in 



NRCS/SDC 2000-2007 

21

female PEs further contributes to reaching out 

to girls and women and addressing female 

issues related to SRH. Cultural beliefs and 

attitudes are gradually changing and 

misconceptions disappearing: "Women no 

longer stay away from the family during 

menstruation, which used to be an important 

old tradition," "women dry their underwears 

and sanitary towels in the sun before using 

them which did not use to be the case." 

Before, minor infections were feared as 

serious STDs or HIV and girls or women 

suffered in silence, without seeking medical 

treatment. Now they are more open to talk 

about any physical 'abnormality' and are less 

shy to visit health facilities for treatment or 

counselling. Although these achievements 

cannot be solely attributed to the NRCS Peer 

Education approach, this change process was 

invariably reinforced by NRCS efforts at the 

school youths and the communities. 

As those students who are already active in 

class are selected as PEs, this entails the risk 

that students from deprived social classes, 

who are less likely to be academically toppers 

at school, are precluded. However, within the 

groups of PE's joint initiatives, new 

responsibilities and a sense of friendship 

contributes to removing class barriers. At 

times youth from lower class backgrounds 

once they are supported become lively and 

active members. 


Youth need to understand how gender 

influences their attitudes and behaviours. 

Training and supervision should cover not 

only biological differences but also the 

influence societal gender roles and norms 

have on HIV and reproductive health and 

on their performance as peer educators. 

Gender norms that affect females may 

include submissiveness, deference to male 

authority, dependence, virginity until 

marriage, and faithfulness during marriage. 

Norms for men, in contrast, are built 

around power and control, independence, 

not showing emotions, risk taking and 

sexual activity. Working in mixed groups in 

the field allows PEs to practise new roles 

while the PEs themselves can serve as role 

models for other youth. Importantly, 

reproductive health education contributes 

to reducing misconceptions and cultural 

beliefs and promoting preventive and safe 

behaviours. 


• Organizing joint activities and talking more 

openly about issues related to Sexual and 

Reproductive Health contributes to 

increasing interaction between boys and 

girls. 

• Education and raising awareness 

effectively reduces culturally entrenched 

misconceptions and gender attitudes and 

norms. 

• Selection of PE should be participatory and 

based on students' preference rather than 

teachers' preference and an effort should be 

made for equitable representation from all 

groups. 

• Direct information exchange on issues 

related to SRH mainly takes place between 

peers of the same gender, a balance between 

female and male PEs therefore is important. 

• Female teachers can play an important role 

as counsellors for girls. 

• Involvement of men is important to gain 

their support and raise awareness on HIV 

prevention. 

• Women themselves have limited capacity 

to inform and involve the men, they feel that 

barriers will persist as long as men are not 

directly targeted. 

• Male and female want the other gender to 

know about their concerns. They therefore 

welcome a joint training. However, at the 

same time a discussion space with only the 

same gender is important to achieve in-depth 

discussion and exchange about more private 

issues. 

22 



NRCS/SDC 2000-2007

Coordination 

at district level 

This section looks at the institutional setting 

of the NRCS as it determines the project 

implementation. It furthermore outlines the 

coordination at district level with the 

different institutions, district committees and 

sectors involved in the project. 

The NRCS has a decentralized structure with 

district chapters, subchapters and a network 

of volunteers including the junior circles and 

teachers that reach out to the community 

level. Countrywide representation and wide 

network down to the community level is one 

of NRCS's key strengths when it comes to 

project implementation and reaching out to 

the community. The close presence at the 

community level has furthermore enhanced 

experience and credibility at central and 

regional policy. The NRCS history of 

community based humanitarian work dates 

back to 1963. J/YRCCs as the "junior wing" 

of volunteers at NRCS was established in 

1965 and includes today over 4,020 circles 

with more than 800,000 members at 

schools. Staff and volunteers share social and 

humanitarian values as expressed in their 

motto "I serve." NRCS has implemented HIV 

related activities in 54 districts, and Youth HIV 

prevention projects are currently 

implemented in 19 districts. The Red Cross is 

today represented at various central and 

regional forums on HIV, including the 

National AIDS Coordination Committee and 

the Country Coordination Mechanism (CCM) 



NRCS/SDC 2000-2007 

23

for Global Fund for AIDS, TB and Malaria 

(GFATM) 1 . Approaches of the NRCS have 

broadened from a focus on humanitarian 

assistance to working towards sustainable 

development and capacity building at system 

and community level. This combination places 

it well to address the continuum from HIV 

prevention to care and support. 

In many districts the NRCS has taken a lead 

in promoting the District AIDS Coordination 

Councils (DACC) as the main coordination 

body for HIV initiatives, usually if it is the 

main agency working on HIV in the 

respective district. DACCs are responsible 

for needs assessment, planning and 

coordination of district activities in the field 

of HIV. Due to its relatively young existence 

and yet limited capacities DACCs have until 

now mainly a coordinating role. The NRCS or 

- if they are active in the district - other 

agencies support the DACC to organize 

meetings on a regular basis (monthly or 

once/twice a year) inviting all the district 

committees in the areas of development, 

health and education, NGOs and INGOs. The 

meetings are used to present and discuss 

current activities in the field of HIV. In 

addition, the NRCS and other agencies 

through the DACC join to organize events on 

occasions such as Condom's Day or World 

AIDS Day. The NRCS has further initiated a 

review of the DACC to improve the 

effectiveness of its bureaucratic constitution. 

Currently a main constraint to the 

functionality of DACCs is that they are 

chaired by the head of the DDC who in 

general is occupied with a number of 

committees and may have other priorities. 

District chapters of the NRCS are autonomous 

and develop their local policies and yearly 

activity plan on HIV in coordination with the 

other actors in the field. The activity plan is 

integrated as part of the annual development 

plan published by the DDCs. The NRCS district 

chapter holds orientation meetings with 

different district representatives, usually on a 

quarterly basis. The NRCS equally participates 

in other district meetings, including, for 

example, quarterly meetings of the district 

health office - which includes reporting of 

health posts on HIV cases. Community 

representatives, district committees and other 

organizations participate in the planning 

process of projects and are informed with 

regard to strategies, work plans, and activities. 

Joint workshops included a comprehensive 

self-evaluation workshop or workshops to 

discuss the issue of sustainability. Information 

on project activities is published at public 

boards in the districts. 

A core approach to all activities is capacity 

building through training, supervision and 

delegation of responsibilities as it is the case 

in the frame of this project with J/YRCCs 

and women groups who develop their own 

activity plans. The project has further 

contributed to increasing capacity at the level 

of NRCS sub-chapters, jointly working on 

community development plans. This 

promotion resulted in an increase of subchapters. 

Despite the large network of the 

NRCS, distribution of IEC materials and 

frequent communication with the subchapters 

remains a challenge. Often 

community volunteers support the 

distribution of IEC materials. 

The education sector has traditionally been a 

main coordinating partner of the NRCS. A 

majority of long term volunteers are teachers 

and many of the NRCS programmes use 

schools and J/YRCCs as a main link to 

communicate with communities. J/YRCCs 

are often the first to report any incidences, 

needs and emergencies, within communities 

to the NRCS support teacher who then 

forwards the information to the district 

1 

Further partners include: South Asia Red Cross/Red Crescent Network on HIV and AIDS (SARNHA), National Centre for AIDS and 

STDs control (NCASC), National Youth Co-ordination Council (NYCC), IEC Co-ordination Committee, NGO Coordination 

Committee, National NGO’s Networks against HIV and AIDS Nepal (Nangan). 

24 



NRCS/SDC 2000-2007

chapters. Most of the project activities are 

implemented through schools. Using this 

institutional network increases sustainability 

and facilitates monitoring of project 

activities. In addition to teachers and 

J/YRCCs the project closely cooperates with 

the headmasters of schools. They receive a 

one day briefing workshop during the 

planning stage of the project and serve then 

as main reference persons. District chapters 

usually use the yearly district meetings for 

headmasters and add one day to discuss the 

issue of teaching HIV and Reproductive 

Health. As a result, all sub-chapters and 

schools in a district are usually aware about 

the NRCS project. As a consequence schools 

that were not included felt neglected. 

The NRCS has developed a policy on 

mainstreaming HIV in 2000 and has since 

then integrated HIV in 3 community based 

programmes and 2 first aid programmes. 

Activities of J/YRCCs cover different sectors 

including community sanitation and hygiene, 

health promotion, clean water and 

environment, and social and emergency 

support. Given that activities on HIV will 

continue as an integrated part of the agenda 

of J/YRCCs, the project has achieved to 

mainstream HIV prevention work within the 

work of the circles. 

The project adapts a multisectoral approach 

with a focus on the educational and social 

development sector and further interventions 

in the health and private sectors. At its core 

the project is primarily working with 

educational institutions and community 

volunteers and groups. Some interventions 

are targeting the health sector through 

promoting youth friendly services and 

implementing HIV interventions in health 

camps. Private sector involvement, though 

minimal, includes working with retail 

shopkeepers and bus ticket counters. 

Overall, the project has strengthened the image 

and credibility of the Red Cross at the district 

level. Moreover, the NRCS District Chapters 

planning capacities' especially with regard to 

HIV prevention initiatives were strengthened. 

One district chapter, for example, has 

developed a project proposal to receive 

additional funding for its HIV programme. The 

project has been supported by the different 

sectors and their committees in the district, 

most of all with regard to the educational 

sector. Especially in districts where the NRCS is 

the main actor it largely contributed to 

initiating and strengthening the DACCs. 


An effective response to HIV needs to come 

from within the communities where the 

epidemic emerges and begins to spread. 

While national strategies, coordinating 

mechanisms, monitoring and evaluation 

systems are essential they must reach down 

to the district and local levels. District and 

community authorities are closer to the front 

lines of the AIDS epidemic than national 

governments and they understand local 

circumstances, needs, social structures, 

attitudes, and traditions. With technical and 

financial support district and local authorities 

are well placed to implement a locally 

effective response to HIV. District authorities 

further play an important role with regard to 

coordination of different responses and 

mainstreaming HIV. 

Lessons from the project include: 

• Using the institutional network of schools 

increases sustainability and facilitates 

monitoring of project activities. 

• District chapters and DACCs can play an 

important role in designing district HIV 

strategies. Due to their relatively young 

existence and yet limited capacities DACCs 

have until now mainly a coordinating role. 

• The implementation of project very much 

depends on the project coordinators at 

district chapters. While most district 

chapters demonstrated an impressive 

commitment to the projects, there is also an 

example where project implementation was 

jeopardized by poor implementation. 



NRCS/SDC 2000-2007 

25

Summary of 

Recommendations 

• Peer educators need a minimum level of 

external support mainly in terms of further 

trainings and provision of IEC materials. 

Small incentives have a high effect but their 

reliability and continuity needs to be assured. 

They will otherwise be discouraged if, 

despite their initiative, support in terms of 

answered questions and provision of IEC 

materials is lacking. 

• Selection of PE should be participatory and 

based on students' preference rather than 

teachers' preferences and an effort should be 

made for equitable representation from all 

groups. 

• To increase the capacities of PEs an option 

may be to provide further training and some 

additional incentive to a selection of active 

PEs (2-4 per schools) which in turn have to 

initiate certain set of activities. Ideally, these 

PEs are selected by the other youth/PEs and 

thus have the mandate and trustworthiness 

of youth to function as their representatives, 

counsellors and role models. 

• Women, teachers and youth that work as 

peer educators for HIV prevention need tools 

to do their work and additional IEC materials 

that can be used for sensitization are highly 

cost-effective. 

26 



NRCS/SDC 2000-2007

• It is essential that teachers are trustworthy 

and supportive of the youth. Where feasible, 

election of counselling teachers through youth 

should be considered. Female teachers can play 

an important role as counsellors for girls. 

• Women groups do not have the same 

institutional links compared to the youth peer 

educators and a main concern regards their 

level of sustainability. Health posts and family 

planning volunteers may be used as more 

sustainable resource persons to provide 

information on HIV. However, they 

contribute less to reducing barriers and 

stigma on issues related to HIV. Where 

women groups or any other community 

groups exist in the frame of other 

programmes they may be used to integrate 

the issue of HIV - provided they bear a 

certain level of sustainability. 

• Women alone have limited capacity to 

inform and involve the men, they feel that 

barriers will persist as long as men are not 

directly targeted. Both male and female want 

the other to know about their concerns. They 

therefore welcome a joint training. Involving 

men/boys is also important to gain their 

support and raise awareness on HIV 

prevention. 



NRCS/SDC 2000-2007 

27

Annex 

I Newspaper extracts 

Advising husband to use 

condom by telephone 

Women from Tatarkot village in Parbat 

district can now talk freely about HIV/AIDS 

and reproductive health issues even as they 

are most backward socially, economically 

and academically. 

They said they are on a campaign to educate 

other community members what they have 

learned: those infected with HIV need care 

and support, women should keep their sex 

organs clean and stay away from unsafe sex. 

“We did not know why it was important to 

keep our sex organs and clothes clean during 

the menstruation cycle,” said Dhana Kumari 

Bishwakarma, President of Tatarkot 

Women’s Group. “We should practise safe 

sex, which is possible through using 

condoms and family planning methods. We 

used to feel shy and hide our face when 

somebody talked about these but now we 

ourselves talk freely and frankly about sexual 

and reproductive health issues.” The change, 

according to her, came after Nepal Red Cross 

28 



NRCS/SDC 2000-2007

Society provided them with basic knowledge 

about HIV/AIDS and sexual and 

reproductive health. 

Members of the Tatarkot Women’s Group 

have also been advising their spouses – 

migrant workers – on the phone to avoid 

unsafe sex and use condoms to protect 

themselves from HIV/AIDS, she said. Many 

have written letters to their husbands, who 

stay away from the family working abroad. 

Women are thankful to the Junior/Youth 

Red Cross Circle of Nepal Red Cross Society 

for raising awareness through school and 

community based peer education project 

about HIV/AIDS and reproductive health. 

Another member of the Group, Sushma 

Bishwakarma said she had also spoken to her 

husband, now working in Qatar, about what 

she had learned from the project. “My 

husband was amazed listening to what I had 

to say and he appreciated for sharing it with 

him,” Sushma said. “After the training, I do 

not feel ashamed or shy talking about sexual 

and reproductive health issues any more.” 

Kopila Bishwakarma said of late her husband 

had started using condoms during sex. 

“Using condom is not just about HIV/AIDS, 

it also is an effective way to plan family.” 

According to Dhana Kumari, a Dalit couple in 

the adjoining village had died of AIDS related 

complications and another adult is suspected 

to have been infected with HIV. “We are 

investigating this. It is difficult to assess the 

number of the infected because there is a 

tendency of denial.” 

Tatarkot is home to about 150 Dalit 

households living in extreme poverty with 

farm producing barely meeting one quarter 

of their food needs. As a result, the Dalit 

adults go for employment, where they could 

be infected with HIV unknowingly. Nepal Red 

Cross Society’s Parbat district chapter 

implements the HIV/AIDS and reproductive 

health project through 15 Youth Red Cross 

Circles and 10 women’s groups formed in 

different parts of the district. 

NRCS Parbat District Chapter President 

Sundar Prasad Joshi said the programme has 

had positive impact in school and 

communities and has also raised public 

awareness about HIV/AIDS and sexual and 

reproductive health. 

Headmaster at a local high school in Khurkot 

Dronaraj Upadhya said the peer education 

approach in school had benefited students, 

their parents and the community members. 

“It also made students creative and motivated 

them to engage in service-oriented activities.” 

Teacher sponsor of the same high school 

Balkrishna Bastola said that peer education 

was very useful and it had not hampered the 

students’ study. “Peer education has created 

an atmosphere, where students can talk 

openly and frankly about sexual education.” 

Learning more and the right things about 

sex, sexuality and reproductive health issues 

will surely help the growing students change 

their behaviour in the long run and this will 

definitely reduce the risks of HIV/AIDS 

spread in the future, said another sponsor 

teacher Shanta Sharma. 

Extracted from Gorkhapatra daily, 19 

November 2006 

Women gifting condoms to 

dear ones 

Now their letters contain condoms and safe 

sex tips along with other private messages. 

Thanks to a campaign undertaken by the Red 

Cross, women of this area have become 

health conscious and they eagerly share their 

knowledge with their husbands and relatives 

living abroad, as well as with ignorant locals. 



NRCS/SDC 2000-2007 

29

Under the initiation of District Red Cross, a 

group of women from Pang VDC – 7 was 

given one year health training. 

“The people’s mindset about sexual health 

has changed. Unlike earlier, they participated 

in discussions related to the subject and feel 

comfortable sharing their knowledge with 

locals ignorant on the matter,” said Dhan 

Kumari BK, chairperson of the group. She 

said that women now insist their husbands 

and also their relatives and neighbours to use 

condoms and have safe sex. “We have also 

been aware of safe maternity and benefits of 

having few children,” she added. 

“Now it has been our habit to write about 

sexual health to our husbands who are 

away from home. We worry that they 

might get infected with HIV as they are 

ignorant about the disease,” said Laxmi 

Sunuwar, a member of the group. 

“Hesitation to learn and confess problems 

does not solve any problem. One has to get 

the knowledge and implement that in life,” 

she added. 

Extracted from The Kathmandu Post, 16 

November 2006. 

II Question Guide 

Questions to Youth circles/ Peer 

Educators 

We would like to learn more about how this 

programme works, from your own personal 

perspective as young people. The 

information you share will be anonymous, so 

that none of the material we discuss will be 

linked with any individual. Let's start with 

some of the basic information about the 

programme and the steps you are involved 

in. WITH EVERY ANSWER, THINK OF 

HOW ANYTHING HAS CHANGED IN THE 

LAST YEARS BECAUSE OF THE PROJECT. 

The main objective of these questions is to 

find out how far the project contributed to 

behaviour change in terms of improved life 

skills. We will look at how far motivation, 

engagement, attitudes, interaction and 

communication between youth and adults, 

etc. have changed. We will further look at 

how far the management capacity of the 

youth circles have improved and how far 

gender roles are addressed. 

Life Skills development/ Behaviour 

Change 

• Describe the programme's goals and 

activities: What activities do you do 

30 



NRCS/SDC 2000-2007 

specifically? Describe in some detail the 

different steps of activities you were involved 

in (selection process, training, activities, 

etc.). 

• Which activities did you enjoy most 

while implementing them? Why? 

• At which activities were participants 

most lively? Why? 

• What do you think attracted the most 

participant? How many? 

• Which activities do you think are most 

popular? Why? 

• Which are the topics youth are most 

interested in? 

• To how many people do you talk on 

issues related to HIV and AIDS on average 

(f.e. per week)? 

• What are the greatest challenges for your 

work? What would you like to do 

differently? What is it that motivates or does 

not motivate you in your work? 

• Which parts of the training did you find 

most useful? 

• How did you become peer educators? 

Probe: What are reasons for joining (such 

as: a way to spend free time, possibility to

meet friends, better position in front of 

adults and teachers, pressure from teachers 

the community). Please give your reasons 

starting with the most important ones. 

• How has the work affected you personally 

(for example, position in the community, 

friends, future plans)? 

• Has your private life and your friendships 

changed in relation with your PE work? How 

often and in what way do you interact with 

your PE colleagues? 

• Were there discussions with your friends 

or others after attending sessions? If so, 

with whom and what were they about? 

• Have you talked about things related to 

HIV prevention outside of school? Were 

there any activities related to your work as a 

PE outside of school? Where and with 

whom? 

• Did participants stay in contact or come 

back with questions? (details) If the same 

youth attended different activities, did you 

notice a change in her/ his participation 

during sessions? (if so, detail some case 

studies from boys and girls) 

• To discuss about issues such as sexuality 

is quite a challenge. What do you think 

works best to introduce and discuss the 

subject? How do discussions often look like - 

when are they more lively and less lively? 

How did the programme help you to address 

the issue? 

• It is even more difficult to talk about these 

issues to the opposite gender. What is your 

experience of talking to classes with both girls 

and boys as well as different age groups? 

How comfortable do you feel about it? 

• Most of the youth today know how to 

protect themselves from HIV. But there are 

many reasons why doing so is always 

difficult. If you think of yours or your friend's 

experiences, what was most helpful to make 

protection easier? Was there anything that 

made it easier (over time)? 

• Do you know anybody living with HIV? 

What has been her/ his story? Does he/ she 

has friends and supporters? 

• There are many reasons why being 

supportive to PLWA can be difficult. It may 

not be accepted by our friends and family 

and we may not know what to do. What is 

your experience? 

• Do your parents support your 

involvement? How? 

• Issues related to family planning, HIV 

prevention, etc. are often not at all talked 

about in families. What is your experience? 

Which topics are more common, which are 

less? Who do you normally talk to? Who 

would you normally not talk to? 

• The conflict increased the number of 

displaced and/ or out of school youth. Has 

this affected your activities? 

• How much interaction is there between inschool 

and out- of school youth? Has this 

changed during conflict? 

Management, cooperation and decision 

making capacity of Youth circles/ PEs: 

• Describe how the peer educators are 

involved in programme planning, training, 

activities, materials development, and 

decision-making. 

• What kind of administrative tools do you 

use? (Reports, record system, meeting 

minutes, reviews, etc.) Do you use some of 

them because of the project? 

• What type of adult support do you receive 

in your work? Probe: (in terms of 

supervision, technical support, emotional 



NRCS/SDC 2000-2007 

31

support.) Do you think there is a youth-adult 

partnership in the programme? How would 

you describe the quality of the partnerships? 

• Describe how decisions are made in the 

programme. Probe: Who decides what 

activities to carry out? Who decides the 

content of these activities and the 

information materials used? Who decides 

programme planning and strategies? 

• Can you make suggestions? Are your 

suggestions and ideas taken seriously? What 

would you do to improve the decisionmaking 

process? 

Gender equity and equality 

• How are responsibilities and decisionmaking 

distributed between female and male 

PEs? 

• Describe how the programme addresses 

gender issues in the training and during 

programme activities. 

• What are the gender dynamics during 

sessions: 

• How often do girls say sth. during the 

sessions compared to boys? 

• Do girls or boys sometimes receive 

more or less attention by their friends during 

discussions? When may this be the case? 

• Are there activities where boys and girls 

are more interacting, more distant, more 

arguing, more agreeing, etc? 

• Describe favourite topics of girls and 

favourite topics of boys. 

• Are there discussions about gender roles 

during activities? How may the issue usually 

come up? What are main subjects of 

discussion? How often does this happen? 

• As a male/ female PE, how do you address 

issues of your own gender? Do peers of your 

own gender approach you to ask more 

private questions? 

Social equity 


distributed between PEs of different 

castes? 

• Among the PEs, are there sub-groups with 

preference to their own castes? When and 

how are they all mixed? 

• What are the dynamics between different 

castes during sessions: 

• How often do students from lower 

castes say sth. during the sessions compared 

students form higher castes? 

• Do students from different castes 

receive more or less attention during 

discussions? How much interaction is there 

during lessons between students from 

different castes? 

Coordination with other initiatives: 

• Describe what the DACC and any other 

organization is doing on HIV (including care 

and support) in your district. How do they 

compare to the NRCS? Do you cooperate or 

are you supported by anybody? 

• What type of direct support does the 

community provide to the programme? 

Questions to Teacher sponsors 



perspective. The information you share will 

be anonymous, so that none of the material 

we discuss will be linked with any individual. 

Let's start with some of the basic information 

about the programme and the steps you are 

involved in it. WITH EVERY ANSWER, 

THINK OF HOW ANYTHING HAS 

CHANGED BECAUSE OF THE PROJECT. 

We investigate how far the capacity of 

teachers to address issues of Sexual and 

Reproductive Health (SRH) in classes has 

changed. We will further ask how far they 

think there have been any changes at the level 

of students and the community. 

32 



NRCS/SDC 2000-2007

Teaching skills/ Behaviour Change 

• Describe the programme's goals and 

activities: What activities do you do 

specifically? Describe in some detail the 

different steps of activities you were involved 

in (selection process, training, activities, 

etc.). 

• Which activities did you enjoy most 

while implementing them? Why? 

• At which activities were participants 

most lively? Why? 

• What do you think attracted the most 

participant? When was this? 

• Which activities do you think are most 

popular? 

• Which are the topics youth are most 

interested in? 

• What are the greatest challenges for your 

work? What would you like to do 

differently? What is it that motivates or does 

not motivate you in your work? 

• How are teachers selected for the training? 

From which subjects? Which teachers do 

you think are best suited for teaching HIV 

prevention? 

• Which parts of the training did you find 

most useful? 

• How has the work affected you personally 

(f.e. position in the community, your 

teaching capacities, your relation to the 

students)? 

• How active are students with questions? 

(details) If the same youth attended different 

activities, did you notice a change in her/ his 

participation during sessions? (if so, detail 

some case studies from boys and girls) 

• To discuss about issues such as sexuality 

is quite a challenge. What do you think 

works best to introduce and discuss the 

subject? How do discussions often look like - 

when are they more lively and less lively? 

How did the programme help you to address 

the issue? 

• Did you notice any impact of the training 

on your general teaching skills? 


What has been her/ his story? Does he/ she 

has friends and supporters? 





your experience? Do you know any cases of 

PLWHA? What is their story? 

• Did you notice a change in attitude in the 

communities and among youth to discuss 

issues related to Sexual and Reproductive 

Health? 

Management, cooperation and decision 

making capacity of Youth circles/ PEs 

• Describe how the youth circles/ peer 

educators are involved in programme 

planning, training, activities, materials 

development, and decision-making. 

• What kind of administrative tools do you 

use? (Reports, record system, meeting 

minutes, reviews, etc.) Do you use some of 

them because of the project? 

• What type of adult support do they 

receive? Probe: (in terms of supervision, 

technical support, emotional support.) Do 

you think there is a youth-adult partnership 

in the programme? How would you describe 

the quality of the partnerships? 

• Describe how decisions are made in the 

programme. Probe: Who decides what 

activities to carry out? Who decides the 

content of these activities and the 



NRCS/SDC 2000-2007 

33

information materials used? Who decides 

programme planning and strategies? 

Gender equity and equality 


distributed between female and male 

PEs? 

• Describe how the programme addresses 

gender issues in the training and during 

programme activities. 

• What are the gender dynamics during 

sessions: 

• How often do girls say sth. during the 

sessions compared to boys? 

• Do girls or boys sometimes receive 

more or less attention by their friends during 

discussions? When may this be the case? 

• Are there activities where boys and girls 

are more interacting, more distant, more 

arguing, more agreeing, etc? 

• Describe favourite topics of girls and 

favourite topics of boys. 

• Are there discussions about gender roles 

during activities? How may the issue 

usually come up? What are main subjects 

of discussion? How often does this 

happen? 

Social equity 


distributed between PEs of different 

castes? 

• Among the PEs, are there sub-groups with 

preference to their own castes? When and 

how are they all mixed? 

• What are the dynamics between different 

castes during sessions: 

• How often do students from lower 

castes say sth. during the sessions compared 

students form higher castes? 

• Do students from different castes 

receive more or less attention during 

discussions? How much interaction is there 

during lessons between students from 

different castes? 

Coordination with other initiatives: 

• How far does the School management 

committee influence the issue of teaching of 

HIV at school? 

• Describe what the DACC and any other 

organization is doing on HIV (including care 

and support) in your district. How do they 

compare to the NRCS? Do you cooperate or 

are you supported by anybody? 

• What type of direct support does the 

community provide to the programme? 

Questions to DACC, headmasters and 

other stakeholders involved in the 

programme 


programme works, from your own 






involved in. WITH EVERY ANSWER, THINK 

OF HOW ANYTHING HAS CHANGED IN 

THE LAST YEARS BECAUSE OF THE 

PROJECT. 

• Describe your relationship to the 

programme. In what ways do you support 

the programme? 

• What are the activities the NRCS is 

carrying out that you are aware of? 

• Which activities were most popular in the 

community? 

• What are the main achievements of the 

programme? Can you think of sth. that may 

be done in a different way? 

34 



NRCS/SDC 2000-2007

• Suppose the NRCS initiatives would stop - 

what do you think would happen with regard 

to HIV and youth activities in the respective 

schools and communities? 

• Are there other organizations in the field of 

HIV and youth? What do they do? If you 

compare them with the NRCS, what are 

differences? 

• What is your experience of working with 

NRCS staff? What are their qualities? 

(examples need to be specified, i.e. with 

regard to planning, implementation) 

Addressing Behaviour change: 

• Did you notice any change in what people 

do or say because of the NRCS activities? 

(Please describe the kind of change, whom it 

affects, when it took place, if it was more 

during certain periods and by whom or what 

it was caused). 

• Anything you do now (with regard to your 

management/ your engagement) you did not 

do before the activities? 

Questions to women group members 

We would like to learn more about how your 







involved in it. WITH EVERY ANSWER, 

THINK OF HOW ANYTHING HAS 

CHANGED IN THE LAST YEARS BECAUSE 

OF THE PROJECT. 

• Describe how your women group is 

structured: 

• How many women are participating? 

• Did you knew each other before? 

• Do members come from different age 

groups and castes? 

• What are the active and the less active 

members (different ages and castes) 

• Is the number changing? Who is 

coming and leaving? 

• Describe your meetings: 

• How often do you meet? 

• What are your activities? 

• What kind of support do you receive? 

• What are your reasons for joining the 

group? Which aspects of the women group 

do you enjoy or appreciate most? What is 

needed so that the women group stays 

active and interesting to you? Are there 

links with other women groups? 

• Did you talk with your partner or others 

about the group? With whom and what do 

you talk about? (for example, do you 

practice any letter writing to partners living 

abroad) 

• Did anything changed for you because of 

the women' group? 

• If you would have a question related to 

SRH, whom would you address? 

• What do you think of youth receiving HIV 

education at school? (If positive: Did you 

think like this before) 

• Thinking of all IEC materials on HIV, 

which one did you like most? 


What has been her/ his story? Does he/ 

she has friends and supporters? 





your experience? 



NRCS/SDC 2000-2007 

35

III Project documents and consulted literature 

Project documents: 

• Credit Proposal 

• Project documents 

• Yearly Plans of Operations and Progress 

Reports 

• IEC materials and trainers' manual 

• Report of previous evaluations of this 

programme 

• Publications, plans and policies of NRCS 

NCASC (2000), Country profile, The HIV 

and AIDS/STD situation and the national 

response in Nepal, UNAIDS/HMG 

(NCASC), Kathmandu 

NRCS (2001), HIV and AIDS prevention 

Project, Annual Report 2001, Nepal Red 

Cross, Junior Youth Department NHQs, 

Kathmandu 

NRCS (2002), A report on Self Evaluation of 

HIV and AIDS Prevention & RH Programme 

of four Districts (internal document). 

NRCS (May 2002), Project Document HIV 

and AIDS Prevention Programme July 2000- 

June 2003, Kathmandu Nepal 

NRCS (October 2000), A Study on 

Knowledge, Attitude and Practice concerning 

HIV and AIDS STDs and RH among the 

Adolescent/youth of sis Districts: Baglung, 

Parbat, Bhaktapur, Dolakha, Ramechhap and 

Sindhuli - base line survey report, Nepal Red 

Cross Society, Kathmandu 

Sharma, Komal, (2003), Situation Analysis 

of Children and HIV and AIDS in Nepal, Save 

The Children, Kathmandu, Nepal 

Sharma, M. Gautam, I. (2003), External 

Evaluation of the HIV and AIDS Prevention 

and Reproductive Health Project. NRCS, SDC. 

Sharma, M. (2002), Youth for Each Other 

Programme, A Participatory Baseline Study 

of youth of Balkot and Thimi, CEDPA/Nepal 

Red Cross Society. 

UNDP, (2004) From Involvement to 

Empowerment: People Living with HIV and 

AIDS in the Asia Pacific. 

36 



NRCS/SDC 2000-2007

Nepal Red Cross Society 

National Headquarters 

Junior/Youth Red Cross Department 

HIV and AIDS Prevention and RH Programme 

P.O.Box: 217 Red Cross Marga, Kalimati, Kathmandu 

Phone No: 977-1-4270650, 971-1-4272761 

Fax: 971-4271915 

Email: hivaids@nrcs.org 

http://www.nrcs.org

HIV/AIDS Prevention & Reproductive Health Project

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