a sourcebook of hiv/aids prevention programs volume 2

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CHAPTER 7The Primary School AIDS PreventionProgram, KenyaAlthough prevention of HIV is critical to control of the disease, littlerigorous evidence from randomized studies about the relative effectivenessof different interventions has been produced. The effectiveness of scalableschool-based HIV/AIDS education programs is also a subject of debate,with skeptics doubting both whether teachers can be effective and whetherschool-based prevention programs represent the best use of scarce preventionfunds. There is also intense debate over the content of prevention programs,particularly whether condom use should be discussed.In a review of 11 school-based HIV/AIDS education programs in Africa,Gallant and Maticka-Tyndale (2004) found that while most programs succeededin improving knowledge and attitudes, the majority of programsfailed to change behavior. Evaluations that claim a change in behavior oftenrely on self-reported data to assess their impact. But self-reported data maysuffer from social desirability biases, in which students report the behaviorthey think is “right” rather than their actual conduct.DescriptionThe Primary School AIDS Prevention Program used a randomized studydesigned to evaluate the impact of four approaches for reducing risky behavioramong adolescents in Kenya’s Western Province. Researchers measured theeffects of the interventions on young people’s knowledge about, attitudestoward, and reported practice of sex; rates of teen pregnancy and earlymarriage; and retention in school. They also estimated the costs of the fourPascaline Dupas, assistant professor of economics at Dartmouth College and member ofthe Abdul Latif Jameel Poverty Action Lab at the Massachusetts Institute of Technology(MIT), and Willa Friedman, evaluation consultant at the Abdul Latif Jameel PovertyAction Lab at MIT, prepared this chapter. Michael Kremer provided support,encouragement, and assistance.135(c) The International Bank for Reconstruction and Development / The World Bank
136 A Sourcebook of HIV/AIDS Prevention Programs, Vol. 2interventions. The results will enable policy makers and program managersto make informed decisions.Rationale and HistoryA survey conducted in Western Kenya in 2002 suggested that the extent towhich the country’s HIV/AIDS curriculum was being taught was worrisomelylow. In response, the National AIDS Control Council (NACC) and Ministryof Education, Science, and Technology (MoEST) hosted a consultation withofficials from MoEST, NACC, the Kenya Institute of Education (KIE), theCenter for British Teachers (CfBT), the World Bank, International ChildSupport (ICS), and academics. Four key concerns were identified.Poor implementation of the HIV/AIDS curriculumKenya’s primary-school national AIDS curriculum and textbooks weredeveloped in 1999 by KIE, an arm of MoEST, with assistance fromUNICEF and extensive input from civic and religious groups in Kenya.The 2002 survey of Western Kenya revealed that despite the introductionof the facilitator’s handbook to all primary schools, effective teaching ofHIV/AIDS in schools was sporadic. Other than receiving the handbook, thevast majority of teachers had not received guidance or training on how toimpart HIV/AIDS education to their students. Visits to schools and classroomobservations suggested that many schools were not providingHIV/AIDS education, often because teachers did not feel comfortable orcompetent to teach the subject. In schools that did provide lessons onHIV/AIDS, not all teachers conveyed accurate information.In an effort to address these shortcomings, MoEST hired trainers to providein-service courses for teachers on HIV/AIDS education based on thetechniques in the facilitator’s handbook. Because of budget constraints, onlya few teachers were offered this training.Lack of engagement with HIV/AIDS issuesRather than encourage students to engage with the material and the issuesraised, HIV/AIDS education often merely provides information. Participantsat the meeting expressed the need to encourage students to remembermore about what is discussed in class and to think critically about what theyhear, in order to be able to put what they know into practice.The dangers of cross-generational sexCross-generational sex is associated with an increased risk of HIV infectionfor adolescent girls, because HIV prevalence among men increases with age.“Sugar daddies”—older men who provide adolescent girls with gifts in return(c) The International Bank for Reconstruction and Development / The World Bank
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A SOURCEBOOK OF HIV/AIDSPREVENTION
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© 2008 The International Bank for
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viContents4 The School Health Educa
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viiiContentsTables7.1 Impact of Sug
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xiiAcknowledgmentsKelly (University
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xviAbbreviationsNASNERDCNGONIEDNSGA
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xviiiIntroductionTable 1: Program D
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xxIntroductionhttp://unesdoc.unesco
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Chapter 3Key evaluation results: A
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Chapter 10Key evaluation results: E
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Table A.1: Overview of Programs in
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236 Indexcivil society organization
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238 IndexGhana AIDS Commission (GAC
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240 Indexmaterialsin ELPE Program (
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242 IndexOlatunde, Bunmi, 203Oren,
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244 IndexRapid Results Initiative (
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246 Indexmaterials needed by teache
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ECO-AUDITEnvironmental Benefits Sta
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