Introduction
The Zimbabwe Catholic Bishops’ Conference (ZCBC) HIV and AIDS Desk is the arm of the Church responsible for AIDS Awareness Campaigns, that include Orphan Care in our Schools. It is located at the corner of Fourth Street and Selous Avenue in Africa Synod House in Harare, Zimbabwe. The ZCBC was constituted by the Roman Decree on 1st October 1969. The ZCBC forms the Coordinating body of the Zimbabwean Bishops. It is made of Commissions, one of them being the ZCBC HIV and AIDS Desk. The primary focus of the HIV and AIDS Desk is to promote values of life which prevent the spread of AIDS. We achieve this by running programmes on HIV and AIDS which focus on Prevention and Life Skills Promotion, AIDS Education, Basic Skills in Counselling, Education For Life Programmes, Behaviour Change, Peer Education and Care of the Infected and Affected in the schools for the past seven years.
BEHAVIOUR CHANGE AND SKILL’S PROGRAMMES:
Zimbabwe Catholic Schools Combat HIV and AIDS
General Background
Zimbabwe is ranked among the countries with the highest incidence of HIV and AIDS in the world. About one in three people are HIV infected; with 50% of the sexually active age bracket being HIV+ Historically, Zimbabwe has been an independent country for twenty-nine years.
The government has developed an Educational Programme for all the schools regarding HIV and AIDS, which is not being fully implemented for various reasons: e.g. lack of training and conviction on the part of the teachers in respect of this programme.
Publicity within the country seems to regard condoms as an answer to the HIV and AIDS crisis. Although there is the call for no sex before marriage and faithfulness in marriage, youth receive mixed messages. Statistics show that an increasingly alarming number of young people are being infected daily. Hence the reasons for a special focus on teachers, students and pupils’ HIV and AIDS Education Programme, with special emphasis on Behaviour Change Programme.
Project Background
The Zimbabwe Catholic Bishops’ Conference (ZCBC) became involved in AIDS Education in the early 1990’s through its influence on the Ministry of Education’s AIDS Action Programme. In 1993 a general Catholic Education Staff Development team was approved by ZCBC. In addition to other ventures, in 1995 the staff development team started going around the country assisting teachers with methods, strategies and a Christian perspective to teaching the AIDS Action programme. In 1996 a supplement to the Government’s programme, “Christian Approach to Sexuality” was developed by ZCBC and promoted throughout the Catholic Schools of the country and 2 colleges.
Workshops were held at the local levels for teachers, administrators and interested mission personnel. The workshops continued throughout 1997 and 1998, with special focus on the administrators and the priests in charge of the local mission schools. It was noted that many schools did not fully implement the AIDS Action Programme, even with the assistance of workshops and teachers’ supplement. It was seen that direct monitoring was necessary. During 1998 each school identified an AIDS Coordinator at the local level to assist the school head with AIDS Education. In 1999 special AIDS Counselling workshops were held in each of the dioceses for the AIDS Coordinator and another teacher from each school to assist them in meeting some of the unique problems faced at the school level due to illness, death, and care of HIV and AIDS as well as deal with child sexual abuses and support the victims.
Project Aim
The major goal in this programme is to assist the young people of Zimbabwe to grow up as an AIDS free generation.
Project Objectives
- To train the Heads and school teachers in Behaviour Change techniques and strategies, in order to continue a version of the programme in their respective schools
- To provide Heads, AIDS Coordinators and teachers of each of the Catholic Schools with strategies, techniques and Participatory Methods to teach young people, in our schools to practice positive behaviours.
- To offer peer support for the teachers and the students with regards to Behaviour Change.
- To facilitate care and support of the orphans in the schools, by the teachers, all staff, the community, the students and the pupils.
- To promote Gender Balance in schools and communities.
- Activities
- Proposed Monitoring System
- Behaviour Change Programme
- HIV/ AIDS Zimbabwe
- What makes young people vulnerable?
- The role of Faith Based Organisations
- HIV/AIDS Desk
- HIV & AIDS Desk Programme Basic Components
- Project Activities & Timeframe
- Tracking & Evaluation
Workshops on:
- Education For Life And Training Of Trainers.
- Use of Participatory Methodology When Teaching AIDS.
- Peer Education.
- Skills In Basic Counselling
Visits to Selected Schools
- To promote The Teaching of AIDS in the school.
- To Monitor and Evaluate the workshop done with Teachers with regard to HIV AND AIDS.
- To Promote Care And Support for the Orphans.
- To Promote Gender Balance.
Orphan Care
- Providing Counselling.
- Providing Spiritual Support.
- Providing Material Support.
Beneficiaries/Target Population:
There are about 175 Catholic schools, both primary and secondary, 3 tertiary colleges, Bondolfi Teachers’ Training College, Catholic university, and Ukusileni Technical College and three registered nursery schools throughout Zimbabwe, with over 2801 teachers and 79 933 students. Each school has an AIDS Coordinator. Almost 87 schools serve primary pupils and about 70 serve secondary students. The schools are both boarding and day, both urban and rural. They serve non-Catholic students as well as Catholic students. Several of the schools cater for disabled children, primary through secondary. Parents, near by communities and adjacent non-Catholic schools will also benefit from the programme
The National AIDS Education Coordinator and the assistant visit selected schools in each diocese to encourage the promotion of Education For Life and Counselling. The visits include an afternoon session with the teachers on teaching of HIV and AIDS in the school and the use of the Participatory Methodology and training in life skills in combating AIDS. Sessions with students according to their age groups on Peer Education are also conducted.
The visits also target those schools and individuals who have done the Education for Life, so as to find out what is happening as regards implementation of techniques and strategies learned.
The Diocesan AIDS Co-ordinators also visit schools in their own diocese, monitor the programme on Behaviour Change, and teaching of HIV and AIDS in the classroom, and keep records of the progress and the drawbacks. They also assist in promoting the Behaviour Change Programmes as well as Peer Education
Our experience of fighting HIV and AIDS in Zimbabwe taught us that knowledge alone is not enough to bring about Behaviour Change. Recent data indicate that the prevalence rate has increased from 25% in the 90s to a current 35% of the adult population. Zimbabwe’s population is expected to drop from the current 12.5 million to an estimated 10 million in 2020. Life expectancy has dropped by half from the mid—60’s to the 30’s to date. HIV and AIDS related illnesses consume 75% of the country’s health budget. The country is as well losing its best and brightest. Changing one’s behaviour is not that easy. This is the only option in Zimbabwe, if we are to stop the spread of HIV. Because there is no vaccine, there is no cure for AIDS. In Zimbabwe there are a few affordable treatments.
The requirements for Behaviour Change are:
- Accurate information about the disease
- An understanding of personal risk and responsibility.
- Skill and confidence to recognise and choose preventive options
- A supportive environment, for those choosing HIV and AIDS resistant behaviour.
- Need for the Divine assistance in order to persevere
Uganda and other Eastern and Southern African countries have shown that Faith—Based Organisations can play a major role in helping people adopt and maintain AIDS resistant roles. It is a blessing in disguise that about 85% of Zimbabwe’s population is affiliated in one way or another with one of the various main Christian Churches. These church groups have the ability to reach their members, (families, parents, school, youth, school-leavers) in ways that are unavailable to other organisations.
Faith-Based Groups in Zimbabwe have been active, in Home-Based Care, and Orphan Care, but more needs to be done in the area of Prevention. Many church leaders have not seen HIV and AIDS as a priority. Today things are changing, because many pastors are spending much of their time conducting funerals and comforting the bereaved. They become acutely aware of the impact of HIV and AIDS is having on their communities and are looking for appropriate ways to protect their members.
In this programme, the overall goal is to provide our Catholic Schools, colleges and others in Zimbabwe, with the implementation and facilitation skills necessary to confidently and effectively implement and facilitate, a variety of Behaviour Change based approaches.
To accomplish this goal, the ZCBC HIV and AIDS Desk plans to:
- Provide experience of Education for Life (Behaviour change process) to Catholic Schools and others. (Teachers, other staff and pupils/students and the community at large and other denominational and non-denominational members).
- This is intended to increase their capacity and ability to effectively change their behaviour, teach and promote behaviour change within their membership.
- Provide facilitation skills’ training to teachers, other staff at school and some students, and some members of the community. This will enhance their capacity and ability to effectively teach and promote behaviour change within the school and the community at large.
- Provide implementation skills and training to teachers’ groups, multi-denominational groups and other agencies, NGO’s working to assist faith-based groups in the promotion, and implementation of behaviour change HIV/AIDS prevention programmes.
ZCBCHIV and AIDS Desk’s Approach to Behaviour Change is based on the belief that:
- Each individual must take a personal responsibility as regards HIV and AIDS.
- Prevention efforts need to be comprehensive and inclusive.
- Efforts must be focussed on youth in and out of School, including the families, and Communities at grassroots.
- People need: accurate information, skills, confidence, hope, a realisation of personal risk and a supportive environment to change behaviour.
- People are ready to act if they are given the proper tools and information.
There are four basic components to the HIV and AIDS Desk’s approach:
- The first is to empower Teachers, students and parents individually. This is done through workshops on Education For Life. This is done to help the youth adopt and maintain HIV and AIDS resistant behaviours.
- Training the schoolteachers in Counselling, so that they will assist students who need counselling.
- We promote orphan care through sourcing fees and material needs for the orphans. We promote Counselling for them as well.
- We promote and monitor the teaching of AIDS in the schools. We run workshops for both teachers and students on HIV and AIDS Prevention and care of the infected and affected. The HIV and AIDS Desk intends to work with teachers of our Catholic Schools and others, to help them adopt, implement and improve this approach. In doing so we hope to help the teachers and youth of Zimbabwe, create an environment where HIV and AIDS resistant behaviours are taught, encouraged and supported by the school and community.
We believe that the active involvement of Church organisations like ZCBC HIV and AIDS Desk, in Behaviour Change based HIV and AIDS Prevention Programmes, is a critical element in turning the tide against AIDS in Zimbabwe.
A decade ago, HIV and AIDS was regarded as a serious health crisis. Today it is clear that it is a development crisis. There is compelling evidence that the trend of HIV and AIDS infection will have a major impact, on the future of the infant child and the country will feel the impact of the epidemic than most countries.
Clearly high proportions of young people are having sex before marriage, often at a very early age. In most Sub-Saharan countries as high as 60% of young people aged 15-19 years now married reported having had sex before marriage. In these countries, Zimbabwe included, prevalence in these groups is very high. Greater sexual activity during the early teens translates into a higher prevalence of HIV later on. Studies have shown that 80% of all deaths of young people aged 25-45 are associated with HIV.
The population structures have been badly affected in countries where HIV and AIDS is wreaking havoc. The structure that in the past was described as a pyramid is happening around those that are 10 – 15 years old. This age group becomes sexually active at an early age, becomes infected early in their lives and also tends to die at an early age. The population of men in their 20s and 30s shrinks drastically. Infected women become infertile early or die of HIV and AIDS even before the end of their reproductive years and so fewer babies are born.
UNAIDS (June 200)Zimbabwean children confront a formidable challenge with the proliferation of HIV and AIDS. The percentage of young people age 15 – 19 years that are HIV positive is on the increase.
Protection of another generation of young people from premature illness and death is a responsibility of the highest order and the greatest leadership challenge. As the rate of infections in the general population increases, the same patterns of sexual risk will result in more new infections simply because the chances of encouraging an infected partner becomes higher.
Many factors and forces exist that particularly expose young people to HIV infection. Most young people face the risk of HIV with very factual-information; too little guidance about sexual responsibility and too little access to both correct information and care. In some cases their rights to information, goods and services for self-protection are compromised. The current high levels of poverty expose girl children to the risks of prematurely engaging in sex for money.
Young people in this country face serious problems in communicating about sex. The communication crisis in most families between parents and children has resulted in children succumbing to peer pressure, which exposes them to problems like drugs, alcohol and sexual abuse. Deep-seated cultural taboos on sex are passed on from generation to generation. As a result, children faced with sexually risk situations find that they have nowhere to go except to their own peers, who themselves usually have very little or no information at all. When children and young people are denied basic information, education and skills to deal with HIV and AIDS, they are weakened in their ability to reduce their own risk of infection.
Young girls are even more vulnerable than their counterparts. Infections are higher among girl children than boys of the same age. It is because of the interplay of biological, cultural and economic factors, that young girls are particularly vulnerable to HIV and AIDS infection. Sometimes, power imbalance over girls, physically, financially and socially further exposes girls to the risk of engaging in sex unwillingly. It has been that, empowering the girl children with information, education and skills will reduce their risk to HIV and AIDS.
The absence of role models in young people’s lives has had a negative impact. Most families in Zimbabwe today, are one parent or nil. Statistics reflect that Zimbabwe has over 600, 000 orphans that are growing up in foster homes, step-parent homes and child-headed homes. These children are already disadvantaged as they lack guidance, love and material support. This predisposes them to risky behaviour that will prematurely expose them to HIV and AIDS.
Due to the death of parents, young people today, find themselves as heads of families/households in their community. They are at risk to various forms of abuse including rape, dropping out of school, early marriages or prostitution in an effort to survive and fend for other siblings. Therefore, they are even more vulnerable to contracting HIV and AIDS.
The African extended family moral fibre, once the bond that protected children, is no more. More relatives have died due to HIV and AIDS, lack of the capacity to absorb more children into their own already over-burdened homes. In view of this the only protection for these people is to equip them with skills to stand up for their own right to survive and stay HIV free.
Unless we can provide the youth with a consistent message about HIV and AIDS, from multiple respected sources, and build an environment supportive of HIV and AIDS resistant behaviour, we are unlikely to lower the infection rates.
Faith-Based Organisations play a powerful role in the lives of many if not most Zimbabweans. Some 85% of Zimbabwe’ s population is affiliated in one form or another with one of many Christian churches. From birth to baptism, to marriage, to death, faith-based organisations help shape views of life and morality and provide guidance for life’s trials and ordeals. Faith-Based Organisations reach a huge number of the population through sermons, Sunday school lessons, youth programmes, catechism classes, women’s confraternities, and general church activities. They are able to draw on the spiritual nature of man to support difficult but life promoting changes in behaviour. Faith-Based Organisations can reach parents, families, and children in ways no other group can approximate.
Faith-Based Organisations have staff, lay-volunteers and community organisation skills that are less apparent in other aspects of Zimbabwean Society. They are able to marshal resources and help individuals draw on spiritual reserves to examine and alter behaviours that are self-destructive. Faith-based Organisations have the ability to support their membership in HIV and AIDS prevention by providing instruction, counsel, reinforcement and guidance. They can support AIDS resistant behaviour with a supportive environment and they can help champion overall all community HIV and AIDS prevention efforts. In short Faith-Based Organisations can be a key force in turning the tide against HIV and AIDS.
The HIV and AIDS Desk plans to support the teachers, and parents in their efforts to halt the high HIV and AIDS pandemic by equipping them with facilitation and implementation skills. We believe that in doing so we will be able to increase their overall capacity and motivation to implement large-scale HIV and AIDS Prevention Programmes within their membership, and thus save tens of thousands of lives. Faith-Based Organisations can play a pivotal role not only in providing accurate information to their members, but also in providing an environment conducive to HIV and AIDS resistant behaviour. Faith-Based Organisations also play a key role in the development, and implementation of HIV and AIDS prevention programmes for the wider communities they serve.
In 1993 Church leaders in Zimbabwe published an, “Appeal by Church Leaders for Behavioural Change to Combat AIDS” This statement indicates commitment to a Behaviour Change based approach to HIV and AIDS prevention. The HIV and AIDS Desk intends to abide by this statement and provide the teachers and parents with critical skills to carry out programmes based on the statement.
The mission of the ZCBC AIDS Education Programme: – “Our mission is to stop the HIV and AIDS pandemic by assisting individuals, families and communities to adopt and maintain HIV and AIDS resistant behaviours.” The strategy has been: to promote concepts of behaviour change through our own implementations, and through assisting other NGO’s agencies and communities in embracing this approach. Wherever possible we work with the client to adopt the programme to the client’s needs and to help the client build the internal capacity to implement, sustain and support the programme.
The HIV and AIDS Desk’s AIDS Prevention Programmes are based on the belief that adopting HIV and AIDS resistant behaviours requires:
- Creating a sense of hope and providing people with a way forward.
- Helping understand their personal risk from HIV and AIDS and take responsibility for it.
- Providing a consistent message to the youth from multiple respected resources.
- Providing a comprehensive programme and a supportive environment for those adopting HIV and AIDS resistant behaviours.
- Developing within individuals and the community the ability to talk openly about the disease.
- Achieving critical mass where a community has a common base of understanding about HIV and AIDS, has the ability to talk about the disease and supportive to its members in HIV and AIDS resistant behaviours.
The HIV and AIDS Desk believes that AIDS resistant behaviours include:
- Choosing to delay sex until marriage.
- Maintaining one faithful partner for life in marriage.
- Openly talking about HIV and AIDS with children, families, and friends.
- Getting tested to know status
- Getting treatments for STDs
- Accepting those who are HIV positive as vital members of the community
- Being involved with care for the infected
- Being involved with care for the affected.
- Offering Counselling Services
- Praying for the strength to make wise choices.
Component # 1. Empowering the Individual
Empowering the individual means providing the individual with
• Accurate knowledge of: how the disease is and is not spread; how it progresses; and what it does to the body
• And understanding of personal and family risk and the options for protection.
• Positive living is vital
• Skills to openly talk about the disease with friends and family.
• Skills to problem solving, solutions, choose options, and designs and carry out personal and family plans to stay AIDS
free.
• Confidence that the disease can be defeated and that personal commitment to AIDS resistant living can be carried out.
• An appreciation that people with AIDS are not to be shunned or feared, but are a valuable part of the community.
• Prayer is vital
• Those with AIDS are also loved by God.
The HIV and AIDS Desk currently uses three primary programmes to achieve individual empowerment:
• “Education For Life’ (EFL) a three-day large group process (40-60 people). EFL involves very little lecture but uses group
process, skills building, sketches and various activities to empower individuals to fight HIV and AIDS.
• Teaching of AIDS in the school.
• Counselling
Component #2 Mobilizing the Community
While individual empowerment is necessary it is not sufficient. To sustain AIDS resistant behaviours, individuals need the support of their families and communities. Communities may be schools, villages, churches, business or combinations of all.
To support HIV and AIDS resistant behaviour communities can:
• Empower all community members to fight HIV and AIDS
• Encourage open and frank talk about HIV and AIDS within the community and within families.
• Support and reinforce HIV and AIDS resistant behaviour
• Implement programmes to overcome high-risk behaviour.
• Implement programmes to provide better care for the infected.
• Implement orphan care programmes.
• Coordinate community services.
Component #3 Building Partnerships
The third component of The HIV and AIDS Desk programme is to help communities build partnerships with other organisations that can enable them to build a more comprehensive HIV and AIDS Prevention Programme. These partnerships may be in the areas of providing assistance to get:
• Counselling and testing
• Early treatment for STDs and opportunistic diseases
• Home-based care
• Orphan care
• Income generation
The HIV and AIDS Desk focuses its efforts on the youth. We work with schools, churches, and communities in an effort to bring a constant and consistent message to the youth about Behaviour Change, and to build a supportive environment for youth to practice AIDS resistant behaviours. We believe this consistent message and supportive environment from multiple sources is key to gaining critical mass and thus lowering the infection rates.
Recent Implementations
The HIV and AIDS Desk has been actively promoting this approach to AIDS prevention for the last 7 years. Currently the HIV and AIDS Desk is involved in several major implementations.
Working with the Ministry of Education and with teachers from the 8 different dioceses, we have completed the training of some 518 teachers in both EFL and to be facilitators of EFL. These teachers are training students in EFL. In each of some 175 schools, teachers, students, and many parents can talk openly about AIDS and have developed a supportive environment in the school to support HIV and AIDS free behaviours. We have also trained 540 teachers in Basic Counselling Skills Course in the past 7 years.
The HIV and AIDS Desk believes that Behaviour Change is a Prevention Strategy that will work. The Desk is, however, aware that changing behaviour is not an easy task. It is complex and it does not require just once off strategies but persistent and consistent reinforced interventions. Behaviour Change requires the person changing to have the internal will power to want to change but it also requires a supportive community and the divine power.
The overall objective of this project is to increase the capacity of schoolteachers to design, implement, facilitate, evaluate and improve Behaviour Change based HIV and AIDS Prevention Programmes. To do this these teachers will need motivation, leadership, resources and the knowledge and skill to implement such programmes. It is in this latter area of knowledge and skill that The HIV and AIDS Desk concentrates. We believe, however, that as we increase the knowledge and skill in these teachers we will also provide motivation and increased ability to obtain and or designate the resources necessary to take such programmes to wide country membership.
There are three primary objectives of this project
Increase the skills and capacity of schoolteachers to effectively facilitate behaviour change based HIV and AIDS Prevention Programmes such as EFL. We have had programmes aimed at prevention. These programmes by-and-large have been intermittently implemented and primarily aims at spreading implementation.
Increase the capacity of teachers to design and implement behaviour change based programmes.
Being able to facilitate specific programmes well is only the first stage of the battle. To be effective, organisations need to be able to design and implement programmes that: get to large groups of people, create critical mass in given communities, and prepare the communities to design and implement on-going AIDS prevention activities. This requires more than just facilitation skills in various programmes. It requires an understanding of the political, logistical and practical problems of implementation in given communities.
The activities include:
a) Conducting training sessions for implementers of implementation issues around “Education For Life”.
b) Providing consulting around implementation issues with an emphasis on achieving behaviour change. This would include such
items as: achieving an environment actively supportive of HIV and AIDS free behaviours, and issues involving expanding the
programme to the wider community.
c) Provide assistance in evaluating the programmes for future improvements.
d) Provide assistance in pilot development, implementation and evaluation with the aim of creating better models of implementation for
use by Faith-Based groups
e) Develop within the schools the capacity for design implementation and evaluation.
Timeframe
The HIV and AIDS DESK envisions this project as a ten-year effort. In the first years there will be more emphasis on:
• marketing the idea to the various schools entities in various geographical areas of the country by holding area specific training
seminars open to teachers.
• developing and supporting efforts to provide training and consulting
• developing the best approaches to reach large numbers of schools personnel.
• Implementing pilot projects to create solid models of implementation that can be shared, and replicated.
• Improving the facilitator and implementation training programmes.
In the middle years there will be more emphasis on:
• Involving a larger number of Non Catholic schools
• Providing deeper pockets of trained personnel within dioceses
• Improving the implementation designs, scale-up and follow-up
• Supporting large-scale implementations
In the latter years there will be more emphasis on:
• Increasing the capacity of more teachers from other denominations and individual denominations to promote and sustain behaviour
change based HIV and AIDS Prevention Programmes on their own.
Objective #1. Tracking progress and evaluating performance on Objective #1 will include:
• Tracking and reporting numbers of training seminars held.
• Tracking and reporting numbers of facilitator’s trained.
• Tracking and reporting number of days spent in coaching, and consulting.
• Summarising seminar evaluation forms
• Quarterly evaluation of progress
Objective #2. Tracking progress and evaluating performance on Objective #2 will include;
• Tracking and reporting numbers of training seminars held
• Tracking and reporting numbers of people trained
• Tracking and reporting numbers of days spent in consulting and design.
• Tracking and reporting on pilot programmes initiated
• Summarising of seminar evaluation forms
• Quarterly reporting on implementations planned or in progress
• Quarterly evaluation of overall progress.
Objective #3 Tracking progress and evaluating performance on Objective #3 will include:
• Tracking and reporting numbers of hours in collaborative sessions with other entities
• Tracking and reporting numbers of hours testing out and evaluating new programmes and materials