Select Committee on International Development Written Evidence


APPENDIX 1

Memorandum submitted by Professor Roy Williams, Education for Development

Note:

  This paper is based in large part on sections of a report by Debbie Gachuhi, UNICEF ESARO Consultant, November 1999. Some additions have been made with reference to South Africa. The section on Pro-change and Education for Development has been added in entirety, and is not part of the Gachuhi report.

  The full Gachuhi report can be made available, as can reports and articles on the Pro-change programme, work that Education for Development personnel have done in Southern Africa, and studies by the South African Council for Scientific and Industrial Research and the Medical Research Council.

  The HIV/AIDS pandemic continues to ravage the Eastern and Southern Africa Region (ESAR). The statistics are disturbing: at least 40 million people are infected with HIV in sub-Saharan Africa. The bulk of new AIDS cases are among young people, aged 15-25 and females are disproportionately affected. The ability of girls and women to protect themselves from HIV is constrained by their status in society.

  Life expectancy in some countries has already started on a downward spiral and is expected to drop to 30 years or less in nine sub-Saharan countries by the year 2010. Figures from the CSIR (Council for Scientific and Industrial Research) in Johannesburg state that for a child born in Kwa-Zulu Natal today, life expectancy is already down to 29 years. AIDS-related mortality has begun to reverse all the gains made in health, education and welfare over the past 20 years.

  Children will be the most affected as a result of HIV/AIDS as they live with sick relatives in households stressed by the drain on their resources. They will be left emotionally and physically vulnerable by the illness or death of one or both parents. Subsequently, children who have lost one or both parents are more likely to be removed from school, to stay home to care for the sick and to be pulled into the informal economy to supplement lost income. This is especially the case for girls.

  The AIDS epidemic is beginning to have a serious impact on the education sector, on demand, on supply, and on the management and quality of education provided at all levels. As a result of HIV/AIDS, there are relatively fewer children needing education. Fewer children are being born because of the early death of one or both parents. Moreover, fewer parents will want to send their children to school, and there will be fewer families who are able to afford to send their children to school. Fewer students in the education system and lower demand for places in education programmes, will most probably lead to a smaller supply of facilities and places. Schools that have enrolments below a certain minimum may therefore be closed and the remaining pupils moved to other schools. Even if facilities continue to be available, there may be a lack of teachers and other personnel to provide teaching services. The quality of learning outcomes and education will be affected by several confounding factors which will emerge as the pandemic takes a deeper hold in the ESAR countries. Already, education systems have begun to experience increased problems of teacher absenteeism and loss of teachers, education officers, inspectors, planning and management personnel. Regrettably, in the ESAR region, the impact and devastation to the education system has yet to be calculated or determined although several countries have planned such studies.

  The health system in many countries is already being overloaded by AIDS and AIDS-related diseases. The infections that have already occurred in countries such as South Africa will cause at least one million AIDS deaths per annum in South Africa from 2005, and the infection rates have not yet peaked: in the Johannesburg region, one study has found that 50 per cent of 20 year old women, and 60 per cent of 25 year old women are infected. The figure for 25 year old women a year ago was 50 per cent (CSIR).

  When one combines these figures with the figure of 50 per cent of pupils in Matric in South Africa (grade 12) are 20 years old, and 25 per cent of them are 25 years old, it is apparent that a large proportion of the pupils, especially girls, will die while at school, or soon afterwards.

  Education systems have an essential role to play in reversing the very pandemic that threatens it. Young people, especially those between five and 14 years, both in-school children and out of school youth, offer a window of hope in stopping the spread of HIV/AIDS if they have been reached by Life Skills Programmes. In the absence of a cure, the best way to deal with HIV/AIDS is through prevention by developing and/or changing behaviour and values.

  Life skills programmes aim to foster positive behaviours across a range of psycho-social skills, and to change behaviours learned early, which may translate into inappropriate behaviour at a later stage of life. Life skills programmes are one way of helping children and youth and their teachers to respond to situations requiring decisions which may affect their lives. Such skills are best learned through experiential activities which are learner centred and designed to help young people gain information, examine attitudes and practice skills. Therefore life skills education programmes promote positive health choices, taking informed decisions, practising healthy behaviours and recognising and avoiding risky situations and behaviours. Research shows that these programmes do not lead to more frequent sex or to an earlier onset of sexual activities, as opponents fear. Nor do they lead young people to promiscuity.

  To date, there are too few life skills programmes in ESAR that are targeting children and young people with information about HIV/AIDS and that meet the criteria for minimally effective education programmes. Many countries in the region are just beginning to explore the concept of life skills and how to advocate for it to be accepted and adopted into the education system.

  In the UK, Pro-change has been working on behaviour change/life-skills programmes for some years, targeting smoking initially, and more recently AIDS and reproductive health, in many Health Authorities in the UK. Pro-change and Education for Development are in discussion with a number of agencies and organisations, to see whether the Pro-change programme can be implemented in South Africa, in Southern Africa, as well as in the Commonwealth.

  The Pro-change programme is a thoroughly researched and tested programme, and has the following advantages: It is

    1.  A population-wide approach.

    2.  Explicitly a behaviour change programme. Information, strategies, support, suggestions and interaction are all designed and compiled to meet behaviour change goals.

    3.  Based on an extensively researched analysis of 15 years of behaviour change programmes.

    4.  A staged behaviour change approach. Taking action to actually change a particular behaviour is only phase four. Before that, there is important work to be done in communicating with people who are not yet thinking about change, who have started to think about changing, and who have started to plan how they will change. The fifth stage is maintaining the change.

    5.  A differentiated message and communication approach. Messages and interactions are customised for each of the five stages in behaviour change.

    6.  An individualised programme. Each user can be given customised information, and can be helped to develop and implement their own change.

    7.  Related to well researched norms of behaviour in the target community. This enables the user to compare her/his progress with her/his peers.

    8.  Available in paper and CD-ROM versions, with group work support.

    9.  Able to use the considerable benefits of computer interaction: guaranteed confidentiality and privacy, which is valuable when discussing sexual diseases and behaviour; and individualised interaction, which allows for a highly responsive programme, based on honest feedback.

    10.  Sustainable and efficient. It is implemented over two years, but requires only about 10 sessions over that period. In the computer version it can be implemented with only one lap-top computer per school.

    11.  Based on developing the user's own resources and strategies for change. It is a life skills programme, and can also be used in similar format for a variety of other behaviours, including smoking, drug use, eating behaviours etc. The life skills learning is, in other words, transferable and generalisable.

    12.  Designed, researched, and implemented in prevention and cessation programme. It has been tried and tested, and subject to published research, in a variety of communities in the USA and the UK, over many years.

  Education for Development, a Reading-based charity that has worked in development in the Commonwealth for 16 years, and Pro-change are available to make further presentations, or to supply further information on request.

Professor Ray Williams
Education for Development
May 2000


 
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