Uganda: Designing Communication and Education Programs to Combat HIV/AIDS
In Uganda, prompt action against HIV/AIDS and high-level political commitment have resulted in declining HIV/AIDS infection rates in urban areas. The Ministry of Education and Sports launched its first HIV/AIDS prevention efforts in 1996. These included media messages targeted to youth, the introduction of HIV/AIDS into primary and secondary curriculum and theatrical activities in schools throughout the whole country. The Ministry is now in the process of elaborating an extensive HIV/AIDS communication and education plan for the next five years, which includes a wide variety of creative projects and media events.
With approximately 10 percent of its adult population, or 2 million people, infected with HIV/AIDS, Uganda is still facing a major health and development problem. However, thanks to the government's determination and prompt action at the onset of the epidemic, HIV prevalence rates in Uganda have been declining since 1992. The Ministry of Education and Sports was quick to implement information campaigns and AIDS education and counselling throughout the education system. Uganda's experience highlights the positive role played by communication and education in combating AIDS.
Setting the scene
The HIV/AIDS epidemic has had a great impact on all aspects of the school environment in Uganda, affecting learners, teachers and administrators. The major route for disease transmission is through heterosexual contact, and evidence suggests that young women of between 15 and 24 years of age have up to six times a higher risk of HIV infection than do men of the same age group. About 54 percent of all reported HIV/AIDS cases are female. HIV/ AIDS is the fourth leading cause of death among children under five and, unless contained, may increase the infant mortality rate by 70 percent and under-five childhood mortality by 100 percent. The numbers of street children have increased greatly and it is estimated that some 1.5 million out of 1.9 million orphans in Uganda are HIV/AIDS-related.
Nonetheless, there are signs that an active awareness campaign is starting to bear fruit. How has Uganda achieved these results, and what is it doing to ensure that its campaign is extended to all areas in formal and non-formal education?
Early Efforts
The Ministry of Education and Sports launched its first HIV/AIDS prevention efforts in 1986. These included media messages addressed to youth, the introduction of HIV/AIDS into the primary school curriculum as part of health education, an HIV/AIDS theatrical activity involving over 8500 primary schools throughout the country, and other performances translated into 12 local languages. During the mid-1990s, a syllabus for secondary schools and written materials for primary schools were produced. The introduction of Universal Primary Education (UPE) in 1997 meant that most children were in school and could be reached with information and activities. The period 1995 to 2000 was the start of a Life Skills Education program designed to help adolescents make informed decisions and healthier choices about their behavior.
Matching means to ends: objectives, outcomes and strategies
These early activities have evolved into a comprehensive policy document for Uganda, based on consultation with a wide range of stakeholders and offering a National Strategic Framework and Action Plan for HIV/AIDS. The Ministry of Education and Sports has played a leading role in defining objectives and promoting strategies to achieve its objectives.
The Ministry's communication and education plan sets forth nine objectives for combating HIV/AIDS during the next five years:
- Develop and implement effective policies for the sector.
- Intensify advocacy efforts for children's rights and needs in the context of AIDS.
- Incorporate HIV/AIDS into the curriculum across all education institutions and non-formal venues.
- Promote skills-based teacher training in colleges.
- Promote AIDS education, counseling and health services support at educational institutions at all levels.
- Foster the welfare of AIDS orphans.
- Build partnerships with community and non-governmental organizations, and undertake joint activities on behalf of communication and education.
- Encourage research on various aspects of HIV/AIDS and its impact on education and related sectors.
- Promote joint planning, coordination, monitoring and evaluation of HIV/AIDS activities in the education sector.
Each general objective is accompanied by a more specific statement of the desired outcome, plus a list of strategies for reaching it.
In defining outcomes, the Ministry of Education and Sports often sets quantifiable goals. For instance, the plan specifies that by the year 2005-06 at least 90 percent of the teacher training collectives shall have introduced skills-based modules on HIV/AIDS into their program. It also states that by that year at least 50 percent of the educational institutions in Uganda shall have introduced welfare/support schemes for HIV/AIDS orphans, and 80 percent of educational institutions shall have introduced HIV/AIDS counseling and health services. It suggests that at least five major studies on various aspects of HIV/AIDS in the education sector be undertaken by the end of the planning period.
The lists of proposed strategies for achieving these goals are detailed and specific. They tend to follow a similar arc, which begins with consultations or other means to examine existing resources or identify needs, then proceed to develop the materials, activities and channels required to get the messages across, and finally end with some kind of evaluation exercise. The action plan opens up a wide variety of creative projects and media events that it considers suitable vehicles of communication. These include workshops, development of training kits and modules, competitions for best article or best performance, use of television, radio and video, lobbying and outreach activities, T-shirts and trophies, curriculum redesign, press campaigns, national debates, parental involvement and joint projects with community organizations.
Looking back in order to move ahead
In its report on actions taken to cope with the impact of HIV/AIDS, the Uganda Ministry of Education and Sports describes a number of stumbling blocks that were encountered along the way. In addition to the false sense of security and mistaken lack of urgency that accompanied the epidemic's early incubation period, those making decisions about strategies treated the virus as a "simple" health problem and the education ministry was not much involved. Also, pressing economic and security matters, including debt servicing, structural adjustment programs, and even daily survival often preoccupied political leaders.
Recent surveys taken by the Ministry of Health indicate that attitudes and practices are changing for the better. The average age of first sexual activity has risen, the average number of casual sex partners has fallen, and more people are using condoms. HIV infection is definitely down--a decline that seems causally linked to changes in high risk behavior. The rate of HIV/AIDS infection in urban areas has declined, especially among pregnant women attending ante-natal clinics. Uganda's experience suggest that the country's ability to combat HIV/AIDS is picking up steam, and the greatest obstacles have been put behind. Thanks to coping strategies that emphasize the need for sustained communication and education efforts at all levels, Uganda's National Strategic Framework and Action Plan for HIV/AIDS offers hope that the future need not be bleak.
Florence Malinga
Commissioner
Education and Planning
Ministry of Education and Sports
Kampala, Uganda
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