Haiti
Youth, Families, and Communities Supporting Abstinence/Be faithful for Youth (ABY) Interventions in Haiti
Activity Dates
4/1/2005 - 7/15/2007
Health focus
HIV/AIDS prevention among youth through the promotion of abstinence and fidelity
Activity Summary
Under the USAID Haiti Emergency Country Operational Plan for 2005, HCP was given the mandate to carry out abstain/be faithful (AB) interventions for youth 10-24 years old. HCP strategies in 2005 included building the capacity of the Ministry of Health, Faith Based Organizations (FBOs) and non-governmental organizations (NGOs) to reach youth with AB prevention, the promotion of non-risky sexual behaviors (including the adoption of primary and secondary abstinence, faithfulness to one partner, and HIV/AIDS testing) and strengthening community mobilization interventions to foster positive norms and a favorable environment for AB youth prevention activities. In this context HCP collaborated with the Ministry of Public Health and Population (MSPP), NGOS, and FBOs to carry out capacity-building, media, interpersonal communication, and community interventions with youth and adult caretakers (e.g., parents, religious leaders).
Implementation
HCP provided assistance to the Ministry of Health National AIDS program and partner organizations to strengthen the capacity of the Groupe Technique (GT), a central HIV/AIDS coordination mechanism, to implement value-added interventions and develop appropriate materials and messages for youth contributing to the prevention of HIV/AIDS among youth with a focus on abstinence/be faithful for youth (ABY).
Objectives/Strategies
The HCP behavior change communication/community mobilization (BCC/CM) strategy was threefold:
- Reinforce the institutional capacity of national and private sector partners in implementing ABY interventions at the central and departmental level;
- Promote sexual responsibility among youth; and
- Improve the quality of youth services.
Strategy 1: Reinforcing institutional capacity. To ensure ownership and synergy of youth prevention interventions, HCP provided technical assistance to the Youth Division of the Unité de Coordination et de Contrôle (UCC--coordinating body of the National HIV/AIDS Control Program) to develop a strategic youth HIV/AIDS BCC/CM framework and ABY strategy in partnership with public and private sector partners. In addition, HCP reinforced the capacity of key youth organizations and FBOs at the departmental level to conduct appropriate ABY interventions. Activities included a 12-day Advances in Strategic HIV/AIDS and Youth Communication workshop, the development of ABY message guidelines, management and monitoring tools, and prevention materials.
Strategy 2: Promoting sexual responsibility among youth. To promote AB among youth, HCP, in partnership with youth NGOs and FBOs, targeted youth based on life cycles and vulnerability factors while working to create a supportive community environment to foster positive social norms. Building on past PEPFAR initiatives, HCP used a multimedia approach to ABY prevention. Using the radio network available in Haiti, radio serial dramas and interactive programs were developed to support ongoing community mobilization interventions, and community mobilization tools developed by partner organizations were duplicated and distributed to community health workers. An effort was made to reinforce the capacity of frontline workers including peer educators and community health workers, as well as increasing the ability of parents, teachers, and pastors to communicate with young people.
Strategy 3: Improving service quality. Linking prevention to services is key to behavior change. Although HCP’s mandate is prevention, HCP collaborated closely with the project Healthy Haitian Families of Desired Size (“HS2007” – implemented by Management Sciences for Health in partnership with the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs, JHPIEGO, Population and Family Education--FOSREF), and provided technical assistance to help develop supportive systems to ensure that quality holistic reproductive health and voluntary counseling and testing (VCT) services were available for youth. Assistance included participating in defining the criteria for quality youth-friendly services using the partnership-defined quality (PDQ) process, support in developing the ability of youth services to reach youth that are not sexually active, and reaching out to youth that are HIV positive.
Evaluation/Findings
To support the AB youth interventions, HCP conducted narrative research to identify behavioral determinants for the practice of AB among 10-14-year-olds, 15- to 19-year-olds and 20- to 24-year-olds. The results were made available to both public and private partners to refine their AB and risk prevention messages.
In addition, HCP conducted research on the quality of services for youth. This study consisted of two components:
- A quantitative assessment of 100 organizations/structures throughout the country providing health services to youth, a description of the services they offer, and an assessment of their needs; and
- A qualitative assessment and improvement of the quality of the services. This activity used a participatory approach, involving service providers and youth themselves, to understand the determinants of quality services (both in-clinic and outreach) for young people 10-24 years old and subsequently to develop appropriate collaborative action plans to arrive at youth-friendly services.
In further providing support to local HCP partner institutions, HCP contracted local research firms to pretest print and media materials developed to support the institutions' ABY interventions.
HCP has recently completed a process evaluation that will be compared with formative research conducted in 2004 to assess changes in knowledge, attitudes and practices related to HIV/AIDS among youth in Carrefour, a neighborhood of Port-au-Prince. Additionally, two new sites, Cap-Haïtien in the North and Léogane in the West, have been included in the process evaluation to provide baseline data for HCP’s expanding interventions. The information collected will be used to develop more appropriate communication activities and to document baseline levels of relevant indicators on youth and HIV/AIDS in these sites. The final report is expected in the fall of 2007.
Highlights
Building the capacity of health care providers and community outreach workers to communicate with youth: Towards the end of 2005 a training-of-trainers (TOT) and 16 roll-out sessions for community leaders were conducted in community dialogue to help foster positive norms and a favorable environment for AB youth prevention activities.
Beginning in September 2005, four TOTs were conducted for an estimated 100 young girls and women aged 10 to 19 to learn how to negotiate sexual activities with their partners, and five TOTs were conducted for group facilitators on community outreach activities (life skills, AB prevention).
In addition, HCP conducted an ABY strategy development workshop for FBOs, NGOs, and public sector partners and two workshops on strategic health communication to improve BCC managers’ competence in designing appropriate communication campaigns or strategies for their communities.
Building the capacity of faith-based organizations in Haiti to fight HIV/AIDS: HCP conducted a message and materials development workshop to design appropriate AB materials with local partners and in collaboration with the MSPP. In addition to a prevention strategy document, HCP also assisted both the Protestant and Catholic churches to develop HIV prevention and life-skills curricula for secondary schools. The curriculum developed in partnership with Caritas Haiti has been translated into English. With the support of Caritas International and Catholic Relief Services, HCP plans for this revised curriculum to be used widely in Haiti and elsewhere.
Five sessions were conducted to train 80 peer educators using the curriculum Manuel de formation sur la sexualité responsable centrée sur l’Abstinence (Training Manual on Responsible Sexuality Centered on Abstinence) developed by HCP under COP 05. 1,519 Peer Educators/animators were trained with the curriculum Choisis la vie (Choose Life) developed by World Relief in the network of 485 churches supporting the program.
Mobilizing youth associations, schools and FBOs for ABY: From July 2005 to March 2006, HCP worked with the national Boy Scout and Girl Guide associations, the Foundation for Reproductive Health and Family Education (FOSREF), Volunteers for the Development of Haiti (VDH), the Development and Education Research and Intervention Group (GRIDE), Quiskeya University, and one Catholic (Caritas) and two Protestant (World Relief and Association of Pastors Evangelical for the Development of Haiti) FBOs to reach thousands of young people, both in and out of school, their parents and church leaders. Each organization specialized in a particular audience or geographic area.
The Boy Scouts set up merit badges for AB and interpersonal communication, trained youth peer educators to hold group discussions with youth and parents, and held theme camps, rallies, information-entertainment days, and singing competitions. The Girl Guides trained troop leaders to focus on issues of self-esteem with young girls, held sessions on HIV/AIDS prevention, community meetings with parents and adults, and an open forum on AB and negotiation skills.
FOSREF used multiple interventions, including conferences, open forums in churches, and group discussions with youth and their parents to promote abstinence and fidelity among 10- to 24-year-old youth. It organized youth clubs in schools, “Supportive Parents” clubs, theater plays, youth fairs and peer educator training. VDH trained young people in participatory theater, and held community meetings (Parents’ School), entertainment-education days, and Youth for Abstinence and Youth for Fidelity walks.
GRIDE and Quiskeya University used their networks of young peer educators and teachers to reach secondary school and university students aged 15 to 24.
The FBOs worked through their Sunday School teachers, youth workers, and teachers in religious schools to reach in- and out-of-school youth aged 10 to 24, as well as their parents. World Relief focused on the South and South East Departments; Association of Pastors Evangelical for the Development of Haiti (ASPEDH) worked in the West Department; and Caritas concentrated on the Departments of the North, Artibonite and South. Children 10 to 14 years old were encouraged to delay sexual debut. The 15- to 24-year-olds learned about the importance of primary and secondary abstinence in preventing HIV and STIs, while young men and women 19 to 24 living in union learned about the importance of being faithful to one partner.
A total number of 58,151 people (youth and adults) were reached in churches, schools and the community through a variety of outreach activities including information sessions, group discussions, rallies, conferences, parents’ group discussions, film projections, info-entertainment days, educational sessions, and individual AB counseling, among others.
Youth and parent radio interventions: To reach youth with ABY prevention messages, HCP produced two community radio programs in collaboration with RAMAK, a USAID-funded community radio network, and CECOSIDA (the HIV/AIDS journalists network): 1) a multimedia program adapted from Takalani Sesame, the South African adaptation of the children’s television program Sesame Street, to inspire parent-child dialogue. Print materials in the form of simple bedtime story booklets were adapted from the Sesame Street Workshop materials. A radio program was developed that used the traditional carnival approach based on the main character of the program and an interactive radio program for older teenagers (15-19 years) on life skills and AB prevention was also developed.
Following the wide broadcast of the 20-episode radio program Paran pitit ann pale in 2006, project partners organized listeners’ groups in the North and the West departments to ensure that messages reached a wider audience in the community. These groups were made up of parents or other responsible adults interested in youth sexuality in order to support young people in their community. All the necessary materials and equipment were provided to the discussion leaders: discussion guides, CD of the radio programs, cassette players, and batteries. The curriculum “Guide de Pascal” was translated into Creole to facilitate discussions in the field with parent groups.
A five-day orientation workshop was conducted for 27 group facilitators from World Relief, FOSREF, and the National Association of Boy Scouts (ANSH) to enhance their participation in their communities. The training was facilitated by HCP staff using the guide “Guide de Pascal.” The workshop helped improve their knowledge of HIV and built their confidence to discuss and address parents’ concerns about their children’s sexuality. Participants appreciated the training and are presently working with parents in the field.
Youth campaign promotional materials: The format and content of these prevention and promotional materials were developed in a message design/materials development workshop with HCP partners in January of 2005. A national youth logo and slogan were also developed and used to link the various youth prevention interventions undertaken. The slogan in Creole, Teke fren w pou SIDA pa frenen w, translates to “Rein yourself in so that AIDS doesn’t rein you in.”
Materials and Resources
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Title: [Parent, child: let's talk]
Episodes: 1, 2, 3, 4
Type of Material: CD ROM (Radio Program)
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Title: [Abstinence and relax]|[Fidelity... You are my only lover]
Track: 1, 3, 5, 6, 7
Type of Material: Audio (Song Radio Spot)
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Title: [HIV/AIDS education] [Large cue cards]
Type of Material: Flipchart (Cue Card)
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Title: [Journey of hope]
Type of Material: Kit (Kit Anatomical Model Bag Manual Package Cloth)
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Title: [Instruction curriculum for education in life, family, sexuality, and HIV/AIDS for Catholic secondary schools in Haiti : Volumes 1 and 2]
Type of Material: Training (Curriculum Pamphlet)
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Title: [Innovative approaches in strategic HIV/AIDS communication for youth]
Type of Material: Training (Training Manual Curriculum)
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Title: [What young people need to know : Advice to young people]
Type of Material: Pamphlet
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Title: [Help your child come into the world without the AIDS virus]
Type of Material: Pamphlet
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Title: [A family without the AIDS virus]
Type of Material: Pamphlet
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Title: [What you need to know about the medications they call ARVs]
Type of Material: Pamphlet
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Title: [Traveler, at any time you can find yourself having sex with someone you don't know : ...To know where you stand, go get tested for AIDS]
Type of Material: Pamphlet
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Title: [Fidelity... You are my only lover : Young people who want to live without being infected by the AIDS virus should choose fidelity or abstinence]
Type of Material: Pamphlet
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Title: [We are parents. It is our responsibility to talk with our children about AIDS]
Type of Material: Pamphlet
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Title: [Parent, child: let's talk : Radio broadcasting tools for encouraging parent-child dialogue : 20 scripts]
Type of Material: Pamphlet (Script Radio Program)
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Title: [Youth passport : Haiti]
Type of Material: Pamphlet
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Title: [Journey of hope : A practical guide for making positive life choices in the time of the AIDS pandemic : Haiti user's guide]
Type of Material: Pamphlet (Manual)
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Title: [ Conserve water and so that you can drink it later : My family drinks treated water. How about yours?]
Type of Material: Poster
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Title: [It's our future that counts! : Pleasure can wait : We're doing abstinence!]
Type of Material: Poster
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Title: [We took the test : We're staying faithful : That way AIDS can't scare us]
Type of Material: Poster
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Title: [Abstinence has no doubt : It's our choice! We're happy with ourselves]
Type of Material: Poster
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Publications
Audience(s)
- Youth 10 – 24 years old, Parents, Service Providers, Decision-makers
Back to Haiti
Note about materials: Some of the materials and resources listed on each page are available in their full form, others are represented by image or citation only. For more information and resources, go to www.jhuccp.org
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