Introduction of Youth Peer Health Education project to the Njombe Community Advisory Committee by Vesna Papuga

These are the notes from the first presentation by Vesna Papuga, MSc student from the McGill School of Nursing and the latest participant in the Highlands Hope Umbrella joint project with McGill University:

Introduction of Youth Peer Health Education project to the Njombe Community Advisory Committee


My name is Vesna Papuga and I am a nurse and graduate student at McGill University in Montreal, Canada. I am here to work with your community to do research project to help youth in the Njombe learn more about HIV/AIDS. I want to thank you for taking the time to meet here and for participating as the community advisory committee for this project. The advisory committee will be involved with all of the decision making and planning along the way. This project will take place over the next 3 months from September to December. There will be three parts to this project that will be explained in greater detail following the background of this project.

Background of project:

Last year one my colleagues from the McGill University collaborated in a project with your community to try and figure out what knowledge, attitudes and practices youth in Njombe have regarding HIV/AIDS, surveying over 800 students in the primary schools. Now to continue with the collaborative work established between Njombe and McGill University's School of Nursing, we want to continue our research and help children learn more about HIV/AIDS. The idea for this project is to create a youth program involving children, by learning through their own peers, to help them develop life skills and knowledge to enable them make better health choices regarding HIV/AIDS. So, now our question we are looking to answer is: Can a peer health education program regarding HIV/AIDS in Njombe?s school-aged children improve their knowledge and attitudes towards HIV/AIDS?

Because CHAKUNIMU is already volunteering in the community to share their knowledge about HIV/AIDS through peer education, we think they would be very useful to help us teach the children to do something similar in their schools.

To try out this idea we will start with two schools in the community. (Nyumbanitu and Mlevela). One class from either standard five or six in each school will be selected to participate in helping us develop and teach a youth peer health education program around HIV/AIDS. However, we will first need CHAKUNIMU volunteers to participate in the role of adult peer health educators (APHEs) to help us teach the children about HIV/AIDS and help them become youth peer health educators (YPHEs) in their schools. This is the part of the project.

Explanation of the three phases of the project.

Phase 1:

Introduction, planning and training the APHEs
The first step is to identify two female and two male CHAKUNIMU volunteers, who will be the adult peer health educators (APHEs) who will be teaching and working with the youth peer health educators (YPHEs). The APHE volunteers will need to sign a consent form prior to participating (Appendix G). An assessment will be completed with the Adult Peer Health Educators by completion of the knowledge and attitudes (KA) questionnaire (Appendix J). The Advisory Committee will also identify an educator partner to assist with teaching the Adult Peer Health Educator volunteers and help set up the workshop sessions. This week we will also present the project to the teachers of the preselected classes to reaffirm their participation and the directors involved at the school level.

The Adult Peer Health Educators will get teaching to cover any data gaps identified through the results of the KA questionnaire and additional training through a workshop created on how to teach and work with the YPHEs by input from the student researcher, Mrs. Betty Liduke and a local teacher.

The next step will be to introduce the project to the selected classes in the two primary schools (Nyumbanitu and Mlevela). The purpose and the methods of the project will be described to the classes in detail by the Adult Peer Health Educators. The classes will nominate Youth Peer Health Educators through an electoral voting process by placing the nominations of students in a ballot box. Five female and five male students will be selected. The students will then get a more detailed explanation of their role as Youth Peer Health Educator. The children will be given assent forms and consent forms for their parents/guardians to be completed and brought back prior to initiation of the project. To test whether this program will work we will do a questionnaire of the students before and after the teaching program (similar to the one they completed during last years project).

Phase 2: Development of the YPHE program

We will assess the knowledge of the YPHEs through results of the primary questionnaire. They will then receive focused education from the Adult Peer Health Educators. Our curriculum will be partly guided by the 'Mema Kwa Vijana' curriculum for standards 4, 5 and 6 in Kiswahili. The length of sessions and location will be decided upon by the Advisory Committee and input from the schools and parents. Roles of the YPHEs and APHEs will be established, as well as goals and objectives for the program. We will take field notes during the training sessions to document the process and evaluate the project's process.

Once the education training session is completed, the planning of the youth HIV/AIDS peer health education program will take place. The Youth Peer Health Educators will work with the Adult Peer Health Educators to decide the curriculum to teach to their peers whether it is through skits, role playing, games, etc. The female APHEs will work with the female YPHEs from the schools and the male APHEs will work with the male YPHEs as it is thought that boys and girls may not feel comfortable and may not ask questions if the opposite sex is present (Obasi, et al.). The Assessment of their training will be done with the post-knowledge and attitudes questionnaire (Appendix J). They will also practice the program and get feedback from the Adult Peer Health Educators.

Phase 3: Implementation of YPHE program

The final phase of the project will be for the YPHEs to teach the program to their classmates. The female Youth Peer Health Educators will teach girls and the male YPHEs will teach boys. Adults will not be present during the YPHE teaching sessions except for a volunteer notetaker, so that discussion can occur freely amongst the peers. After completion of the teaching program by the YPHEs, a post-test of the knowledge and attitudes survey will be conducted of the students in the class to evaluate the effectiveness of the peer health education program (Appendix J). There will also be an evaluation form for the program and YPHEs (Appendix L). The students will be able to express what they did and didn't like about the HIV/AIDS peer health education program and what improvements could be made. The YPHEs will have a chance to fill out an evaluation form about teaching their peers after the program (Appendix K). Finally we will evaluate how effective our program was and share these results with the community and other schools for further development.