GYMO project year 2 2014 evaluation report

GYMO EVALUATION REPORT Reach a Hand Uganda August 2013 – July 2014.

Kampla, Wakiso, Entebbe & Mukono

Get your mix out! Campaign which is a behavior Change campaign targeting young people between the ages of 15 to 24 focusing on empowering the youth to understand their sexuality as they grow in order to make informed choices in life and understand the aspects surrounding HIV/AIDS. This project helps young people to better understand and deal with their daily life challenges as they grow and are faced with HIV/AIDS and rising issues of sexuality in general.

The theme of the campaign is “My body, My life, My Choice” which encourages free and open discussions about sexual reproductive health issues among the youth. The young people are encouraged to “Get their Mix Out” which is their inner positive strength that they can share with their friends and peers on various platforms. They work together to make a difference and to create a better environment for youth to express themselves and be heard.

The theme was supported and promoted by a strap phrase or slogan “MBWAASE” in 2013 and “Change Your Ways” in 2014.

“Mbwasse” is a local Ugandan slung that means leaving or going from one place to another. It literally means advancing from the ordinary level to the next best level.

“Change Your Ways” is also translated into Luganda as “Kyusa Embeera Zo.” This is a continuation of the 2013 campaign and we strongly believe that young people have the ability to positively impact their communities but it all starts with the individual. Therefore, the 2014 campaign is built on the belief that if an individual can accept and appreciate who they are they have the potential to change others around them. This theme was the inspiration behind the Peer Education Academy.

Through peer education, school outreaches and sexuality clubs, participating youth themselves develop materials like skits, poetry, songs, animations, games, booklets among others with comprehensive health and sexuality messages to;  Assist young people to make healthy decisions about sex and sexuality.  Reduce risk-taking behavior among the young people in Uganda.

Project goal and objectives; The goal of the project is for young people to accept and deal with themselves as sexual beings and to actively participate in developing and disseminating programs and materials on prevention of HIV, sexually transmitted infections (STIs) and sexual reproductive health and rights issues like sex, love, among others that affect and concern them.

Objectives;  Increase young people’s (15 to 24 years) reproductive and sexual knowledge and wellbeing in Uganda.  To encourage young people (15-24 years) to adopt safer sexual behaviors and also access health service facilities.  To prevent the spread of HIV and reduce stigma for those infected and affected by HIV/AIDS.

Project activities Peer education; peer education related to sexual reproductive health and rights and HIV/AIDS. Peer educators are trained for one month in SRHR, HIV/AIDS, and life skills. They are provided continuous mentoring and supported to provide peer to peer support on SRHR to young people in and out of school.

School and community outreaches; young people reach out to other young people in school with SRHR information and services and carry out community outreaches to enable the out of school young people access SRHR services and information.

Sexuality clubs; young people are supported to enable fellow young people create SRHR clubs to provide peer to peer support and create an enabling environment for themselves through activities such as essay competitions, poetry and drama among others. RAHU attaches a volunteer to each school club and their responsibility is to provide support and guidance, deliver SRHR materials and check on club status among others.

Referral and voucher system; mapping out health centers that provide youth friendly services, production of referral sheets that are distributed in schools and communities to encourage young people to access services.

Evaluation goal; The primary goal of the evaluation was to ascertain whether RAHU was the main source of information about SRHR & HIV/AIDS for young people, measure change in knowledge, attitudes and behavior of young people who participated in the project towards issues of SRHR & HIV/AIDS including accessing health services. A secondary goal was to collect information about how young people respond to issues of contraception & social & gender norms.

This evaluation was done as a build up from a previous evaluation done in December 2014 that focused on;  Identifying the project’s gains and achievements.  Describing the lessons learnt and examples of best practice.  Providing options for future developments.

In addition, we were interested in involving the peer educators in the evaluation activities and involving them in the development of evaluation materials to be used in the future. Therefore, two RAHU staff met with the peer educators several times to design and implement the evaluation. As a group, they carefully went through the questionnaire to acquaint themselves with its contents, they were responsible for collecting students completed questionnaires and also participated in focused group discussions.

Evaluation methods; Quantitative and qualitative evaluation tools were administered to students between January to July 2014. The “Get Your Mix Out” consisted of a series of mentoring sessions, outreaches and discussions. This project was funded by Rutgers WPF. The methodology behind each evaluation tool is described below; Student pre and post project survey; a sample of students picked from senior 4, 5 & 6 completed a pre survey questionnaire in January and the same number completed an identical post survey at the end of the project in July. The project objectives were used as the basis for developing the questionnaire for the survey. The survey was designed to show whether any of the project objectives were met and if there were any changes in students’ knowledge, attitude and behavior as a result of participating in the project. The survey contained questions with various answer options and participants were asked to check appropriate boxes. This type of technique was decided appropriate for the age of the student participants (15-25 years). A variety of questioning strategies were used, some questions checked for knowledge while others required critical thinking strategies or more indepth knowledge.

158 students (75 girls & 83 boys) completed the pre & posttest project surveys. Participants were selected from senior 4, 5 & 6 and each administered a script by peer educators. The students used their initials and nicknames for some to identify themselves on their surveys. The anonymity of the surveys helped students to understand that this was not a “test” that would be included in their school grades.

The project implemented activities in 15 schools. For the purpose of the evaluation, 9 schools were sampled. These included; Kiira College Butiiki, Sir Apollo Kagwa S.S, Mariam High School, Kiwoko S.S, Hana Mixed S.S, Bishop Cipriano S.S, Brilliant S.S, Our Lady of Africa S.S and Namirembe Hillside S.S. in total 158 students (75 Girls & 83 Boys).

In order to evaluate changes in knowledge, attitudes and behavior of the participants, their knowledge of SRHR issues were measured by a survey given at the beginning of the project and the same survey given at the end of the project and the differences in pre and post responses over this time were compared. The survey questionnaire was divided into 7 sets focusing on;  Knowledge This was to find out information sources young people have access knowledge on SRHR, HIV/AIDS and pregnancy. This was the basis for this evaluation to ascertain if RAHU was indeed a source of information for young people.  HIV/AIDS This chapter examines the knowledge young people have regarding HIV/AIDS on how it can be transmitted and how one can prevent him/herself from infection. This section also follows from the previous evaluation about informing young people about their HIV status by encouraging them to get tested.  Attitudes, social and gender norms.

This section focuses on what young people think about sexuality and gender.  Confidence This chapter deals with level of confidence with regard to sexuality.  Behaviour This chapter will focuses on sexual experiences.  Knowledge about contraceptives.

This chapter was focusing on whether young people have knowledge about contraception including how to use them and if they have accessed youth friendly services.  Behaviour intentions.

This was to find out behaviour change intentions of young people.

In addition to the pre and posttests, focused group discussion was held in all circumstances focusing on sex, relationships and HIV/AIDS with a group of no more than 10 young people per school.

Knowledge; This focused on trying to assess which areas/topics young people needed more information on by asking what the sources of information young people have at their disposal to access information on SRHR, HIV/AIDS, STIs and pregnancy and whom they would prefer to get this information from.

Gender * RAHU P. Educators

Gender

Boy

Count % within RAHU P.Educa tors Count % within RAHU P.Educa tors Count % within RAHU P.Educa tors

Girl

Total

RAHU P. Educators as information source.

Missing Yes No Data 29 53 1

Total 83

55.8%

50.5%

100.0%

52.5%

23

52

0

75

44.2%

49.5%

.0%

47.5%

52

105

1

158

100.0%

100.0%

100.0%

100.0%

RAHU P.Educators

Chart Title Missing Data No Yes 0%

20%

40%

60%

80%

100%

Gender Boy

Yes 29

RAHU P.Educators No 53

Missing Data 1

Gender Girl

23

52

0

Out of the 158 respondents we had, 157 answer this question. 52, 33% (29 boys & 23 girls) of them agree that RAHU Peer Educators were the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.) we concluded that the majority of these were probably boys because in most schools in Uganda, there are more boys enrolled than girls.

55.8% of those who agree are boys and 44.2% girls.

67% of the young people asked said RAHU Peer educators were not the source of information SRHR & HIV/AIDS.

RAHU runs a Television program (The Mix Out program on NBS) and face book pages.  https://www.facebook.com/sautiplus  https://twitter.com/SAUTIplus  https://twitter.com/REACHAHAND  https://www.facebook.com/reachahand  https://www.facebook.com/GeNextUganda This evaluation was also to assess how much the young people were using these social media pages to access information on SRHR & HIV/AIDS. During the baseline, 27, 17% of the young people ( 10 boys and 17 girls) said they were using RAHU social media and television platforms to access information on SRHR & HIV/AIDS. Gender * Television PREVIOUS

Gender

Total

Television & face book pages Yes No 10 75

Total 85

Boy

Count

Girl

Count

17

56

73

Count

27

131

158

Count Boy Girl

Gender

Tot al

Chart Title

Count Count 0%

20% 40% Gender

60%

80%

100% Total

Television Yes

Boy Count 10

Girl Count 17

Count 27

Television No

75

56

131

Gender * Television & face book pages NOW Television & face book Yes No Gender Boy

Coun t % within

Total

38

45

83

45.8%

60.0%

52.5%

Telev ision Coun t % within Telev ision Coun t % within Telev ision

Girl

Total

45

30

75

54.2%

40.0%

47.5%

83

75

158

100.0%

100.0 %

100.0 %

Count Boy Girl

Gender

Tota l

Chart Title

Count Count 0%

50% Gender

100% Total

Television Yes

Boy Count 38

Girl Count 45

Count 83

Television No

45

30

75

During the evaluation, out of the 158 respondents we had, 83 (52.5%) of them agree that the Television & social media are the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc), compared to 27 (17.1%) Previously.

This is probably because of the RAHU social media pages and television programs being more accessible for the young people. These young people are also mostly at school hence less time to watch television and access face book.

Of the 83 (52.5%) respondents who agree that the social media pages & Television are their source of information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.), 24% are boys and 28% are girls. Ideally more girls take time to watch television and log on to face book than boys.

This is evident enough that girls watch Television more than Boys. Girls can be intervened or influenced more on Television.

Television Influence is also contributed by the RAHU program on NBS that has been emphasized by the RAHU Peer Educators.

The evaluation also wanted to assess the role parents/ care takers play in providing young people with information on SRHR & HIV/AIDS. Young people were asked during the baseline the how many got information through their parents or care takers.

Only 32 young people (20.3%) then said their parents were the source of information on SRHR & HIV/AIDS. Gender * My Parents / Caretakers - PREVIOUSLY

Count Boy Girl

Gender Total

Chart Title

Count Count 0%

50%

100%

Gender

Total

Boy Count

Girl Count

Count

My Parents / Caretakers Yes

9

23

32

My Parents / Caretakers No

51

72

123

Gender * My Parents / Caretakers - NOW My Parents / Caretakers Gender

Boy

Girl

Count % within My Parents / Caretake rs Count

Yes 43

No 40

Total 83

47.3%

59.7%

52.5%

48

27

75

% within My Parents / Caretake rs Count % within My Parents / Caretake rs

40.3%

47.5%

91

67

158

100.0%

100.0%

100.0%

Girl

Count

Count

My Parents / Caretakers Yes

Gender

My Parents / Caretakers No Boy

Axis Title

Total

Total

52.7%

Count

0%

20%

40%

60%

80%

100%

Axis Title

All the 158 respondents we had, 91 (57.6%) of them agree that the Parents/Caretakers are the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.), compared to 32 (20.3%) Previously.

This we attributed to the fact that the Get Ur Mix Out project helped build confidence of young people to openly talk to their parents and care takers about issues of SRHR. These young people got confidence and approached their parents and care takers with questions on SRHR. RAHU also targeted parents during parent days, PTA and career days to talk to parents about the importance of openly discussing issues of sex, sexuality, SRHR & HIV/AIDS with their children. Also during community outreaches and television shows, parents were challenged to engage more with their children.

Of the 91 (57.6%) respondents who agree that the Parents/Caretakers are the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.), 52.5% are boys and 47.5% are girls.

It was attributed that girls require more information on SRHR & HIV/AIDS that’s why girls probably received this information more than girls.

Television Influence is also contributed by the RAHU program on NBS that has been emphasized by the RAHU Peer Educators.

Gender * Facebook Crosstabulation

Gender

Boy

Count % within Faceboo k Count % within Faceboo k Count % within Faceboo k

Girl

Total

Facebook Yes No 24 59

Total 83

55.8%

51.3%

52.5%

19

56

75

44.2%

48.7%

47.5%

43

115

158

100.0%

100.0%

100.0%

All the 158 respondents we had, 43 (27.2%) of them agree that the Facebook is the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.), compared to 12% previously.

Of the 27.2% respondents who agree that the Facebook is the source of their information regarding puberty (body changes in boys and girls during teenage years, HIV/AIDS, STI, Pregnancy etc.), 55.8% are boys and 44.2% are girls.

This is evident enough that Boys use Facebook more than Girls. Boy can be intervened or influenced more on Facebook.

Facebook Influence is also contributed by the RAHU Facebook pages that has been emphasized by the RAHU Peer Educators.

Gender * Preferred Source of Information Cross tabulation

Gender Boy

Count

Preferred Source of Information Magaz My ines, Parent RAH newsp s/ U P. Rel. apers, caretak Tea Friend Educ Lead poster Inter Missing ers cher s ators ers s net Data 24 13 11 21 7 2 1 4

Total

83

Girl

Total

% within Prefered 54.2 Source of 47.1% 55.0% % Informatio n Count 27 11 9 % within Prefered 45.8 Source of 52.9% 45.0% % Informatio n Count 51 24 20 % within Prefered 100. 100.0 Source of 100.0% 0% % Informatio n

47.7 % 23 52.3 %

87.5 100.

50.0% % 0% 1

2

0

12.5 50.0% %

.0%

44

8

100.0 %

100.

0%

4

66.7% 52.5%

2

75

33.3% 47.5%

1

6

158

100.0 100. % 0%

100.0%

100.0 %

30

Prefered Source of I My Parents / caretak 20

ers Teacher Friends RAHU P. Educators

10

Rel. Leaders Magazines, newspaper

Count

s, posters Internet 0

Missing Data Boy

Gender

Girl

Prefered Source of Information about Sex & Reproductive Health Missing Data 3.8% Internet .6% Magazines, newspaper 2.5% Rel. Leaders 5.1%

My Parents / caretak 32.3%

RAHU P. Educators 27.8%

Teacher Friends

15.2%

12.7%

In conclusion, majority of young people get their information on SRHR & HIV/AIDS from their parents, followed by their peers (RAHU peer educators), teachers, friends, internet, Religious leaders and magazines or newspapers. This therefore means that our interventions should focus on ensuring that parents, teachers and friends of the young people are more informed with information regarding SRHR & HIV/AIDS such that they are able to provide the young people with the right information.

HIV/AIDS This chapter examines the knowledge young people have regarding HIV/AIDS on how it can be transmitted and how one can prevent him/herself from infection. This section also follows from the previous evaluation about informing young people about their HIV status by encouraging them to get tested.

HIV can be transmitted by sharing food with someone infected Previously

Can HIV be transmitted by sharing food with someone infected TRUE

FALSE

Dont Know

15% 36%

49%

Currently.

Valid

True False Dont Know Missing Data Total

Frequen cy Percent 8 5.1 140 88.6

Valid Cumulativ Percent e Percent 5.1 5.1 88.6 93.7

7

4.4

4.4

98.1

3

1.9

1.9

100.0

158

100.0

100.0

HIV can be transmitted by sharing food with some one infected Missing Data Dont Know

True

False

There is more awareness that HIV cannot be transmitted by sharing food with someone who is infected. Compared to before where most young people did not know the end results.

The evaluation was also to find out how many young people knew their HIV status as the GYMO campaign focused on having young people get to know their HIV status.

Previous evaluation result of 3 schools.

Current evaluation of 9 schools.

Do you know your HIV status?

Boys girls

YES 70 55 125

NO 13 20 33

Young people who knew their HIV Status

Girls who know status

Girls who do not know status

Boys who know status

Boys who don't know status

Here the evaluation focused on checking the number of young people who had gone for HCT. The majority of young people asked where sure they knew their HIV status. Most said they decided to go check during the RAHU outreaches in their schools where they did not feel shy because their friends where testing as well. It is worth noting that RAHU has been encouraged by the high number of young people who always turn up for HCT whenever there is an outreach at the school where RAHU moves with the team from Reproductive Health Uganda (RHU) to carry out HCT.

Graph of HCT done.

Number of young people who went for HCT

Boys

Girls

HIV Positive

During the school outreach activities, young people got confidence to test for HIV. RAHU had at hand Reproductive Health Uganda (RHU) who carried out HCT during all outreaches.

It is possible to protect oneself from HIV by only having intercourse with HIV negative and faithful partner

Missing Data Dont Know False True 0% 20% 40% 60% 80% 100% Gender Boy Count

True 54

False 24

Dont Know 1

Missing Data 4

83

Gender Girl Count

48

22

2

3

75

Total Count

102

46

3

7

158

Out of 151 (79 boys & 72 girls) young people asked, 68% (54 boys & 48 girls) responded correctly.

This question was to assess the level of knowledge young people had about how HIV was transmitted. 3 did not know.

Attitudes, social and gender norms including what young people think about homosexuality.

This page focuses on what young people think about sexuality and gender.

A young person that is not yet sexually active (virgin) does not need any information about sexuality Previously

Valid

Agree Disagre e Cannot Decide Missing Data Total

Frequen cy Percent 27 17.1 91

57.6

40

23.3

0

0

158

100.0

Currently.

Valid

Agree Disagre e Cannot Decide Missing Data Total

Frequen cy Percent 20 12.7

Valid Percent 12.7

Cumulativ e Percent 12.7

132

83.5

83.5

96.2

4

2.5

2.5

98.7

2

1.3

1.3

100.0

158

100.0

100.0

158 132

20

4

Agree

Disagree

9

2 Missing Data

Total

Currently 83.5 % of the respondents agree that there is need for young people whether sexually engaged or not to have information on sex and reproductive health, compared to the 57.6% previously.

Homosexuals should be accepted in the community; RAHU decided to have this question asked to young people to engage what they thought about this issue as it has become a national issue with a law signed in February 2014 prohibiting homosexuality.

We also wanted to know if young people felt that homosexuals should be discriminated against.

Majority of young people agree that homosexuals should be accepted in communities.

Frequenc y Valid

Agree

Percent

Valid Percent

Cumulative Percent

105

66.5

66.5

66.5

Disagree

27

17.1

17.1

83.5

9

20

12.7

12.7

96.2

6

3.8

3.8

100.0

Missing Data

Total

158

100.0

100.0

Homosexuals should be accepted in the community Missing Data 9

Disagree

Agree

This question was not asked before, but however in our activities, we have intensively put much more effort on the issue and the response so far is promising.

Confidence This chapter deals with level of confidence with regard to sexuality.

How confident are you that you will use a condom during every sexual intercourse to prevent HIV/AIDS & pregnancy?

PREVIOUSLY CONFIDENCE LEVELS ON USING A CONDOM EVERY SEXUAL INTERCOURSE TO PREVENT HIV AND PREGNANCY confident

Not confident

Not Sure

11%

Missing data

12%

21%

56%

Confidence levels in using condoms during sex.

Missing data Not Sure Not confident confident 0

10

20

30

40

50

60

girls

confident 5

Not confident 50

Not Sure 8

Missing data 20

Boys

9

42

16

8

CURRENTLY

Gender

Boy

Girl

Total

Count % within Gender Count % within Gender Count % within Gender

How confident that you will use a condom every sexual intercourse to prevent HIV & pregnancy Confide Not Not Missing nt Confident sure Data 36 32 14 1

Total 83

43.4%

38.6%

16.9%

1.2%

100.0%

34

32

5

4

75

45.3%

42.7%

6.7%

5.3%

100.0%

70

64

19

5

158

44.3%

40.5%

12.0%

3.2%

100.0%

40

30

20

How confident that y Conf ident

10

Count

Not Conf ident 9 0

Missing Data Boy

Girl

Gender During the assessment, we learnt that the average confidence was 44.3 %. This is not enough confidence. RAHU needs to continue engaging young people in order to drive up their confidence to use or demand for use of contraceptives during sexual intercourse.

Both sex, are almost at the same level of confidence 43.4% for Boys and 45.3% for the girls.

Confidence that you will ask parent about sexuality without fear PREVIOUSLY

Confidence that you will ask a Parent about sexuality without fear Not Sure 17%

Missing data 0%

Not confident 16%

confident 67%

CURRENTLY

Missing data 0%

Chart Title

Not Sure 17% Not confident 16%

confident 67%

Chart Title Missing data

Not Sure

Not confident

confident

0

10

20

30

40

50

60

70

confident

Not confident

Not Sure

Missing data

girls

64

7

12

0

Boys

50

12

13

0

Behavior This chapter focuses on sexual experiences.

Had sex in exchange for commodities 60

Axis Title

50 40 30 20 10 0 #REF!

YES 2

NO 58

MISSING DATA 15

#REF!

21

40

22

Had sex in exchange for commodities YES 3% MISSING DATA 20%

NO 77%

Ever been pressured to have sex when you did not want Ever been pressured to have sex when you did not want to

80 70

Axis Title

60 50 40 30 20 10 0 #REF!

YES 0

NO 72

MISSING DATA 1

#REF!

3

65

15

Knowledge about contraceptives.

This chapter was focusing on whether young people have knowledge about contraception including how to use them and if they have used contraceptives during sex.

Did you/partner use any contraceptive method, the last time you had sex?

Cross tabulation Did you/partner use contraceptive methods, the last time you had sex

Total

Gender

Boy

Girl

Total

Count % within Gender Count % within Gender Count % within Gender

Yes 17

Cannot recall

No

Missing Data

9

4

1

31

54.8%

29.0%

12.9%

3.2%

100.0%

5

2

4

4

15

33.3%

13.3%

26.7%

26.7%

100.0%

22

11

8

5

46

47.8%

23.9%

17.4%

10.9%

100.0%

20

10

Did you/partner use Yes

Count

No Cannot recall 0

Missing Data Boy

Girl

Gender Asked whether their partners used any form of contraceptive method the last time they had sexual intercourse, few young people were comfortable talking about whether they had had sex or not. Many girls were not sure if their partners had used any form of contraception compared to boys. This showed that many girls did not feel they controlled if and when contraception should be used like condoms. Hence many girls have ended up being infected with HIV/AIDS. The GYMO project continues to build confidence of young people to be able to demand for their partners to use contraception during sexual intercourse.

In conclusion, the evaluation showed that the Get Ur Mix Out project has indeed been successful in the following ways; 









Being a source of information on SRHR & HIV/AIDS to young people. This has been through peer educators during school outreaches and focused group discussions, The Mix Out television program that airs every Sunday, social media and music.

Many of the young people showed that they had some knowledge about HIV/AIDS and how it was transmitted as a result of this project. During this project, many young people tested for HIV and STIs. This showed that the project had impact in building confidence in young people.

With this knowledge we hope young the level of stigma will reduce and young people will use condoms when having sex.

Young people also agreed that it was important for them to know about sex, sexuality, SRHR & HIV/AIDS even when they are still virgins. This, we saw as important to help young people take steps to protect themselves when they do decide to have sex.

On homosexuality, most young people asked did not find any problem having homosexuals as friends and neighbors. This we saw as an important achievement because the GYMO project also focused on the need for young people to accept everybody regardless of race, color and sexual orientation.

Young people knew about condoms and that it was important that they used them during sex.

However boys were more confident than girls in ensuring use of condoms during sexual intercourse.

On the next phase of the GYMO project, RAHU needs to focus more on;  

Building confidence of young people to use contraception especially condoms during sex or demand for their partners to use condoms.

Engaging parents more to be able to communicate to their children about sex, sexuality, SRHR & HIV. This is because this evaluation showed that many young people prefer to get information from their parents or guardians.