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GHARF
Affiliated Networks
Global Health and Awareness Research
Foundation GHARF is affiliated within international agencies and
organizations among which are:
International Affiliates
Global Alliance for Youth Empowerment
National Affiliates
MGN-MacArthur Grantees Network
CISCGHAN-Civil Society Consultative Group
on HIV/AIDS in Nigeria
NIPRANET-Nigeria Participatory Rural
Appraisal Network
CENGOS-Coalition of Eastern Non
Governmental Organisation
FMWAYD-Federal Ministries of women Affairs
and Youth Development Abuja
Ministry of Health and Social Welfare,
Enugu State
NAPHAD-Nigerian Association for Promotion
of Adolescent Health Development
National Council of women society, Enugu
State
Enugu State, FSP-Family Support Programme
WARO-Women’s Action Research Organisation
WACOL-Women’s Aid Collective
GRRDOC-
GPI-Girls Power Initiative
ANPPCAN-African Network for the Prevention
and Promotion of Child and Neglect
CAECFA-
ESCHA-
GHARF since inception in
1986, has facilitated the establishment of some CBOS in the country.
GHAR is currently providing both technical and finding support to
four CBOS in Enugu through the Action International, Nigeria PRSHH
project.
GHARF have received funding
at various times from the following organizations:
q
MacArthur
Foundations, USA
q
The Fund Foundation for West
Africa
q
The Global
Fund for Women
q
Rainbauf USA
q
Action Aid
International, Nigeria
q
World Bank
(Small Client)
q
Unicef
q
WHO
q
IMO
q
PATH
q
Smithkline
Beecham
GHARF
in Partnership with the Public Sector, Donor Agencies and Community
Stakeholders for the Promotion of Family Life Health Education in
Enugu State
Partnership
between governments (National and State and Local) and
non-governmental/civil society organizations is becoming a common
phenomena in the development field. This is because partnership is
viewed as a strategy that guarantees a more direct link with local
reality and enhances sustainability in interventions.
For partnerships
to be successful they must consist of: mutual trust, complementary
strengths, reciprocal accountability, joint decision-making, a
two-way process of adjudicating disputes among others. Each
organization brings in its comparative advantage into the
partnership.
The first
segment of this article will focus on the partnership between Global
Health Awareness Research Foundation (GHARF) a non-governmental
organization and Enugu state Government, a public sector
organization.
The partnership
was preceded by series of advocacy meetings with policy makers in
the Ministry of Education and other relevant allied Ministries –
Health, Women Affairs/Social Development, Human Development and
Poverty Reduction. Dr. Kole Shettima, MacArthur Foundation Country
Representative in Nigeria participated at the first meeting with
Ministry of Education Officials. Subsequent meetings were held with
GHARF team led by its President. The purpose of the meetings were:
(i) To
bring to their notice the call for scaling up of Sexuality and
reproductive health (SRH) by peer educators and Guidance Counselors
from 50 primary and post primary schools where GHARF instituted peer
education
(ii) The
opportunity provided by MacArthur Foundation for the implementation
of FLHE in the State
(iii) The
need to adopt/establish appropriate policy structure for the
implementation of Family Life Education in public post primary
schools in Enugu State.
An enabling
environment which facilitated the partnership already existed: In
2001 the Nigerian government through its National Council on
Education (NCE) gave approval for inclusion of Family Life Education
in school curriculum in the country. At this time, there was a call
by some school Principals, Guidance counselors and peer educators
for GHARF to scale up information dissemination on sexuality and
reproductive health in post primary schools because SRH information
had tended to restore discipline and morality in schools: Reduction
in teenage pregnancies were reported in post-primary schools with
GHARF peer educator clubs. Many school prefects, house captains were
GHARF peer educators. Perhaps the most important factor was the
preparedness of MacArthur Foundation to provide sponsorship for the
integration of FLHE into the school curriculum in Enugu State
through an NGO partner. It must be observed that with MacArthur
Foundations’ support, Nigerian NGOs are working with Ministries of
Education in six States (Lagos, Cross River, Jos, Kano, Niger and
Enugu) to integrate sexuality curriculum in Nigerian schools.
The various
advocacy meetings between GHARF and policy makers culminated in the
constitution of a Think Tank Committee comprising of the Honourable
Commissioners for Education, Health, Women Affairs/Social
Development, Human Development and Poverty Reduction, the Permanent
Secretary Ministry of Education, four Directors of the Ministry of
Education (Educational Services, Curriculum, Inspectorate and Desk
Officer HIV/AIDS, Director, Post Primary Schools Management Board (PPSMB),
the President GHARF and four GHARF Staff. The Honourable
Commissioner for Education is the Chairman of the Committee while
the Desk Officer HIV/AIDS, Ministry of Education is the Secretary.
The Think Tank Committee takes vital decisions as it relates to the
implementation of FLHE in the State.
Initially
meetings of the committee were held once a month. However, during
the early stage in the partnership meetings were convened as the
need arose.
A major outcome
of Think Tank Committee meetings was the signing of a Memorandum of
Understanding (MOU) between Enugu State Government and GHARF on 18th
August, 2004. This included the roles of the various stakeholders
during the implementation process. The FLHE workplan was approved
and agreement was reached on the need for the Ministry of Education
to make budgetary allocation for FLHE for purposes of
sustainability.
Actual
implementation started with sensitization workshops for school
principals, traditional rulers from the seventeen local government
areas of the State, faith-based organizations (Anglican, Roman
Catholic, Methodist, Pentecostal Churches and the Imam), members of
parents teachers associations, town union leaders from each of the
three senatorial zones of the State (Enugu East, Enugu West and
Enugu North) and media practitioners, who assisted in ensuring the
success of the programme:
The objective of
the sensitization workshops was to raise awareness among the various
stakeholders on the need to improve adolescents’ sexuality and
reproductive health knowledge. A major outcome of the stakeholders
workshops is the commitment and support for the implementation of
FLHE by the stakeholders. Also their fears on the adequacy of the
teachers in communicating FLHE messages to students were allayed.
Relevant teachers and other implementers were selected and trained
appropriately. Two (2) teachers each for integrated science and
social studies were selected from each of the 280 post primary
schools in the State. Training was carried out simultaneously in
each of the six educational zones (Agbani, Awgu, Enugu, Obollo-Afor,
Nsukka and Udi) for 10 days. At the conclusion of the trainings, a
total of 483 (four hundred and eight-three) integrated science and
social studies teachers were trained.
Also trained
were Inspectorate staff of the Ministry of Education, Supervisors in
the Post-Primary Schools Management Board (PPSMB) all drawn from the
six educational zones as well as GHARF staff. During the workshop
process and output indicators which will enable participants monitor
classroom teaching of FLHE in schools were developed.
A
baseline/situation analysis was carried out in two randomly selected
post primary schools (one urban and one rural) in each of the six
educational zones using both qualitative and quantitative
instruments. The qualitative survey instrument (questionnaire) was
an adaptation from the one provided by MacArthur Foundation. This
was administered on 35 randomly selected students each from JSS1 and
JSS3 classes. Also focused group discussions were carried out in
each of the communities where the schools are sited with adult male
and female members of the community. In-depth interviews were held
with principals in each of the schools as well as with community
leaders. The aim of the baseline survey was to determine the level
of knowledge, attitude and practice of both students and
stakeholders on sexuality and reproductive health issues before the
commencement of intervention.
A scheme of work
for teaching of FLHE was developed through the integration of Family
Life and HIV/AIDS Education topics into existing core subjects in
Integrated Science and Social Studies. This was put together by a
team from Ministry of Education, University of Nigeria, Nsukka (UNN)
Enugu State University of Science and Technology (ESUT) and GHARF.
The scheme has
been approved by the Curriculum Department of the Ministry of
Education, printed and distributed to all public post-primary
schools and stakeholders in the State. Actual teaching of FLHE in
all junior public post-primary schools commenced in February 2006
while monitoring in schools started in May 2006, and this is still
ongoing.
The partnership
has recorded some achievements and challenges:
Achievements
·
The partnership
will be remembered as a successful break through in government NGO
relationship in Enugu State
·
For GHARF, the
partnership has created a conducive working atmosphere/rapport
between it, the Ministry of Education and Post Primary Schools
Management Board (PPSMB)
· Four
hundred and eight-three (483) integrated science and social studies
teachers were trained
·
Integrated scheme
of work for FLHE was developed
· Monitoring
indicators were developed
·
Fifty-five (55)
officers have been trained for monitoring FLHE teaching in schools
· A
baseline data set is in place for JSS1 and JSS3 students in 12
schools prior to teaching of FLHE in schools.
Challenges:
· Transfer
of trained FLHE teachers in some schools despite agreement that
teachers should spend five years in a school
· Misconceptions
on the content of the curriculum by Faith-based organizations
particularly the Roman Catholic Church with regard to inclusion and
distribution of condom in schools and masturbation.
·
Non-availability of
training manual and student texts for Enugu State.
· Other
partners not fully committed to implementation of programme
Conclusion
Way Forward
· Policy
on transfer of FLHE teachers to be put in place
· Scheme
of work and FLHE curriculum circulated to faith-based organizations
to allay their fears
·
Team work and
commitment is expected from each of the partners for the programme
to succeed
·
Enugu State to
produce training manual on FLHE
· Programme
should be extended to senior secondary and private schools
· FLHE
should be included in the curriculum of Teacher Training Colleges of
Education in the State.
B. Partnership with Action
Aid Nigeria (AAN)
Action Aid
Nigeria engaged Civil Society Organization partners in promoting
sexual and reproductive health as well as the reduction of HIV/AIDS
in Nigeria (PSRHH). This was carried out through an educational
programme prosecuted in partnership with Society for Family Health.
(SFH). Action Aid Nigeria partnership process started with initial
selection process of potential civil society organizations (CSO).
This was followed by a pre-assessment visit and participatory
self-assessment process (POSAP) conducted using the Participatory
Assessment and Development Framework (PADEF) with a view to
deepening understanding of the organization. GHARF was one of the
civil society organizations selected at the end of the above
exercise. There followed series of capacity building activities on
financial management, advocacy and participatory monitoring and
evaluation for all partners. A Memorandum of Understanding was later
signed between AAN and the partners. The partnership, which started
in September, 2004 was proposed for one year in the first instance.
It could be renewed subject to agreement by partners.
The PSRHH
programme was anchored on communication for social change, which
focuse on empowering communities and societies to tackle the
underlying issues of discrimination, gender, poverty, lack of
services and marginalization that propel the HIV/AIDS pandemic. The
implementation of the programme in Enugu State commenced in 2005
with the selection of four (4) intervention sites; namely, 9th
mile corner, Udi local government area, Obollo Afor, Udenu Local
Government Area, Garriki 1 and 2. Enugu South local Govt. The four
sites are junction towns with large population of out of school
youths (mechanic apprentices, bread sellers, barrow pushers,
traders, seamstress, apprentices and long distant drivers). Small
towns exist around these intervention sites, attracting migrants
and bustling nightlife. The main strategy adopted in attaining the
programme expectation is peer facilitation. Peer facilitators were
selected from various sites and trained for 2 days on monthly basis
for over a 10-month period using a manual adopted for the purpose. A
total of eight-two (82) peer facilitators [9th mile corner (22),
Garriki 1(20), Garriki 2 (20) and Obollo Afor (20)] were trained
between March and December 2005. After training, the peer
facilitators are paired in teams. Each team was expected to reach at
least 10-20 of their peers for bi-weekly meetings.
A centrally
located venue was identified and used in each site for the training.
GHARF staff monitor each team during its bi-weekly meetings. This
ensured regularity of peer facilitation and that topics taught on
monthly basis were properly discussed. In addition to training peer
facilitators, GHARF also worked with influencers in the four sites.
Influencers were classified as members of a group within the
community who could influence others and act as information brokers.
GHARF worked mainly with master mechanics whose apprentices are
trained as peer facilitators. Influencers are expected to
1.
Breaking barriers
in behaviour change communication
2. Diffuse
information and knowledge on sexuality and reproductivehealth issues
3. Release
peer facilitators for training
GHARF exited
from the four old sites in December, 2005 and have moved to two new
sites (302 battalion Onitsha, Anambra State and Abakpa Nike Enugu)
where the programme is replicated with out of school male and female
youth. In the old sites emphasis was on behaviour maintenance and
mentoring of emerging CBO clubs in each site. (Detailed information
on PSRHH programme will be documented in a separate article).
Action Aid
Nigeria and GHARF partnership has been rewarding. The assessment
process has contributed to improved understanding of the vision and
mission of GHARF leading to sharpened organizational focus. Staff
attached to PSRHH programme have received skills in financial
management, programming, implementation and monitoring. The
partnership has provided funds for GHARF to implement community
level activities and for institutional development in terms of some
furniture, computers and support to office costs and salaries. Local
communities have also been empowered with increased knowledge on
sexuality and reproductive health including HIV/AIDS; Action Aid
Nigeria holds periodic participatory review and reflection meetings
with partners to make necessary adjustments in the programme.
Achievements
· Peer
facilitators, their peers and influencers are now more informed on
sexuality and reproductive health issues
· Between
April and November a total of 3509 youths were reached through
step-down training
· Some
youths have accepted/realized the need for voluntary confidential
testing (VCT)
· Reduction
of multiple partners teenage pregnancies and early marriage
·
Emergence of
HIV/AIDS clubs in each intervention site
Challenges
· Unequal
power relations between partners
· Quest
for money among stakeholders (influencers and peer facilitators)
· Time
consciousness among peer facilitators/difficulty in mobilizing peers
for biweekly meetings
·
Programme is donor
driven
C.
GHARF is also collaborating with Partnership for Transforming Health
Systems (PATHS) to effect health sector reform in Enugu state under
the District Health System (DHS). According to Dr. F Uzor, the
former Commissioner for Health, The District Health System is the
foundation for a major health sector reform and provides for:
1. A
pro-poor focus health care service
2. An
integration of primary, secondary and tertiary health cares
3.
A strong partnership between
public and private care providers and
4. A
devolved management structure down to the point of service delivery
The system aims
at making health more accessible, affordable as well as provide wide
spread information to people particularly at the grass root so that
they can make informed choices about their health. There are seven
District Health Boards in Enugu state viz Agbani, Awgu, Enugu, Enugu-
Ezike, Nsukka and Udi. GHARF was given the responsibility to build
capacity of community- based organizations and informal groups in
Agbani Health District comprising, Nkanu East and west local
government areas on the increased demand generation and utilization
of public health facilities in their communities. Trainee
participants were representatives of yam sellers’ association, okada
riders, vigilante groups, market women and faith-based
organizations. (Anglican, Roman Catholic, Methodist).
Prior to the
training at community level, PATHS conducted master training at
Abuja for selected partner NGOs. The master trainers then stepped
down training to staff in their organization who assisted in
training community members. GHARF trained a total of sixty one (61)
community members in the two local government areas. Training was
carried out in two batches lasting four (4) days each. As part of
exit strategy, GHARF has formed five health groups for (Agbani/Umueze,
Ozalla/Obe, Akpugo, Amuri and Ugbawka) for continued sensitization
of community members. GHARF monitors and mentors the groups to
ensure sustainability.
Partnership for
Transforming Health Systems has completed the renovation of twenty
hospitals (designated early bed clinics) in the seven District
Health Boards, supplied drugs and trained health workers. Partner
NGOs are required to generate demand for utilization of these early
bed clinics. PATHS also provided funds for community activities
while GHARF contributed half of the programme budget as counterpart
fund.
Achievements
· Sixty-two
(62) community members were selected and trained on the need for
increased utilization of public health facilities
·
Twenty-two (22)
traditional/opinion leaders were sensitized on the benefit of better
health in the community
·
Increased awareness
of better health among communities
· Establishment
of health groups to sustain the programme
Challenges
· Sustainability
of programe by community members when PATHS exits
· Whether
traditional/opinion leaders will continue to support the programme
References
1. Family
Life and HIV/Aids implementation in Enugu State from 2004-2005, A
report submitted to Mac Arthur Foundation by GHARF
2. Health
Sector Reform: implementing the District Health System, A Ministry
of Health Enugu Publication
3. Action
Aid Nigeria News Letter January- March 2004.
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