INTEGRATED ACTIVITY FLAG:

This activity relates to activities to be carried out by Harvard School of Public Health (HSPH) in Other Prevention (#7291), OVC (#7292) and Policy/System Strengthening (#7293).

SUMMARY:

Through the South African Center for the Study and Support of Peer Education (SACSSPE), HSPH contributes to PEPFAR prevention (AB and Other Prevention), OVC, and system/capacity building goals by providing training, technical assistance, and materials development to government, NGO, FBO, corporate, and other organizations using peer education strategies. SACSSPE is the first academic center devoted to development and continuing improvement of a sustainable national inter-sectoral peer education system. Major emphasis will be IEC, while minor emphasis will be local organization capacity development, policy and guidelines and training. The targets will be children and youth, adults, HIV affected families, religious and community leaders, program managers, South African-based volunteers, CBOs, FBOs and NGOs.

BACKGROUND:

This project is an expansion and institutionalization of a five-year national consultative process developing consensus on goals, essential elements and standards of practice for peer education programs, and materials and tools in wide circulation to improve how peer education is conducted. Rutanang peer education is consistently defined and implemented as including, among other characteristics, multiple-dose small-group structured and facilitated discussions; informal influence; recognition and referral of those with further needs (e.g., VCT, treatment, OVC); and advocacy.

ACTIVITIES AND EXPECTED RESULTS:

SACSSPE provides PEPFAR and non-PEPFAR partners with training and ongoing technical assistance and assists with the development and adaptation of educational materials, tools, policy guidelines, linkages and community mobilization, and strategic information specifically focused on AB prevention in multiple settings. The Center will prepare and coordinate trainers (with accreditation process initiated) from a variety of sectors and geographic areas. Partners will use evolving standardized monitoring and evaluation tools to collect and share comparable data on program activities and outcomes. All SACSSPE peer education AB activities and materials explicitly and intensively address the following areas of legislative interest: male norms and behaviors, sexual violence and coercion, stigma reduction, and maintaining infected and affected children in school. Peer education with adolescents and adults emphasizes delaying sexual debut, secondary abstinence, and reduction in concurrent partners. Peer education having primary AB prevention goals is also a means for early identification and referral to services of vulnerable children and youth, and HSPH is pursuing strategies that enhance peer education as an advocacy tool to make environments safer. Each of the foregoing content themes is explicitly addressed in the design of peer education support systems, training of peer educators, and the content peer educators are trained to deliver. AB activities are conducted through partners including:

ACTIVITY1: KwaZulu-Natal Department of Education

SACSSPE will train and support regional and district-level trainers and administrators in three of six districts to provide supervision and oversight for high school-based peer education. More than 50 personnel from NGOs, CBOs and FBOs serving KwaZulu-Natal will be trained and equipped to organize and supervise peer education programs in 120 KwaZulu-Natal schools, working with teams of 15 peer educators per school.

ACTIVITY 2: Catholic Institute of Education

Three Catholic Institute of Education schools in KwaZulu-Natal will be assisted to develop integrated models including primary prevention, services for OVCs, workplace peer education for educators, and use of school-trained peer educators in community settings.

Integrated work in KwaZulu-Natal will promote an intersectoral advocacy process involving policymakers and leaders from government departments and public and private sector stakeholders.

ACTIVITY 3: Eastern Cape Department of Education (ECDOE)

A total of 1000 schools are receiving Rutanang-based peer education through ECDOE tenders with Youth for Christ (YFC) and Planned Parenthood Association of South Africa (PPASA), and these are expected to extend to another 500 schools in 2007. This initiative predated YFC funding by Department of Health/PEPFAR, uses ECDOE conditional grant funds, and specified the use of Rutanang in the tender. SACSSPE maintains an ongoing consultative (at least two meetings) and monitoring and evaluation (M&E) training relationship with YFC and with ECDOE officials.

ACTIVITY 4: Western Cape Education Department (WCED)

Building on its Rutanang-adapted Generation of Leaders Developed (GOLD) model funded by the Global AIDS Fund, SACSSPE will support the extension of peer education to a total of 350 high schools reaching 21,000 learners. A range of service providers working under the GOLD umbrella receive at least two consultations per year with SACSSPE staff, and additional trainings and consultations, including one for principals, are planned.

ACTIVITY 5: Free State Education Department (FSED)

Strengthening the peer education called 'Radically Different Species' (RADS), the FSED adaptation of Rutanang, SACSSPE will promote the integration of peer education into the scheduled curriculum, reaching approximately 80 high schools and 3200 learners. Work in 2007 will especially strengthen M&E for Department of Education provincial and district officials.

ACTIVITY 6: Mpumalanga Department of Education (MPDOE)

The Mpumalanga Department of Education began in 2005 to use the RADS adaptation, and HSPH training and technical assistance (T&TA), to develop a province-wide peer education strategy. SACSSPE will provide T&TA to 50 MPDOE supervisory and M&E personnel, supporting rigorous peer education programs in 60 schools reaching 3000 learners.

ACTIVITY 7: Anglican Church of the Province of Southern Africa

SACSSPE is working with the Anglican Church of the Province of Southern Africa (CPSA) to tailor T&TA and materials for AB activities in churches, religious schools, and FBO community outreach projects. SACSSPE is also developing memorandums of understanding with three FBOs that provide school-based peer education under PEPFAR funding to the Department of Health: Youth for Christ, with whom HSPH has a long and productive relationship, the Muslim AIDS Program, and Scripture Union. ACTIVITY 8: In FY 2006, HSPH began to support peer education in middle and primary schools in Eastern Cape by Africare, and will continue to provide technical assistance. HSPH will also provide consultation to large NGOS working in various parts of the country, including Hope Worldwide, Population Council, and Childline. Each year, as HSPH's Rutanang materials become more familiar, more such requests are received.

ACTIVITY 9: Sport and Recreation

In FY 2006 HSPH began articulating how peer education might be used to take advantage of the natural appeal and access to youth of sports programs. Specifically, SACSSPE will develop materials and a T&TA field test, and eventually a systematic approach, for Swimming South Africa. HSPH has been working with GrassRoots Soccer, Playing for Peace (Durban area), Hoops for Hope (Cape Town) and FIFFA-KIDS (Pietermaritzburg) to help coaches integrate peer-led AB activities.

In addition to contributing to PEPFAR annual and cumulative targets, long-term results of the HSPH project will be the establishment of a sustainable integrated system supporting

rigorous, measurable peer education that increases the amount and quality of social interactions and skills acquisition concerning norms, traditions, and behaviors that will help reduce the transmission of HIV.

INTEGRATED ACTIVITY NARRATIVE: This activity relates to activities to be carried out by Harvard School of Public Health (HSPH) in AB (#7295) and Policy/System Strengthening (#7293). While no specific targets are set, the project also expects to reach significant numbers of OVC (#7292) as a result of peer-based AB programs.

SUMMARY: Through the South Africa Center for the Study and Support of Peer Education (SACSSPE), the Harvard School of Public Health (HSPH) contributes to PEPFAR prevention (abstinence and being faithful (AB) and Other), orphans and vulnerable children (OVC), and system/capacity building goals by providing training, technical assistance, and materials development to government, NGO, faith-based organizations (FBO), corporate, and other organizations using peer education strategies. SACSSPE is the first academic center devoted to development and continuing improvement of a sustainable national intersectoral peer education system.

BACKGROUND: This project is an expansion and institutionalization of a five-year national consultative process developing consensus on goals, essential elements and standards of practice for peer education programs, and materials and tools (Rutanang) in wide circulation to improve how peer education is conducted in settings including schools, FBOs, sport and recreation, clinics, and worksites. Rutanang peer education is consistently defined and implemented as including, among other characteristics, multiple-dose small-group structured and facilitated discussions; informal influence; recognition and referral of those with further needs (e.g., voluntary counseling and testing (VCT), treatment, OVC); and advocacy. The first HSPH initiative in workplace Other Prevention activities was launched in 2005 with the South Africa Police Services and expanded through a collaboration with the South Africa Business Coalition on HIV/AIDS (SABCOHA) and the Wits Business School (WBS). The latter is funded through the private sector, but adds to the expertise and influence of SACSSPE and provides trained peer educators who are deployed in other settings in the community.

ACTIVITIES AND EXPECTED RESULTS: SACSSPE provides PEPFAR and non-PEPFAR partners with training and ongoing technical assistance and assists with the development and adaptation of educational materials, tools, policy guidelines, linkages and community mobilization, and strategic information focused on Other Prevention in multiple settings. All SACSSPE Other Prevention activities and materials explicitly and intensively address the following areas of legislative interest: male norms and behaviors, sexual violence and coercion, stigma reduction, and maintaining infected and affected children in school. Peer education with adolescents and adults emphasizes delaying sexual debut, secondary abstinence, and reduction in concurrent partners. Peer education having primary Other Prevention goals is also a means for early identification and referral to services of vulnerable children and youth, and we are pursuing strategies that enhance peer education as an advocacy tool to make environments safer. Each of the foregoing content themes is explicitly addressed in the design of peer education support systems, training of peer educators, and the content peer educators are trained to deliver.

While SACSSPE Other Prevention peer education focuses on teenagers and older youth, young adults, workers and families through worksite programs and FBOs, it continues to emphasize the benefits and rewards of primary and secondary abstinence, delay of sexual onset, and fidelity. However, for many populations (out-of-school youth, some high school learners, university students, and adults) it is also necessary to address information, attitudes and skills concerning reduction in number of concurrent partners, condom use for those who are not abstinent, improved diagnosis and treatment of sexually transmitted infections (STIs), and promotion of voluntary counseling and testing (VCT). In all settings, a persistent reconsideration of male roles and behavior, reductions in gender violence and discrimination, and encouragement of participation in organizational governance are critical SACSSPE peer education prevention strategies. Peer education activities at worksites also emphasize the roles audiences play as parents, grandparents and guardians, and prepare them to promote abstinence and sexual safety for their children. Activities include:

1. Eastern Cape: Working through Youth for Christ, SACSSPE provides materials, training and technical assistance (T&TA), and monitoring and evaluation (M&E) consultation for an extensive program targeting Out of School Youth. We will also support HIV and AIDS education and VCT for students (youth and adults) in Further Education and Training (FET) and Adult Basic Education and Training (ABET) institutions in the province. 2. Mpumalanga Department of Health: Other Prevention training for 40 provincial and district level staff on T&TA, planning, M&E of peer education programs. 3. South Africa Police Services (SAPS): SACSSPE will develop materials and tools, provide ongoing T&TA, and assist with M&E as SAPS reconsiders its original workplace program. Sixty peer educator supervisors and trainers from nine provinces will be supported; each supervisor is responsible for an average of eight peer educators, and the number of SAPS personnel expected to be reached by these peer educators is 9600. 4. NGOs, FBOs and community-based organizations (CBOs) in out-of-school and after-school settings: SACSSPE will reach approximately 6,000 youth. A minimum of 20 learners/high school (in excess of the learner counts enumerated under AB) will require Other Prevention activities in addition to AB. 5. Free State, Mpumalanga and KwaZulu-Natal Departments of Education: Peer education is part of the institutional response for FET and ABET sector. Peer education addresses Other Prevention in this subsector. SACSSPE will work with 56 education staff from 14 selected institutions; peer educators working under their direction will reach more than 8000 youth. 6. Worksite programs: SACSSPE will provide planning, T&TA, materials development, and M&E support to 4 public sector departments or corporate entities. We target 120 supervisors and trainers for this support; by conservative estimate, if each works with only 6 peer educators, and each of 360 peer educator teams conducts Other Prevention activities with 20 employees, 7200 adults will be reached. Two private employers in KwaZulu-Natal will partner with SACSSPE and SABCOHA on workplace peer education projects.

In addition to contributing to PEPFAR annual and cumulative targets, long-term results of the HSPH project will be the establishment of a sustainable integrated system supporting rigorous, measurable peer education that increases the amount and quality of social interactions and skills acquisition concerning norms, traditions, and behaviors that will help reduce the transmission of HIV.

INTEGRATED ACTIVITY NARRATIVE:

This activity relates to activities to be carried out by Harvard School of Public Health (HSPH) in AB (#7295), Other Prevention (#7291) and Policy/System Strengthening (#7293). While no specific targets are set, the project also expects to reach significant numbers of OVC (#7292) as a result of peer-based AB programs.

SUMMARY:

Through the South Africa Center for the Study and Support of Peer Education (SACSSPE), the Harvard School of Public Health (HSPH) contributes to PEPFAR prevention (abstinence and being faithful (AB) and Other), orphans and vulnerable children (OVC), and system/capacity building goals by providing training, technical assistance, and materials development to government, NGOs, faith-based organizations (FBO), corporate, and other organizations using peer education strategies. SACSSPE is the first South African academic center devoted to development and continuing improvement of a sustainable national intersectoral peer education system. The major emphasis area for this activity is training with a minor focus on local organization capacity development and policy and guidelines. The target populations are OVC, their caregivers, primary and secondary school students, community and religious leaders, volunteers, teachers, CBOs, FBOs and NGOs.

BACKGROUND:

This project is an expansion and institutionalization of a five-year national consultative process developing consensus on goals, essential elements and standards of practice for peer education programs, and materials and tools in wide circulation to improve how peer education is conducted (Rutanang). Rutanang peer education is consistently defined and implemented as including, among other characteristics, multiple-dose small-group structured and facilitated discussions; informal influence; recognition and referral of those with further needs (e.g., voluntary counseling and testing (VCT), treatment, OVC); and advocacy.

ACTIVITIES AND EXPECTED RESULTS:

All SACSSPE OVC peer education activities and materials will explicitly and intensively address the following areas of legislative interest: male norms and behaviors, sexual violence and coercion, stigma reduction, and maintaining infected and affected children in school. Though focused on specific OVC needs, peer education activities also emphasize delay of sexual debut, secondary abstinence, and reduction in concurrent partners. Peer education to provide psychosocial support for OVC also seeks to promote advocacy to make environments safer.

NGOs and government departments addressing the urgent needs of South Africa's estimated one million OVC face a critical shortage of professional capacity. Beyond necessary survival resources, OVC require sustained psychosocial support, assistance with a variety of concrete coping skills, and effective education to prevent behaviors that put them at risk of HIV infection and other threats to health and safety. Many OVC do not understand these needs or seek this help, and will only receive it in environments that have their own appeal and are protected from stigma and shame. They also need what all young people need: Social activities that are fun and connect them with their peers, schools and churches, and communities. Structured, time-limited, highly interactive groups with clear sequential educational objectives can provide activities that get youth to laugh, and also help them acknowledge and express their grief and fears and recognize their strengths and assets. Focused mutual-help groups also enable participants to experience themselves as valued supporters for their peers while they are being helped themselves. Well-trained and carefully supervised peer educators can plan and facilitate these groups, serve as role models of resilience, and help OVC form a mutual support network to assist with maintaining school attendance and accessing critical services.

Building on its ongoing PEPFAR-funded work to promote a sustainable intersectoral system of rigorous peer education standards and practices, the Harvard School of Public Health will collaborate with six PEPFAR-funded OVC service providers to develop, implement, assess, refine and disseminate tools and materials, training and technical assistance packages, and monitoring and evaluation protocols for peer education strategies to help OVC apply their own considerable strengths to the creation of sustainable community-based supports. In late 2007 and in 2008, with materials field-tested and formative evaluation complete, HSPH will implement systematic training and technical assistance in the use of these materials to support OVC. We will also take advantage of national meetings and conferences to convene working groups of OVC-serving partners for periodic feedback on how the materials are being used, and on needed improvements and additions. Special attention will be paid to monitoring and evaluation processes, including the tracking of group participants over time to assess their degree of effective coping.

Materials and models developed through this project will constitute much-needed resources to expand the number of OVC for whom psychosocial support, with its positive effects on other OVC outcomes such as retention in school and access to health services, will be available.

This Harvard activity will contribute to the PEPFAR goal of providing care to 10 million people, including orphans and vulnerable children.

INTEGRATED ACTIVITY NARRATIVE:

This activity relates to activities to be carried out by Harvard School of Public Health (HSPH) in AB (#7295) and Condoms and Other Prevention (#7291).

SUMMARY:

Through the South African Center for the Study and Support of Peer Education (SACSSPE), the Harvard School of Public Health (HSPH) contributes to PEPFAR prevention (AB and Other), OVC, and system/capacity building goals by providing training, technical assistance, and materials development to government, NGOs, FBOs, corporate, and other organizations using peer education strategies. SACSSPE is the linchpin of an unprecedented sustainable, intersectoral national system delivering rigorous peer education in schools, FBOs and CBOs, clinics, sport and recreation programs, higher education, and public and private sector workplaces. The major emphasis area is training; minor emphasis areas are local organization capacity development and policy and guidelines. The target populations are girls and boys, primary and secondary students, out-of-school youth, adults, orphans and vulnerable children, HIV and AIDS affected families, the community, policy makers, and CBOs, FBOs, NGOs and other implementing organizations.

BACKGROUND:

This project is an expansion and institutionalization of a five-year national consultative process developing consensus on goals, essential elements and standards of practice for peer education programs, and materials and tools in wide circulation to improve how peer education is conducted. Rutanang - meaning "teaching one another" -- peer education is consistently defined and implemented as including, among other characteristics, multiple-dose small-group structured and facilitated discussions; informal influence; recognition and referral of those with further needs (e.g, VCT, OVC); and advocacy.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1:

SACSSPE is especially designed to build capacity among PEPFAR and non-PEPFAR partners through training and ongoing technical assistance and assists with the development and adaptation of educational materials, tools, policy guidelines, linkages and community mobilization, and strategic information. The Center will prepare and coordinate trainers (with accreditation process initiated) from a variety of sectors and geographic areas. Partners will use evolving standardized monitoring and evaluation tools to collect and share comparable data on program activities and outcomes. All SACSSPE materials explicitly and intensively address the following areas of legislative interest: male norms and behaviors; reducing sexual violence and coercion; stigma reduction; and maintaining infected and affected children in school. By its very nature, peer education also explicitly promotes democratic leadership development.

ACTIVITY 2:

SACSSPE will attempt to work with Learner Representative Councils, the Congress of South African Students, and the National Youth Commission to articulate and evaluate the extent to which peer education programs contribute to active participation in school governance. Peer education with adolescents and adults emphasizes delaying sexual debut, secondary abstinence, and reduction in concurrent partners. Peer education also is a means for early identification and referral to services of vulnerable children and youth, and SACSSPE is pursuing strategies that enhance peer education as an advocacy tool to make environments safer. Each of the foregoing content themes is explicitly addressed in design of peer education support systems, training of peer educators, and content peer educators are trained to deliver.

The SACSSPE initiative strengthens an essential strategy currently used across South Africa, and indeed, across the world, with little rigor and evaluation. A key SACSSPE goal is South African Qualification Authority (SAQA) and other accreditation for programs, peer

educator trainers and supervisors, and peer educators themselves. SACSSPE policy and system strengthening activities also feature education of multi-sectoral policymaking bodies, including National and Provincial Infectious Diseases Advisory Committees, unions, and the business community. SACSSPE continues to work at the Deputy Director-General and ministerial levels in a number of national and provincial departments.

ACTIVITY 3:

SACSSPE will also develop, refine, and implement standardized monitoring and evaluation (M&E) tools and develop a database on peer education activities conducted by its partners. An annual conference of peer education evaluators and researchers will be part of its ongoing program; the seeds for this collegial approach to peer education measurement have been thoroughly sown in years of consensus-building and networking. Additionally, expert peer educators and supervisors will convene at least once a year to develop new tools and materials as needs are identified by practitioners in the field or researchers around the world. An integral part of systems/capacity building is dissemination through training and technical assistance, articles and publicity of our models and materials for psychosocial support of OVCs and for workplace programs in public and private sectors, especially components that focus on motivating and equipping workers who are parents and guardians to engage in early and useful discussion and limit-setting with children/teens on norms of abstinence and delay of sexual debut.

In addition to contributing to PEPFAR annual and cumulative targets, long-term results of the HSPH project will be the establishment of a sustainable integrated system supporting rigorous, measurable peer education that increases the amount and quality of social interactions and skills acquisition concerning norms, traditions, and behaviors that will help reduce the transmission of HIV.