The labyrinth of HIV and AIDS education and teaching
3.4 HIV and AIDS education: a window of hope
3.4.2 Challenges facing education systems and schools in delivering HIV and AIDS education
102
This crucial potential of HIV and AIDS education to decrease the probability of HIV transmission should be enhanced (Kelly, 2002b). The effectiveness of such HIV-prevention programmes, however, has increasingly been put under scrutiny (Campbell & Foulis, 2002;
Campbell et al., 2005; Clarke, 2008; Kelly, 2002c). While some countries such as Cambodia, Thailand, Brazil, Senegal and Uganda have reported success (Clarke, 2008; Kelly, 2002b;
Piot et al., 2001), the precise contribution of the education sector towards such success remains unclear. Evidence establishing the effectiveness of educational programmes presents conflicting results of success and failure (Campbell & Foulis, 2002; Clarke, 2008). This puts the role of HIV and AIDS education under the spotlight, and points to the urgent need for such research, which is currently scarce.
While this section shed light on the crucial role of education in general, and schools in particular, to address and curb the HIV and AIDS pandemic, they are nevertheless confronted with challenges which threaten effective delivery of HIV and AIDS education. Such challenges are outlined in the following discussion.
3.4.2 Challenges facing education systems and schools in delivering
103
on education systems. In much the same way, Kelly (2000) asserts that the increase in HIV- prevalence weakens and decreases the ability of education systems to deliver quality education. Generally, this is due to more teachers and learners becoming sick, resulting in increased absenteeism, orphans and even death. Additionally, the increase in illiteracy levels and decrease in skilled workers impacts on economy and funding for education and health care (Wood & Hillman, 2008; World Bank, 2002). Recognising these impacts, Kelly (2000) contends, will assist policy-makers, managers and teachers to develop possible solutions and effective interventions to offset and mitigate such impacts. The upshot of such impacts is that education systems and schools are no longer tranquil HIV-free places, Kelly (2002a, p. 28) contends, which signals the urgent need for “a radical re-thinking of educational provision”.
Nevertheless, he cautions, recognition of the need for such reform is inadequate and delayed.
Shaeffer (1994) therefore suggests that schools need to undergo two major changes, in order to address the challenges of HIV and AIDS impacts: (i) engage in open, candid discussions on topics of sexuality and sex education, sexually transmitted diseases (STDs) and condoms, drug abuse and the role and status of women, and (ii) deliver broader, integrated age and language appropriate HIV and AIDS messages. Also, teachers need to teach these topics in more open, creative and interactive ways which include peers, parents, role models, respected members of the community and local religious leaders. Along this line of argument, Kelly (2002b) contends that education systems, therefore, need to be protected in order to serve as vehicles to reduce HIV and AIDS prevalence. As such, education systems need to be stabilised to ensure that teachers teach, children enrol and remain at school to learn and managers and finance personnel are efficient.
It is widely acknowledged that the HIV and AIDS pandemic severely impacts education systems in three ways (Gachuhi, 1999; Kelly, 2000; Shaeffer, 1994; Wood & Hillman, 2008;
World Bank, 2002):
i. Decreasing demand for education: due to declining enrolment and attendance of children and loss of income due to illness and death, an increasing number of orphans having to care for HIV-infected and affected family members and vulnerable children and orphans dropping out of school
104
ii. Decreasing supply of education: due to increased mortality of teachers, lesser productivity and greater absenteeism of sick teachers, decreased enrolments, increased financial costs to carry unproductive and absent teachers, teachers’ HIV- related stresses and reduced funding
iii. Deteriorating quality and management of education: due to increased mortality, illness and absenteeism of teachers, fewer senior managers to plan and manage implementation of policies, less qualified teachers, increased psychological effects of HIV-infection and deaths, stigma and discrimination of HIV-infected and HIV- affected teachers and managers, negative impact on quality of teaching and learning
Related to such impacts on education systems, Crouch (2003) highlights the “turbulent change” and “large and looming imbalance between the supply and demand” of teachers, exacerbated by the HIV and AIDS pandemic (2003, pp. 46-47). Similarly, Ramrathan (2003) and Coombe (2003a) contend that the HIV and AIDS pandemic severely impacts on attrition and supply and demand of teachers. Added to this, Coombe (2003a) asserts that: “the paradigm of education must shift” with the following response from the education sector:
“helping to control the spread of the disease, providing social support for learners and teachers affected by the disease and protecting the quality of education provision” (2003a, pp.
84, 88). This signals the urgent need for policy and the education sector to respond to such challenges and threats.
HIV and AIDS mainstreaming in general, and integration of HIV and AIDS education across the curriculum in particular, is not only integral to respond to the pandemic, but also presents a challenge for education systems and schools (Kelly, 2002b; 2002c; Otaala, 2003; van Laren
& Ismail-Allie, 2008). Mainstreaming can be distinguished from integration as follows:
HIV and AIDS mainstreaming is considered to be a process of integrating HIV and AIDS throughout the functioning of the whole school. One part of mainstreaming is the integration of HIV and AIDS education in the curriculum (van Laren & Ismail-Allie, 2008, pp. 201-202)
While mainstreaming has the potential to empower teachers and learners to live healthy, sexually responsible lives, it has nevertheless been marginalised and neglected over the years.
105
Indeed, this means that education systems and schools (Kelly 2002b; 2002c) as well as tertiary institutions (Otaala, 2003) are not fully exploiting the possibilities of mainstreaming to develop life skills, survival skills and HIV-related coping mechanisms that extend beyond HIV-related knowledge and skills. HIV and AIDS education can be integrated in the curriculum in three ways (van Laren & Ismail-Allie, 2008, pp. 203-204): (i) as a main carrier subject, such as Life Orientation in South African schools; (ii) as a cross-curricular topic in other subjects or (iii) by infusion throughout the curriculum.
Policy guidelines and recommendations regarding integration and implementation of HIV and AIDS education varied across different Eastern and Southern African countries (Gachuhi, 1999): In Zimbabwe, Namibia, Uganda and Lesotho it was integrated into curricula of primary and secondary schools; in Malawi it was infused in Standard four in primary schools only; while in Botswana it was included in the curriculum in secondary schools only.
However, in Swaziland, clear policy guidelines regarding integration of HIV and AIDS education into school curricula were lacking. A significant challenge highlighted in HIV and AIDS education research is that teachers in most of these countries were inadequately trained, lacked knowledge, skills and confidence to implement HIV prevention and life skills programmes and avoided teaching sensitive topics related to HIV and AIDS (Boler et al., 2003; Gachuhi, 1999). This has consequence for this study and signals an area in urgent need of further research.
Gachuhi (1999) contends that stand-alone or entirely separate life skills HIV-prevention programmes, however, have greater levels of success than those infused throughout the curriculum. Education departments, Kelly (2002a) argues, have not collaborated with teachers, parents and community based organisations concerning the integration of HIV and AIDS education in the curriculum. This represents a serious challenge since delivery of integrated curricula is the sole responsibility of teachers. Precisely how this integration influences teacher roles will be examined later in this chapter. The crucial role of teachers in HIV and AIDS education is outlined next.
106