AIDS education for primary school children in Tanzania: An evaluation study
Objective: To test the effects of an HIV/AIDS education program.
Design: A quasi-experimental, nested cross-sectional design including baseline and 6-month follow-up surveys. Schools, stratified according to location, were randomly assigned to intervention (n=6) or comparison conditions (n=12).
Setting: Public primary schools in Arusha and Kilimanjaro regions, Tanzania.
Participants: A total of 2026 sixth and seventh grade pupils (average age, 14.0 years) participated at baseline (85%) and 1785 at follow-up.
Intervention: The program was designed to reduce children's risk of HIV infection and to improve their tolerance of and care for people with AIDS. Local teachers and health workers attended a 1-week training workshop before implementing the program over a 2-3-month period (averaging 20 school hours per class).
Main outcome measures: Self-reported exposure to AIDS information, communication regarding AIDS; AIDS knowledge, attitudes towards people with AIDS, attitudes towards having sexual intercourse, subjective norms regarding sexual intercourse, and intention to engage in sexual intercourse.
Results: Following this program, intervention pupils reported significantly higher scores for the following outcome measures than pupils attending the comparison schools: AIDS information (13.1 versus 10.5; P=0.0001), AIDS communication (10.9 versus 7.8; P=0.0001) AIDS knowledge (14.5 versus 11.5; P=0.0001), attitudes towards people with AIDS (9.0 versus 6.7; P= 0.0008), subjective norms (45.5 versus 43.9; P=0.011), and intention (1.3 versus 1.4; P=0.020). No program effect was seen for attitudes towards sexual intercourse (47.0 versus 46.3, P=0.44).
Conclusions: These results indicate that it is feasible and effective to provide AIDS education for Tanzanian primary school children.
PIP: In the adjacent regions of Arusha and Kilimanjaro in Tanzania, researchers conducted a quasi-experimental, nested cross-sectional design to evaluate the Ngao (shield) HIV/AIDS education program for public primary school children, a culturally specific program. The baseline survey and the 6-month follow-up survey included 2026 and 1785 6th-7th grade children, respectively. Teachers of the participating schools and health workers participated in a 1-week training workshop before they implemented the program over 2-3 months. Its intent was to reduce the pupils' risk of HIV infection and to improve their acceptance of and care for people with AIDS. At baseline, the pupils in intervention and comparison schools tended to be comparable. At follow-up, however, intervention pupils had been exposed to more AIDS information (scores, 13.1 vs. 10.5), had discussed AIDS more often (10.9 vs. 7.8), and had a higher increase in AIDS knowledge (14.5 vs. 11.5) than did the comparison pupils (p = .0001 for all the above). They also had significantly more positive attitudes towards people with AIDS than the comparison pupils (9 vs. 6.7; p = .0008). Pupils in the intervention had more restrictive subjective norms regarding sexual intercourse (45.5 vs. 43.8; p = .011) and less intention to engage in sexual intercourse over the next 3 months than at baseline. Yet, they were not significantly different from comparison pupils, because the comparison pupils also had a change in attitude. These findings show that teachers in primary schools and health educators can implement a workable and effective HIV/AIDS education program for school children.