Improving the Sexual and Reproductive Health of Pre-Service Teachers. Endline Study of the Tiphunzit
In Malawi teachers are the labour group with the third highest HIV prevalence and an astonishing 40% of teachers’ deaths are related to HIV/AIDS. This makes AIDS-related deaths the most common cause of teacher attrition.
Through funding from the Medicor Foundation, Theatre for a Change's (TfaC) education program implemented a two-year project from 2014 - 2016 called "Tiphunzitsane, Let's Teach each other!". The program aimed to improve the Sexual and Reproductive Health (SRH) of pre-service teachers in seven targeted Teacher Training Colleges (TTCs) as well as improve the life chances of primary school children located in ten primary schools surrounding six of the targeted TTCs. TfaC also ran Tisinthe!, an interactive radio program focusing on SRH, gender equality and children's rights.
Scope of Work
The Endline Study aimed to determine and report benchmark measures against project logframe indicators, discuss the likelihood of intended and unintended project impact, and provide recommendations for future project design and implementation based on criteria of effectiveness, relevance and sustainability.
In order to identify and infer both intended and unintended project impacts the study used a mixed-methods approach relying on a cross-sectional comparison between treatment and control schools.
For quantitative SRH variables the study calculated composite scores or indices for sexual reproductive health (1) knowledge, (2) attitudes, and (3) practices. Knowledge and Attitudes refer to what people say; whereas practices refer to what people do.
All impact level findings were triangulated through qualitative approaches. Particular emphasis was placed on utilizing qualitative methods to understand and infer unintended project impact, verify impact level findings, and identify alternate explanations of change. Although impact cannot be determined quantitatively for beneficiaries without a control group, we utilized outcome level data and qualitative findings to infer project impact.
Both core and peer group pre-service teachers participating in TfaC's workshops demonstrated improved sexual and reproductive health knowledge, attitudes, and practices between Baseline and Endline.
Focus Group further supported these quantitative findings. A female Core Group Student in Lilongwe mentioned, “For example, at first I was thinking that when you have sex with a man and take a bath immediately you cannot get pregnant and also that when you have sex while standing you cannot get pregnant. This is not true because you can get pregnant even if you do it while standing, sleeping, kneeling and whatever style is used”. A male student in the same focus group believed that “People were saying that you cannot contract HIV or STIs when you are circumcised. But there are still chances of contracting HIV or STIs that’s why it is important to use condoms when having sex. So I think differently now”. These qualitative findings support quantitative achievements demonstrating improvements in participant’s sexual reproductive health knowledge.
Whilst participants demonstrated the ability to correctly use a male condom in condom demonstrations, many participants could not demonstrate how to correctly use a female condom.
In line with the findings from TfaC’s Report to the Medicor Foundation (2015), the Endline evaluation demonstrated that the Tiphunzitsane project improved the sexual reproductive health knowledge, attitudes and practices of Core and Peer Group pre-service teachers as well as primary learners when compared to the 2015 Baseline results and often also against Baseline data from 2014. Beyond empowering teachers and learners with improved SRH knowledge; TfaC enabled them to make informed decisions; overcome peer pressure, better manage conflicts, set realistic goals in life and raise their self-esteem.