THE IMPACT OF HIV/AIDS ON FORMAL SCHOOLING IN UGANDA Karin A. L. Hyde Andrew Ekatan Paul Kiage Catherine Barasa Funded by the Rockefeller Foundation Contact: [email protected] or [email protected] THE IMPACT OF HIV/AIDS ON FORMAL SCHOOLING IN UGANDA Table of Contents LIST OF FIGURES ..............................................................................................................III LIST OF TABLES ................................................................................................................III EXECUTIVE SUMMARY.......................................................................................................... VI 1. INTRODUCTION ..................................................................................................1 1.1 THE AIDS CRISIS AND EDUCATION..................................................................................1 1.2 THE KNOWLEDGE BASE ..................................................................................................1 1.3 STUDY OBJECTIVES .........................................................................................................4 1.4 REPORT STRUCTURE ........................................................................................................4 1.5 TEAM MEMBERS ..............................................................................................................5 1.6 ACKNOWLEDGEMENTS ....................................................................................................5 2. OVERVIEW AND CONTEXT......................................................................6 2.1 THE EDUCATION SYSTEM.................................................................................................6 2.2 GOVERNMENT EDUCATION POLICY ..................................................................................7 2.3 NGOS REACHING OUT TO YOUTH IN SCHOOLS ................................................................9 3. HIV/AIDS—THE CHALLENGE AND THE RESPONSE......14 3.1 THE EXPERIENCE OF HIV/AIDS IN UGANDA ..................................................................14 3.2 FIGHTING AIDS—THE MESSAGE ...................................................................................22 3.3 THE CONDOM DEBATE .....................................................................................................23 3.4 CONTINUING CHALLENGES .............................................................................................24 4. METHODOLOGY...............................................................................................26 4.1 INTRODUCTION................................................................................................................26 4.2 SCHOOL SURVEY .............................................................................................................27 4.3 STAKEHOLDER INTERVIEWS............................................................................................28 4.4 MODELLING ....................................................................................................................29 4.5 LESSONS LEARNED..........................................................................................................29 5. PREVENTING HIV INFECTION AMONG STUDENTS.......31 5.1 HIV/AIDS EDUCATION IN SCHOOLS...............................................................................31 5.2 FORMAL CURRICULUM....................................................................................................32 5.3 STUDENT KNOWLEDGE ...................................................................................................33 5.4 GUIDANCE AND COUNSELLING .......................................................................................36 5.5 EXTRA-CURRICULAR ACTIVITIES ....................................................................................37 5.6 STUDENT ATTITUDES AND BEHAVIOUR ..........................................................................38 5.7 SEXUAL HARASSMENT ....................................................................................................38 6. IMPACT ON STUDENTS ..............................................................................42 6.1 CHARACTERISTICS OF STUDY SCHOOLS ..........................................................................42 6.2 REPETITION, ABSENTEEISM AND SCHOOL INTERRUPTION ...............................................43 6.3 ORPHANS ........................................................................................................................45 6.4 HIV POSITIVE STUDENTS................................................................................................49 6.5 STUDENTS LOOKING AFTER SICK FAMILY MEMBERS .....................................................50 6.6 ADDRESSING THE PROBLEMS ..........................................................................................51 7. IMPACT ON TEACHING STAFF ...........................................................53 i THE IMPACT OF HIV/AIDS ON FORMAL SCHOOLING IN UGANDA 7.1 INTRODUCTION................................................................................................................53 7.2 IMPACT OF HIV/AIDS ....................................................................................................55 7.3 PROJECTIONS...................................................................................................................64 8. GOVERNMENT OF UGANDA RESPONSE ....................................68 8.1 PLANNED GOVERNMENT INITIATIVES .............................................................................69 8.2 COMMENT ON INITIATIVES..............................................................................................71 9. HIV PREVENTION............................................................................................73 9.1 INTRODUCTION................................................................................................................73 9.2 ENHANCING HIV/AIDS CONTENT...................................................................................73 9.3 CAPACITY BUILDING FOR TEACHERS ..............................................................................75 9.4 ENHANCING GUIDANCE AND COUNSELLING ...................................................................75 9.5 SEXUAL HARASSMENT ....................................................................................................76 10. MITIGATION OF IMPACT ON STUDENTS..............................77 10.1 PRIMARY EDUCATION....................................................................................................77 11. TEACHING STAFF--MITIGATION...................................................79 12. CONCLUSION AND RECOMMENDATIONS ............................83 12.1 PREVENTION .................................................................................................................83 12.2 IMPACT ON STUDENTS...................................................................................................83 12.3 TEACHERS AND OTHER STAFF.......................................................................................83 12.4 RESEARCH AND MONITORING .......................................................................................84 APPENDIX 1: FOCUS GROUP STATEMENTS ...............................................92 APPENDIX 2: STAKEHOLDERS INTERVIEWED ........................................94 APPENDIX 3: MODELLING STRATEGY AND PROCEDURES .............97 APPENDIX 4: EDUCATIONAL DATA FROM STUDY SCHOOLS.......102 APPENDIX 5: EDUCATIONAL STATISTICS, UGANDA..........................124 APPENDIX 6: RESPONDENT RECOMMENDATIONS .............................134 ii THE IMPACT OF HIV/AIDS ON FORMAL SCHOOLING IN UGANDA LIST OF FIGURES Figure 1: Impact of HIV/AIDS on Education……………………………………..………….3 Figure 2: Infection Rates at ANC Sentinel Sites……………………………………..……...14 Figure 3: Trends in HIV Rates Among Female First Time Testers………………………….15 Figure 4: Trends in HIV Rates Among Male First Time Testers……………………….……16 Figure 5: HIV Seroprevalence by Education Level………………………………………….16 Figure 6: Number of Orphans in Primary Schools, 1995- 98……………………………..….46 Figure 7: AIDS Mortality (%) – Primary Teachers, 1997 – 2013.………………………..…63 Figure 8: AIDS Mortality (%) --- Secondary Teachers, 1995 – 2013……………….………63 LIST OF TABLES TABLE 1: COMPARISON OF POPULATION BASED KABP FINDINGS, 1995 AND 1998 .................15 TABLE 2: DISTRIBUTION OF INSTRUMENTS AND RESPONDENTS ...............................................28 TABLE 3: STUDENT KNOWLEDGE OF HIV/AIDS, PERCENTAGE WRONG BY CLASS AND GENDER ............................................................................................................................34 TABLE 4: STUDENT KNOWLEDGE OF HIV/AIDS, PERCENTAGE WRONG BY LOCATION ..........34 TABLE 5: MOST USEFUL SOURCE OF INFORMATION ABOUT HIV/AIDS ...................................35 TABLE 6: STATEMENT RESPONSES, STUDENT QUESTIONNAIRE—HIV/AIDS TEACHING.........36 TABLE 7: INDIVIDUAL IN SCHOOL WITH WHOM PROBLEMS ARE DISCUSSED, BY LEVEL..........37 TABLE 8: PRIMARY TEACHERS STATEMENT RATINGS (QUESTIONNAIRE)—SEXUAL HARASSMENT ...................................................................................................................38 TABLE 9: SECONDARY TEACHERS- QUESTIONNAIRE STATEMENT RATINGS .............................39 TABLE 10: STATEMENT RESPONSES FROM STUDENT QUESTIONNAIRE......................................39 TABLE 11: STUDENT STATEMENTS FROM FOCUS GROUPS........................................................40