HLS HEALTH AND LIFE SKILLS CURRICULUM

HLS HEALTH AND LIFE SKILLS CURRICULUM

The Population Council confronts critical health and development issues--from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees.

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Population Council ? Zambia Plot 3670 No. 4 Mwaleshi Road Olympia Park, Lusaka P/Bag RW 319X, Lusaka 10101, Zambia Lusaka, Zambia 10101 Tel: +260 211 295925

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This curriculum has been adapted from several sources, which are listed in the references section.

Please include the following statements on all section reproductions: Reprinted from Population Council: Life Skills and Health Curriculum for the Adolescent Girls Empowerment Program (AGEP).

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Overview of AGEP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Beneficiaries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Curriculum Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Before the Program Begins. . . . . . . . . . . . . . . . . . . . . . . . 4 General Facilitation Tips. . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Talking about Sensitive Issues. . . . . . . . . . . . . . . . . . . . . . 5 Working with Parents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Participatory Teaching Methods. . . . . . . . . . . . . . . . . . . . 7 Session Structure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Introductory Sessions

10

Session 1: What to Expect ? Part 1. . . . . . . . . . . . . . . . . . 11

Session 2: What to Expect ? Part 2. . . . . . . . . . . . . . . . 17

Session 3: Teamwork. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Session 4: His and Hers (Gender Roles). . . . . . . . . . . . 26

Session 5: Communication. . . . . . . . . . . . . . . . . . . . . . . . 32

Session 6: Self-Esteem. . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Session 7: Goal Identification ? The Road of Life. . . . . 42

Session 8: Goal Setting and Achieving. . . . . . . . . . . . 46

Session 9: My Relationships. . . . . . . . . . . . . . . . . . . . . . . 51

Reproductive Health

55

Session 1: Life Cycle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Session 2: My Body Is Changing ? Am I Normal?. . . . 60

Session 3: How Does Pregnancy Happen, Anyway?. . 66

Session 4: Preventing Unintended Pregnancy (Contraceptives). . . . . . . . . . . . . . . . . . . . . . . 75

Session 5: Reproductive Myths. . . . . . . . . . . . . . . . . . . . 83

Session 6: Sexual Desire. . . . . . . . . . . . . . . . . . . . . . . . . . 89

Session 7: Unsafe Abortion. . . . . . . . . . . . . . . . . . . . . . . 93

Session 8: Abortion and Stigma. . . . . . . . . . . . . . . . . . 100

Session 9: Maternal Mortality . . . . . . . . . . . . . . . . . . . . 106

Life Skills

112

Session 1: I Have Healthy Relationships. . . . . . . . . . . . 113

Session 2: Reasons to Delay Sex . . . . . . . . . . . . . . . . . 120

Session 3: Strategies for Delaying Sex . . . . . . . . . . . . 124

Session 4: Passive, Assertive, Aggressive. . . . . . . . . . 130

Session 5: Drugs, Alcohol and Other MindAltering Substances. . . . . . . . . . . . . . . . . . 136

Session 6: Peer Pressure . . . . . . . . . . . . . . . . . . . . . . . . 141

Session 7: Making Good Decisions. . . . . . . . . . . . . . . . 146

Session 8: How to Communicate with Adults. . . . . . 152

Session 9: How to Communicate with a Partner. . . . 156

Session 10: Managing Stress, Anger, and Conflict. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

Session 11: Conflict Resolution and Problem Solving Skills. . . . . . . . . . . . . . . . . . . . . . . . 168

HIV, AIDS, and STIs

174

Session 1: HIV and AIDS. . . . . . . . . . . . . . . . . . . . . . . . . 175

Session 2: Myth or Fact? . . . . . . . . . . . . . . . . . . . . . . . . 185

Session 3: HIV Testing and Counseling. . . . . . . . . . . . 193

Session 4: Risky Behavior . . . . . . . . . . . . . . . . . . . . . . . 198

Session 5: The Relationship of STIs and HIV and AIDS. . . . . . . . . . . . . . . . . . . . . . . . . . . 203

Session 6: Stigma and Discrimination in HIV-Positive People. . . . . . . . . . . . . . . . . . . 210

Gender and Gender-Based Violence

215

Session 1: Sexual Exploitation. . . . . . . . . . . . . . . . . . . . 216

Session 2: How to Report and Avoid Cases of Sexual Violence. . . . . . . . . . . . . . . . . . . . 223

Session 3: Rape and Gender Violence. . . . . . . . . . . . . 228

Session 4: Preventing Unwanted Advances. . . . . . . . 235

Leadership

239

Session 1: Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . 240

Session 2: Community Service--Putting Leadership into Action. . . . . . . . . . . . . . . 244

Human Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Session 1: Human Rights and Children's Rights. . . . 250 Session 2: Sexual and Reproductive Health

Rights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 Session 3: HIV and AIDS and Human Rights. . . . . . 263

Appendixes

268

Glossary of Terms

269

Appendix A: Additional Topical Information

274

The Menstrual Cycle. . . . . . . . . . . . . . . . . . . . . . . . . . . . 274

Reproduction and Pregnancy. . . . . . . . . . . . . . . . . . . . 276

Emergency Contraception. . . . . . . . . . . . . . . . . . . . . . . 278

Zambia's Abortion Act and Regulations. . . . . . . . . . . 279

Childbirth and Breastfeeding . . . . . . . . . . . . . . . . . . . . 281

Tips for Teaching about HIV and AIDS. . . . . . . . . . . . 282

Background Information on HIV and AIDS. . . . . . . . 283

Frequently Asked Questions About HIV and AIDS. . 284

HIV and AIDS and Human Rights. . . . . . . . . . . . . . . . 286

Appendix B: Participatory Facilitation

Resources

288

Trust-Building Activities. . . . . . . . . . . . . . . . . . . . . . . . 288

Group Formation Activities. . . . . . . . . . . . . . . . . . . . . 295

Icebreaker Activities (from The International

HIV/AIDs Alliance)

297

References

305

Acknowledgments

This manual was adapted by Averie Baird, Bwalya Mushiki, Cassandra Burke, Deogratias Chileshe, Diana Bulanda, Karen Austrian, Natalie Jackson Hachonda, and Pamela Nyirenda.

Technical input was provided by Abigail Tuchili, Alice L. Bwalya, Andrew Saka, Andrew Tandeo, Benjamin Mwape, Chanda Katongo, Chikonde Ngwira, Chinyama Augustine, Diana B. Shalala, Diana Macauley, Eugenia Temba, Febby Imbula, Francis Kapapa, Gershom B.M. Banda, Hamaundu Hachonda, Izek Jere, Josephine T. Mukandawire, Kamanda Mwelwa, Mara Hildebrand, Martin Chidwayi, Michelle Hunsberger, Misheck Mwanza, Mwenda Mweetwa, Mwenya C. Mabuku, Nambula Kachumi, Nelson Banda, Precious Njamba, Richard Mwape, Shadrick Kaputa, Sue Gibbons, Yvonne Haching'anju, and Zigeville Ndlovu.

We would like to acknowledge several organizations whose materials have been adapted or used in this curriculum including: Elizabeth Glaser Pediatric AIDS Foundation, Exhale, The Guttmacher Institute, International HIV and AIDS Alliance, International Alliance for Youth Sports, International Labor Organization (ILO), International Sexuality and HIV Curriculum Working Group, Ipas, Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs, Joint United Nations Program on HIV/AIDS (UNAIDS), Margaret Sanger Centre International, Mexican Institute for Research of Family and Population (IMIFAP), Mobilizing Access to Maternal Health Services in Zamba (MAMaZ), Motivational Centre for Africa's Transformation (MoCAT), National Institutes of Health (NIH), One Love Southern Africa Campaign, Peace Corps, Project Concern International, Population Council, Program for Appropriate Technology in Health (PATH), Queensland Health Australia, Sustainability Through Economic Strengthening Prevention an Support for Orphans and Vulnerable Children, Youth and Other Vulnerable Populations (STEPS OVC/Consortium) Zambia, United Nations Children's Fund (UNICEF), United Nations High Commissioner for Refugees (UNHCR), United Nations Population Fund (UNFPA), United States Agency for International Development (USAID), World Health Organization (WHO), and World Young Women's Christian Association (YWCA). A citation for the materials used from these organizations can be found in the footnotes at the beginning of each session and a complete reference is located in the "References" section at the end of this document.

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Introduction

Zambian girls are faced with social isolation, economic vulnerability, and lack of appropriate health information and services--factors that prevent a healthy transition from girlhood into womanhood. They are faced with high rates of gender-based violence and unsafe sex--increasing their risk for unwanted pregnancy, HIV infection, and school dropout. This leads to a lack of economic resources and income-generating options, and a general lack of agency in shaping their lives. The root cause of these vulnerabilities is largely determined by girls' weak social, health, and economic assets.

The Adolescent Girls Empowerment Program (AGEP) aims to build these assets as an interconnected approach towards mitigating girls' vulnerabilities. The Population Council and partners have piloted and implemented a social, health, and economic asset-building program for vulnerable adolescent girls in Zambia. Girls joined groups of 25?30 girls, which meet once a week under the guidance of a female mentor. In weekly group meetings, girls are provided with training on health and life skills ( ) and financial education ( FE ) and given the opportunity to interact to build strong relationships with other girls in their community.

Overview of AGEP

The overall goal of AGEP is to facilitate the building of social, health, and economic assets in a safe and fun learning environment. Participants are equipped with life skills and knowledge to help maintain happy and healthy lifestyles, and be empowered with the confidence to assert their rights and protect themselves from harm and threats.

The `safe spaces' component is at the core of AGEP. The girls groups, to which each girl belongs, are meant to provide a safe and supportive learning environment. Regular and reliable girls' group meetings, under the guidance of a female mentor from the same community, are critical in building social assets for vulnerable girls--including friendships, self-esteem, trusting relationships with adults, social support, etc.

The objectives of including this curriculum in AGEP are to:

? Increase adolescent girls' knowledge of reproductive health and sexuality;

? Reinforce and promote attitudes and behaviors that will lead to a better quality of life for adolescent girls; and

? Instill skills among adolescents to enable them to overcome the challenges of growing up and becoming responsible adults. These skills include communication skills, decision-making, assertiveness, setting goals, and resisting peer pressure.

Beneficiaries

AGEP participants are girls who are 10?19-years-old from vulnerable backgrounds. While some girls may be in school, the program is not meant to target in-school girls, nor are the groups meant to meet in school or be seen as school clubs. Special recruitment is done to ensure that out-of-school girls, young mothers, married girls, domestic workers, disabled girls, HIV-positive girls, and other profiles of vulnerable girls are included.

Group structure Each group meets once a week in a time and location that is deemed appropriate by the girls, the community, and the mentor. Groups meet in various locations throughout the community and the meetings last between 1-2 hours.

Meeting functions The meetings serve two functions. The first is for the mentor to facilitate a short training session. The training content over the course of the year varies from sexual and reproductive health and life skills to financial education (see separate Financial Education FE curriculum), and other content that is identified as relevant and appropriate. These sessions should be engaging, interactive, and make use of best practice youth learning principles ? that is games, small group work, etc.

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The second function is for the meetings to provide a space and opportunity for girls to regularly interact with each other. During meeting times, they can share updates about their weeks, address any concerns they may have, laugh, sing, dance, express themselves, and in general, have fun. As cultivating this sort of environment is a primary aim of weekly girls group meetings, it is important that these groups not be run like a classroom. Mentors will have to ensure that during each meeting, girls have ample time for conversation and interaction, and should encourage an informal learning environment at all times.

Age appropriateness

This program was designed for girls from 10 to 19 years of age. However, some of the material contained in the curriculum may not be suitable for participants at the younger end of this age spectrum. Though participants will attend sessions with other participants closer to their age (groups of 10?14 year-olds and 15?19 year-olds formed in the first session), topics or activities that are more appropriate for younger adolescents (ages 10?14) or older adolescents (ages 15?19) are specified throughout the curriculum. They are marked with the following signs:

10?14-year-olds only

15?19-year-olds only

The final decision on how to present the material is at the discretion of the mentor.

For more information about the Adolescent Girls Empowerment Program, please visit: .

For any inquiries, please contact: agep@.

Curriculum Structure

The curriculum for the weekly safe space meetings will cover a variety of topics including sexual reproductive health, life skills, HIV and AIDS, STIs, gender and gender-based violence, leadership, human rights, and financial education.

In addition to life skills and health topics, mentors will facilitate trainings for girls on financial education, which is found in a separate curriculum (see separate Financial Education curriculum ( FE ). The FE sessions will be integrated in between the life skills and health sessions. The suggested order for combining the two curricula is presented here:

Introductory Sessions Session 1: What to Expect ? Part 1 Session 2: What to Expect ? Part 2 Session 3: Teamwork Session 4: His and Hers (Gender Roles) Session 5: Communication Session 6: Self-Esteem

FE Introduction to Financial Education Session 1: Dream Big! Session 2: Why Save? Session 3: Choose a Savings Goal Session 4: Make a Savings Plan Session 5: Learning about Banks and Bank Accounts

Introductory Sessions Session 7: Goal Identification ? The Road of Life Session 8: Goal Setting and Achieving Session 9: My Relationships

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Round 1 Reproductive Health Session 1: Life Cycle Session 2: My Body Is Changing ? Am I Normal? Session 3: How Does Pregnancy Happen, Anyway? Session 4: Preventing Unintended Pregnancy (Contraceptives) Session 5: Reproductive Myths

FE Financial Education Session 6: Exploring Options for Earning Money Session 7: Girls Money and the Risky Income Cycle

Life Skills Session 1: I Have Healthy Relationships Session 2: Reasons to Delay Sex Session 3: Strategies to Delay Sex Session 4: Passive, Assertive, Aggressive

HIV and AIDS and STIs Session 1: HIV and AIDS Session 2: Myth or Fact? Session 3: HIV Testing and Counseling

FE Financial Education Session 8: Know the Difference Between Needs and Wants Session 9: Control Spending Session 10: Think About the Future: Money In and Money Out Session 11: Save Regularly! Session 12: Save in a Safe Place Session 13: Dealing with Setbacks in Saving

Gender and Gender-Based Violence Session 1: Sexual Exploitation Session 2: How to Report and Avoid Cases of Sexual Violence

Leadership Session 1: Leadership Session 2: Community Service: Putting Leadership in Action

Round 2 Reproductive Health Session 6: Sexual Desire Session 7: Unsafe Abortion Session 8: Abortion and Stigma Session 9: Maternal Mortality

Life Skills Session 5: Drugs, Alcohol and Other Mind Altering Substances Session 6: Peer Pressure Session 7: Making Good Decisions Session 8: How to Communicate with Adults

FE Financial Education Session 14: Your Own Money Vs. Someone Else's Money Session 15: Talking About Money Session 16: The DOs and DON'Ts of Talking About Money Session 17: Resolving Conflicts About Money Session 18: Role-play Resolving Conflicts Session 19: Our Journey to Good Money Management

Human Rights Session 1: Human Rights and Children's Rights Session 2: Sexual and Reproductive Health Rights Session 3: HIV and AIDS and Human Rights

HIV and AIDS and STIs Session 4: Risky Behavior Session 5: The Relationship of STIs and HIV and AIDS Session 6: Stigma and Discrimination in HIV-Positive People

Gender and Gender-Based Violence Session 3: Rape and Gender Violence Session 4: Preventing Unwanted Advances

Life Skills

Session 9: How to Communicate with a Partner

Session 10: Managing Stress, Anger, and Conflict

Session 11: Conflict Resolution and Problem Solving Skills

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Before the Program Begins

Mentors should look through the curriculum and thoroughly read as much of the background information as possible (i.e., facilitator notes at the beginning of each session and extra information provided in Appendix A: Additional Topical Information). This will help mentors gain a strong general sense of the topics that will be covered throughout the program, and an idea of where to find answers to any questions that participants may ask. This information for each session should be re-read just before conducting the corresponding session. Mentors should prepare any necessary materials before each session and ahead of time, thinking about their own values regarding young people and about the topics to be discussed.

Collect and have on hand referral information for:

1. Sexual/reproductive health services (including contraceptives)

2. HIV testing and counseling

3. How/where to report sexual or domestic violence

4. Psychosocial counseling referral for any vulnerable girls who have been abused or raped

5. Legal services

Invite guest speakers

Some topics and sessions may benefit from a guest speaker, especially those that the mentor does not feel confident about, or those that require technical or professional guidance. These topics may include unsafe abortion, sexual exploitation, rape, STIs, and HIV. Mentors are encouraged to invite a guest speaker or facilitator for these sessions.

To ensure the session is successful, mentor should invite the guest ahead of time, provide the guest with a session guide that he or she is expected to facilitate, and make certain that all materials for the session are ready beforehand. The guest speaker should also be made aware of the principles and attitudes mentioned throughout the curriculum, so that contradictions are not created. Guest speakers should be notified up front that their participation is voluntary and they will not be paid.

What if participants want to be paid for their time?

The recruiters for the program should make it clear that participants will not receive money when participating. During the first session the mentor should remind participants that their involvement in this program is voluntary and they will not be paid. However, participants will gain many non-monetary benefits from the program by building skills, confidence, and knowledge.

Know your audience Depending on the group, it may be necessary to change the approach to leading the sessions. For example, out-of-school girls may have lower literacy skills than in-school girls. For lower literacy groups, facilitators may want to draw more pictures and use more symbols when writing on the flipchart or chalkboard. Facilitators should also use simple language and be sure that the instructions are clear before starting any activity. Do not ask more than a few questions at the end of each activity. It is important that mentors work with adolescent girls where and as they are, not where or as the mentor thinks they should be. Mentors should also check sessions for cultural acceptability. Be familiar with local cultural norms and adjust sessions accordingly.

Be prepared Every training experience has the potential to bring challenges. The most effective way to minimize challenges is to be prepared. Mentors should know the material they will present, and they should practice facilitating the activities on their own or with a friend.

General Facilitation Tips

Below are some tips and methods to help build your capacity as a facilitator. A good facilitator: 1. sees the participants as experts with information and skills to share, rather

than seeing themselves as the only experts in the room. 2. encourages participants to learn from each other, and guides this process

rather than providing direct instructions and lecture-style learning. 3. believes we learn by doing, experiencing, practicing, and feeling, rather than

by memorizing, repeating, and recording information. 4. is organized, but flexible in changing methods based on participant needs. 5. is enthusiastic about the topic and participants. 6. keeps promises to the group (to let participants speak, take a break, etc.) 7. is patient and a good listener. 8. is prepared to handle strong emotions that may arise during discussions.

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