Understanding Sexuality, Gender, Health, Rights and HIV

RaniYouthLeaderJhansi

“Prior to learning about Comprehensive Sexuality Education, I had no clue that female condoms also existed. I used to be very shy to talk about my body and bodily changes in front of my family but now I do not feel shy or hesitate to talk about these issues. My goal is to ensure that every young person should have access to information about their body changes through comprehensive sexuality education but I am not sure that it has fulfilled completely. Young people have very less information about their changes in their bodies and some young people do not have any information. One of my friends asked me once – Do girls not menstruate before marriage? Because of all these myths and lack of knowledge every young person requires comprehensive sexuality education.” - Youth Leader, Male, 19 years, Jhansi.

“I used to feel very shy to talk about menstruation, condom, violence, reproductive health with at home but now I can talk about these issues with my mother very openly. I want to tell other people about these issues and want to talk about caste discrimination and discrimination with transgender, especially want to remove myths associated with them like we should not share food with transgender and they are scary.”  - Youth Leader, Female, 19 years, Lucknow.

 “Through trainings in Shareer Apna Adhikaar Apne, I have become more comfortable with my body, I was not able to talk to my mother about menstruation and ‘gupt ang’ before joining this campaign but now I am able to talk about it with my mother and any male doctor also.” - Youth Leader, Female, 21 years, Lucknow

The Rationale

‘Know Your Body, Know Your Rights’ (KYBKYR)/’Shareer Apna, Adhikaar Apne is a youth-led and -run national policy and peer education programme, founded in 2002. The programme builds young people’s technical capacities to access unbiased, evidence-based information on gender, sexuality, health and rights, enabling them to negotiate cultural and political barriers faced at both community and policy levels. The genesis of the programme emerged from the realization that for many young people, concepts of the self, body and identity lie at the centre of much confusion and that this is compounded by the uncertainty of their position in society and what their entitlements and roles in regards to issues of sexuality, health and gender are.

Young people face increasing pressures regarding their bodies, sexuality and health particularly by way of conflicting norms and messages. On the one hand society projects messages of sexuality as being negative associated with fear, guilt and disease, while on the other hand it is seen as positive or desirable by media and peer groups. The programme team at the concept stage itself felt that ensuring the Sexual and Reproductive Rights of young people is critical because it empowers young people to negotiate the vulnerabilities of violence, HIV, abuse, climate, gender inequality and poverty. It also enables a positive attitude towards relationships and improves the quality of health and life of young people. Our work with young people challenges the silences that exist in society around these issues.

CSEWorkshopsIn 2006, the programme expanded to begin working with young people from peri-urban and semi-rural areas, focusing on adolescents and young people living in at-risk contexts (street and slum children, young people living with HIV, young injecting drug users, children of female sex workers, young people living in BPL (below the povertyline) communities through peer to peer education and policy consultative processes. KYBKYR also strengthens platforms for young people to advocate with decision makers for Comprehensive Sexuality Education (CSE), through dialogue and monitoring and evaluation processes at local, state, national and international levels. This ensures that young people can effectively participate in policy processes and provide critical inputs that correspond with lived, community realities.

Programme Structure

The programme addresses young people’s need for Comprehensive Sexuality Education (CSE) and their increasing lack of access to information regarding their health and rights, through the following components:

PeerEdWorkshopsA Peer Education Programme:

The programme trains an annual cohort of 30-40 young people as peer educators on Comprehensive Sexuality Education (CSE) and HIV Prevention, who conduct peer-to-peer workshops in communities with 1,500 – 3,000 young people each year.

This is primarily based in two states, the National Capital Region and Uttar Pradesh (Jhansi and Lucknow).

In 2011, the programme began working in Lucknow and Jhansi districts in Uttar Pradesh on delivering sexual and reproductive health information to young people and adolescents as well as mobilizing them to demand for sexual and reproductive health information with key gatekeepers and stakeholders.

 

A National Capacity Building, Training of Trainers (ToT) Programme:

TYPF conducts ToT capacity building programmes with youth leaders, master trainers and community service providers from both our own programmes and also with partner networks and organizations, who are implementing CSE or Youth Friendly Health Services (YFHS). The ToT focuses on sharing best practises, increasing access to and scaling the quality of implementation in youth led and run CSE and YFHS programmes. Watch videos where participants give feedback about such trainings in the past here.

Project19festivalCommunity Campaigns and Public Festivals:

In 2007, the programme hosted The Project 19 Festival, in partnership with the Center for Human Progress, one of India’s largest youth-led festivals for Sexuality Education that brought together 1500 young people from states in India to lobby with government officials and advance the need for CSE in India.

The festival used multiple performing arts and digital media platforms to highlight the role of stigma and discrimination and the cross-cutting role of class, caste, patriarchy, violence and punitive laws that inhibit young people from accessing information and services that India has committed to ensuring for its citizens through internationally binding agreements such as the International Conference on Population and Development in 1994 and the Beijing Platform for Action in 1995.

Voices of Young People on Chapters of Silence:

  • In 2011, TYPF partnered with Plan India with technical support from UNESCO, to conduct youth-led consultations with 287 adolescents and young people across eight states, (Delhi, Tamil Nadu, Andhra Pradesh, Maharashtra, Jammu & Kashmir, Nagaland, Chandigarh and Uttar Pradesh) to obtain their recommendations on HIV Prevention, AIDS and Sexuality Education provided under the National AIDS Control Organisation’s guidance in schools. Qualitative recommendations from the consultation were provided to NACO in August 2011. The final report submitted to NACO can be downloaded here.

Press & Publications

The programme’s approach has been highlighted extensively by technical agencies and in the media, covered by the United Nations Headquarters, USAID,  Conversations For a Better World, the UNAIDS Programme Coordinating Board Meeting in GenevaFrench MediaTimes of IndiaHindustan Times, The HinduUNESCOUNAIDS Inter Agency Task Team on Education, Community of Practitioners for Accountability and Social Action in Health, Americans for Informed Democracy and the Global Health Council  to name a few instances.

Impact

Through varied partnerships and national level work, the programme has engaged 300 peer educators and 6000 youth leaders across 16 states in the last 12 years, conducted training of trainer programmes with more then 120 young leaders from 8 states and bought together over 200 young activists from across the country to share best practices and examine strategies to increase access to and scaling the quality of youth led and run Comprehensive Sexuality Education and Youth Friendly Health Services programmes. In two years (2011-2013), the programme worked with 1574 young people from in-school and out-of-school communities through workshops and on ground (offline) campaigns in both National Capital Region (NCR) and Uttar Pradesh. Across 2011-2013, the programme also conducted a national survey with 3,500 young people across 4 states (Goa, Chattisgarh, UP and Delhi) to document and build an evidence base of the ground realities with regard to lack of access to comprehensive sexuality education (CSE) and health services.

The programme has developed a rigorous Monitoring and Evaluation frameowrk that allows us to track the knowledge, attitudes and practises of the young people that we work with. Some key highlights from the two states the programme works in are as follows, from data in the programme’s end-line survey across 2013 – 2014.

Increase in awareness on components of Comprehensive Sexuality Education (CSE), focusing on issues of gender, sexuality, health, rights and HIV & AIDS.

  • 73% participants through the workshop process began questioning gender ‘norms’ and shifted their opinion to state that gender stereotypes are a way of discriminating against girls and women. Many girls shared their every day struggles with not wanting to do house work and having to convince their parents and other family members to allow them to go to school.
  • The participatory nature of the module included activities that were conducted with males and females separately, as well as together. Collective conversations were considered an important part of developing interpersonal communication skills in the programme and addressing issues of power dynamics, peer pressure, negotiation, consent and violence.
  • At the start of the process, 49% of participants felt comfortable discussing these issues with the opposite sex, which over the course of our workshops increased to a total of 72%. If participants do not wish to have mixed-gender exercises, this is respected and exercises are changed accordingly.
  • In communities that included both male and female participants, partner staff reported that after training, male and female participants were observed as being comfortable conducting discussions in mixed groups on queries and concerns relating to sex and relationships.
  • Secondly, in workshops that consisted of only female participants, the end line found that by the end of the workshop process, young girls were asking comfortable questions and responding to sessions on gender and sexuality that were facilitated by male peer educators.
  • It was noted that although initially participants across various workshops on the first instance would blush and giggle, particularly whilst naming sexual and reproductive parts during body mapping exercises, post workshops they not only felt comfortable in naming these parts but also did so with increased confidence.
  • There was a 27% increase in participants being able to accurately identify and locate reproductive and sexual organs through body mapping exercises. During the baseline and prior to the workshops only 42% of participants were able to do so whilst this increased to 69% during the end line.
  • The end line also showed an increase in the basic understanding of the functions of these reproductive and sexual organs across participants, which rose from 37% to 65%. Although for in school participants from private schools it was found that even prior to the training, participants had significantly higher knowledge, this end line data reflected above in the graph shows only the data from the end line assessments with out-of-school groups. Therefore, a 50% increase in basic understanding of the functions as well as location of reproductive and sexual organs reflects a key success of the sessions conducted on the same.
  • During the base line survey only 46% had correct information regarding their understanding on menstruation, masturbation, voice cracking, nightfall, vaginal discharge and erection. Post workshops, it was found that 69% out of the participants now had this information and were also able to question the myths around these.

Increase in access to SRH services through partner organizations:

As a direct result of the peer education sessions, partner organizations responded to the SRH service needs that were highlighted from the workshops and structured referral services for participants accordingly. An example of the kind of referrals that were provided to young people was:

  • In Tis Hazari, NCR with our partner Salaam Baalak Trust, an HIV Testing facility and trainings on STI’s was made available on the request of 23 young boys, after the peer education process finished. This was supported with an in-house counseling facility that the organization already has, to ensure sustainability.
  • In Gautam Nagar, NCR with our partner Chetna, participants from the workshops were trained along with their mothers in a Menstrual Hygiene Awareness Camp. These participants then worked with a Gynecologist to conduct a larger health camp on misconceptions relating to Menstrual Health and Hygiene with the larger community of 42 young girls the programme is working with.
  • In Lajpat Nagar, NCR with our partner FAT (Feminist Approach to Technology), refresher trainings were subsequently conducted with 19young girls on safe access to contraception, condom demonstrations and condom use. This was supplemented with a campaign on contraceptive use and safe sex with 35 young girls from the community to address the challenges of accessing contraception and negotiating condom use. Post these workshops and a campaign with staff in FAT, the concerned staff has begun conducting individual sessions with participants on any clarifications they may seek. One staff member at FAT has stated that she often uses pictures and material used in the workshops to make presentations to use with girls at the centre. As the partner staff themselves are not equipped with complete information, they have referred girls to existing services such as the TARSHI helpline and The YP Foundation for specific individual queries. They have also stated their interests in training previous participants in workshops to become peer educators in the programme.
  • Within a span of 16 months into the programme, youth leaders in Uttar Pradesh claimed to have  increased their awareness and knowledge on basic SRH issues. They were also able to recognize myths and misinformation in certain cases as well as place it within their context and link the importance of working as youth leaders with issues of violence, gender, decision making, caste, discrimination and right to voice their opinion.
  • Participants reported that where limited conversations took place, more young people are discussing SRH needs with members of their households. The programme has also noted a marked increase in mobility specifically for adolescent and young girls as a result of the ongoing peer education process at community level in Jhansi, Uttar Pradesh.

 

4 Comments

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