ICT
and HIV/AIDS Preventive Education in the Cross-border
Areas of the Greater Mekong Subregion Project:
A Model on the Use of ICT in Preventive Education
Paper
presented at Asia-Pacific Workshop of Academic Parliamentarians
on Education, Population, & Sustainable Development
Convened
by the Asian Forum of Parliamentarians on Population and Development
(AFPPD), Ao Nang Villa Resort, Krabi, Thailand, 8-9 March 2005
by
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M.
R. Rujaya Abhakorn, PhD
Former Deputy Directorfor Administration
and Communication, SEAMEO Secretariat;
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Sandra
Tempongko, PhD
Deputy Network Coordinator
SEAMEO TROPMED
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Background
The
Greater Mekong Subregion (GMS) comprises Cambodia, the Lao people’s
Democratic Republic (Lao PDR), Myanmar, Thailand, Vietnam, and Yunnan,
province of China – all of whom share the Mekong River and
also all are confronted by the problem of HIV/AIDS. Of the estimated
40 million people living with HIV/AIDS (PLWHA) worldwide at the
end of 2003, more than seven million are reported to be from Asia
and the Pacific. Almost two million of these are from the GMS countries
Cambodia, Lao PDR, Myanmar, Thailand, Vietnam, and Yunnan province
of China. UNAIDS report states that as of the end of 2003 the number
of adults (15-49 years) and children living with HIV in four of
the countries included in the Project are as follows: Cambodia-
170,000; Lao PDR– 1,700; Thailand– 570,000, and Vietnam-
220,000. China is reported to have an estimated 840,000 cases, half
of which are in Yunnan province. New infection cases are increasingly
found among women who also bear the responsibility of caring for
those living with HIV/AIDS. In 2001, 290,000 children (0-14 years)
were orphaned by HIV/AIDS in Thailand compared with 75,000 in 1999;
22,000 in Viet Nam; and 55,000 in Cambodia compared with 13,000
in 1999. Although the national adult HIV prevalence is still low
in Lao PDR (below 1 percent) its proximity to drug trafficking routes,
increasing integration with the region and high STI levels in some
populations could facilitate the spread of the virus.
Among the youth, HIV is considered as one of the biggest threats.
It is reported that (UNAIDS/UNICEF/WHO, 2004) - a total of 10 million
aged 15-24 years are living with HIV at the end of 2003, 20% of
which are found in Asia. Several factors that increase their vulnerability
to HIV include lack of HIV information, education, and services
as well as adolescent experimentation and curiosity, coerced sexual
relationship, and gender inequalities
The regional economic cooperation through the “economic corridor”
approach has opened borders and stimulated economic activity such
as tourism, special production and trade zones. This has resulted
to increase flow of populations across borders with major implications
for both the epidemiology and prevention of HIV/AIDS. The influx
of primarily male workers along the borders creates a demand for
sex work that is usually met by the local communities. These border
areas also provide easy access to injecting drugs. In other cases,
people from nearby poor communities cross the borders, get infected
with HIV and upon their return serve as bridges of HIV transmission
in their home communities along the borders. To summarize, the factors
that facilitate the spread of HIV in Mekong include availability
of drugs for injecting drug use, the sex industry, migration and
mobility, poverty, stigma and lack of opportunities for women.
There is still no cure for AIDS and vaccines are still being developed.
Thus success in reducing the spread of the virus depends on changing
behaviours and addressing the environmental and socio-economic factors
that increase people’s vulnerability to the infection. For
example, delaying the onset of sexual activities among adolescents,
with special emphasis among the girls is a major contributing factor
in preventing the spread of HIV through sexual contact. Another
important factor is resisting peer pressure to take or inject drugs.
The earlier the youth can be reached by preventive programs, the
greater the hope of changing the course of the epidemic.
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The
Role of Preventive Education
The school-based preventive education programme plays a major
role in prevention activities especially for the youth. It is
a key approach for a comprehensive prevention and care programme.
In addition, the school setting offers a ready made infrastructure
for the delivery of preventive education. It can reach large number
of young ones long before they get to be sexually active. The
use of the skills-based approach in preventive education enhances
the development of life skills that enable the youth to make healthy
decisions to protect them from HIV/AIDS and also improve their
educational and economic opportunities.
The
school more than any other institution, can reach further into
the community. This is an important consideration since significant
proportions of the youth with increased vulnerability to HIV are
out of school. Furthermore, preventive education for the community
through the schools allows provision of coordinated messages for
the community and the school population.
In
all of the participating countries, policies/enabling statements
of the Ministries of Education are in place to support implementation
of preventive education for HIV/AIDS in the school setting. These
policies mandate the implementation of HIV/AIDS preventive education
in all levels i.e. primary, secondary, and tertiary. In a number
of countries, HIV/AIDS preventive education is also implemented
in teacher training institution.
In
Cambodia, a policy and strategy for integration of HIV/AIDS for
“in and out” of school youth is included in the Education
Strategic Plan of the Ministry of Education Youth and Sports (MoEYS).
A decree of the Ministry of Education and Training (MOET) of Vietnam
calls for the strengthening of HIV/AIDS preventive education.
A provincial regulation of Yunnan province requires all schools
to carry out HIV/AIDS preventive education. In Lao PDR, an AIDS
Education Team in the Ministry of Education was established in
1996 to be responsible for the implementation of its preventive
education following the organization of a multi-sectoral National
Committee for the Control of AIDS (NCCA). The policy of the Ministry
of Education in Thailand emphasizes the right of children to understanding
and realization of HIV/AIDS danger.
The
implementation of preventive education in the school setting is
undertaken through curricular and co-curricular activities. The
curricula of the countries were revised to integrate HIV/AIDS
concepts in a number of courses/subjects and life skills approach
is currently being utilized. The courses involved include health
education, biology, civic and moral education, and languages.
AIDS education team comprising members coming from different departments
of the Ministries of Education were formed. However, the coverage,
and scope of implementation vary from country to country. Moreover,
there are several issues and concerns that affect its effective
and efficient implementation. Two of these concerns are appropriateness
of teaching/learning materials and teaching methodologies.
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The
Use of ICT
The
use of ICT in HIV/AIDS preventive education can promote fundamental
improvements in teaching and learning. Creative, interactive, integrated
and contextually appropriate ICT-based interventions can enhance
the teaching/learning process. Materials developed together with
the learner can address issues specific to the school population.
Furthermore, ICT-based educational materials can be stored for ready
access on demand, allowing for more flexible use and self-paced
learning. Nonetheless, it should be emphasized that mere exposure
to ICT is not an end goal. ICT interventions should be integrated
into broader educational processes. ICT stimulates higher order
cognitive learning like problem-solving through creative projects
involving all students both in the classroom and co-curricular activities.
To
date, the use of ICT for HIV/AIDS preventive education is not maximized
in all GMS countries. It is envisioned that it can address the two
most pressing issues in implementation of preventive education:
to improve the teaching/learning environment and methodology and
allow for the development of appropriate materials right at the
implementation level with little cost.
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ADB-SEAMEO
Project
The Asian Development Bank (ADB), as part of its regional technical
assistance to promote human development and poverty reduction in
the Greater Mekong Sub-region (GMS), provided technical assistance
amounting to $1,000,000 to support a regional project on ICT and
HIV/AIDS Preventive Education in the Cross-Border Areas of the GMS
(TA 6083) for an 18-month period beginning March 2003. The Southeast
Asian Ministers of Education Organization (SEAMEO) and the United
Nations Educational, Scientific and Cultural Organization (UNESCO)
were appointed Executing Agencies for implementation of the Project
each with its own sub-project component amounting to $500,000. The
SEAMEO Component of the Project was implemented by the SEAMEO Secretariat,
SEAMEO TROPMED, SEAMEO INNOTECH and SEAMEO SEAMOLEC in partnership
with participating GMS countries (Cambodia, Lao PDR, People’s
Republic of China [Yunnan Province], Thailand and Vietnam). It focused
on expanding the use of information and communication technology
(ICT) and other multimedia technologies by teachers for HIV/AIDS
preventive education in schools in selected cross-border sites of
the GMS.
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Goals
This
ADB technical assistance has two development goals i.e. (i) to reduce
incidence of HIV/AIDS infection among vulnerable age groups, poor
and marginalized population groups; and (ii) to expand the use of
ICT and other multimedia technologies in HIV/AIDS preventive education.
The
objectives of the Project are; (i) to develop ICT learning materials
for HIV/AIDS preventive education in local languages; (ii) to build
capacities of teachers, health workers, multimedia providers, and
other stakeholders for HIV.AIDS preventive education; (iii) to expand
the use of ICT interventions in HIV/AIDS preventive education; and
(iv) to deliver ICT-based interventions to isolated, marginalized,
and vulnerable populations. There are two international organizations
designated as executing agencies, one for each of the two project
components, SEAMEO (Southeast Asian Ministers of Education Organization)
and UNESCO.
The
SEAMEO’s component focuses primarily on teachers and in-school
youth and addresses indirectly the communities where the selected
schools are located. This component of the Project was implemented
in nine border areas between the five participating countries i.e.
Cambodia, Lao PDR, Thailand, Vietnam and the Yunnan Province of
PRC. A total of 36 lower secondary schools, two schools per side
of the border, were included in the Project.
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Project
Sites
The
project was implemented in nine border areas between the five participating
countries. These border areas were selected collectively by the
five national teams in consideration of a number of factors. These
include potential for spread of the infection, magnitude of the
need for preventive education, and presence of an enabling environment
e.g. absence of border conflicts, commitment of local authorities,
related HIV/AIDS activities in place.
In
terms of socio-economic conditions the local population in the selected
borders belongs to the poor sector of society. In addition, these
areas are active in terms of mobile population crossing borders
for economic reason. However, the presence of economic activity
also resulted to the increasing presence of establishments catering
to commercial sex. In one of the Cambodian border, casinos and other
entertainment establishments are the primary source of economic
activity.
The
high vulnerability to HIV of these borders is shown by the presence
of HIV cases .In Cambodia, the prevalence rate of HIV in the three
provinces involved among sex workers are 37 %, 51% and 36% respectively,
while among pregnant women, the rates are 4.4%, 3.3% and 1.7%. In
Lao PDR, 38 cases have been reported in the two provinces involved
which represent about 3.13% of the total cases reported for the
whole country. In Thailand, a total of 709 cases are reported in
the three provinces involved, while in Vietnam, the five provinces
have 211 cases. Furthermore, in the six schools of Thailand, there
are 36 HIV/AIDS affected students. In Yunnan, exact figures are
not available in the project sites. However, qualitative reporting
of the stakeholders in the project validated presence of a number
of cases along the borders.
Reaching
the minorities was also considered in the selection of the border
areas. For example in Lao PDR, there are about 36 ethnic groups
in the four provinces involved out of the 49 groups present in the
whole country. In Yunnan, significant proportions of the population
of the four schools are minorities. Figure 1 and Table 1 show border
areas involved in the project.
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Figure
1: Border areas included in the project
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Table
1: Selected Border areas in five countries involved
in the project
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| 1. |
Koh
Kong, Cambodia border with Trad, Thailand |
| 2. |
Bantaey
Meanchay, Cambodia border with Sakeo, Thailand |
| 3. |
Svay
Rieng, Cambodia border with Long Anh, Vietnam |
| 4. |
Phongsaly,
Lao PDR border with Lai Chau, Vietnam |
| 5. |
Luang
Namtha Lao PDR border with Muong La, Yunnan |
| 6. |
Borikhamsay,
Lao PDR border with Ha Tinh, Vietnam |
| 7. |
Saravanh,
Lao PDR border with Ubon Ratchathani, Thailand |
| 8. |
Ha
Giang, Vietnam border with Malipo County, Yunnan |
| 9. |
Lao
Cai, Vietnam border with He Kou County, Yunnan
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A total of 36
secondary schools, in most cases two schools per side of the border,
were included in the project.
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| Inputs
The
project’s inputs include: (i) situational analysis of the
sites and schools (ii) training of national trainers in a regional
centre for the enhancement of their skills on instructional design
development, use of ICT tools (Word processing, Presentation, Spread
sheet, Video) and hands on production of prototype ICT based materials;
(iii) provision of basic ICT equipment to the five national teams
and 36 schools; (iv) training of classroom teachers implementing
preventive education on use of ICT and development of learner generated
materials at the school level; (v) materials development; (vi) delivery
of ICT enhanced preventive education in the school setting; (vii)
community preventive education; (viii) development of data base
for the SEAMEO component; and (ix) monitoring.
Outputs
and Outcomes
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The outputs of
the Project are: |
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A. |
One
regional and five national training curricula and manual on the
local language for use of ICT in preventive education; |
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B. |
10 national trainers’
ICT capability strengthened; |
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C. |
614
classroom teachers trained on the use of ICT which is much higher
than the targeted number of 200, 57.82% % of whom are females; |
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D. |
a
total of 650 computer generated print materials like flyers, brochures,
newsletters, posters and pop-up materials; 207 PowerPoint presentations;
15 video in the local languages ; 79 ICT based interactive games;
8 VCD of folk songs; and 6 radio scripts for local community; |
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E. |
26,679
students reached by ICT enhanced preventive education of whom 46.79%
are females; |
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F. |
an
estimated 100,000 community members reached by community preventive
education activities in the border sites; |
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G. |
ICT capability
of 36 schools and five national teams strengthened; and |
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H. |
Web-based
project database developed. |
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Other
intangible outcomes of the project are: |
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(i) |
establishment
of the culture of ICT among the 36 schools, thus contributing to
the reduction of the ICT divide; |
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(ii) |
higher morale
and satisfaction of teachers delivering the program; |
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(iii) |
increased interest
and participation of students; |
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(iv) |
higher
commitment of school officials and community leaders and members
on the project and school programmes as manifested by the provision
of financial support to build infrastructure to house the ICT hardware,
provision of electricity to a number of schools in Lao PDR to accommodate
the ICT equipment, and their participation in school-community activities;
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(v) |
strengthened
partnership between health and education sectors at different levels; |
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(vi) |
upgraded
local capacities for decentralized responses to emerging issues
at the communities initiated; |
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(vii) |
cross-border
activities and bilateral cooperation between countries initiated; |
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(viii) |
access to poor
marginalized population along the border areas; and |
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(ix) |
access
to girls and women in the school and communities and addressing
their need to reduce their vulnerability to HIV.
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What
can be learnt from the Project?
The
HIV/AIDS preventive education is most needed among the poor and
marginalized people. Poverty can never be eradicated as long as
people do not know how to lead a healthy way of life and protect
themselves from basic diseases. By concentrating on border communities,
the Project brought new methods in learning to the people that need
them most.
The
Project was localized and run by people who knew the local needs,
especially in relation to language and ethnic values and beliefs,
resulting in local ownership and, hopefully, sustainability of its
outcomes. As the local people develop their own understandings of
HIV situation and their own solutions to the problems, a tradition
of learning was instigated.
At
the forefront of the activities would be the schools, that are strengthened
as Community Learning Centres. The ICT use was not isolated in computer
rooms, but part of school curricula and communal activities, addressing
health issues of collective concern.
The
most desirable outcome would therefore be the development of an
ICT culture that corresponds to a form of life skills in handling
information, acquiring knowledge, using knowledge and information
in social communication and interaction, and making an intelligent
use of ICTs in the process. It is an important part of the global
efforts to build HIV resilient communities everywhere.
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