Sangsangai Report (Related to HIV and AIDS)

REPORT OF LONG TERM IMPACT OF SANGSANGAI PROGRAM:

Introduction:

This report sets out the finding (impact) of Join-in circuit, Nepali named SangSangai  program conducted by YOUTH ACTION NEPAL, in school level and also security personal (Nepal Army) in different districts of Nepal  i.e. Kathmandu, Bhaktpur, Lalitpur, Dhading, Palpa, Dang, Manang etc.

Of these, YOUTH ACTION Nepal; it program was conducted with 18245 participants and approximately 50000, audience, which is altogether of 68245 in number.

So, SangSangai is an effective educative and interactive methodology, a tool for communication with young people aged 15 years onwards. It emphasizes participation, communication and responsibility. The JIC (The Join-in-circuit on AIDS, Love and Sexuality in Nepal) has been used scientifically tested in more than 15 countries for the last ten years. Through its didactic process it creates a special situation where the participants are engaged both on an intellectual and an emotional level. This makes learning about the sensitive issues of sexual and reproductive health and HIV more memorable and applicable to their own lives.

Apart from the direct and practical knowledge they receive regarding the specific topics, the young people often undergo a change in attitude regarding HIV, sexuality, and their health, thanks to the encouragement of open discussions. A personal overcoming of sexual taboos is often a considerable benefit for the participant. Also, the participants may eventually become knowledgeable activists in their own communities and districts and thus multiplying the benefits.

As a large number of people visit SangSangai in a short time, it is most suitable for groups in certain settings, e.g. youth clubs, schools, vocational training institutions or work places, Potentially, SangSangai can also be used with other social or professional groups e.g. teachers. Police, and military recruits.

How does it work?

SangSangai consists of six physical stations. Up to 90 participants are divided in six groups which move simultaneously from station to station. At each station they learn about one particular topic with the help of a team of youth facilitators. They remain at each station for 15 minutes and complete the entire circuit in 90 minutes. Topics are revealed and discussed through the use of pictorials, role plays exhibitions, and games, SangSangai engage the participants emotionally, physically, intellectually, and verbally.

Definition about the stations:

 -Sexually Transmitted Infections (STIs):

This station explains the symptoms of the most common STIs and provides the message that these diseases are curable. Through the use of a Tiger puzzle, a fun game on misconceptions about STIs and a discussion on the use of the four Cs (Complete treatment, Counseling, Condom use and Contract tracing), he facilitators can communicate about a difficult topic in a fun way.

- HIV Transmission and Prevention:

In this station the participants learn o differentiate between risky and non-risky behavior with regard to HIV transmission. Based on the principle that' prevention is better than cure', the station communicates the importance of being abstinent and faithful, to use condoms and clean needles (if injection drugs) to protect oneself from HIV. 

- Protection:

This station focuses on the reasons for and benefits of condom use. Through playing a 'condom race' game, the proper use of a condom is demonstrated. The station also exhibits six other methods of contraception available in Nepal and educates on their advantages and disadvantages.

- My Body Station:

Given the taboos regarding adolescent sexuality, participants are encouraged to discuss the physical and emotional changes during growing up. It addresses sexuality, peer pressure, the risk associated with drug and alcohol use, and the connection to HIV and STIs. Through the 'wheel of fortune' game, discussions about these topics are provoked. This activity is aimed to make young people understand their own body better, resulting in increased to preserve your own health.

- You and Me – Gender Station:

This station addresses situations of daily gender inequality and possible way to change this. Through role plays, differences between six and gender, gender violence and sexual harassment and their relationship to HIV are talked about. The emphasis is on generation mutual respect between boys and girls and an open atmosphere of communication.

- My Life – Solidarity:

This station has the purpose of establishing s sense of solidarity for people living with HIV (PLHA) and reducing stigmatization. After the participants have constructed an imaginary life for an imaginary friend, they reflect on how the HIB infection affects this person's life. The role of voluntary counseling and testing (VCT) and opportunity for treatment is communicated.

Objectives of research:  

Ø  To find out knowledge level of SangSangai in school child.

Ø  To find out Behavior of SangSangai in school children.

Ø  To find out personal opinion in school children.

Research Methodology:

Data was collected from Youth Action Nepal from 2068/8/16 B.S; we carried out SangSangai evaluation on 45 students of two schools on the different date i.e. 2068/8/16 and 2068/8/19 B.S in Deepmala Secondary School and Kalyan Secondary School respectively. In Deepamala the number of respondents were 16, among them 7 were Male and 9 were Female. Also in Kalyan Secondary School the total answering respondents were 29 in number, where 16 were Male and 13 were Female.

 This SangSangai evaluation was on altogether 45 students of two different schools among SangSangai participants. Respondents were from the grade 8 to 10, among all of them 23 were male’s number and 22 were female, from the aged group of 13 to 17 .Who were from different cast like Brahmin, Chhetri, Newar, Magar, Thakuri, Lama, Rai, Dhamana, Tharu, Dhalan. This shows participants were from different community and religion on the research.

So, in this way the main procedure of data collection was interview schedule the estimated time was for 20 minute per participants.

All 19 questionnaires were taken from six different SangSangai stations to find out respondents knowledge level, behavior and opinion in general. From 19 questionnaires, two questions were opened ended and rest of other questions was close ended.

All the main aim of research was to explore the understanding and effectiveness of SangSangai program on participants through direct and practical knowledge they receive regarding the specific topics, the young people often undergo a change in attitude regarding HIV and AIDS sexuality and their health.

Finding and analysis:-

To find out or analyze the impact of SangSangai program conducted by Youth Action Nepal on previous days with students and security personals (Nepal Army). We had designed  19 question from each six different SangSangai stations to know the knowledge level, Behavior and personal opinion of the aged group from 13 to 17 years of old and from grade 8 to 10 regarding Sexually Transmitted Infections(STI), HIV Transmission and prevention, Protection, My body, You and Me – Gender and My Life – Solidarity. So all the questions were based on above mentioned. In the questionnaire, question starting 1 to 6, 7 to 12 and 13 to 18 were to know the knowledge level, behavior and opinion respectively. And last question i.e. 19 was open question which was to find out the overall change of participants after participating in the program.

1.      What kinds of behavior risks in HIV transmission?

S.N.	Answer	Number of respondents
a.	Safe sex	2
b.	Exchange of syringe	-
c.	HIV infected mother to child	-
d.	All above	43

From above asked question 2 participants answered unsafe sex and 43 answered focusing on all above.

As the participants were asked about the risking factor of HIV transmission, respondent answered correctly focusing on all the given option like, change of syringe, HIV infected mother to child, unsafe sex so, we can assure that the knowledge regarding HIV transmission was correct and good.

2.      What are the symptoms of sexual diseases?

S.N.	Answer	Number of respondents
a.	Headache	-
b.	Vomiting	1
c.	Vaginal fluid with bad smell	26
d.	Don’t know	18

According to respondent’s level of knowledge, 27 answered focusing on vaginal fluid with bad smell, like wise 18 answered focusing on don’t know and none of them showed response on option headache.

Two options were incorrect so, respondents did not show any response towards them. That’s why the knowledge of the total respondents was good enough. But 18 respondents replied that they were unknown regarding the correct answer.

3.      Please note down the names of temporary contractive methods?

This question was open ended so all of them answered focusing on temporary family planning methods which prevents from the sexual diseases as well such as, condom (male and female), IUCD, pills, sangini (three months syringe), copper T, Norplant  only. 

This shows that all of the respondents were well known about the contractive. So, we can easily consider that all of them have idea of temporary contractive means of family planning. 

4.      The means cycle of women consist of 28 days in how many days before and after the cycle continue?

	Answer	Number of respondents
a.	One day	3
b.	Five days	13
c.	Ten days	2
d.	Fifteen	25

From 45 participants, 25 students answered Fifteen days, 13 students answered five days, 3 students answered on a day and 2 students remain neutral i.e. they did not replied.

In this question 13 respondents answered correctly that means in this question their reply was poor because most of respondents replied that the means cycle is of 15 days which was incorrect. That’s why they haven’t known about the answer correctly.

5.      Who plays important role in determining the child sex?

S.N.	Answer	Number of respondents
a.	Male	25
b.	God	1
c.	Female	7
d.	Don’t know	12

Among the total participants, 15 students said male plays important role in determining child’s sex where as a single student said god, 7 students said female and 12 respondents said don’t know.

From this question what we found is that, most of the respondents answered correctly saying male plays important role in determining child’s sex. But 20 of the total respondents replied incorrectly focusing on female, god and some of them also replied as they had no idea about the asked question. This clearly shows us that the knowledge level of the student was satisfying but not so good enough.

6.       What do you mean by ARV?

S.N.	Answer	Number of respondents
a.	Diseases	1
b.	Immunity increasing medicine	32
c.	Virus	8
d.	Don’t know	4

In this question’s reply 32 respondents answered it ARV as immunity increasing medicine, like wise 8 respondents replied it as virus, 4 of them replied don’t know, 1 of them replied it as diseases.

This was also the question to know the knowledge level of respondents regarding “ARV” which means Anti Retro Virus. Majority of student i.e. 32 replied this question correctly saying ARV as an immunity increasing medicine, where as 13 of respondents replied incorrectly saying it as virus, diseases.

7.      Have you ever shared the toilet used by HIV infected?

S.N.	Answer	Number of respondents
a.	Yes	-
b.	No	33
c.	Sometimes	-
d.	Don’t know	12

Actually this was the question of behavior from the answer what we focused is that, 33 respondents answer was no i.e. don’t use, 12 replied they didn’t know, none of them replied yes and sometimes respectively.

Respondent’s reply from this question wasn’t satisfactory we can consider it as poor reply because most of them have replied that they don’t use the toilet used by the infected person and rest of all replied as they don’t know, this clearly shows that still they are lacking knowledge/ education regarding HIV and AIDS transmission.

8.      What will you do if you found wounds on your sexual organs?

S.N.	Answer	Number of respondents
a.	Health post	43
b.	Witch doctor	-
c.	Don’t do anything	-
d.	Don’t know	2

43 respondent replied their answer as health post, 2 respondent said don’t know and rest of them remain neutral.

The majority of student said they go to health post if they found such problems. And very few i.e. 2 respondents replied don’t know. This shows that their behavior for taking health service is very good. They are far from traditional belief on witch doctor.

9.      How often you go to health post to take family planning service?

S.N.	Answer	Number of respondents
a.	As for need	37
b.	It has needed but didn’t go	-
c.	Less than 5 times	2
d.	More than 5 times	6

This question was set to know the behavior of the SangSangai participants regarding their visit to health post to take family planning services. 37 participants goes to hospital as for their need, 2 respondents replied they go more than five times a year and six of them said they go less than five a year.

This data clearly addresses that used to visit health post they needed family planning services. Also this shows that they are conscious/ aware about family planning services. But few of them are not interested in visiting health post for the service. So, that we can analyze that most of the people are conscious which shows that they have importance of family planning.

10.  To whom have you informed first about your physical change?

S.N.	Answer	Number of respondents
a.	Friend	25
b.	Parents	13
c.	Relative	-
d.	No one	7

Among the total of 45 respondents, 25 were found to have shared about their physical change with their friends, 13 had shared with their parents, none of them had shared with their relatives and 7 had not shared with anyone.

The above data shows that majority of the people feel free to share their experiences with their friends without hesitation. Even today, some are introvert and they hesitate to talk about their physical change with parents and relatives etc. With this we found that this kind of sharing is always within their friends only and parents. So that we can conclude saying that they do share things and impact is in them too.

11.  What is the practice in your family that shows gender quality?

S.N.	Answer	Number of respondents
a.	Equal education to both male and female	29
b.	Help in household chores	11
c.	Freedom to go out	3
d.	Don’t know	2

From above the question, 29 respondents focused for equal education between male and female, 11 of them replied that they will help each other household work, 3 of them said that they will allow them to go out freely and 2 of them said they don’t i.e. they don’t have the idea.

So, we can analyze idea given by them is that they will help in providing equal education between male and female. They found education as important means of equality between both male and female. Because of they thought that male and female will be equal when they will be provided equal education which will help in empowerment of them.

Also, 11 of them said that they will help female equally. They will be treated equally. Whereas 3 of them told that they will provide freedom to male and female. They provide freedom with the male and female. And minority of them said that, they don’t have the idea. So, we can say that their perception regarding male and female members in family is found good.
So, we can say that male and female should empower equally which we found good enough. And idea was effective. Most of them focused for education only.

12.  How do you behave with HIV infected people?

S.N.	Answer	Number of respondents
a.	Equally	27
b.	Loveable	17
c.	No thing	1
d.	Hate rate	-

From the above question, 27 respondents replied they behave equally like other normal people, 17 of them behave loveable and a single participant said s/she does nothing and none of them replied saying sense of hate rate.

Among the 45 participants, 27 of them said that they behave equally with HIV positive person. They behave them normally. But 17of them replied saying they love them showing sympathy on them. This shows that their behavior regarding HIV infected is good so we can say that their behavior towards infected is positive.

13.  Among the victims of sexual diseases, do you think that the sexual disease will be cured if only one friend gets the treatment?

S.N.	Answer	Number of respondents
a.	The one who gets treatment will be cured	27
b.	All will be cured	2
c.	None of them will be cured	5
d.	Don’t know	11

In this question majority of the respondents answered i.e. 27 of them replied saying the one who gets treatment will be cured, 2 of them said all will be cured, 5 of them focused on none of them will be cure and 11 of them said that they well unknown about it.

This question was associated with the respondents opinion, Majority of respondents replied correctly saying one who gets treatment will be cured which showed the opinion of them is of high. Whereas two of them replied saying both of them will be cured which was incorrect. Also five of them also replied saying none of them will be cured and eleven of them said don’t know. As a whole we can say that the majority of respondents replied correctly focusing one who gets treatment will be cure so, we can say they have good knowledge.

14.  In your opinion, HIV infected person should be given to continue their work in his office?

S.N.	Answer	Number of respondents
a.	Yes	43
b.	No	1
c.	Separate	-
d.	Don’t know	1

In regard the question 43 respondent replied saying they should continue their work, 1 respondents replied saying infected shouldn’t be given chance to work, none of them replied saying most be given separate place to work and single respondent replied saying don’t know.

Above the finding clearly suggests us that, their opinion is correct. Because most of them said that they must be given chance to continue their work in the office. And two of them were incorrect because they said no for their work in office and next replied saying they don’t have idea. So, the opinion is good regarding the question then we can assume that behavior is biasness. They focused to treat in equally and normally in his/her office to work.

15.  You think is it right, when wife doesn’t agree to have sexual relation with infected husband of sexual diseases without using condom?

S.N.	Answer	Number of respondents
a.	It is right	33
b.	It is wrong	9
c.	They can do it if they agree	-
d.	No idea	3

Among the total respondent, 33 respondents said it is right when wife doesn’t agree to have sexual relationship with husband without using condom, 9 respondents said it is wrong, 3 respondents said they don’t have idea and none of them said that they can do it if they agree.

From the answer of them, majority of the respondents replied currently saying it is right and other remaining or minority of respondents said it is wrong and they don’t have idea about the situation. It is clearly shows that they have good knowledge according to majority of respondent and about the temporary contraceptive and aware about sexual disease also. From the answer, we analyzed that they careful about sexual communicable diseases. They can think about their future life and also can say they are educated to make better family life. Every sexual relationship have to do with agreement between husband and wife and also women’s have  also such types of rights to have sex. So, this data shows that they have good knowledge about preventive methods and sexual diseases. It is also provides good impact of SangSangai program.

16.  In your opinion, what is the main reason women’s means cycle?

S.N.	Answer	Number of respondents
a.	Natural rules	41
b.	Previous life sin	-
c.	Diseases	2
d.	Don’t know	2

This was also the question regarding behavior of participants of SangSangai to know the reason of menstruation cycle on women. Where 41 of participants said it was natural rules, 2 of them said it is a disease and two of them said they were unknown about the reason of means cycle.

From above finding what we can know is that, most of the participants are well know about the reason of means cycle. The reason was due to natural process, which occurs naturally but very few of them said it was disease and sin of previous life. So, we can assure that the knowledge regarding this question is very good and high.

17.  In your perception, what is the main basis of distinction among male and female?

S.N.	Answer	Number of respondents
a.	Natural distinction/ difference	6
b.	Social difference	2
c.	Gender roles	1
d.	All of the above	37

Among the 45 respondents, 6 said that they thought natural/physical differences were the main basis of distinction among males and females. Only 2 respondents expressed that social differences played significant role in distinction between males and females. Majority of that believed that all these were the basis of distinction between males of females.

Through these questions respondents, it can be said/analyzed that the program has shown a positive impact on the respondents. As the majority of respondents have responded saying that they believe it is all the three factors that they distinguish males and females, it can be said that the program has a positive impact on the large i.e. the respondents as the program had the objective making them aware regarding gender differences.

18.  In your opinion, should a HIV positive mother be pregnant?

S.N.	Answer	Number of respondents
a.	Yes	-
b.	No	14
c.	Should take suggestion from doctor	27
d.	Don’t know	4

This question was set to know the opinion of the respondents regarding should a HIV positive mother be pregnant. And 27 respondents told they should take suggestion from doctor, whereas 14 of them said they shouldn’t get pregnant, 4 of them said they don’t have idea and none of them said they should be pregnant.

From this question, respondent reply could be analyzed good and positive. Most of them said that before getting pregnant HIV infected mother should consult with doctor and other group of respondents replied saying they shouldn’t get pregnant after knowing the HIV infection. That’s way we can say we can analyze that impact of this SangSangai program was affected.  Also they have dealt with this question correctly. But few of them haven’t expressed their ideas because they might be confused

19.  How did you feel after participating in SangSangai program?

This was the second open question. In which participants has expressed different ideas regarding the question. They have answered perfectly and after reading their ideas we can consider that their ideas and answers seemed good. Through we can easily say that this SangSangai program’s impact seemed good and effective.

Their different ideas were, they learnt more about HIV/AIDS. They don’t have hesitation to talk about their physical change, STIs, preventive methods as a whole also they do treat equally with HIV infected person, they know about risky behavior of STIs etc. That’s why we knew their opinion regarding their behavior which was effective enough.

Conclusion:

This research was started from 2068/8/16 to 2068/8/19 to find out the whole impact of SangSangai program, was conducted by Youth Action Nepal in previous days. So, in regard to this we tried to find out impact of the project/ program by using the three aspects addressing their knowledge level, behavioral change and personal opinion as a whole.

So, this research was conducted to check the long term impact of the program i.e. it was evaluated after a year. After evaluating the respondent’s knowledge level of six different stations i.e. Sexually Transmitted Infection (STIs), HIV Transmitted and Prevention, Protection, My Body, You and Me – Gender and My Life – Solidarity.  We found that their knowledge level was good enough because they have answered all six question of each station correctly. So, we can assure that their knowledge level is impressive.

Now as for this, we evaluated their behavior. We found positive in every six stations. Because they have been taking every activity normally like physical change, relation with HIV positive so we can assure that the program have given them impressive effect.

And in the part of opinion of questionnaire, the respondent opinions were very good regarding sexual disease, gender discrimination, sexual transmitted diseases and prevention methods. Among the total respondent they have replied correct answer and few of them were have very near to the right answer so we can analysis that their behavior level is good after involving in the SangSangai programs.

In this way we have come to the end of this impact evaluation report regarding SangSangai program conducted by Youth Action Nepal (YOAC) in past days which was to generate awareness in school children about sexual health. So, we can assure that this SangSangai program was shown good and effective impact on life of those participated children. They have been practicing the knowledge gained from the program.

Thus, at last we can say that, this program have shown positive change on the life of school children that’s why it was fruitful for them.