%PDF-1.3 %âãÏÓ 1 0 obj << /Type /Catalog /Pages 3 0 R >> endobj 2 0 obj << /Title (The Baaba Project) /Author (GOAL Uganda) /Creator (Word 97 or later) /Producer (antiword 0.37 (21 Oct 2005)) /CreationDate (D:200703261405) /ModDate (D:200703271032) >> endobj 4 0 obj << /Type /Encoding /BaseEncoding /StandardEncoding /Differences [ 128 /Euro 140 /ellipsis /trademark /perthousand /bullet /quoteleft /quoteright /guilsinglleft /guilsinglright /quotedblleft /quotedblright /quotedblbase /endash /emdash /minus /OE /oe /dagger /daggerdbl /fi /fl 160 /space /exclamdown /cent /sterling /currency /yen /brokenbar /section /dieresis /copyright /ordfeminine /guillemotleft /logicalnot /hyphen /registered /macron /degree /plusminus /twosuperior /threesuperior /acute /mu /paragraph /periodcentered /cedilla /onesuperior /ordmasculine /guillemotright /onequarter /onehalf /threequarters /questiondown /Agrave /Aacute /Acircumflex /Atilde /Adieresis /Aring /AE /Ccedilla /Egrave /Eacute /Ecircumflex /Edieresis /Igrave /Iacute /Icircumflex /Idieresis /Eth /Ntilde /Ograve /Oacute /Ocircumflex /Otilde /Odieresis /multiply /Oslash /Ugrave /Uacute /Ucircumflex /Udieresis /Yacute /Thorn /germandbls /agrave /aacute /acircumflex /atilde /adieresis /aring /ae /ccedilla /egrave /eacute /ecircumflex /edieresis /igrave /iacute /icircumflex /idieresis /eth /ntilde /ograve /oacute /ocircumflex /otilde /odieresis /divide /oslash /ugrave /uacute /ucircumflex /udieresis /yacute /thorn /ydieresis ] >> endobj 5 0 obj << /Type /Font /Subtype /Type1 /Name /F1 /BaseFont /Courier /Encoding 4 0 R >> endobj 6 0 obj << /Type /Font /Subtype /Type1 /Name /F2 /BaseFont /Courier-Bold /Encoding 4 0 R >> endobj 7 0 obj << /Type /Font /Subtype /Type1 /Name /F3 /BaseFont /Courier-Oblique /Encoding 4 0 R >> endobj 8 0 obj << /Type /Font /Subtype /Type1 /Name /F4 /BaseFont /Courier-BoldOblique /Encoding 4 0 R >> endobj 9 0 obj << /Type /Font /Subtype /Type1 /Name /F5 /BaseFont /Helvetica /Encoding 4 0 R >> endobj 10 0 obj << /Type /Font /Subtype /Type1 /Name /F6 /BaseFont /Helvetica-Bold /Encoding 4 0 R >> endobj 11 0 obj << /Type /Font /Subtype /Type1 /Name /F7 /BaseFont /Helvetica-Oblique /Encoding 4 0 R >> endobj 12 0 obj << /Type /Font /Subtype /Type1 /Name /F8 /BaseFont /Helvetica-BoldOblique /Encoding 4 0 R >> endobj 13 0 obj << /Type /Font /Subtype /Type1 /Name /F9 /BaseFont /Times-Roman /Encoding 4 0 R >> endobj 14 0 obj << /Type /Font /Subtype /Type1 /Name /F10 /BaseFont /Times-Bold /Encoding 4 0 R >> endobj 15 0 obj << /Type /Font /Subtype /Type1 /Name /F11 /BaseFont /Times-Italic /Encoding 4 0 R >> endobj 16 0 obj << /Type /Font /Subtype /Type1 /Name /F12 /BaseFont /Times-BoldItalic /Encoding 4 0 R >> endobj 17 0 obj << /ProcSet [ /PDF /Text ] /Font << /F1 5 0 R /F2 6 0 R /F3 7 0 R /F4 8 0 R /F5 9 0 R /F6 10 0 R /F7 11 0 R /F8 12 0 R /F9 13 0 R /F10 14 0 R /F11 15 0 R /F12 16 0 R >> >> endobj 18 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 19 0 R >> endobj 19 0 obj << /Length 20 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F9 10.0 Tf 0.000 0.000 0.000 rg (Received ) Tj /F7 12.0 Tf (October 2006, accepted for publication following revisions, February 2007) Tj 1 0 0 1 78.12 666.48 Tm /F6 14.0 Tf (How effective are street youth peer educators? Lessons learned from) Tj 1 0 0 1 132.99 651.92 Tm (an HIV/AIDS prevention programme in urban Uganda) Tj 1 0 0 1 143.86 593.69 Tm (Kirstin Mitchell, Monica Nyakake, and Juliet Oling) Tj 1 0 0 1 72.00 489.53 Tm /F6 12.0 Tf (Author Details) Tj 1 0 0 1 72.00 459.77 Tm /F5 12.0 Tf (Kirstin Mitchell [Corresponding author]) Tj 1 0 0 1 72.00 444.89 Tm (PEHRU, Dept. of Public Health and Policy, London School of Hygiene and Tropical) Tj 1 0 0 1 72.00 430.01 Tm (Medicine. Kirstin.mitchell@lshtm.ac.uk) Tj 1 0 0 1 72.00 400.25 Tm (Monica Nyakake) Tj 1 0 0 1 72.00 385.37 Tm (GOAL Uganda. PO Box 33140, Kampala, Uganda Mnyakake@goaluganda.com) Tj 1 0 0 1 72.00 355.61 Tm (Juliet Oling) Tj 1 0 0 1 72.00 340.73 Tm (Independent Consultant ) Tj 0.000 0.000 1.000 rg (Julietoling@yahoo.com) Tj 0.000 0.000 0.000 rg (.) Tj ET endstream endobj 20 0 obj 1064 endobj 21 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 22 0 R >> endobj 22 0 obj << /Length 23 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F6 12.0 Tf 0.000 0.000 0.000 rg (Abstract) Tj 1 0 0 1 72.00 725.36 Tm (Purpose) Tj 1 0 0 1 72.00 710.48 Tm /F5 12.0 Tf (This paper explores \220lessons learned\221 resulting from a process evaluation of a peer-led) Tj 1 0 0 1 72.00 695.60 Tm (HIV/AIDS prevention programme targeting street children and youth in urban Uganda.) Tj 1 0 0 1 72.00 680.72 Tm (The purpose was to explore aspects of implementation that either enhanced or hindered) Tj 1 0 0 1 72.00 665.84 Tm (the effectiveness of the peer educator \(PE\) role.) Tj 1 0 0 1 72.00 650.96 Tm /F6 12.0 Tf (Methods) Tj 1 0 0 1 72.00 636.08 Tm /F5 12.0 Tf (The process data derive from three reviews conducted throughout the project lifespan.) Tj 1 0 0 1 72.00 621.20 Tm (The reviews engaged participatory evaluation methods such as focus groups \(4\) and) Tj 1 0 0 1 72.00 606.32 Tm (workshops \(3\), as well as drawing on monitoring data such as activity evaluations.) Tj 1 0 0 1 72.00 591.44 Tm /F6 12.0 Tf (Findings) Tj 1 0 0 1 72.00 576.56 Tm /F5 12.0 Tf (The street youth in this project made effective peer educators. We suggest that letting) Tj 1 0 0 1 72.00 561.68 Tm (the target group choose their peers and focusing on street youth undergoing) Tj 1 0 0 1 72.00 546.80 Tm (rehabilitation engendered ownership of PE\221s by the target group and accountability) Tj 1 0 0 1 72.00 531.92 Tm (among PE\221s themselves. The role was highly coveted and the PE\221s became powerful role) Tj 1 0 0 1 72.00 517.05 Tm (models. The most useful work of the PE\221s lay in helping their peers to leave the risky) Tj 1 0 0 1 72.00 502.17 Tm (environment of the streets, hence reducing their vulnerability to HIV/AIDS. By defining) Tj 1 0 0 1 72.00 487.29 Tm (the role broadly and situating peer education activities within a broader strategy of) Tj 1 0 0 1 72.00 472.41 Tm (capacity building and advocacy, we were able to remain sensitive to the context in which) Tj 1 0 0 1 72.00 457.53 Tm (street youth make \220choices\221 about their sexual behaviour. ) Tj 1 0 0 1 72.00 442.65 Tm /F6 12.0 Tf (Original value) Tj 1 0 0 1 72.00 427.77 Tm /F5 12.0 Tf (This paper contributes significantly to our understanding of the effective implementation) Tj 1 0 0 1 72.00 412.89 Tm (of the PE method in this setting. It will be particularly helpful to practitioners in the design) Tj 1 0 0 1 72.00 398.01 Tm (stage of similar peer-led programmes.) Tj 1 0 0 1 72.00 353.37 Tm /F6 12.0 Tf (KEY WORDS:) Tj /F5 12.0 Tf ( peer education, HIV/AIDS Prevention, Street children, Uganda, process) Tj 1 0 0 1 72.00 338.49 Tm (evaluation, Non-governmental organisation \(NGO\)) Tj ET endstream endobj 23 0 obj 2641 endobj 24 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 25 0 R >> endobj 25 0 obj << /Length 26 0 R >> stream BT 1 0 0 1 72.00 740.24 Tm /F6 12.0 Tf 0.000 0.000 0.000 rg (INTRODUCTION) Tj 1 0 0 1 72.00 725.36 Tm /F5 12.0 Tf (Several million young people are currently living on the streets of urban centres) Tj 1 0 0 1 72.00 710.48 Tm (worldwide \(UNICEF, 2006\) and their numbers are rising steadily. Street children and) Tj 1 0 0 1 72.00 695.60 Tm (youth are particularly at risk of HIV/AIDS. There is often little protection against physical) Tj 1 0 0 1 72.00 680.72 Tm (and sexual violence by adults operating on the street. In addition, despair, feelings of) Tj 1 0 0 1 72.00 665.84 Tm (abandonment and extreme poverty engender risky sexual behaviour. Survival sex,) Tj 1 0 0 1 72.00 650.96 Tm (prostitution and rape are not uncommon, and sex and drug taking are often linked) Tj 1 0 0 1 72.00 636.08 Tm (\(SwartKuger and Richter,1997; GOAL Uganda, 2001\)[1]. Inevitably, consequences of) Tj 1 0 0 1 72.00 621.20 Tm (risky sexual behaviour, such as HIV infection, remain secondary to day-to-day concerns) Tj 1 0 0 1 72.00 606.32 Tm (with survival \(GOAL Uganda, 2001\). Access to formal information and services is often) Tj 1 0 0 1 72.00 591.44 Tm (limited and the informal networks in which young people find themselves may not be) Tj 1 0 0 1 72.00 576.56 Tm (supportive of protective health behaviour \(Chase and Aggleton, 2006\).) Tj 1 0 0 1 72.00 546.80 Tm (Raising awareness about HIV/AIDS and protecting street children from adverse sexual) Tj 1 0 0 1 72.00 531.92 Tm (outcomes is challenging. Often the most vulnerable children are those hardest to reach,) Tj 1 0 0 1 72.00 517.05 Tm (trust takes time to establish, and continuity of support is difficult where children are) Tj 1 0 0 1 72.00 502.17 Tm (transient. In order to overcome these challenges, HIV/AIDS interventions must situate) Tj 1 0 0 1 72.00 487.29 Tm (the sexual health needs of street youth within a broader context of proximate needs, risk) Tj 1 0 0 1 72.00 472.41 Tm (and vulnerability, recognising that children and young people have \220varying degrees of) Tj 1 0 0 1 72.00 457.53 Tm (agency, resourcefulness and resilience to cope with adversity\221 \(Chase and Aggleton,) Tj 1 0 0 1 72.00 442.65 Tm (2006; p95\). Attention to context of young peoples\221 lives is widely recognised as crucial) Tj 1 0 0 1 72.00 427.77 Tm (in the promotion of their sexual health \(see Ingham, 2006\), particularly where the) Tj 1 0 0 1 72.00 412.89 Tm (environment itself presents significant barriers to protective behaviour. Principles of) Tj 1 0 0 1 72.00 398.01 Tm (good practice for work with street children also include: putting them first; ensuring) Tj 1 0 0 1 72.00 383.13 Tm (gender equity; promoting meaningful participation; and adopting a rights based approach) Tj 1 0 0 1 72.00 368.25 Tm (\(Aggleton ) Tj /F7 12.0 Tf (et al.) Tj /F5 12.0 Tf (, 2004\)) Tj 1 0 0 1 72.00 338.49 Tm (Defined as \220) Tj /F7 12.0 Tf (the teaching or sharing of health information, values and behaviours by) Tj 1 0 0 1 72.00 323.61 Tm (members of similar age or status groups) Tj /F5 12.0 Tf (\221 \(Sciacca 1987\), the central tenet of peer-to-) Tj 1 0 0 1 72.00 308.73 Tm (peer communication has intuitive appeal as a way of working effectively with hard-to-) Tj 1 0 0 1 72.00 293.85 Tm (reach young people. It certainly has potential to generate meaningful participation and to) Tj 1 0 0 1 72.00 278.97 Tm (address risk and vulnerability in context. The pros and cons of the method have been) Tj 1 0 0 1 72.00 264.09 Tm (discussed at length \(see Milburn, 1995; Turner and Shepherd, 1999\). Much has been) Tj 1 0 0 1 72.00 249.21 Tm (documented about what makes an effective peer educator. Prominent attributes include:) Tj 1 0 0 1 72.00 234.33 Tm (being a credible communicator; a positive role model; and an empathic peer \(UNAIDS,) Tj 1 0 0 1 72.00 219.45 Tm (1999\). Much less has been written about the extent to which at-risk adolescents in) Tj 1 0 0 1 72.00 204.57 Tm (resource poor settings can successfully take on these attributes.) Tj 1 0 0 1 72.00 174.81 Tm (In 2001, GOAL Uganda[2] embarked on an HIV prevention programme targeting street) Tj 1 0 0 1 72.00 159.93 Tm (children which used peer education as a central strategy. This was a highly innovative) Tj 1 0 0 1 72.00 145.05 Tm (project with a difficult-to-reach target group in a resource-poor setting. We utilised project) Tj 1 0 0 1 72.00 130.17 Tm (monitoring systems and regular reviews to systematically document the implementation) Tj 1 0 0 1 72.00 115.29 Tm (process. Our broad aim was to identify challenges, good practice and lessons learned by) Tj 1 0 0 1 72.00 100.41 Tm (the project[3].) Tj ET endstream endobj 26 0 obj 4636 endobj 27 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 28 0 R >> endobj 28 0 obj << /Length 29 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (In this paper we focus on the role of street children and youth as peer educators. We use) Tj 1 0 0 1 72.00 740.24 Tm (our process data to explore aspects of project implementation that either enhanced or) Tj 1 0 0 1 72.00 725.36 Tm (hindered the effectiveness of their role. Due to resource constraints typical of a project of) Tj 1 0 0 1 72.00 710.48 Tm (this nature, we were not able to measure effectiveness in terms of behavioural outcomes) Tj 1 0 0 1 72.00 695.60 Tm (or STD/HIV incidence. Rather our focus is on effectiveness in terms of communication -) Tj 1 0 0 1 72.00 680.72 Tm (the extent to which peer educators were able to reach their target audience with clear) Tj 1 0 0 1 72.00 665.84 Tm (and positive messages about HIV prevention that were understood and internalised by) Tj 1 0 0 1 72.00 650.96 Tm (recipients. We measure this qualitatively, through the reports of those involved in the) Tj 1 0 0 1 72.00 636.08 Tm (project.) Tj 1 0 0 1 72.00 591.44 Tm /F6 12.0 Tf (METHODS) Tj 1 0 0 1 72.00 561.68 Tm /F5 12.0 Tf (The evidence presented in this paper comes from project process monitoring and) Tj 1 0 0 1 72.00 546.80 Tm (evaluation data, comprising mainly of three project reviews: a participatory project review) Tj 1 0 0 1 72.00 531.92 Tm (in 2002; an independent review of peer education activities in 2004; and a project review) Tj 1 0 0 1 72.00 517.05 Tm (of peer education activities in 2005 \(GOAL Uganda, 2003; GOAL Uganda, 2005\).) Tj 1 0 0 1 72.00 487.29 Tm /F9 12.0 Tf (The 2002 project review was based on minutes from regular stakeholder review meetings;) Tj 1 0 0 1 72.00 472.41 Tm (ongoing project monitoring data; evaluation reports from training sessions and workshops; and) Tj 1 0 0 1 72.00 457.53 Tm (four focus groups with young people involved in the project \(two with peer educators and two) Tj 1 0 0 1 72.00 442.65 Tm (with the project target group\). Focus group participants \(n=14\) also completed anonymous) Tj 1 0 0 1 72.00 427.77 Tm (feedback quest) Tj /F5 12.0 Tf (ionnaires.) Tj 1 0 0 1 72.00 398.01 Tm /F9 12.0 Tf (In 2004, an independent consultant was hired to review the peer education activities of the) Tj 1 0 0 1 72.00 383.13 Tm (project) Tj /F5 12.0 Tf ( \(Kelly, 2004\). Two workshops were held with 13 peer educators \(known as) Tj 1 0 0 1 72.00 368.25 Tm (Baabas, meaning \220respected elder sibling\221 in local dialect\) from 6 partner NGOs, in which) Tj 1 0 0 1 72.00 353.37 Tm (the Baabas developed an evaluation questionnaire and were trained in its administration.) Tj 1 0 0 1 72.00 338.49 Tm (The questionnaires combined open and closed questions and were developed in English) Tj 1 0 0 1 72.00 323.61 Tm (and local language Luganda. Each Baaba agreed to administer 4 questionnaires; 2 to) Tj 1 0 0 1 72.00 308.73 Tm (young people from their NGO and 2 to young people living on the street. Forty-seven) Tj 1 0 0 1 72.00 293.85 Tm (complete questionnaires were received. During a final workshop, the same Baabas) Tj 1 0 0 1 72.00 278.97 Tm (analysed the questionnaire results and generated key lessons from their experiences. A) Tj 1 0 0 1 72.00 264.09 Tm (key output of this review was a \220Six-monthly Review Framework\221 which formed the basis) Tj 1 0 0 1 72.00 249.21 Tm (for a follow-up internal review in 2005. Conducted by project staff, the 2005 review used) Tj 1 0 0 1 72.00 234.33 Tm (the framework tools to review a series of project activities. Direct observation of each) Tj 1 0 0 1 72.00 219.45 Tm (activity was followed by focused discussion with those attending the activity.) Tj 1 0 0 1 72.00 189.69 Tm (The results presented here represent a summary of the findings of the above project) Tj 1 0 0 1 72.00 174.81 Tm (reviews. We also draw on key project materials such as the Baaba Manual, the end of) Tj 1 0 0 1 72.00 159.93 Tm (project report, and an independent survey of HIV/AIDS knowledge among street children) Tj 1 0 0 1 72.00 145.05 Tm (\(Baliesima, 2001) Tj /F9 12.0 Tf (\)) Tj /F5 12.0 Tf (, for background information.) Tj 1 0 0 1 72.00 115.29 Tm /F6 12.0 Tf (BACKGROUND TO THE PROJECT) Tj 1 0 0 1 72.00 85.53 Tm /F5 12.0 Tf (Established in 2001, the Baaba project developed partnerships with 12 NGOs \(non-) Tj ET endstream endobj 29 0 obj 4279 endobj 30 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 31 0 R >> endobj 31 0 obj << /Length 32 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (government organisations\) catering for the immediate and longer-term needs of street) Tj 1 0 0 1 72.00 740.24 Tm (children and youth. It worked to mainstream HIV/AIDS prevention into on-going street) Tj 1 0 0 1 72.00 725.36 Tm (children interventions and into the activities of other agencies that impacted on the health) Tj 1 0 0 1 72.00 710.48 Tm (and welfare of street children and youth \(e.g. police, local councillors\). The project) Tj 1 0 0 1 72.00 695.60 Tm (revolved around a group of 170 trained peer educators, or Baabas within each NGO who) Tj 1 0 0 1 72.00 680.72 Tm (planned and implemented HIV/AIDS prevention activities \(see box 1\). A life skills) Tj 1 0 0 1 72.00 665.84 Tm (approach was adopted in tackling not only HIV/AIDS prevention but also issues central to) Tj 1 0 0 1 72.00 650.96 Tm (street life, such as drug abuse and rape. The project objectives were as follows:) Tj 1 0 0 1 82.46 621.20 Tm (\217 To reduce the sexual and physical risks associated with the environments in which) Tj 1 0 0 1 90.00 606.32 Tm (street children and street youth live \(advocacy\).) Tj 1 0 0 1 82.80 591.44 Tm /F9 12.0 Tf (\217 To increase the capacity of member NGOs to effectively promote life-skills, and sexual and) Tj 1 0 0 1 90.00 576.56 Tm (reproductive health amongst staff and child ) Tj /F5 12.0 Tf (beneficiaries and to advocate on behalf of) Tj 1 0 0 1 90.00 561.68 Tm (those infected and affected by HIV/AIDS \(capacity building\).) Tj 1 0 0 1 82.80 546.80 Tm /F9 12.0 Tf (\217 To empower street children and youth with the knowledge, skills, motivation and support to) Tj 1 0 0 1 90.00 531.92 Tm (sustain existing safe sexual behaviour and change unsafe behaviour ) Tj /F5 12.0 Tf (\(behaviour change\)) Tj 1 0 0 1 72.00 496.17 Tm (Key project activities are summarised in Box 1.) Tj 1 0 0 1 90.53 460.41 Tm /F6 12.0 Tf (. Peer education:) Tj /F5 12.0 Tf ( Baabas plan and implement a programme of activities within their) Tj 1 0 0 1 97.20 445.53 Tm (NGO including regular HIV/AIDS prevention clubs, individual counselling, and) Tj 1 0 0 1 97.20 430.65 Tm (seminars with surrounding communities.) Tj 1 0 0 1 90.53 415.77 Tm /F6 12.0 Tf (. Outreach:) Tj /F5 12.0 Tf ( Baabas from different NGOs accompany project staff to the street, to talk) Tj 1 0 0 1 97.20 400.89 Tm (informally about HIV/AIDS and give condoms to sexually active young people.) Tj 1 0 0 1 97.20 386.01 Tm (Sport, drama and puppetry are also regularly used to attract community and street) Tj 1 0 0 1 97.20 371.13 Tm (children to talks about HIV/AIDS.) Tj 1 0 0 1 90.53 356.25 Tm /F6 12.0 Tf (. Capacity building:) Tj /F5 12.0 Tf ( Regular \(6 monthly\) refresher training for Baabas. Internally and) Tj 1 0 0 1 97.20 341.37 Tm (externally run training for link staff and NGO staff teams.) Tj 1 0 0 1 90.53 326.49 Tm /F6 12.0 Tf (. Advocacy:) Tj /F5 12.0 Tf ( Participating in national events such as World AIDS day. Inter-NGO) Tj 1 0 0 1 97.20 311.61 Tm (events such as a drama festival and fun day with an HIV/AIDS theme. Awareness) Tj 1 0 0 1 97.20 296.73 Tm (raising and training workshops with key local leaders, security personnel and child) Tj 1 0 0 1 97.20 281.85 Tm (rights advocates in the sexual health rights of street children.) Tj 1 0 0 1 90.53 266.97 Tm /F6 12.0 Tf (. Service provision:) Tj /F5 12.0 Tf ( Improving access to \220street friendly\221 sexual and reproductive) Tj 1 0 0 1 97.20 252.09 Tm (health clinics. Baabas refer other children to service providers who have been) Tj 1 0 0 1 97.20 237.21 Tm (trained by the project in counselling out of school youth) Tj 1 0 0 1 72.00 222.33 Tm /F6 12.0 Tf (BOX 1) Tj 1 0 0 1 72.00 192.57 Tm (Project Stakeholders) Tj 1 0 0 1 72.00 162.81 Tm /F5 12.0 Tf (There were a number of different actors and stakeholders within the project and their) Tj 1 0 0 1 72.00 147.93 Tm (titles and roles can quickly become confusing. We briefly outline the key actors and) Tj 1 0 0 1 72.00 133.05 Tm (terms \(Box 2\), as a reference for what follows.) Tj 1 0 0 1 72.00 103.29 Tm /F6 12.0 Tf (Baabas) Tj /F5 12.0 Tf (: The peer educators. In local dialect Luganda, a Baaba refers to a respected) Tj 1 0 0 1 72.00 88.41 Tm (elder sibling.) Tj 1 0 0 1 72.00 73.53 Tm /F6 12.0 Tf (Partner NGO) Tj /F5 12.0 Tf (: Ugandan Non-government organisation catering for the long and short) Tj ET endstream endobj 32 0 obj 4387 endobj 33 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 34 0 R >> endobj 34 0 obj << /Length 35 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (term needs of street children. Each partner NGO had a group of Baabas who ran) Tj 1 0 0 1 72.00 740.24 Tm (activities within the organisation. Also referred to as \220street children NGOs\221) Tj 1 0 0 1 72.00 725.36 Tm /F6 12.0 Tf (Peers or target children: ) Tj /F5 12.0 Tf (Children targeted by the Baabas to receive counselling and) Tj 1 0 0 1 72.00 710.48 Tm (information; \220NGO children\221 refers to children affiliated with one of the partner NGOs, and) Tj 1 0 0 1 72.00 695.60 Tm (\220street children\221 refers to children living on the street, not directly involved with a partner) Tj 1 0 0 1 72.00 680.72 Tm (NGO.) Tj 1 0 0 1 72.00 665.84 Tm /F6 12.0 Tf (NGO staff) Tj /F5 12.0 Tf (: Staff belonging to partner NGOs. A \220link staff\221 in each partner NGO was) Tj 1 0 0 1 72.00 650.96 Tm (trained by the project to act as the main point of contact and support for the Baabas \(a) Tj 1 0 0 1 72.00 636.08 Tm (voluntary role, undertaken in addition to their usual responsibilities within the NGO\).) Tj 1 0 0 1 72.00 621.20 Tm /F6 12.0 Tf (GOAL staff) Tj /F5 12.0 Tf (: Also referred to as project staff. Their role was to co-ordinate joint activities,) Tj 1 0 0 1 72.00 606.32 Tm (support Baabas in each NGO to plan and implement activities, organise advocacy) Tj 1 0 0 1 72.00 591.44 Tm (events, and undertake capacity building work with each of the partner NGOs.) Tj 1 0 0 1 72.00 561.68 Tm (The project was implemented by GOAL Uganda. The project team comprised a team) Tj 1 0 0 1 72.00 546.80 Tm (manager and three project officers. The project was funded by Irish Aid, the Elton John) Tj 1 0 0 1 72.00 531.92 Tm (AIDS Foundation, Tobermore, the British Council, and the Bank of Ireland.) Tj 1 0 0 1 72.00 502.17 Tm /F6 12.0 Tf (RESULTS) Tj 1 0 0 1 72.00 472.41 Tm /F5 12.0 Tf (Our process data suggest that the Baabas were effective in the sense that they were) Tj 1 0 0 1 72.00 457.53 Tm (generally respected; generally regarded as knowledgeable and responsible; and were) Tj 1 0 0 1 72.00 442.65 Tm (able to empathise with the target group. During focus group discussions, the Baabas) Tj 1 0 0 1 72.00 427.77 Tm (spoke of their perceived \220added value\221: ) Tj /F7 12.0 Tf (\220children are more close to us. They look at us as) Tj 1 0 0 1 72.00 412.89 Tm (their helpers in case of health problems and other personal issues.\221; ) Tj /F5 12.0 Tf (\220) Tj /F7 12.0 Tf (some people) Tj 1 0 0 1 72.00 398.01 Tm (change their bad ways\221) Tj /F5 12.0 Tf (; ) Tj /F7 12.0 Tf (\220young people listen to us as we are the same age group) Tj /F5 12.0 Tf (\221) Tj /F7 12.0 Tf ( ) Tj /F5 12.0 Tf (.) Tj 1 0 0 1 72.00 383.13 Tm (However, they were also aware of limits to their effectiveness: ) Tj /F7 12.0 Tf (\220some children ask us) Tj 1 0 0 1 72.00 368.25 Tm (questions that we do not know how to answer\221) Tj /F5 12.0 Tf (; ) Tj /F7 12.0 Tf (\220some children do not want to listen to our) Tj 1 0 0 1 72.00 353.37 Tm (messages\221; ) Tj /F5 12.0 Tf (\220) Tj /F7 12.0 Tf (some children think that only elder people can advise them\221) Tj /F5 12.0 Tf (.) Tj 1 0 0 1 72.00 323.61 Tm (Critically, the Baabas were effective at actually reaching the target group \(children living) Tj 1 0 0 1 72.00 308.73 Tm (on the street\). In addition to our own monitoring data, an external study conducted during) Tj 1 0 0 1 72.00 293.85 Tm (the project lifespan confirmed that Baabas were the primary source of information about) Tj 1 0 0 1 72.00 278.97 Tm (HIV/AIDS among children living on the street [4].) Tj 1 0 0 1 72.00 249.21 Tm (Our process data highlighted several factors that appeared to have an impact on Baaba) Tj 1 0 0 1 72.00 234.33 Tm (effectiveness: there was close affinity to the target group; the role was broadly defined;) Tj 1 0 0 1 72.00 219.45 Tm (the position was coveted by other street children; messages were usually targeted and) Tj 1 0 0 1 72.00 204.57 Tm (generally used lively channels; there was ongoing contact with the target group; and peer) Tj 1 0 0 1 72.00 189.69 Tm (activities were augmented with other approaches. We discuss each of these factors in) Tj 1 0 0 1 72.00 174.81 Tm (turn.) Tj 1 0 0 1 72.00 130.17 Tm /F6 12.0 Tf (Affinity to the target group) Tj 1 0 0 1 72.00 100.41 Tm /F5 12.0 Tf (We opted to let children and youth within partner NGOs vote for their Baabas. Young) Tj 1 0 0 1 72.00 85.53 Tm (people tended to select Baabas who staff rated as responsible and of \220good character\221;) Tj ET endstream endobj 35 0 obj 4523 endobj 36 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 37 0 R >> endobj 37 0 obj << /Length 38 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (indeed it is likely that the same young people would have been selected had the staff) Tj 1 0 0 1 72.00 740.24 Tm (made the decision. However, by handing over the selection process, we sought to) Tj 1 0 0 1 72.00 725.36 Tm (engender a sense of accountability among Baabas towards their peers. Conversely, we) Tj 1 0 0 1 72.00 710.48 Tm (sought to engender a sense of \220ownership\221 of Baabas by the target group.) Tj 1 0 0 1 72.00 680.72 Tm (The elected Baabas were all street youth cared for by street children NGOs and) Tj 1 0 0 1 72.00 665.84 Tm (undergoing some form of rehabilitation. With their shared experience of street life and) Tj 1 0 0 1 72.00 650.96 Tm (common language, they were adept at relating to young people still living on the street) Tj 1 0 0 1 72.00 636.08 Tm (and were able to empathise with the harsh realities. For instance, during night outreach,) Tj 1 0 0 1 72.00 621.20 Tm (they were faced with children who were hungry and asking, ) Tj /F7 12.0 Tf (\220how do you expect us to live) Tj 1 0 0 1 72.00 606.32 Tm (under coldness and not take drugs?\221.) Tj /F5 12.0 Tf ( Baabas were able to offer alternative solutions to) Tj 1 0 0 1 72.00 591.44 Tm (street life from their own personal experience. They also acted as intermediaries,) Tj 1 0 0 1 72.00 576.56 Tm (introducing young people to project staff and playing an instrumental role in breaking) Tj 1 0 0 1 72.00 561.68 Tm (down initial mistrust. We also found that meeting with children in their own environment,) Tj 1 0 0 1 72.00 546.80 Tm (engendered positive dialogue because it demonstrated a high level of interest and) Tj 1 0 0 1 72.00 531.92 Tm (concern.) Tj 1 0 0 1 72.00 502.17 Tm (We sought to reflect the diverse age range of the target group by ensuring that younger) Tj 1 0 0 1 72.00 487.29 Tm (\(10 to 13\) as well as older \(14 to 22\) Baabas were selected. We assumed that younger) Tj 1 0 0 1 72.00 472.41 Tm (Baabas would be better able to relate to the younger street children. However, in general) Tj 1 0 0 1 72.00 457.53 Tm (younger Baabas had to work harder to be as effective as their older colleagues. They) Tj 1 0 0 1 72.00 442.65 Tm (sometimes found it difficult to talk to older children, who would often interrupt and) Tj 1 0 0 1 72.00 427.77 Tm (express doubt over the message, causing the younger Baaba to lose confidence and) Tj 1 0 0 1 72.00 412.89 Tm (resolve. In addition, during joint planning and implementing of activities such as) Tj 1 0 0 1 72.00 398.01 Tm (prevention clubs, younger Baabas tended to be overlooked by their older colleagues.) Tj 1 0 0 1 72.00 368.25 Tm (Unsurprisingly, gender emerged as an important factor affecting the degree of affinity felt) Tj 1 0 0 1 72.00 353.37 Tm (between Baabas and their peers. During outreach, young girls on the street were) Tj 1 0 0 1 72.00 338.49 Tm (sometimes concerned about being approached by male Baabas, while female Baabas) Tj 1 0 0 1 72.00 323.61 Tm (sometimes feared ridicule from street girls. In general, it appeared easier for boys to talk) Tj 1 0 0 1 72.00 308.73 Tm (to other boys about behaviour change, than for girls to talk with other girls, and the) Tj 1 0 0 1 72.00 293.85 Tm (evaluation noted that female Baabas tended to talk less during outreach.) Tj 1 0 0 1 72.00 264.09 Tm /F6 12.0 Tf (A broadly defined role) Tj 1 0 0 1 72.00 234.33 Tm /F5 12.0 Tf (The Baabas did much more than talk about HIV/AIDS; they referred street children to) Tj 1 0 0 1 72.00 219.45 Tm (local youth-friendly health centres and assisted them in leaving the street to join NGOs) Tj 1 0 0 1 72.00 204.57 Tm (able to cater for their material and emotional needs. Baabas also gave personal) Tj 1 0 0 1 72.00 189.69 Tm (testimonies during regular one-day advocacy workshops with local leaders, Child Rights) Tj 1 0 0 1 72.00 174.81 Tm (Advocates and security personnel. These testimonies were often powerful in challenging) Tj 1 0 0 1 72.00 159.93 Tm (widely held prejudices against street children. In this way, the Baabas were not only) Tj 1 0 0 1 72.00 145.05 Tm (communicators of health information, but also providers of valuable local knowledge, and) Tj 1 0 0 1 72.00 130.17 Tm (advocates on behalf of their peers.) Tj 1 0 0 1 72.00 100.41 Tm (The Baabas also served as role models, not only as young people avoiding HIV, but also) Tj 1 0 0 1 72.00 85.53 Tm (as young people attempting to get their lives back \220on track\221 and as young people holding) Tj ET endstream endobj 38 0 obj 4504 endobj 39 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 40 0 R >> endobj 40 0 obj << /Length 41 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (positions of responsibility within their NGO. For instance, the Baabas provided positive) Tj 1 0 0 1 72.00 740.24 Tm (role models to incarcerated youth in a local Remand home and youth prison that they) Tj 1 0 0 1 72.00 725.36 Tm (visited regularly. It was not uncommon for the incarcerated youth to recognise former) Tj 1 0 0 1 72.00 710.48 Tm (inmates among the Baabas and it is reasonable to assume that witnessing their former) Tj 1 0 0 1 72.00 695.60 Tm (friends in a \220leadership\221 position was positively motivating for the imprisoned youth.) Tj 1 0 0 1 72.00 665.84 Tm (The Baabas soon came to represent a convenient and coherent group of responsible) Tj 1 0 0 1 72.00 650.96 Tm (young people within each NGO. According to NGO staff, Baabas were often given) Tj 1 0 0 1 72.00 636.08 Tm (additional responsibilities, from \220prefect\221 or \220monitor\221 roles through to positions on the) Tj 1 0 0 1 72.00 621.20 Tm (NGO \220junior management\221 team. In helping to bridge the gap between staff and children,) Tj 1 0 0 1 72.00 606.32 Tm (these additional responsibilities were viewed as beneficial to the smooth running of the) Tj 1 0 0 1 72.00 591.44 Tm (NGO. However, where Baabas were required to exert discipline and control over other) Tj 1 0 0 1 72.00 576.56 Tm (\(usually younger\) children in the NGO, there was the potential for an imbalance of power) Tj 1 0 0 1 72.00 561.68 Tm (to develop \(or intensify\), which could potentially detract from the benefits of the peer to) Tj 1 0 0 1 72.00 546.80 Tm (peer approach.) Tj 1 0 0 1 72.00 517.05 Tm (High expectations of \220good\221 behaviour came from within the Baaba group, from other) Tj 1 0 0 1 72.00 502.17 Tm (young people in the NGO, and from NGO staff. The pressure associated with acting as a) Tj 1 0 0 1 72.00 487.29 Tm (role model was considerable, yet most Baabas managed to meet these expectations.) Tj 1 0 0 1 72.00 472.41 Tm (Conspicuous lapses in \220good behaviour\221 were inevitable but generally uncommon.) Tj 1 0 0 1 75.00 442.65 Tm /F6 12.0 Tf (A coveted position) Tj 1 0 0 1 72.00 412.89 Tm /F5 12.0 Tf (It was clearly evident that the role of Baaba was coveted by other children in the NGO,) Tj 1 0 0 1 72.00 398.01 Tm (and that most Baabas enjoyed and valued their position. Fear of losing their \220job\221) Tj 1 0 0 1 72.00 383.13 Tm (provided strong motivation for exemplary behaviour by Baabas \(described above\).) Tj 1 0 0 1 72.00 368.25 Tm (Children and youth appeared to covet the status and responsibility associated with the) Tj 1 0 0 1 72.00 353.37 Tm (role, but also the opportunity for training and skills building.) Tj 1 0 0 1 72.00 323.61 Tm (Comments made by Baabas during focus groups suggested that they perceived) Tj 1 0 0 1 72.00 308.73 Tm (increased knowledge about behaviour change as a benefit of the role: \220) Tj /F7 12.0 Tf (My bad behaviour) Tj 1 0 0 1 72.00 293.85 Tm (has changed so I can now help others to change too.\221, ) Tj /F5 12.0 Tf ( ) Tj /F7 12.0 Tf (\220peer education teaches us the) Tj 1 0 0 1 72.00 278.97 Tm (difference between good and bad\221; \220peer education allows you to challenge bad) Tj 1 0 0 1 72.00 264.09 Tm (behaviours and maybe change them\221.) Tj 1 0 0 1 72.00 234.33 Tm /F5 12.0 Tf (Baabas also reported learning a variety of new skills such as handling \220difficult children\221) Tj 1 0 0 1 72.00 219.45 Tm (during clubs sessions and, importantly for them, improved skills in English. Baabas also) Tj 1 0 0 1 72.00 204.57 Tm (appeared to value gaining experience in planning, organising and evaluating activities.) Tj 1 0 0 1 72.00 189.69 Tm (NGO staff noted that the confidence of Baabas tended to increase following training,) Tj 1 0 0 1 72.00 174.81 Tm (such that even the more shy children were able to stand before contemporaries and) Tj 1 0 0 1 72.00 159.93 Tm (facilitate discussions. Baabas also frequently reported that they had gained life skills) Tj 1 0 0 1 72.00 145.05 Tm (such as decision making, self-control, self-esteem, confidence and assertiveness.) Tj 1 0 0 1 72.00 130.17 Tm (However, in the hierarchical environment of some of the NGOs, the building of life-skills) Tj 1 0 0 1 72.00 115.29 Tm (among Baabas was not always viewed positively by NGO staff. In some NGOs assertive) Tj 1 0 0 1 72.00 100.41 Tm (behaviour earned the Baabas respect from staff, while in others, \220assertive\221 was confused) Tj 1 0 0 1 72.00 85.53 Tm (with \220aggressive\221 and frowned upon.) Tj ET endstream endobj 41 0 obj 4526 endobj 42 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 43 0 R >> endobj 43 0 obj << /Length 44 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F6 12.0 Tf 0.000 0.000 0.000 rg (Targeted messages using lively channels) Tj 1 0 0 1 72.00 725.36 Tm /F5 12.0 Tf (As far as possible, we sought to ensure that Baaba messages were appropriately) Tj 1 0 0 1 72.00 710.48 Tm (targeted, using participatory and lively channels. However, this was not always easy,) Tj 1 0 0 1 72.00 695.60 Tm (particularly during seminars and dramas, which were generally conducted \220under a tree\221,) Tj 1 0 0 1 72.00 680.72 Tm (with community members \(young and old\) gathering out of interest. However, other) Tj 1 0 0 1 72.00 665.84 Tm (Baaba strategies, such as one-to-one discussions during night outreach provided) Tj 1 0 0 1 72.00 650.96 Tm (opportunity for highly targeted messages.) Tj 1 0 0 1 72.00 621.20 Tm (As far as possible, day-to-day planning and running of activities was led by the Baabas) Tj 1 0 0 1 72.00 606.32 Tm (and their peers, with GOAL and NGO staff providing back-up and assistance.) Tj 1 0 0 1 72.00 591.44 Tm (Increasingly, Baabas took responsibility for training each other, for instance in puppetry.) Tj 1 0 0 1 72.00 576.56 Tm (They discovered for themselves that puppets were an ideal media for tackling sensitive) Tj 1 0 0 1 72.00 561.68 Tm (issues, and that sport was an ideal way to attract street children to a seminar. However,) Tj 1 0 0 1 72.00 546.80 Tm (Baabas sometimes chose to employ the didactic style of teaching \(rote learning, lectures\)) Tj 1 0 0 1 72.00 531.92 Tm (typical of their own educational experience. At other times, more participatory and) Tj 1 0 0 1 72.00 517.05 Tm (interactive methods such as role plays and debates were not followed up with questions) Tj 1 0 0 1 72.00 502.17 Tm (and a good technical summary so that the message was sometimes lost.) Tj 1 0 0 1 72.00 472.41 Tm (Keeping the delivery of prevention messages interesting and lively was a particular) Tj 1 0 0 1 72.00 457.53 Tm (challenge. Baabas tended to rely on \220tried and tested\221 methods such as drama and) Tj 1 0 0 1 72.00 442.65 Tm (discussions, rather than experiment with innovative approaches. \220Tried and tested\221) Tj 1 0 0 1 72.00 427.77 Tm (methods such as drama were clearly popular with their intended audience however.) Tj 1 0 0 1 72.00 412.89 Tm (Baabas sometimes also regurgitated the peer educator manual without necessarily) Tj 1 0 0 1 72.00 398.01 Tm (understanding the underlying issues. In 2004, the Baabas themselves expressed a need) Tj 1 0 0 1 72.00 383.13 Tm (to increase the use of other innovative and participatory methods. This led to the) Tj 1 0 0 1 72.00 368.25 Tm (development of a series of educational games which were subsequently presented at the) Tj 1 0 0 1 72.00 353.37 Tm (national AIDS conference.) Tj 1 0 0 1 72.00 308.73 Tm /F6 12.0 Tf (Ongoing contact with the target group) Tj 1 0 0 1 72.00 281.85 Tm /F5 12.0 Tf (During the 2004 survey, 91% of NGO children and 43% of street children said they) Tj 1 0 0 1 72.00 266.97 Tm (attended Baaba activities more than once a month. This suggested a fairly high level of) Tj 1 0 0 1 72.00 252.09 Tm (ongoing contact.) Tj 1 0 0 1 72.00 237.21 Tm (According to the 2002 review, the young people met by Baabas regularly during night) Tj 1 0 0 1 72.00 222.33 Tm (outreach gradually gained confidence in sharing their personal concerns regarding) Tj 1 0 0 1 72.00 207.45 Tm (HIV/AIDS and sexual health. However, children on the street were a particularly transient) Tj 1 0 0 1 72.00 192.57 Tm (group and there were often new faces. Ensuring continuity was not always within the) Tj 1 0 0 1 72.00 177.69 Tm (control of the project either. For instance, outreach activities were intermittently disrupted) Tj 1 0 0 1 72.00 162.81 Tm (by Government directives to clear the streets of the capital city Kampala. Children) Tj 1 0 0 1 72.00 147.93 Tm (\220rounded up\221 following these directives were placed in a local youth prison. The project) Tj 1 0 0 1 72.00 133.05 Tm (was able to continue working with incarcerated youth through regular visits to the prison;) Tj 1 0 0 1 72.00 118.17 Tm (however those driven \220underground\221 by these policies became much harder to reach) Tj 1 0 0 1 72.00 103.29 Tm (through conventional street outreach.) Tj 1 0 0 1 72.00 76.41 Tm (Given the transient nature of the target group, the project anticipated that turnover of) Tj ET endstream endobj 44 0 obj 4350 endobj 45 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 46 0 R >> endobj 46 0 obj << /Length 47 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (Baabas would be high. As an indication, 25 \(15%\) left the project during the second year,) Tj 1 0 0 1 72.00 740.24 Tm (a figure actually below the expectations of project staff. None of the peer educators) Tj 1 0 0 1 72.00 725.36 Tm (dropped out due to lack of motivation, but several were resettled, acquired places in) Tj 1 0 0 1 72.00 710.48 Tm (boarding school \(sponsored by NGOs\), and a few were suspended or forfeited their) Tj 1 0 0 1 72.00 695.60 Tm (position following misbehaviour. As young people showing potential, Baabas were more) Tj 1 0 0 1 72.00 680.72 Tm (likely than other street youth to be resettled or placed in boarding schools. High turnover) Tj 1 0 0 1 72.00 665.84 Tm (implied loss of continuity for the target children, as well as expensive re-training. Basic) Tj 1 0 0 1 72.00 650.96 Tm (training was continually required to enable replacement Baabas to \220catch up\221 with their) Tj 1 0 0 1 72.00 636.08 Tm (peers. ) Tj 1 0 0 1 75.00 561.68 Tm /F6 12.0 Tf (Augmentation of peer communication with other approaches) Tj 1 0 0 1 72.00 531.92 Tm /F5 12.0 Tf (As described above, peer education was just one prong in a three-pronged approach.) Tj 1 0 0 1 72.00 517.05 Tm (The other prongs, advocacy and capacity building clearly augmented the peer approach) Tj 1 0 0 1 72.00 502.17 Tm (as well as being effective prevention strategies in their own right.) Tj 1 0 0 1 72.00 472.41 Tm (Capacity building of project partners focused on individuals within each organisation) Tj 1 0 0 1 72.00 457.53 Tm (\(such as link staff\), and on the organisation as a whole. It became apparent that the) Tj 1 0 0 1 72.00 442.65 Tm (project worked best where Baabas had a supportive environment. In practical terms, this) Tj 1 0 0 1 72.00 427.77 Tm (implied an NGO in which the Director gave active support to the Baabas. Practical) Tj 1 0 0 1 72.00 412.89 Tm (support included integrating Baaba activities into existing work plans; developing Baabas) Tj 1 0 0 1 72.00 398.01 Tm (in leadership roles; and participating in project review meetings. Link staff were also) Tj 1 0 0 1 72.00 383.13 Tm (crucial in providing support to the Baabas in planning and undertaking activities. The) Tj 1 0 0 1 72.00 368.25 Tm (project also trained an additional staff member to support the link staff, in recognition of) Tj 1 0 0 1 72.00 353.37 Tm (the high staff turnover characteristic of small local NGOs. A manual, outlining the key) Tj 1 0 0 1 72.00 338.49 Tm (project components and tools, guided each NGO in implementing activities without the) Tj 1 0 0 1 72.00 323.61 Tm (support of project staff. Capacity building activities with staff teams as well as directors) Tj 1 0 0 1 72.00 308.73 Tm (generated a supportive and sustainable platform for the implementation of HIV/AIDS) Tj 1 0 0 1 72.00 293.85 Tm (prevention work. Thus the peer education work became a direct beneficiary of the) Tj 1 0 0 1 72.00 278.97 Tm (capacity building strategy.) Tj 1 0 0 1 72.00 249.21 Tm (As part of the advocacy strategy, the project worked with adults with responsibility for the) Tj 1 0 0 1 72.00 234.33 Tm (protection of street children \(such as Child Rights Advocates \(CRAs\) and the police\)) Tj 1 0 0 1 72.00 219.45 Tm (through a series of training days. Although ostensibly concerned with protecting street) Tj 1 0 0 1 72.00 204.57 Tm (children from HIV/AIDS, the training days, in which the Baabas gave testimonies and) Tj 1 0 0 1 72.00 189.69 Tm (performed role plays, proved to be powerful mechanisms in breaking down widespread) Tj 1 0 0 1 72.00 174.81 Tm (prejudice towards youth on the street. The impact of the workshops was felt during) Tj 1 0 0 1 72.00 159.93 Tm (street outreach. For instance, on one occasion, a confrontation between project staff and) Tj 1 0 0 1 72.00 145.05 Tm (security personnel was averted because one of the policemen involved had attended a) Tj 1 0 0 1 72.00 130.17 Tm (project training session. He told his colleagues to\221 leave the Baabas alone\221 because they) Tj 1 0 0 1 72.00 115.29 Tm (were doing positive work with street children.) Tj 1 0 0 1 72.00 85.53 Tm (The project also worked alongside other street children NGOs in lobbying local and) Tj ET endstream endobj 47 0 obj 4257 endobj 48 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 49 0 R >> endobj 49 0 obj << /Length 50 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (central government authorities on their child protection policies. The aim was to reduce) Tj 1 0 0 1 72.00 740.24 Tm (the number of \220sweeps\221 in which street children were forcibly removed from the street and) Tj 1 0 0 1 72.00 725.36 Tm (placed in remand centres or driven underground \(where it was difficult to reach and) Tj 1 0 0 1 72.00 710.48 Tm (support them\).) Tj 1 0 0 1 72.00 680.72 Tm (Residents in the surrounding community were often opposed to NGOs working with) Tj 1 0 0 1 72.00 665.84 Tm (street children and providing services for them within their neighbourhood. The project) Tj 1 0 0 1 72.00 650.96 Tm (worked hard to involve these communities in project activities, and events organised by) Tj 1 0 0 1 72.00 636.08 Tm (the Baabas such as community seminars did much to improve relations.) Tj 1 0 0 1 72.00 606.32 Tm /F6 12.0 Tf (DISCUSSION) Tj 1 0 0 1 72.00 576.56 Tm /F5 12.0 Tf (We have described a peer-led HIV prevention programme with street children. Drawing) Tj 1 0 0 1 72.00 561.68 Tm (on our project monitoring data and process evaluation results, we have identified several) Tj 1 0 0 1 72.00 546.80 Tm (factors that, in our project, appeared to impact on the effectiveness of the peer educator) Tj 1 0 0 1 72.00 531.92 Tm (role. Here we discuss some of the implications of our findings.) Tj 1 0 0 1 72.00 502.17 Tm (Although it sounds obvious and straightforward, reaching the target group in a) Tj 1 0 0 1 72.00 487.29 Tm (meaningful way was actually a significant achievement. There were several) Tj 1 0 0 1 72.00 472.41 Tm (organisations in the capital city claiming to work with street children on HIV/AIDS issues,) Tj 1 0 0 1 72.00 457.53 Tm (but none others \(to our knowledge\) actually spent time with them in their own street) Tj 1 0 0 1 72.00 442.65 Tm (environment. The peer approach was fundamentally important in enabling us to conduct) Tj 1 0 0 1 72.00 427.77 Tm (effective outreach work.) Tj 1 0 0 1 72.00 398.01 Tm (In agreement with previous research, we found that much of the Baaba credibility) Tj 1 0 0 1 72.00 383.13 Tm (stemmed from their \220inside knowledge\221 of their intended audience and experience of) Tj 1 0 0 1 72.00 368.25 Tm (\220similar struggles\221 \(UNAIDS 1999; Milburn 1995\). Our selection strategy, which gave the) Tj 1 0 0 1 72.00 353.37 Tm (target audience a sense of \220ownership\221 of their Baabas, helped to enhance this credibility.) Tj 1 0 0 1 72.00 338.49 Tm ( It was also important that the Baabas were selected from NGOs \(i.e. those already) Tj 1 0 0 1 72.00 323.61 Tm (undergoing some form of rehabilitation\) as opposed to those living full time on the street.) Tj 1 0 0 1 72.00 308.73 Tm (These two strategies may partly explain the difference between our experience and that) Tj 1 0 0 1 72.00 293.85 Tm (of Ebreo ) Tj /F7 12.0 Tf (et al.) Tj /F5 12.0 Tf ( \(2002\) who trained as peer educators, risk taking youth selected by their) Tj 1 0 0 1 72.00 278.97 Tm (teachers. They found that the peer educators did not enjoy the role and yielded little) Tj 1 0 0 1 72.00 264.09 Tm (influence among their peers.) Tj 1 0 0 1 72.00 234.33 Tm (Peer educators tend to prefer talking to peers who are most similar to themselves \(Wolf) Tj 1 0 0 1 72.00 219.45 Tm (and Bond 2002; Mitchell ) Tj /F7 12.0 Tf (et al. ) Tj /F5 12.0 Tf (2001\) and this is entirely understandable. We found that) Tj 1 0 0 1 72.00 204.57 Tm (matching on the basis of \220street life\221 experience was not enough; Baabas worked better) Tj 1 0 0 1 72.00 189.69 Tm (with peers of the same sex and similar age. In line with previous research, the Baabas) Tj 1 0 0 1 72.00 174.81 Tm (also recognised that at times, the target group preferred information on sexual health) Tj 1 0 0 1 72.00 159.93 Tm (matters to come from respected adults and authority figures \(Cline and Engel 1991;) Tj 1 0 0 1 72.00 145.05 Tm (Helgerson and Peterson 1988\). This need not be viewed as a drawback because it) Tj 1 0 0 1 72.00 130.17 Tm (presents opportunity for adults and young people to collaborate in providing a multi-) Tj 1 0 0 1 72.00 115.29 Tm (faceted programme, which involves both youth and adult educators \(Macdowall and) Tj 1 0 0 1 72.00 100.41 Tm (Mitchell, 2006\).) Tj ET endstream endobj 50 0 obj 4289 endobj 51 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 52 0 R >> endobj 52 0 obj << /Length 53 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (Although not an explicit aim of the project at the outset, it soon became apparent that) Tj 1 0 0 1 72.00 740.24 Tm (assisting children to leave the street and seek help from NGOs was the HIV prevention) Tj 1 0 0 1 72.00 725.36 Tm (strategy with the most immediate impact, since it meant in effect that the young person) Tj 1 0 0 1 72.00 710.48 Tm (was no longer exposed to the physical and sexual risks associated with the street) Tj 1 0 0 1 72.00 695.60 Tm (environment. Had we narrowly defined the role of Baabas in terms of sexual health) Tj 1 0 0 1 72.00 680.72 Tm (education we would have missed out on this highly effective component of their work.) Tj 1 0 0 1 72.00 650.96 Tm (We found strong evidence of Baabas acting as role models, not only in relation to) Tj 1 0 0 1 72.00 636.08 Tm (preventive behaviour, but also as young people attempting to rehabilitate and take on) Tj 1 0 0 1 72.00 621.20 Tm (responsibility. In agreement with previous research \(HEA 1993; Phelps ) Tj /F7 12.0 Tf (et al. ) Tj /F5 12.0 Tf (1994;) Tj 1 0 0 1 72.00 606.32 Tm (Wilton ) Tj /F7 12.0 Tf (et al. ) Tj /F5 12.0 Tf (1995\), Baabas valued the new skills they acquired as well as the status and) Tj 1 0 0 1 72.00 591.44 Tm (responsibility conferred by the role. The incentives associated with the role, as well as) Tj 1 0 0 1 72.00 576.56 Tm (high expectations of exemplary behaviour from their peers, exerted a degree of) Tj 1 0 0 1 72.00 561.68 Tm (regulation on Baaba behaviour. Again this has been found in previous research \(Perry) Tj 1 0 0 1 72.00 546.80 Tm (and Sieving 1993\). We feel that it is important to be aware of the \220down sides\221 of this) Tj 1 0 0 1 72.00 531.92 Tm (pressure; it has the potential to become stressful for the peer educators, and salient) Tj 1 0 0 1 72.00 517.05 Tm (lapses from exemplary behaviour by peer educators can reverberate widely among the) Tj 1 0 0 1 72.00 502.17 Tm (target group. However, handled with sensitivity, such lapses can potentially be used) Tj 1 0 0 1 72.00 487.29 Tm (positively to raise issues among the target group. Interestingly, the skills most valued by) Tj 1 0 0 1 72.00 472.41 Tm (Baabas appeared to be general life-skills, leadership skills and improving English, rather) Tj 1 0 0 1 72.00 457.53 Tm (than skills specifically associated with HIV prevention. This was an important reminder to) Tj 1 0 0 1 72.00 442.65 Tm (project staff that sexual health is often less of a priority to street children and youth than) Tj 1 0 0 1 72.00 427.77 Tm (immediate material needs and future employment.) Tj 1 0 0 1 72.00 398.01 Tm (Our project clearly lay at the participatory end of the spectrum. However, having handed) Tj 1 0 0 1 72.00 383.13 Tm (over responsibility for teaching to the Baabas, the project had to tread a careful line) Tj 1 0 0 1 72.00 368.25 Tm (between respecting the decisions of Baabas with regard to activity planning, and) Tj 1 0 0 1 72.00 353.37 Tm (ensuring that messages were accurate, lively and participatory. We found that it was) Tj 1 0 0 1 72.00 338.49 Tm (important not to assume that the Baabas would be less judgmental and more empathic) Tj 1 0 0 1 72.00 323.61 Tm (than adults. Training in participatory approaches helped to minimise the risk of peer) Tj 1 0 0 1 72.00 308.73 Tm (educators simply transmitting internalised attitudes, norms and beliefs of the adults in) Tj 1 0 0 1 72.00 293.85 Tm (authority around them \(Macdowall and Mitchell, 2006\).) Tj 1 0 0 1 72.00 264.09 Tm (In agreement with previous research, we found that the peer approach afforded) Tj 1 0 0 1 72.00 249.21 Tm (considerable opportunity for regular contact thus enabling messages to be reinforced) Tj 1 0 0 1 72.00 234.33 Tm (\(Jay ) Tj /F7 12.0 Tf (et al.) Tj /F5 12.0 Tf (, 1984; Kelly ) Tj /F7 12.0 Tf (et al.) Tj /F5 12.0 Tf ( 1991\). Because of the transient nature of the target group, it) Tj 1 0 0 1 72.00 219.45 Tm (was not always possible for this contact to be sustained over a long period. Our) Tj 1 0 0 1 72.00 204.57 Tm (experience was that turnover of Baabas had less impact on the continuity of the project) Tj 1 0 0 1 72.00 189.69 Tm (than we originally anticipated. We found that regular contact was important for children) Tj 1 0 0 1 72.00 174.81 Tm (living on the street who were particularly distrustful of new faces. Contact with young) Tj 1 0 0 1 72.00 159.93 Tm (people in street children NGOs was actually so regular that our particular challenge lay) Tj 1 0 0 1 72.00 145.05 Tm (more in keeping the communication media engaging and varied, and messages fresh) Tj 1 0 0 1 72.00 130.17 Tm (and interesting.) Tj 1 0 0 1 72.00 100.41 Tm (Narrowly defined sexual health interventions are unlikely to impact on the wider social) Tj 1 0 0 1 72.00 85.53 Tm (and economic causes of vulnerability to adverse sexual health outcomes \(Chase and) Tj ET endstream endobj 53 0 obj 4902 endobj 54 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 55 0 R >> endobj 55 0 obj << /Length 56 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F5 12.0 Tf 0.000 0.000 0.000 rg (Aggleton, 2006\). Recognising this fact, we situated our peer education activities within a) Tj 1 0 0 1 72.00 740.24 Tm (wider strategy of capacity building and advocacy. By working with partner NGOs we were) Tj 1 0 0 1 72.00 725.36 Tm (able to target the wider environmental determinants of behaviour as well as individual) Tj 1 0 0 1 72.00 710.48 Tm (factors. Our advocacy strategy, targeting the adults who impact on the safety of the) Tj 1 0 0 1 72.00 695.60 Tm (street environment, recognised the fact that children are not always able to protect) Tj 1 0 0 1 72.00 680.72 Tm (themselves against HIV. This broader perspective enabled us to remain sensitive to the) Tj 1 0 0 1 72.00 665.84 Tm (risks and vulnerability associated with the context in which young people come to, and) Tj 1 0 0 1 72.00 650.96 Tm (survive on the street \(see Chase and Aggleton, 2006\).) Tj 1 0 0 1 72.00 621.20 Tm (Can we rely on street children and youth to communicate HIV/AIDS prevention) Tj 1 0 0 1 72.00 606.32 Tm (messages effectively? Based on our project experience, we conclude that street children) Tj 1 0 0 1 72.00 591.44 Tm (and youth can make highly effective peer educators where they feel accountable to their) Tj 1 0 0 1 72.00 576.56 Tm (peers, where they perceive benefits to the role, where they are able to assist peers on) Tj 1 0 0 1 72.00 561.68 Tm (broader issues beyond HIV prevention \(particularly rehabilitation\), where they can make) Tj 1 0 0 1 72.00 546.80 Tm (repeated contact with their peers, and where their work is backed up by broader capacity) Tj 1 0 0 1 72.00 531.92 Tm (building and advocacy approaches.) Tj 1 0 0 1 72.00 487.29 Tm /F6 12.0 Tf (Acknowledgements) Tj 1 0 0 1 72.00 457.53 Tm /F5 12.0 Tf (We learned so much from the street children and youth who participated in this project.) Tj 1 0 0 1 72.00 442.65 Tm (We hope this article adequately conveys the hard work and enthusiasm of the Baabas,) Tj 1 0 0 1 72.00 427.77 Tm (without whom this project would have amounted to very little. We would also like to thank) Tj 1 0 0 1 72.00 412.89 Tm (the staff \(particularly Link Staff\) and children from our partner NGOs who embraced the) Tj 1 0 0 1 72.00 398.01 Tm (project with great energy. Finally, we acknowledge the hard work of the other GOAL) Tj 1 0 0 1 72.00 383.13 Tm (project staff: Moses Wamara, Annociate Kagabiirwe and Tony Onen, and also former) Tj 1 0 0 1 72.00 368.25 Tm (and current GOAL management/support staff; in particular Hope, Ponthey, Sarah, Sue,) Tj 1 0 0 1 72.00 353.37 Tm (Mark, Kati and Fiona.) Tj ET endstream endobj 56 0 obj 2620 endobj 57 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 58 0 R >> endobj 58 0 obj << /Length 59 0 R >> stream BT 1 0 0 1 72.00 740.24 Tm /F6 12.0 Tf 0.000 0.000 0.000 rg (REFERENCES) Tj 1 0 0 1 72.00 710.48 Tm /F5 12.0 Tf (Aggleton, P., Chase, E. and Rivers, K.) 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Geneva.) Tj 1 0 0 1 72.00 174.81 Tm (UNICEF \(2006\) ) Tj /F7 12.0 Tf (The State of the World\221s Children: Excluded and Invisible, ) Tj /F5 12.0 Tf ( New York:) Tj 1 0 0 1 72.00 159.93 Tm (UNICEF.) Tj 1 0 0 1 72.00 130.17 Tm (Wilton, T., Keeble, S., Doyal, L. and Walsh, A. \(1995\) ) Tj /F7 12.0 Tf (The Effectiveness of Peer) Tj 1 0 0 1 72.00 115.29 Tm (Education in Health Promotion: Theory and practice. ) Tj /F5 12.0 Tf ( Faculty of Health and Community) Tj 1 0 0 1 72.00 100.41 Tm (Studies, University of the West of England) Tj ET endstream endobj 62 0 obj 3858 endobj 63 0 obj << /Type /Page /Parent 3 0 R /Resources 17 0 R /Contents 64 0 R >> endobj 64 0 obj << /Length 65 0 R >> stream BT 1 0 0 1 72.00 755.12 Tm /F9 12.0 Tf 0.000 0.000 0.000 rg (Wolf, C. ) Tj /F5 12.0 Tf (and Bond, K. \(2002\) \224Exploring the similarity between peer educators and their) Tj 1 0 0 1 72.00 740.24 Tm (contacts and AIDS-protective behaviours in reproductive health programmes from) Tj 1 0 0 1 72.00 725.36 Tm (adolescents and young adults in Ghana\225 ) Tj /F7 12.0 Tf (AIDS Care) Tj /F5 12.0 Tf ( 14\(3\):367-373) Tj 1 0 0 1 72.00 665.84 Tm (------------------------------------) Tj 1 0 0 1 72.00 650.96 Tm /F9 12.0 Tf ([1] According the project baseline survey, 91% of sexually active girls say they \220always\221 or) Tj 1 0 0 1 72.00 636.08 Tm (\220sometimes\221 have sex in order to receive money or gifts, while 74% of boys say they \220always\221 or) Tj 1 0 0 1 72.00 621.20 Tm (\220sometimes\221 take drugs just before having sex.) Tj 1 0 0 1 72.00 606.32 Tm ([2] GOAL is an international non-government organisation based in Dublin, Ireland. GOAL) Tj 1 0 0 1 72.00 591.44 Tm (Uganda is a field office of GOAL based in Kampala, Uganda) Tj 1 0 0 1 72.00 576.56 Tm ([3] For further information about the project please contact GOAL \(www.goal.ie\)) Tj 1 0 0 1 72.00 561.68 Tm ([4] A masters student \(Baliesima\) at Makarere University undertook a KABP survey of street) Tj 1 0 0 1 72.00 546.80 Tm (youth and HIV/AIDS in 2001. See references) Tj ET endstream endobj 65 0 obj 1355 endobj 3 0 obj << /Type /Pages /Count 16 /MediaBox [ 0 0 595 842 ] /Kids [ 18 0 R 21 0 R 24 0 R 27 0 R 30 0 R 33 0 R 36 0 R 39 0 R 42 0 R 45 0 R 48 0 R 51 0 R 54 0 R 57 0 R 60 0 R 63 0 R ] >> endobj xref 0 66 0000000000 65535 f 0000000015 00000 n 0000000064 00000 n 0000065204 00000 n 0000000260 00000 n 0000001574 00000 n 0000001668 00000 n 0000001767 00000 n 0000001869 00000 n 0000001975 00000 n 0000002071 00000 n 0000002173 00000 n 0000002278 00000 n 0000002387 00000 n 0000002486 00000 n 0000002585 00000 n 0000002686 00000 n 0000002791 00000 n 0000002992 00000 n 0000003075 00000 n 0000004193 00000 n 0000004214 00000 n 0000004297 00000 n 0000006992 00000 n 0000007013 00000 n 0000007096 00000 n 0000011786 00000 n 0000011807 00000 n 0000011890 00000 n 0000016223 00000 n 0000016244 00000 n 0000016327 00000 n 0000020768 00000 n 0000020789 00000 n 0000020872 00000 n 0000025449 00000 n 0000025470 00000 n 0000025553 00000 n 0000030111 00000 n 0000030132 00000 n 0000030215 00000 n 0000034795 00000 n 0000034816 00000 n 0000034899 00000 n 0000039303 00000 n 0000039324 00000 n 0000039407 00000 n 0000043718 00000 n 0000043739 00000 n 0000043822 00000 n 0000048165 00000 n 0000048186 00000 n 0000048269 00000 n 0000053225 00000 n 0000053246 00000 n 0000053329 00000 n 0000056003 00000 n 0000056024 00000 n 0000056107 00000 n 0000059654 00000 n 0000059675 00000 n 0000059758 00000 n 0000063670 00000 n 0000063691 00000 n 0000063774 00000 n 0000065183 00000 n trailer << /Size 66 /Root 1 0 R /Info 2 0 R >> startxref 65412 %%EOF