Materials > EU Tacis HIV/AIDS Prevention and Awareness Programme for Ukraine

EU TACIS HIV/AIDS PREVENTION
AND AWARENESS PROGRAMME FOR UKRAINE
DECEMBER 2001

MATERIALS REVIEW AND DEVELOPMENT

Lucy Platt

1. Aims and objectives
2. Report from workshop
3. Recommendations
4. Appendix 1
5. Appendix 2
6. Appendix 3

1. Aims and objectives

1.1. The aim of the trip was to provide technical expertise and training in using qualitative and quantitative data to develop relevant health promotion materials on HIV/AIDS/STIs for target groups, and to provide a report on the trip including recommendations for further action.

1.2. The consultants, Lucy Platt and Konstantin Talalaev, spent two and a half days working with the team in Sevastopol and 2 days working with the British Council team in Kiev.

1.3. This report includes an assessment of the workshop held on qualitative and quantitative data, recommendations arising from the workshop on future programme activities and general observations on the programme. Attached in Appendix 2 and 3 are English translations of materials given out to the workshop participants.

2. Report from workshop

2.1. A one and a half day workshop was conducted by Lucy Platt and Konstantin Talalaev the Ukrainian expert on using qualitative and quantitative data to develop information materials for the target groups.

2.2.The workshop was run using a mixture of presentations and group work. The topics covered are as follows:

• An update on the work completed through the programme so far and focussing specifically on the written material review
• Methodologies of qualitative and quantitative data collection
• Methodology of running a focus group
• Presentation on the practical experience developing materials for a sex worker project in Moscow
• Involving the target group - participative approaches to research
• Development of guidelines for moderating focus groups for the target groups.

2.3. Participants of the workshop comprised members of the Sevastopol working group:

• Irina Anatolyevna Potapova - Oblast Co-ordinator
• Anna Chornolichenko - Project Administrative Assistantу
• Ludmilla Alekseevna Litvinenko representative of the NGO "Volunteer Centre"
• Svetlana Victorevna Ternitskaya - Head of the City Harm Reduction Programme
• Svetlana Vladimirovna Dragun - Specialist at the Centre for Social Services for young people and communication
• Irina Vasilyevna Novinkova - Director of the Centre for Social Services for Young People
• Svetlana Alekseevna Lyuchenko -- Representative of the NGO "Youth Centre of the Women's Initiative"
• Galina Yakovlevna Busalaeva - Specialist of the education department on prevention work

2.4.All participants had some experience in material development, though the majority had not developed health promotion materials but booklets advertising services of their organisations. Each participant expressed the need for specific health promotion materials for the groups they are working with. They had no prior experience of conducting focus groups or participative research but all have experience of working with the target groups identified.

2.5.The workshop was well attended and participants participated enthusiastically on both days. Participants grasped the fundaments of the topics covered and by the second day were developing guidelines for the focus groups with minimum assistance from the consultants.

2.6.A generic guide for each focus group was developed as follows. This will be adapted according to the specific needs of each group. Irina Potapova has a complete list of questions:

• Where do they currently get their information?
• What kind of information do they require?
• Defining their behaviour and attitude towards the subject (for this various interactive methods and games were demonstrated that could be used e.g. spider diagram, role plays, mapping))
• In what form would they like to receive the information (including language, format, style)
• Where should the information be made available?/li>

2.7.The working group felt that the focus groups should be conducted as soon as possible. The following timetable was agreed on for the work, ideally to begin mid January/early February:

• 2 weeks - focus groups
• 2 weeks - putting together the first draft
• 2 weeks - pretesting and adaptation
• 1 week - printing

2.8.2.8 One weak area would be that too much emphasis was placed on conducting focus groups as a means to completing a scheduled activity rather than as a means to raising awareness amongst the target groups in these issues, involving them in the programme and mobilising the communities. I imagine this is due to pressures of completing activities as well as adapting to a different approach to work.

3 Recommendations

3.1.There already exists a rich range of IEC materials for the majority of target groups identified in Sevastopol with the exception of street children and men in the army. The Oblast Co-ordinator with the assistance of Konstantin Talayaev has assessed each material and catalogued them so they are easy to access and review.

3.2. New materials will need to be developed for street children and men in the armed services.

3.3. There is a need to link up Oblast Coordinators with existing organisations who produce these materials to negotiate obtaining copies or permission to adapt them for their Oblast. Key organisations include many NGOs in the Ukraine, Aids Foundation East West, in Moscow; AIDS infoshare, Moscow, MSF Ukraine, PSI Russia.

3.4.Focus groups and other participatory methods to incorporate the target groups in the activity should be used whether materials are to be developed from scratch or adapted. The use of innovative methods such as using photographs of local landmarks should be explored to assist the feeling of local ownership of the materials. One project in Nepal gave a group of sex workers a digital camera and they in turn took photographs of important places for them such as the STI centre which were included in the printed materials.

3.5. Whilst a very comprehensive strategic plan has been developed for the Oblast covering the key target groups identified, at present there appears to be little intervention work occurring in the field within the target groups with the exception of IDUs and young people. More support is needed for Project Management at the intervention level in order to facilitate the implementation of programme areas identified in the strategic plan. This could include project management, training of trainers programmes or counselling skills. There is a certain amount of concern about working with some groups in terms of how to access people and whether they will be accepted and listened to. This specifically applies to injecting drug users, street children and people living with HIV/AIDS.

3.6. In the case of sex workers there is a lot of knowledge about the needs of this target group gathered through previous needs assessment but to date no concrete intervention work. The development of IEC materials is particularly important to this group as a way of bringing them into contact with health services.

3.7.The programme is structured to build up the expertise of different Oblasts in a range of areas, for example social marketing, social contracting, material development, working with the media. This will assist in ensuring the sustainability of the project and encourage cross fertilisation of ideas across the Oblasts

3.8.In order to facilitate the process it would be worth developing the training skills of the Oblast Co-ordinators and the people who will be conducting the training needs through a training of trainers programme or in participative adult learning techniques. This would also assist the Coordinators in their work with the target groups.

3.9.Additional work to build up the concept of participation and empowering of target groups should be incorporated into subsequent workshops.

3.10.It would be of benefit for the Oblast Coordinator to be aware of the overall programme to encourage independent programme planning at Oblast level. At present they wait instructions from Kiev before going ahead with activities which could be stifling the progress of the programme activities and innovation.

Appendix 1

Itinerary for Lucy Platt

Appendix 2

Key considerations in the development of sex work materials

• What is the purpose of the material?
• How is it to be used - read once, as a reference, or shown to others?
• Is the aim to provide basic information, stimulate discussion, foster a sense of a shared problem, remind people to practise safe sex, or instruct about a particular aspect of health awareness such as hygiene and sanitation, safe sex fantasies or safe drug injecting? Or is it to be used as a tool in negotiating safe sex or work conditions to inform about another issue such as first aid, contraception or avoiding violence?
• Who is the intended audience?
• Is it intended for use in negotiations with clients or management's, or is it information for sex workers themselves?
• What is the literacy level and culture of the target audience?
• Are people likely to want material, which mentions prostitution or should information, be presented in some other way?
• Is there really a need for new materials or do suitable ones already exist, from another area or country, which could be translated or adapted?
• How can the target audience be involved in the design and evaluation of this material?
• How can the material be checked before it is published?
• Is the language and presentation clear or could it be misinterpreted?
• Is the material factually correct?
• Which images will contribute to sex workers' self esteem and encourage them to relate to the material?
• How will the material be distributed? Are there more effective ways, such as using matchboxes, key rings, and nail file packets?
• Every commercial sexual transaction involves at least two people. If both of those people are fully informed about sexual health they are more likely to practise safe sex. This is an argument for targeting clients as well as sex workers.

Appendix 3

Focus groups

Focus groups can also be made participatory. It is unlikely that sex workers are going to want to take part in a focus group to help you develop education materials unless they feel ownership of the project and ideally there is some other kind of incentive for them to do so.

For example: beauty sessions, self-defence class, English lessons, free treatment at health centre etc.

The practical organisation of focus groups

• Recommended number of people per group is 6 to 10
• Duration - from 1 to 2 hours
• Neutral locations to avoid either negative or positive associations with a particular site or building
• Participants - it is not always easy to identify the most appropriate participants for a focus group.
• Too diverse can make a considerable impact on their contributions
• Too homogenous - diverse opinions may not be revealed
• Participants need to feel comfortable with each other
• Recruitment can be time consuming, especially if the topic under consideration has not immediate benefits or attractions to participants - incentives usually need to be offered.

Role of the moderator

Crucial in terms of providing clear explanations of the purpose of the group, helping people feel at ease and facilitating interaction between group members

• Moderators need to promote debate, perhaps by asking open questions
• Open questions - questions that cannot be answered with a yes or no response.
• How did that make you feel?
• What do you think of that?
• Six helpers to asking open-ended questions - Who? What? Why? Where? When? How?
• Avoid leading questions: What is a leading question? i.e. Would you read health education materials on STIs if the health service provided them?
• Avoid ambiguous questions
• Avoid jumping from topic to topic
• Challenge participants, especially to draw out people's differences, and tease out a diverse range of meanings on the topic under discussion
• Keep the session focussed and so sometimes deliberately steer the conversation back on course.
• Ensure that everyone participates and gets a chance to speak.
• Avoid giving personal opinions so as not to influence participants towards any particular position or opinion.

Qualities of a moderator

• Good interpersonal skills
• Good listeners
• Non judgmental and adaptable

These qualities will promote the participants' trust in the moderator and increase the likelihood of open, interactive dialogue.

Recommendation of 2 moderators, one to facilitate and one to take notes.

Ethical considerations

Researchers must ensure that full information about the purpose and uses of participants' contributions is given. Confidentiality - inform participants that each contribution will be shared with the rest of the group, but participants need to be encouraged to keep confidential what they hear during the meeting and researchers have the responsibility to anonymise data from the group.

Advantages and Disadvantages of Focus groups

Disadvantages

Time consuming
Success depends of ability of the moderator

Advantages

Benefits to participants of focus groups should not be underestimated - the opportunity to be involved in decision making process, to be valued as experts, to encourage the feeling of ownership of the project is very empowering for many participants and essential to the sustainability and success of the project.