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Why did sexuality education programme The World Starts With Me not show to be effective? In discussion with students, teachers and principals in Nairobi, Kenya. Sanne van Lieshout, MSc. Global Health October 16th, 2012. Table of content. What is The World Starts With Me (WSWM)?

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sanne van lieshout msc global health october 16th 2012

Why did sexuality education programme The World Starts With Me not show to be effective?In discussion with students, teachers and principals in Nairobi, Kenya

Sanne van Lieshout, MSc. Global Health

October 16th, 2012

table of content
Table of content
  • What is The World Starts With Me (WSWM)?
  • Prior evaluation outcomes
  • Research questions
  • Hypotheses
  • Theoretical framework
  • Data collection
  • Results
  • Conclusions and recommendations

2-11-2012 / dia 2

the world starts with me
The World Starts With Me

Computer-based sexuality educationprogramme

Rights-based approach

Rutgers WPF and SchoolNet Uganda

Culturally adapted to othercountries, among which Kenya

2-11-2012 / dia 3

prior evaluation outcomes
Prior evaluation outcomes
  • Processevaluation was positive
  • Outcome evaluation disappointing:

- No significant improvements

- Even a móre negative attitude towards consistent condom use after WSWM participation

2-11-2012 / dia 4

research questions
Research questions
  • What goes wrong in the correct adoption and implementation of the programme, regarded as an innovation?

- Rogers’ Diffusion of Innovation (2003)

  • Why are there no positive outcomes with regard to sexual behaviour of WSWM participants?
    • Delay
    • Consistent condomuse

- Fishbein& Ajzen, Reasoned Action Approach

2-11-2012 / dia 5


Severalpossibleexplanationsfor these outcomes:

  • The programme itself
  • The implementation (completeness and fidelity)
  • Research methods
  • Living environment of the students and the current social norms about sexuality

2-11-2012 / dia 6

data collection
Data Collection

Table 1: distribution of the interviewed participants per school.

2-11-2012 / dia 8

results 1 principals and wswm teachers about adoption and implementation
Results (1) Principals and WSWM teachersaboutadoption and implementation
  • Principalsneed to representCatholicchurch
  • Shift of priorities
  • Teachers do getincentivesforotherafter-school clubs
  • Computers break down and power costs money
  • Students are sometimes sent home for school fees
  • “Don’t expect results too soon. These studentscomefrom families thatdon’t talk aboutsex. This is a process that takes time.”
  • Femaleteachersfinditdifficult to discusscondomusewith the girls
  • Teacher transfer

2-11-2012 / dia 9

results 2 wswm participants about the programme
Results (2) WSWM participantsabout the programme
  • Whydecided to join WSWM:
  • “I expected to get to change my life“
  • “To gain knowledge and self-control”
  • “I wanted to know more about some questions which go unanswered, so I can help other people”
  • “Tounderstand myself better, deliver that to others, that can make them change”
  • Parents
  • Spreading the message:
  • Individually and in groups. At school, butalso in the neighbourhood and at the church
  • “I discusswithfriendswho never got the chance to get to school”

2-11-2012 / dia 10

results 3 students about delay and condoms
Results (3) Studentsaboutdelay and condoms
  • (dis)advantages of delay are clear, but different viewpoints:

“ premaritalsexcheapensyour soul and demotesyourcharacter”

“ifyouwaituntil 25, yourchildrenwillget a betterlife and iteradicatespoverty”

  • Knowledgeableaboutcondoms, but…
    • Abuse, storing, man-madeinstead of God-made, holes, oils,
    • “we don’t do condoms in our home area”
  • Peer pressure and myths

2-11-2012 / dia 11

results 4 principals and wswm teachers about youth s sexuality
Results (4) Principals and WSWM teachers about youth’s sexuality
  • Media and porn have a bad influenceon the youth
  • “society is rotten”
  • Interviewed men seemed more open thanwomen
  • “parents have forgotten to assist these people in growing up”

2-11-2012 / dia 12


At one school principal, WSWM teacher and students were interviewed

  • Principal: later appeared to be a WSWM trainer, didn’t mention it
  • WSWM teacher: seemed very dedicated
  • Student: “condoms, they contain some, what are theycalled? … whichmightcauseharmtoyour body. So in WSWM we are advisednottousethem”

2-11-2012 / dia 13

conclusions and recommendations
Conclusions and recommendations

Withregard to the theoreticalframework:

  • Character of WSWM is very different fromprevailingreligiousnorms(compatibility)
  • This, and time contraintsmakeadoption and implementation of WSWM verydifficult(complexity)
  • Relativeadvantagepotentiallyfor the youth’shealth, certainlynotfor image of the school
  • Observability: schools are invited to WSWM expositions at other schools
  • Trialability: -
  • Recommendations werecommunicated with Rutgers WPF and The Centre for the Study of Adolescence

2-11-2012 / dia 14

conclusions 2
Conclusions (2)
  • Despite multiple problems, everyone interviewed was very enthusiastic about WSWM
  • Outcome measures of previous effect evaluation seem to have been too ambitious and take more time
  • Narratives of students, WSWM teachers and principals can be very helpful for Rutgers WPF and local partner CSA to adapt and optimize the programme and its implementation

2-11-2012 / dia 15

thank you for your attention
Thank you for your attention!


2-11-2012 / dia 16