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SOUL BEAT AFRICA
 
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Beyond South Africa

Choose Life Project

“The booklet tought me that love doesn’t mean sex.” (Lesotho, urban boy)

“I now believe that I can have a boyfriend and not sex.” (Swaziland, rural girl)

“I used to think that being beaten by a boyfriend was a good thing; now I have learnt that it is a crime.” (Botswana, rural girl)

“Choose life made me stand up on my feet and say ‘no’ to sex.” (Lesotho, urban girl)

“It [Choose Life] helped me gain confidence.” (Swaziland, urban girl)
 Choose Life image 1

Choose Life is an education booklet produced by the Soul City: Institute for Health and Development Communication (Soul City: IHDC). Aimed at 12 –16 year olds in Botswana, Lesotho, Swaziland and Namibia, over 1.3 million copies of the booklet have been printed and distributed in the four countries and in seven different languages. The booklet was adapted for each country to ensure its contents were appropriate and well tailored. The project was funded by the UK Department for International Development.

The Choose Life project addresses the HIV/AIDS pandemic in Sub-Saharan Africa by positively informing adolescent sexual behaviour in order to reduce teenage pregnancy, HIV and other sexually transmitted diseases. International and local research indicates that effective lifeskills/sex education helps delay the commencement age of sexual activity and results in an increase in safer sexual practices. Furthermore, educating young people to adopt safer sexual behaviour reduces HIV/AIDS risk.

‘We have to ensure our youth are appropriately armed in their expedition as they choose life and live it to the fullest. This book …nourishes youth with lifeskills that are critical for survival and success in today’s challenging environment.’

Minister of Health - Botswana launch



Soul City: IHDC worked in partnership with the following organisations in each country to adapt, produce and distribute the Choose Life booklets.
  • Botswana: Population Services International (PSI)
  • Lesotho: Catholic Council of Lesotho (CCL) - this changed to The Lesotho Network for AIDS Service Organisations (Lenaso) during Phase 4 of the project. Lenaso is a consortium of organisations working in the field of HIV/AIDS.
  • Namibia: Initial partner was Population Services International (PSI). This changed to the Red Cross in Phase 4.
  • Swaziland: Schools HIV/AIDS and Population Education (Shape)

The content and format of the booklet
An effective HIV/AIDS booklet for youth cannot simply provide accurate information on how HIV/AIDS is transmitted. It needs to deal with a range of issues that affect and impact on the sexual decisions and choices that young people make. Teenage sexual activity is profoundly influenced by feelings of self-esteem, an ability to be assertive and an understanding of what sex really means in a relationship. Young people need appropriate knowledge and information, as well as opportunities to practice life and decision-making skills.

Young people also need a fresh approach. If we want teenagers to read we need to give them something that they want to read; that speaks to them in a voice and language they know, with a look and feel that is young and vibrant.

The Choose Life booklet was developed in a way that would appeal to youth.
  • Simply written stories deal with a range of relevant lifeskills e.g. Being a teenager, Violence in Relationships, Standing up for yourself and Living with HIV/AIDS.
  • Full-colour photographs give a vibrant youth feel
  • True stories and youth voices create identification
  • Through quizzes and interactive questions skills are practiced, discussion and debate promoted and community action encouraged.
  • Celebrities act as role models to carry key health messages
 Choose Life image 2

An outline of the development process
Research and the development of partnerships - at the core of Soul City’s approach - informed the Choose Life development process.

  • Phase 1: Research
    The aim of this phase was to consult with key people in each country on the viability of the project, ascertain the distribution possibilities and select a local partner.
  • Phase 2: Develop core publication
    The aim of this phase was to develop a core publication for youth 12-16 years on HIV/AIDS which would be pretested in each country and could form the basis of country specific versions.
    A new publication called Choose Life – Living with HIV/AIDS in our Community was researched and developed in SA ready to be tested in the 4 countries. During Phase 2 a second round of consultation meetings were conducted in the four countries with key people in the health and education sector to get feedback on the core publication and explain the testing process.
  • Phase 3: Pre-test in each country
    The aim of pre-testing was to ensure that the booklet was relevant and appropriate for local use and to inform the development of a country specific version.
    This process involved administering questionnaires and conducting focus group discussions with the target audience. It also included a stakeholder workshop in each country to present the research findings. On the basis of the research findings and a mandate from stakeholders, final recommendations for the development of a country specific version were made.
  • Phase 4: Develop country specific versions
    The aim was to develop country specific versions of the booklet.
    Strong local input into materials development and writing ensured an effective product. During this phase black and white copies of the new booklet were shown to stakeholders for final approval.
  • Phase 5: Design marketing & distribution strategies
    The aim was to distribute the booklet to all 12 –16 year olds in each country and to promote and popularise its usage. The original broad strategy envisaged was to:
    • Distribute through the school system in consultation with the departments of education in each country.
    • Identify other potential distribution points.
    • Run a promotional campaign using radio, to encourage youth to access the material. This would include a competition element and a promotional campaign using radio, to encourage teachers to use the publication. The concept of a national radio promotional campaign has been developed by Soul City in order to create awareness of the materials. This broad strategy was adapted and modified to suit the needs and priorities of the different countries.
  • Phase 6: Print and Distribution
    By January 2002 a total 1, 331, 000 copies of the booklet were printed and distributed in the four countries in seven different languages;
    • In Botswana: one edition in English with some Setswana
    • translations
    • In Swaziland: two editions; English & siSwati
    • In Lesotho: two editions; English & Sesotho
    • In Namibia: 3 editions; Afrikaans (with key word translations in Otjiherero); English (key word translations in Lozi and Rukwangali ) and Oshivambo.
    A ll countries used the school system as the primary distribution vehicle to reach youth but the out-of- school sector was accessed differently.

    The following table shows the distribution reach and outlets in the different countries.
    Country Quantity Distribution Outlets
    Botswana 400 000 Schools:
    - junior & senior secondary
    Out of school:
    - Teacher training colleges
    - District youth offices
    - BP filling stations
    - Roadshows
    - Botswana College of Distant Ed
    Swaziland 116 000 Schools:
    - 177 high schools
    Out of school:
    - Tinkundla Centres
    - Clinics
    Lesotho 435 000 Schools:
    - 1050 primary schools and 154 high schools
    Out of school:
    - NGOs (Lenaso members)
    - Maseru Roller Mills
    - District Hospitals
    - Adolescent Corners
    Namibia 380 000 Schools:
    - 170 000 school learners (Gr 7 –12)
    Out of school:
    - Namcol
    - Red Cross Regional Centres
    - Post Offices
    - Community Libraries
    - Clinics

 In Lesotho, in addition to distribution through schools, an agreement was made with Lesco foods to distribute 165,000 copies of the booklet inside selected maize bags that sell in far-flung rural communities. The booklets are covered in a plastic sleeve to protect them and a label has been sewn on the outside of the bag telling customers that there is a free health booklet inside! In exchange Lesco foods have a full-colour advert on the back of the booklet as well as product acknowledgement on other promotional elements such as posters. Their product is being promoted to 400,000 young people around the country as well as key decision-makers and teachers. And the Choose Life booklet is getting to places it otherwise wouldn’t reach.

 Choose Life image 3

Phase 7: Project Evaluation
The evaluation critically examines the implementation of the Choose Life project, its reach and its reception by the primary target audience.

KEY EVALUATION FINDINGS
  • The Choose Life Magazine was distributed to youth audiences in 4 SADC countries: Lesotho, Swaziland, Botswana and Namibia. In Botswana alone, 79% of the target audience saw the magazine, and 62% read it, or read parts of it; 31% still had a copy one year later.
  • 16% of youth rated Choose Life amongst their top 3 sources of information on HIV/AIDS.
  • The trends in impact emerging from the qualitative evaluation across all 4 countries were as follows:
    • Choose Life created an opportunity for communication and discussion amongst peers, and awareness around the need to communicate;
    • ... improved awareness & attitudes around gender based violence;
    • ... served as a catalyst for assertiveness (girls);
    • ... improved awareness & attitudes around people living with AIDS, and stigmatization.
  • The trends in impact emerging from the quantitative evaluation conducted in Botswana were as follows:
    Exposure to Choose Life is a significant predictor of
    • Accurate knowledge of HIV/AIDS
    • Positive attitudes around
      • Youth sexuality
      • Stigma
      • Gender issues
      • Risky behaviour
    • A sense of self-efficacy in preventing HIV/AIDS
    • Reported use of condoms
    • Three in five youth in Botswana (59%) reported that they had discussed the booklet with someone.
  • 45% off Choose Life readers knew that it was safe to touch an HIV positive person, whilst 30% of youth not reading Choose Life knew this (p<0.05).
  • Exposure to Choose Life is associated with condom use reported: 33% off all Choose Life readers said they used condoms when having sex, whilst 28% of youth not reading Choose Life said they used condoms when having sex (p<0.05).
  • In response to the statement “people with HIV/AIDS should be moved away”, 81% off all Choose Life readers disagreed, whilst 63% of youth not reading Choose Life disagreed with the statement (p<0.05).
  • Willingness to use the same cutlery as someone with AIDS is low; but those exposed to Choose Life were more likely to display positive attitudes in this regard: 30% of Choose Life readers said they would use the same cutlery as someone with AIDS, whilst 14% of youth not reading Choose Life said they would (p<0.05).
  • 84% off all Choose Life readers disagreed with the statement “boys have a right to sex if the buy their girlfriends gifts”, whilst 70% of youth not reading Choose Life disagreed with this statement (p<0.05).

Choose Life image 4
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