Kenya

Kenya: Healthy Outcomes through Prevention Education (HOPE) Final Evaluation

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In Kenya, high poverty, insecurity, poor health outcomes, substance abuse and low levels of education make young people, especially girls, vulnerable to a variety of risks such as Human Immunodeficiency Virus (HIV) infection, Acquired Immunodeficiency Syndrome (AIDS), other Sexually Transmitted Infections (STIs) and Diseases (STDs), and Sexual and Gender-Based Violence (SGBV). To help address this crisis, the Healthy Outcomes through Prevention Education (HOPE) Program was designed to help prevent the spread of HIV/AIDS, STIs and STDs, and generally promote healthy outcomes among at-risk Kenyan students and their families. The HOPE Program was funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), from March 2012 through June 2015. HOPE was implemented by Global Communities (GC) in partnership with the National Organization of Peer Educators (NOPE), Kenya Girl Guide Association (KGGA), St. John’s Community Center (SJCC) and Support for Addiction Prevention and Treatment in Africa (SAPTA). The program was implemented in Nairobi and Kiambu counties, and tasked with reaching at-risk youth in informal urban settlements. This report presents the findings of a summative end-line program evaluation funded by Global Communities and carried out in the summer of 2015.

HOPE Background

The HOPE Program was designed to enhance at-risk students’ Knowledge, Attitudes and Practices (KAP) related to HIV/AIDS and other STIs/STDs, and substance abuse. The program’s stated Goal was: Improved HIV knowledge, attitudes and practices among Kenyan students through peer-, school- and community-based interventions. The HOPE Program had four main Objectives (Outcomes):

Improve students’ HIV and AIDS Knowledge, Attitudes and Practices through Peer-To-Peer support and mentoring; Equip schools with the capacity to provide HIV- and AIDS-related knowledge, information, and support through classroom instruction and extra-curricular activities; Increase involvement of parents and community members in schools in order to promote healthy living; and Equip the Ministry of Education, Science and Technology (MoEST) and new County Education Officers to implement the Ministry of Education's Revised Sector Policy on HIV and AIDS. HOPE was intended to be a four-year, $6.3 million initiative that included a control community of 24 schools using a Healthy Outcomes through Prevention Education (HOPE) Program: Final Evaluation Report 8 quasi-experimental research design. Given a 27% USAID budget cutback in Year 2 as PEPFAR moved away from population-based HIV prevention programming, the program was cut to $4.6 million and reduced from four to three years. As a result, services were significantly condensed and the research component was not completed as planned.

Evaluation Purpose

Global Communities undertook this internally funded evaluation because it believed not only that HOPE had been successful, but also because it believed that the Life Skills curriculum, and the peer education (PE) and training approaches used may have resulted in significant and positive unintended outcomes for youth that were not being monitored through the program’s performance monitoring system. These included improvements in youth coping skills, inter-ethnic and inter-generational communications, and academic performance. Global Communities also heard about corresponding improvements in the way teachers and parents interacted with youth and dealt with the unique needs of adolescents. These positive, unintended outcomes of the HOPE Program were being communicated to HOPE staff during continuous supervisory visits to the field and during workshops and interviews with project beneficiaries carried out by the Global Communities’ Senior M&E Specialist in March, 2015. As a result, Global Communities sought to document the project model and achievements, and ascertain whether evaluation data would provide evidence of these positive, transformational outcomes, both intended and unintended. Given that the project had only been tracking planned results related to HIV/AIDS, STI/STD and substance abuse knowledge, attitudes and practices, coupled with the fact that a mid-term evaluation had not been conducted, an end-line evaluation was needed to document and measure any unintended results that had occurred. Global Communities kept the evaluation objectives broad to focus on both attainment of planned and unplanned results as well as overall program impact and effectiveness, and beneficiary satisfaction with the training and services received. The target populations for the assessment were the primary and secondary school students, teachers, school administrators, parents/caregivers, and other key informants residing in or working in Nairobi and Kiambu counties. The four Evaluation Objectives were to:

  1. Establish the extent to which HOPE achieved its Goal and intended Outcomes;

  2. Assess the overall effectiveness and impact of the HOPE model in addressing the needs of at-risk youth in the urban slums of Nairobi;

  3. Assess and document whether the program had unintended outcomes (positive or negative) beyond the original HOPE Goal and intended Outcomes;

  4. Examine whether there are elements of HOPE that can guide future Global Communities efforts at working with at-risk youth within the structure of their schools, communities and families.