HEALTH (RH) PROGRAM: SCHOOL-BASED
RH EDUCATION IN SNNP REGION
IN ETHIOPIA
AN EVALUATION PLAN PROPOSAL PREPARED TO BE
SUBMITTED TO HEALTH MONITORING & EVALUATION
DEPARTMENT OF PUBLIC HEALTH FACULTY,
JIMMA UNIVERSITY
Final Draft
By
FIKRU TESSEMA (B.Sc)
03 November 2006
SCHOOL- BASED REPRODUCTIVE HEALTH EDUCATION
IN SNNP REGION IN ETHIOPIA
By
FIKRU TESSEMA (B.Sc)
ADVISORS:
Dr FREHIWOT (E-mail:
f_berhane@yahoo.com
)
Dr BINYAM (E-mail:
Binuad2002@yahoo.com
)
TABLE OF CONTENTS
Contents
Page
TABLE OF CONTENTS---i LIST OF ACRONYMS---iii EXECUTIVE SUMMARY---iv CHAPTER ONE---1 1.1 INTRODUCTION---1 1.2 BACKGROUND---31.2.1 Global & National Context---3
1.2.2 Program objectives---11
1.2.3 Rationale for program evaluation---15
CHAPTER TWO---17
2.1 STAKEHOLDERS DESCREPTION/CONSULTATION---17
2.1.1 Key stakeholders identification---17
2.1.2 Stakeholder participation---17
2.1.3 Communication with stakeholders---18
2.1.4 Primary users of evaluation findings---19
CHAPTER THREE---20
3.1 EVALUATION QUESTIONS AND OBJECTIVES---20
3.1.1 Evaluation questions---20
3.1.2 General Objectives---20
3.1.3 Specific Objectives---21
CHAPTER FOUR---23
4.1 EVALUATION METHODOLOGY---23
4.1.1 Evaluation purpose and focus---25
4.1.2 Study Area---26
4.1.3 Evaluation approach and design---26
4.1.4 Target Population---28
4.1.6 Case Selection and sample size---29
4.1.7 Matrix of analysis of evaluation dimensions for program components---30
4.1.8 Matrix of Analysis and Judgment---32
4.1.9 Data collection techniques and procedures---35
4.1.10 Pre-Test---36
4.1.11 Ethical Consideration---37
4.1.12 Study project management:---38
4.1.13 Data analysis and management---40
4.1.14 Operational Definitions---41
4.1.15 Scope and Limitations of the Evaluation---43
CHAPTER FIVE---44
5.1 BUDGET---44
5.1.1 Timeline for Evaluation---44
5.1.2 Budget for evaluation---46
CHAPTER SIX---47
6.1 REPORT OF THE EVALUATION---47
6.1.1 Report-writing Plan---47
6.1.2 Result Dissemination Plan---47
CHAPTER SEVEN---48 7.1 META EVALUATION---48 7.1.1 Utility---48 7.1.2 Feasibility---48 7.1.3 Accuracy---48 7.1.4 Propriety---48 REFERENCES---49 ANNEX (1-7)--- 55
LIST OF ACRONYMS
AIDS : Acquired Immuno Deficiency Syndrome BSS : Behavioural Surveillance Survey
HIV : Human Immuno Virus
STI : Sexually Transmitted Infections
ISY : In-School Youth
OSY : Out-of-School Youth
RH : Reproductive Health
YRH : Youth Reproductive Health UNAIDS : United Nations AIDS USAID : United State AID
ARH : Adolescent Reproductive Health
SNNPR : South Nation and Nationalities People Region NGOs : Non-Governmental Organizations
NRHS : National Reproductive Health Strategy UNICEF : United Nations Fund for Children WHO : World Health Organization CDC : Center for Disease Control NGO : Non-Government Organization SNNP : South Nations & Nationalities People STIs : Sexually Transmitted Infections USA : United State of America
EXECUTIVE SUMMARY Background
Numerous evaluations around the world show that comprehensive adolescent reproductive health (ARH) education programs help youth to delay the onset of sexual intercourse. It also helps sexually active young people to protect themselves from pregnancy, HIV, and STIs.
According to an assessment on youth ARH conducted (2004) in Ethiopia in three regions (Oromiya, SNNPR, and Amhara), youth less than 20 years of age who have begun childbearing at earlier age accounts for 37%; unintended births among women less than 15 years of age is over 50%; unintended births among 15-24 year olds is about 33%; youth receiving antenatal care is about 27%; and youth currently using modern contraception accounts for 5%. HIV/AIDS youth prevalence is 6.1% and youth 15-19 year olds with no knowledge of STIs accounts for more than 50% for females and 40% for males.
The Government support for youth RH is fairly strong in Ethiopia and reflects the concern on the part of Government authorities to prevent unintended pregnancies, STIs, and HIV among youths. Some NGOs are working on adolescent RH services in high schools and 20 elementary schools in Oromiya, Amhara, and SNNPRs and Addis Ababa City.
Need for program evaluation
There is a global intention to focus more on issues related to ARH and their implications for health and well-being. Even if there is a considerable amount of input for ARH services including financial, it is now highly recognized that the existing ARH service is inadequate in the country. Still youths/adolescents are underserved and the program is poorly promoted.
In response, the Government and program operators need to know whether the existing interventions produce effects to the acceptable level that will help to explain how outputs of the interventions lead to outcomes. Many youths still
become sexually active without accurate information about safe sex. This lack of information can put them at risk of unplanned pregnancy, sexually transmitted infections (STIs) and HIV, unsafe sex and inability to delay first or onset of intercourse.
Overall evaluation objectives
This evaluation mainly aims at increasing evidence pertaining to school-based RH education program implementation so as to make conclusion based on the findings for reasons of success or failure for program promotion and expansion.
Methods
A qualitative method will be employed. Semi-structured/open-ended self-administered and unstructured expert interviews techniques will be used for data collection. In-depth interview can explore to the depth of the root causes for success or failure of RH education in schools by providing a confidential environment for principals. Data will be collected using triggering questions for interviewing of principals of six high schools. The principal investigator will do interviewing of principals. The facilitator will arrange interview sessions in both high schools. Semi-structured interview can also provide in-depth data with the potential to be quantified and generalizable to population. Data will be also collected using semi-structured self-administered questions for science teachers in high schools. The questionnaire will be pre-tested and translated to Amharic. The facilitator will distribute the questionnaire to six high school teachers and collect after they fill it.
Time line
Project timeframe is estimated to be less than one year including data collection analysis and result dissemination. The interview will start at the beginning of the year 2007 and cover one month.
The over all total budget for the implementation of the case study evaluation is ETB 36,025 (US$ 4,190).
CHAPTER ONE
1.1 INTRODUCTION
Program evaluation is “the systematic collection of information about the activities, characteristics, and outcomes of programs to make judgments about the program, improve program effectiveness, and/or inform decision makers about future program development.”1
Numerous evaluations around the world show that comprehensive ARH education programs help youth delay the onset of sexual intercourse. It also helps sexually active young people to protect themselves from pregnancy, HIV, and STIs. In addressing ARH promotion, explicit attention is needed to be given to sex education and particularly to safer sex because it is the backbone of ARH. Efforts to tackle the HIV/AIDS pandemic have demonstrated the importance of understanding sexual behaviour, challenging social stigma and discrimination, and preventing and managing STIs and teen pregnancy.2
School-based ARH education programs generally have considerable role in sexual health by sharing information on sexuality, HIV/AIDS transmission and prevention, contraception, condoms, sexually transmitted diseases, and decision making and refusal skills. Education of youths involves the development of cognitive skills, the acquisition of knowledge, and the shaping of values, attitudes, and beliefs.3
Educating young people about reproductive health improves their ability to make informed and responsible choices. Teaching them skills in negotiation, critical thinking, decision-making, and communication also improves their self-confidence. Family life education is an especially effective way to teach young people critical life skills. It can help them to postpone sex until they are mature enough to protect themselves from unintended pregnancy. Messages of abstinence also appear to work best when aimed at younger youth who are not yet sexually active. Especially in girls, it has achieved a delay in sexual initiation of about a year.4
Adolescents who successfully practice abstinence require strong social support from community members. They also need the development of specific skills, including strong motivation, self-control, and communication. Programs that include comprehensive messages can teach skills for practicing abstinence. It also provides information for sexually active youth about condoms and reducing the number of partners.5 If a comprehensive RH education provided through
regular schools is strengthened, more girls can easily make a choice for safe sex. Most sex-education programs present data in a so-called value neutral way. But, in trying to be amoral, these programmes become immoral. Sexuality in human RH must be related to moral values. Young people need information about sex, but it must be placed in a moral context. The greatest problem among young people today is not a lack of education about sexual RH, but a lack of moral instruction about sexual RH.6
1.2 BACKGROUND
1.2.1 Global & National Context
Global program context: Evaluation has identified many effective, comprehensive, school-based ARH education programs for young people in less developed and advanced nations. Several case study evaluations show that teaching young people about RH reduces their risk for pregnancy and STIs, including HIV.
In Central America, in the United States teen pregnancy and birth rates have declined steadily in recent years. U.S program planners looked to the available evaluation and research to identify effective programs promotion.7 A number of
evaluated programmes have been compiled to see their effectiveness in RH education. Twelve programs effectively demonstrated a statistically significant delay in the timing of first sex among program adolescents, relative to control youth. Many of the programs also demonstrated reductions in other sexual risk-taking behaviors among participants relative to control youth. Eleven programs demonstrated an ability to assist sexually active youth to increase their use of condoms. Eight demonstrated success at increasing contraceptive use other than condoms. Six resulted in a reduction of the number of sex partners among program participants. Six assisted sexually active youth to reduce the frequency of sexual intercourse. Four demonstrated the ability to reduce the incidence of unprotected sex. Eight programs showed statistically significant declines in teen pregnancy, HIV or other STIs. Seven demonstrated a statistically significant
impact on teenage pregnancy among program participants, compared to controls, and one, a reduced trend in STIs.8
In Latin America, 22 states and the District of Columbia require public schools to teach RH education. In Jamaica, a program promoted abstinence for youth ages 10 to 12, emphasized increased self-knowledge and abstinence for youth ages 13 to 15, and promoted protection from unintended pregnancy, HIV, and other STIs for older youth.9
In Asia, India, a study conducted (1989-90) on the opinion of parents on problems of introducing family life ARH, specific to sex education courses in secondary schools showed that 89.3% of the parents felt that a definite need for family life education in secondary schools.10 Teachers’ comfort levels while
teaching ARH, explicitly sexuality education in response to the statement, “I feel comfortable discussing non-sexual ways of displaying affection with my students,” of 61.6% of teachers, agreed (35.2%) and strongly agreed (26.4%).11
Evaluation of comprehensive ARH programs in Africa in Nigerian schools showed decreased incidence of STIs, increased abstinence, increased condom use, and reduced numbers of sex partners. Evaluation has also identified effective community-based ARH programs for young people in Zimbabwe, Kenya, Cameroon, Guinea, and Uganda—programs that successfully delay initiation of sex and effectively foster risk reduction among sexually active youth.12 During the late 1980s and early- to mid-1990s, a wide-scale anti-AIDS
in HIV rates. From 1989 to 1995 in Uganda, the proportion of 15- to 19-year-olds reporting that they “never had sex” rose from 31% to 56% among males and from 26% to 46% among females.13
In the most comprehensive analysis of ARH education, the Joint United Nations Programme on HIV/AIDS (UNAIDS) examined 68 evaluations of ARH, specific to sex education projects, 53 of which evaluated specific interventions. Of these 53 interventions, 22 delayed the onset of sexual activity, reduced the number of sexual partners or reduced unplanned pregnancy and STI rates.14
National program context: According to an assessment on youth RH conducted in Oromiya, SNNPR, and Amhara (2004), youth less than 20 years of age who have begun childbearing at early age accounts for 37%; unintended births among women less than 15 years of age is over 50%; unintended births among 15-24 year olds is about 33%; youth receiving antenatal care is about 27%; and youth currently using modern contraception accounts for 5%. HIV/AIDS youth prevalence is 6.1% and youth 15-19 year olds with no knowledge of STIs accounts for more than 50% for females and 40% for males.15
The HIV/AIDS BSS, conducted in 2002 in Ethiopia, also contains a useful data that describe reported sexual behaviors of both in-school youth (ISY) and out-of-school youth (OSY). As expected, the OSY report much higher levels of sexual activity, including higher levels of unprotected sexual activity. Most program
assessments and reviewing of interventions, they indicated and concluded that school-based RH education is a program with low promotional aspects in the country. Consequently many youths become sexually active without accurate information about safe sex. In response, there is a strong argument that school-based adolescent reproductive health education is necessary to help adolescents in making informed decisions about sexuality issues.16
Problem Statement: Given its conservative culture and religion, Ethiopia is faced with an overwhelming challenge to assist its young people and society, in general to openly discuss issues related to reproductive health, specifically about sexuality, family planning, STIs, and HIV/AIDS. As a result, most youths lack basic knowledge of reproductive anatomy and physiology, how pregnancy or STIs/HIV occurs, how to prevent them, and where to obtain information and services.17 In community, parents and adults also feel ill-prepared or
uncomfortable talking about RH with their children. This cultural unwillingness and embarrassment to discuss such issues presents a great barrier to youth and youth reproductive health programs promotion to reduce the number of unintended pregnancies and STIs/HIV in youths in Ethiopia. Some parents feel uncomfortable talking with their children about sexuality. Others do not have enough specific facts about sexual issues themselves to adequately do the job.18
An RH educator must be knowledgeable about sexual anatomy and physiology. If adolescents perceive a teacher as not being personally and professionally prepared, pandemonium and tumultuous discussions may occur. For some
teachers, the content taught in RH courses is new information. Lack of appropriately trained educators can obstruct the implementation of RH programs. To assure that school-based RH programs are being properly implemented, teachers and peers must be adequately trained and given up-to-date resources. They also need good pedagogical skills, and an understanding of child and adolescent development pertaining to sexuality.19 Among the many
RH problems faced by youth in Ethiopia are gender inequality, sexual coercion, early marriage, polygamy, female genital cutting, unplanned pregnancies, abortion, sexually transmitted infections (STIs), and HIV/AIDS.20
Most challenges in RH education promotion comes from overlooking of potential role of parents in RH education; the appropriateness/willingness of schools/teachers as RH educators and promoters; ethnic or cultural factors both in in-school settings and out-of-school as barrier to ARH education communication that must be broken down.21
Program Logic Model: The logic model describes the sequence of events for bringing about changes to the ARH problems by synthesizing the main program elements into a picture of how the program is supposed to work to solve the problems.22 The main problems in many youths those become sexually active are
lack of accurate information about safe sex.23,24 This lack of information can put
them at risk of unplanned pregnancy, sexually transmitted infections (STIs) and HIV, unsafe sex and inability to delay first or onset of intercourse.25 The earliness
education should be provided. Teens also consider that accessing contraception would disclose their sexual activity; contraceptives to be unaffordable and family planning distribution centers are for married women only.26 Prioritizing ARH
education in school timetable/curriculum is also least practiced if not nil. Teachers’ participation must also increase as to the feeling of comfort in teaching about sexuality and answering adolescents’ questions about sexuality issues.27
This logic model displays the resources needed to support program operations and links processes to intended effects for changes in the problems. Elements that are connected within this logic model include program inputs, processes, outputs, outcomes and impacts.
PROCESSES/ACTIVITIES OUTPUTS
INPUTS OUTCOMES IMPACTS
Program fund
Decreased prevalence rate of unintended teen pregnancy, STIs, HIV/AIDS & early onset of sexual intercourse HR, Training
Train peer on RH
Logic Model for School-Based RH Education Interventions
Provide life skill for ARH education GOs, NGOs, Community
IEC/BCC materials
Mini-media, School clubs Policy
Increased number of educated youths
No of IEC/BCC materials supplied & distributed Distribute IEC/BCC materials on RH
Strategy, Curriculum
Increased number of youths accessing health information No of trained peers
No of adolescents educated
No of trained teachers Train teachers on RH
No of RH club disseminating RH message
Increased number of trained teachers
Stage of Program Development: Some pilot programs are running in this regard in schools in some regions of the country. Few of them are located in Addis Ababa, Dessie, Awassa and Jimma; and supported by Family Guidance Association of Ethiopia (Packard funded); Awassa supported by Ethiopian Kale Hiwot Church (Pathfinder funded); Kombolcha and Jimma supported by Opportunities Industrialization Centers (Packard and USAID/W funded); Addis Ababa supported by Save the Children USA (Packard funded); Addis Ababa supported by CARE/Ethiopia; and Jimma supported by Ethiopian Muslim Development Agency (Pathfinder funded). It is agreed that school-based ARH programs implementation rests on school administrator and teachers willingness to promote ARH education. Some school administrators have tried to provide continuous teachers and peers development sessions and give teachers and peers current information resources.
Program Resources: NGOs both international and Ethiopian, are at the forefront of youth RH programs in Ethiopia and provide a variety of services to youth. Government support for YRH is fairly strong and reflects the concern on the part of Government authorities to prevent unintended pregnancies, STIs, and HIV among youth.28 The policy & legal framework for youth reproductive health is
also positive.29
On the other hand, Ethiopia is a nation of young people, over 65% of its population is under 25 years of age.30 The rapid population increase will
constrain the government’s ability to provide health care31 and education to
young people. Examples of governmental support for YRH include the adoption of the 1993 population policy (still in effect today), Passage in the Parliament of the Family Law (raising the minimum age of marriage, among other supportive articles), and revision of the penal code, decriminalizing the advertisement and sale of contraceptives.32
1.2.2 Program objectives Overall program objectives:
To increase access and utilization of adolescent reproductive health services by youths; and
To reach in-school and out-of-school youths with knowledge and skills needed to foster and sustain health-affirming behaviors issues of sexuality.33
Objectives pertinent to school-based ARH education:
To reach in-school youths with knowledge and skills needed to foster and sustain health-affirming behaviors issues of sexuality
School-based ARH education program components: 1. Training of peer on reproductive health
2. Provision of life skill reproductive health education for adolescent 3. Training of teachers on reproductive health
4. Distribution of IEC/BCC materials on reproductive health 5. Dissemination of reproductive health and RH related message
ARH education promotion is the process of enabling young people to increase their control over their health and to improve it.34 In-school RH education
encompasses a range of issues including:
1. STIs, HIV and reproductive tract infections (RTIs); 2. Unintended pregnancy;
3. Unsafe abortion and infertility;
4. Violence related to gender and sexuality; 5. Female genital mutilation
Program activities: Some NGOs, located in different parts of the country, like Pathfinder Private Franchise Clinic (Packard funded), Family Guidance Association of Ethiopia (FGAE) (Packard funded), Organization for Social Services for AIDS (Packard and UNFPA funded), Amhara Development Association (Packard funded), Ethiopian Kale Hiwot Church (EKHC) (Pathfinder funded), Africa Humanitarian Action, (Pathfinder funded) Ethiopian Evangelical Church Mekane Yesus, Save the Children USA (Packard funded), etc are working on school-based RH education in in-school and out-of-schools through RH clubs/centers in Oromiya, Amhara, SNNPR and Addis Ababa. 35
Save the Children- trained peer educator in front of classroom Source: YouthNet, April 2004
FGAE began providing ARH information and services directly to youth through the establishment of youth centers in 1990. Twenty-four youth centers presently exist throughout the country, with six located in Addis Ababa. More than 200 youth peers educators work in and through these youth centers that provide a variety of services to ISY and OSY. Where there are clinics with no youth centers in close proximity, the clinics offer special week end hours for young people.
Computer-assisted learning for at-risk youth at OIC Center Source: YouthNet, April 2004
The focus of EKHC’s youth program includes: 1) working with in-school youth in 15 elementary schools to form anti-AIDS clubs; 2) training peer educators to implement the “Stepping Stones” curriculum with in-school and out-of-school youth; 3) building capacity among teachers around issues related to HIV/AIDS and reproductive health; 4) working with out-of-school youth to form anti-AIDS clubs; 5) training in drama to do conduct outreach in the local communities.
FGAE Youth Center in Addis Ababa Source: YouthNet, April 2004
Program detail activities:
Se. No.
Program components (Processes)
Program detail activities (Actions)
1
Train peer on reproductive health
Prepare peers training sessions. Conduct peers training at youth centers/schools
2
Provide life skill reproductive
health education for adolescent Impart RH education for in-school adolescents
3
Train teachers on reproductive health
Prepare teachers training.
Provide teachers training in training centers/schools
4
Distribute IEC/BCC materials on
reproductive health Request & dispense IEC/BCC materials for health information
5
Disseminate reproductive health
message Use RH clubs for health information dissemination
1.2.3 Rationale for program evaluation
The reason for this program evaluation is much influenced by the stage of program development. The program is long-standing and has changed over the years. Evaluating the program will produce valid comparisons between programs’ components to decide which should be retained. In general, this evaluation can facilitate managers’ and operators’ thinking about what their program is all about, including how it meets its goals. It can also produce data or verify results that can be used for public relations and promoting services in the community.36
Overall why evaluating ARH education in school is for the following reasons:37
To gain insight about a program and its operations – to see where the program is going and to find out what works and what doesn’t;
To improve practice – to modify or adapt practice to enhance the success of activities; and
To build capacity - increase funding, enhance skills, and strengthen accountability.
Since the start of ARH program, several changes have been taken place in the country which includes support for youth by the Government in the form of advocacy, sectoral guidance, policy and strategy formulation, inter-agency coordination (resource mobilization), leadership development, and family life education.38
Even if there is a considerable amount of input for RH services including financial, it is now highly recognized that the existing ARH services are inadequate and significant number of youths/adolescents is still underserved.39
This is the point where to decide evaluating ARH program is important in general and particularly identify insufficiencies in delivering school-based education program or accurately portraying to stakeholders how school-based RH education program truly operates (e.g., for replication elsewhere). Focusing on school-based RH is important because young people are spending more of their adolescence in school. As school enrollment rates rise, ARH education programs have the potential to reach a large number of young people.40
CHAPTER TWO
2.1
STAKEHOLDERS DESCREPTION/CONSULTATION
2.1.1 Key stakeholders identification
A number of stakeholders (NGOs and GOs) have a role and interest in ARH education interventions in schools and community. Identification of key stakeholders is, therefore, critical for this evaluation success in providing insights and support.41
The following are considered as principal groups of stakeholders with different level of participation in this evaluation:
Stakeholders to be evaluation supporters: These are stakeholders categorized as funders.
Stakeholders to be case study participants: These are also stakeholders considered to be involved during implementing the evaluation.
Stakeholders to be primary users of evaluation results: These are stakeholders primary benefited from the evaluation users of the findings for program improvement.
2.1.2 Stakeholder participation
Key stakeholders and people involved in the program operation are approached through MoH with signed letter of support.
Stakeholders to be evaluation supporters: These are stakeholders categorized as main evaluation supporters.42
Stakeholders (Supporters)
Area of interest/involvement in the evaluation
Ministry of Health Letter of support for visit and interviewing of program operators and supporters
CDC, NGOs, UN Agencies Funding
CORHA Coordination and funding
Regional H&E Bureaus Coordination, letter of support District H&E Desks Coordination
Stakeholders to be case study participants: These are stakeholders expected to participate in open-ended interview. They provide information on what they know all about sex education intervention in school.
Stakeholders (Participants)
Area of interest/involvement in the evaluation
RH&EB Facilitators
MoH Facilitator
Youth Centers Facilitators
School principals Information providers/respondents
2.1.3 Communication with stakeholders
The success of stakeholders’ engagement is greatly enhanced by phase-based approach.
Phase one: The success engagement in this evaluation is greatly enhanced by beginning with a visit to program operators and supporter prior to the development of the plan. The visit did orientation to the stakeholders on the process, expectations, and roles; determining needs and interests of stakeholders; negotiation on the levels of participation in the evaluation.
Phase two: focused on sharing of information and advisory and participatory role for resolving problems during conducting the evaluation.
Phase three: includes evaluation result dissemination for larger group after a consensus will be made with program operators, supporters and evaluation funders.
2.1.4 Primary users of evaluation findings
These are all stakeholders primarily use the evaluation results for program improvement and promotion.
Stakeholders Purpose/perspective
Community Raising awareness
School principals/teachers Raising awareness & program promotion
Youths Raising awareness
Regional H&E Bureaus Program improvement & promotion District H&E Desks Program improvement & promotion
Donors Funding for disseminating the result
NGOs, CORHA Disseminating the result and promotion
MoE Disseminating the result and promotion
CHAPTER THREE
3.1
EVALUATION QUESTIONS AND OBJECTIVES
3.1.1 Evaluation questions
Questions are selected based on the objectives by carefully considering what is important to know about the program.
The evaluation research questions arising from objectives are as follows:
1. How ISYs are enrolled in reproductive health education and provided with health information?
2. How RH education program components inculcated in learning-teaching processes in a school?
3. How school-based RH education program activities are being implemented in accordance with the plan?
4. How funds are devoted to RH education in school for running RH clubs and training of peers and teachers?
3.1.2 General Objectives
The overall objective of the evaluation is to assess school-based RH education program implementation so as to increasing evidence pertaining to the reasons of success or failure for the program interventions.
3.1.3 Specific Objectives The specific objectives are:
2. To know the extent and description of ISYs who are reached by RH education
More specifically, it attempts to:
Know the level of reproductive health education interventions in school and the target age group.
3. To know the extent and types of school-based RH education provided More specifically, it attempts to:
Have a better understanding of implemented program components specific to school-based ARH education.
4. To describe how school-based RH education are provided. More specifically, it attempts to:
Know school-based ARH education implementation in compliance with the local and National policies and action plans.
Adolescent provided life skill increased No of RH education sessions in school timetable/curriculum
No of enrolled adolescents with life skill RH education
Age and grade of imparting life skill RH education Health message disseminated increased
No of message related to RH
No of RH club disseminating RH message IEC/BCC health Distributed increased
No of IEC/BCC materials supplied No of IEC/BCC materials distributed
No of youths approached with IEC/BCC materials Trained teachers increased
Trained peer increased No of training conducted for peers No of training sessions for peer training No of trained peers on RH
Fund devoted to training for teachers No of training conducted for teachers No of training sessions for teachers training No of trained teachers on RH
Program Objectives met:
Increased youths with RH knowledge and skills
M&E Indicators Program shot & long outcomesDecreased prevalence rate of unintended teen pregnancy, STIs & HIV/AIDS
Program Goal achieved:
CHAPTER FOUR
4.1
EVALUATION METHODOLOGY
It is a method how this program evaluation will be conducted. It is illustrated by conceptual framework for evaluating RH education program in school. In a sense, it is a theoretical logical model showing process of the evaluation.43 The
whole idea is aimed at evaluating the way how in-school RH education is operating in helping young people to be prepared for healthy adulthood life. In evaluating such a program on the ground, it requires a well focused evaluation approach. Focusing the evaluation also needs understanding of what and how to measure area of interest from program theory.44
This theoretical logical model conceptually illustrates relevant evaluation dimensions for each strategic program components. Evaluation dimensions confirm whether clear evaluation indicators are identified to measure program immediate results. Once the relevance of the dimensions is clear with evaluation indicators, it is so possible to identify study design and methods of measurements to collect credible data by using appropriate tools, instruments and procedures. In this evaluation model, implementation process of the program is the core issues for which a mixed-design will be employed for data collection and analysis. And finally evaluation results will be communicated for program improvement in the health and education sector.45
Increased number of educated youths
Increased number of youths accessing health information
Provide life skill RH education for adolescents Train peer on RH
Availability of fund for training Availability of training
Distribute IEC/BCC materials Decreased prevalence rate of unintended teen pregnancy, STIs & HIV/AIDS
Availability of IEC/BCC supply & distributionCompliance with planned activities
P ro gr am p ro ce ss es P ro gr am o utc om es Impact E va lu at io n D im e ns io n s
Compliance with life skill education plan
Availability of RH timetable /curriculum Compliance with planned activities
Input, process/output indicators
Disseminate RH message Tra in tea che rs on RH
Compliance with planned activities
Availability of fund for training
Availability of training
Availability of RH messageCompliance with planned activities
Increased number of trained teachers
4.1.1 Evaluation purpose and focus
Purpose of evaluation: The main purpose of evaluation of school-based ARH education program is to create grater understanding of the program and its implementation, and improving way of imparting RH education to youths.
Focus of the evaluation: It is aimed at evaluating process of a program to examine and explore what RH education services are actually explicitly being delivered in schools. ARH education program in school is underway under the National population policy framework. Several strategies outlined in the 1993 population policy, which the National Office for Population (NOP) is charged with helping to implement, pertain specifically to adolescents. These include reducing the high attrition rate of females in the educational system, providing career counseling in secondary schools and universities, establishing youth reproductive health counseling centers, and raising the minimum age of marriage for girls from 15 to 18 years of age. 46
On the other hand, YRH strategy is not yet actualized, but the program has a Five-Year Action Plan for Adolescent Reproductive Health in the country (2002-2007), developed by MoH in 2002. The plan aims to increase access and utilization of YRH services by youth, and increase information and knowledge about reproductive health that leads to positive behavior change by youth. With regard to the implementation of the action plan, it has not received adequate attention by the Government and has not progressed far. Some NGOs are
participating in the provision of ARH in-and out-of schools on a pilot bases in line with the National plan and policy.47
4.1.2 Study Area
The study will be conducted in the high schools found in Awassa Town, South Ethiopia. Awassa is the capital of Southern Nations, Nationalities and peoples Regional State. It is located on the shores of Lake Awassa in the Great Rift Valley. It lies on the Addis Ababa –Nairobi road, with a longitude and latitude of 7°3′N 38°28′E. The town is about 275 km away from Addis Ababa. It has 14 administrative ‘Kebeles’ and the total population size is estimated to be 119,623, of which 60,378 men and 59,245 women.48 The Town has three hospitals (one
private, the second one is a referral Hospital owned by Awassa University as a teaching Hospital and the third one is an Army Hospital) and two health centers (one governmental and the other non-governmental) and several private clinics. The total number of high schools is six (three governmental and three non governmental) namely Addis Ketema, Awassa, Komboni Catholic Missionary, Adventist, SOS and Alamura senior secondary schools. Out of these three are preparatory schools namely Awassa, Komboni Catholic Missionary and SOS Senior Secondary Schools.
4.1.3 Evaluation approach and design
Evaluation Approach: Formative and process evaluations are critical to a successful program in general. Outcome evaluation will often not show positive results unless formative and process evaluations have been taken place. 49
To conduct an outcome evaluation the program has to be well established enough to potentially produce the desired outcomes. The use of formative evaluation approach is primarily important in a program development stage. It helps to guide and refine messages, program components and activities that may not be seen in the program initial stage. If the program is in operation, but having unanticipated problems, a formative evaluation may help to find the cause. It is also useful when an existing program is targeting a new problem or behavior.50
Evaluating a program process is for understanding whether the program’s procedures reaching the target population are working as planned. It indicates know how well a program is working (e.g., how many youths are participating or reached by the program). More important it shows how well the process is working and whether there are any snags in the system. It identifies any problems that occur in reaching the target population. It can be used to show funding agencies the program’s level of activity and to provide encouragement to participants. It also makes adjustments before logistical or administrative weaknesses become rooted by showing critical problem areas. This may lead to have some additional formative evaluation for the critical problem. Formative evaluation is not said to be only important at program initial stage but it is an on-going process that should be used throughout the program’s existence. It allows program managements to understand the emerging new problems. But more importantly, process evaluation allows programs to evaluate how well their plans, procedures, and activities, are working. This is the point where an approach for this evaluation research delineated a process evaluation for RH education in
school. An outcome evaluation is not also delineated because the program is on-going and a baseline measurement has not been established. In the absence of baseline knowledge, attitudes and beliefs of the target population and demonstrated changes following completion of the program, focusing on evaluating a process of program on RH education in school is more applicable to make the program a success.51
Evaluation Design: The process evaluation for this study will use a multiple designs: case study and cross-sectional surveys. Case study is the most basic type of evaluation study and extensively used particularly in evaluating implementation of a pilot program. It describes the program, and its outcomes, and participant’s perspectives. It describes the program at one point in time or describes what is occurring over time. A cross-sectional survey design describes a population or a sample of a population at one point in time in order to explain their characteristics. It is a cross sectional view of a population.52
4.1.4 Target Population
Schools to be included in the case study are six governmental and NGOs high schools. The total number of students in the two high schools who are in grades 9 and 10 are about 1918. The support for youth reproductive health programs comes primarily from Pathfinder and Packard Foundation. The two agencies (Ethiopian Kale Hiwot Church and Family Guidance Association of Ethiopia) support school-based ARH services as integral part of out-of-school services. RH education targets adolescents that bring them RH knowledge and skills building.
4.1.5 Source Population
The population under the study is school principal and teachers. Principals are the one who have major role in providing administrative support for educators (teachers and peers). They assure that the service is given by trained teachers and peers. They also communicate with program supporters and supervisors for staff development in RH services. The trained teachers are expected to teach in a class with consulting adolescents. Peers are also play a role in running RH clubs and convey health information and distribute IEC/BCC materials. Students in the grade 9-10 are also the one who are appropriate to be taught RH education because most pupils in these grades are expected to be in the adolescence age (15-19).53
4.1.6 Case Selection and sample size
It is a multiple-data source oriented case selection to assure to have a full picture of data. The study targets principals of two high schools with a purposive selection. There are schools supported by Ethiopian Kale Hiwot Church, and Family Guidance Association of Ethiopia. One school will be a school supported by Ethiopian Kale Hiwot Church and the other one will Family Guidance Association of Ethiopia supported. 30 science teachers teaching in grade 9-10 of all six high schools will be included in the study. 30 students from all six schools will be also included in the study. The pupils will be selected from grade 9-10 who have been given RH education.
Se. No. Evaluation Dimension54 Program Process Train peer on reproductive health
Provide life skill reproductive health education for adolescent
Train teachers on reproductive health Distribute IEC/BCC materials on reproductive health Disseminate reproductive health message 1
Availability of fund devoted to training of peers RR R NR NR NR
Availability of training to be conducted for peers RR NR NR R R
Compliance with planned training activities for
peers R NR R NR NR
2
Availability of RH education sessions in school
timetable/curriculum R RR R R R
Compliance with life skill education plan R RR R R NR
3 Availability of fund devoted to training of teachers NR R RR NR NR
Availability of training to be conducted for teachers NR R RR R R
Compliance with planned training activities for
teachers NR R R NR R
4 Availability of IEC/BCC supply & distribution RR RR RR RR RR
Compliance with planned supply & distribution
activities R R R RR RR
5
Availability of RH club disseminating RH message R R R RR RR
Compliance with planned RH message activities R R R RR RR
Evaluation Indicators and Data requirements for measurements
Se. No. Indicators Data requirement for measurements Data sources
1 Fund devoted to training for peers Fund for training and total program fund Training plan, school-based survey, principals 2 No of training conducted for peers Training specific to RH education and # of
planned training
Training plan/report, school-based survey 3 No of training sessions for peer training Training sessions specific to RH education
and # of planned training
Training plan/report, school-based survey, teachers
4 No of trained peers on RH # of trained peers and number of youths in the adolescence age group
Training plan, school-based survey, principals 5 No of RH education sessions in school
timetable/curriculum
# of session and weekly based total sessions
school-based survey, principals, teacher, students
No of enrolled adolescents with life skill
RH education # of enrolled adolescents and # of total adolescents in the same age group school-based survey, principals, teacher, students
6 Age of imparting life skill education Grade of imparting life skill education
Age limit Grade limit
school-based survey, principals, teacher, students
7 Fund devoted to training for teachers Fund for training and total program fund Training plan, school-based survey, principals 8 No of training conducted for teachers Training specific to RH education and # of
planned training
Training plan/report, school-based survey 9 No of training sessions for teachers
training
Training sessions specific to RH education and # of planned training
Training plan/report, school-based survey 10 No of trained teachers on RH # of trained teachers and number of total
teachers
Training plan, school-based survey, principals 11 No of IEC/BCC materials supplied IEC/BCC materials requested and supplied School-based survey,
principals, teachers 12 No of IEC/BCC materials distributed EC/BCC materials supplied and distributed School-based survey,
principals, teacher, students
13 No of youths approached with IEC/BCC materials
# of youths approached and planned to be approached
School-based survey, principals
14 No of message related to RH # of message and planned to message School-based survey, principals, teacher, students
15 No of RH message dissemination sessions
# of sessions and planned session School-based survey, principals, teachers
No. (Processes) Evaluation Dimensions Evaluation Indicators55 (level of implementation) Evaluation judgment 1 Train peer on
reproductive health Availability of fund devoted to training of peers
Fund devoted to training for peers Amount of fund: >90% of need 80-90% of need 60-79% of need <60% of need Excellent Attainable Need improvement Critical/not accommodate Availability of training to be conducted for
peers
No of training conducted for peers
No of training sessions for peer training Training: >50% specific to RH 25-49 specific to RH 10-24 specific to RH <10% specific to RH Excellent Attainable Need improvement Critical
Compliance with planned training activities for peers
No of trained peers on RH Rate: >90% from plan 80-90% from plan 60-79% from plan <60% from plan Excellent Very good Need improvement Critical
2 Provide life skill reproductive health education for adolescent
Availability of RH education sessions in school timetable/curriculum No of RH education sessions in school timetable/curriculum Training sessions: >50% specific to RH 25-49 specific to RH 10-24 specific to RH <10% specific to RH Excellent Attainable Need improvement Critical
Compliance with life skill education plan No of enrolled adolescents with life skill RH education
Rate: >90% from plan 80-90% from plan 60-79% from plan <60% from plan Excellent Very good Need improvement Critical
Program Components
(Processes) Evaluation Dimensions Evaluation Indicators
Evaluation parameters
(level of implementation) Evaluation judgment
Age of imparting life skill education
Grade of imparting life skill education Age limit: 10-19 yrs 10-24yrs >19 yrs <10 yrs Grade limit: 9-10grade 9-12 grade >10grade <9 grade Excellent Manageable Need improvement Not accommodate Excellent Manageable Need improvement Not accommodate 3 Train teachers on
reproductive health Availability of fund devoted to training of teachers
Fund devoted to training for teachers Amount to run RH: >90% of need 80-90% of need 60-79% of need <60% of need Excellent Sustainable Need improvement Critical
Availability of training to be conducted for teachers
No of training conducted for teachers
No of training sessions for teachers training RH training: >90% specific to RH 70-89 specific to RH 50-69 specific to RH <50% specific to RH Excellent Reasonable Need improvement Critical
Compliance with planned training activities for teachers No of trained teachers on RH Rate: >90% from plan 80-90% from plan 60-79% from plan <60% from plan Excellent Very good Need improvement Critical
Program Components
(Processes) Evaluation Dimensions Evaluation Indicators
Evaluation parameters
(level of implementation) Evaluation judgment
4 Distribute IEC/BCC materials on reproductive health
Availability of IEC/BCC supply & distribution No of IEC/BCC materials supplied Supply rate: >90% of need 80-90% of need 60-79% of need <60% of need Excellent Manageable Need improvement Critical
Compliance with planned supply & distribution activities
No of IEC/BCC materials
distributed Distribution rate: >90% of plan 80-90 of plan 60-79 of plan <60% of plan Excellent Manageable Need improvement Critical 5 Disseminate reproductive health message
Availability of RH club disseminating RH message RH club functioning in disseminating RH message Rate: >90% running 80-90% running 60-79% running <60% running Excellent Very good Need improvement Critical
Availability of RH message dissemination sessions No of RH message dissemination sessions RH message: >90% specific to RH 70-89 specific to RH 50-69 specific to RH <50% specific to RH Excellent Reasonable Need improvement Critical
Compliance with planned RH message activities No of message related to RH RH message: >90% specific to RH 70-89 specific to RH 50-69 specific to RH <50% specific to RH Excellent Reasonable Need improvement Critical
4.1.9 Data collection techniques and procedures
Techniques for methods of measurements: A qualitative method will be employed with semi-structured/open-ended self-administered and unstructured expert interviews techniques to know how RH education is carried out in schools and
why RH is not so progressed as compared to the magnitude of problems related to adolescent RH. In this regard the data obtained has to be detailed. A qualitative method can provide context, language, relationships of ideas and deep information.56 It provides in-depth information and can be done at low costs as compared to quantitative methods.57
Both semi-structured/open-ended self-administered and unstructured expert interviews techniques will be used for data collection because the topic of imparting RH to youth is sensitive in Ethiopian context both in school and community.
In-depth interview can explore to the depth of the root causes for success or failure of RH education in schools by providing a confidential environment for principals. It gives opportunity for interviewer to explore unexpected issues. In-depth interview is selected as a technique for several reasons: in data collection there is no issue of extra time, subjectivity and peer influences that alter data to be obtained from respondents.50
Semi-structured interview can also provide in-depth data with the potential to be quantified and generalizable to population. An open-ended questionnaire will be used. The questionnaire will be translated to Amharic and re-translated back to English to check for correct translation.
Procedures for Data Collection: Data will be collected using triggering questions for interviewing of principals. The principal investigator will do interviewing of principals. The conversation will be in Amharic, the regional official language.58
The respondent will have full right to explain what he knows in his words. Two coordinators (one from each education and health bureaus) will do arranging interview sessions in both high schools.
Data will be also collected using semi-structured self-administered questions for science teachers and students. Science teachers are selected because they have already had exposure to RH education through teaching reproductive anatomy. All science teachers will be included whether they are trained in RH education in school or not. For students, a separate semi-structured open ended self-administered questionnaire will be used. The two coordinators will distribute the questionnaire to six high school teachers and students and collect after they fill it.
4.1.10 Pre-Test
A self administered questionnaire for interviewing of teachers and students will be pre-tested on a pilot bases in Addis Ababa City in the same level of schools to be included in the study. The pre-test is to check: whether the tools will allow collecting the information needed; data to be collected is relevant to the problem or in a form suitable for analysis; time needed to complete the questionnaire; the logical sequence of questions; the clarity of wording of the questions; accuracy of the translations, and sufficiency of space for answers
4.1.11 Ethical Consideration
Ethical clearance: For ethical clearance, the protocol will be submitted to the Jimma University Ethical Clearance Committee prior to its implementation.
Confidentiality: Respondents’ view and opinion will be treated as confidential and anonymous.
Protecting participants’ confidentiality will include:
Protecting the identities of the people whom will be interviewed, Securing computer file with limited access.
Personal characteristics that could allow others to guess the identities of people who played a role in the evaluation research will not be disclosed.
Key informants may ask questions about things to test whether the evaluator discloses information, refusal to reveal will also reassure them that the evaluator protect their confidentiality as well.
Participant confidentiality will be respected during eventual presentation of the data in public dissemination events, as well as in printed publications.
Informed consent: Key informants will be informed about the evaluation research in a way they can understand. It may begin by approaching regional officials and explaining the evaluation research to them with signed letter from Jimma
University and MoH. The officials will then facilitate key informants. An informed consent from that key informant is expected, regardless of whether officials’ permissions exist.
The information to key informants will include: The purpose of the evaluation research
Expected benefits, including risks if there is any
The fact that participation is voluntary and that he/she can withdraw at any time with no negative repercussions How confidentiality will be protected
The name and contact information of the local coordinator and principal investigator to be contacted for questions or problems related to the evaluation research.
4.1.12 Study project management:
It will have three phases. Phase one is planning the evaluation and making decision; phase two is Implementation and phase three evaluation feedback. This framework will be helpful in the implementation of evaluation findings in the future. Phase 1 Plan for evaluation: Some stakeholders have already communicated to agree on the subject matter and reach consensus that the evaluation is important. These are MoH, UN Agencies and NGOs.
Phase 2 Implementation: The project team comprises one evaluator and two coordinators from regional health/education bureau. According to the time table each school will be visited.
Coordinator: The coordinator will be hired and paid on weekly bases. The payment will be man-days based on the agreement made. The principal evaluator will have DSA according to university standard for DSA. The coordinator will facilitate open-ended interview with principals in schools supported by Family Guidance Association of Ethiopia and Kale Hiwot Church. They also communicate schools for teachers and students interview.
The Evaluator: Jimma University and MoH should sign a letter of support to each agency (SNNPR H&E Bureaus) for legal support. The evaluator will meet the SNN Regional Health and Education Bureaus for letter of support for interviewing schools principals, teachers and students.
Phase 3 Evaluation feedback: The evaluation results will be communicated to enhance its utilization. The beneficiaries of evaluation all who need to promote and increase awareness of sex education in schools and community to tackle the problem of teen’s pregnancy and HIV and STI infection. They will benefit a lot from this evaluation results. Its implementation can contribute to minimizing economic burden of the country as a result of unintended pregnancy and infections from the diseases.
Planning & making Decision: Stakeholder engagement, Plan proposal, Refinement of Plan Evaluation Project Standards: Utility Accuracy Propriety Feasibility Reporting: Feedback
Feedback of evaluation findings to Stakeholders, Use data for program improvement
Jimma University Stakeholders Program managers/operators Cas e s ele ctio n Jimma University Stakeholder analysis Site: Awassa
Case: Sch.1-KH Church, Pathfinder Funded
Secure budget NGOs
Case: Sch.2-FGAE, Packard Funded
Implementation:
Form project team, Mobilization Actualize the plan Collection of data for evaluation,
Analysis of Data Conceptual framework of evaluation project management
4.1.13 Data analysis and management
Data Analysis: It comprises a matrix of categories, graphic data displays, tabulating frequency of different events; developing tabulations to check for relationships; and ordering information chronologically; some of which have been adapted for computers. Descriptive analytic techniques such as rearranging the arrays, placing the evidence in a matrix of categories, creating flowcharts or data displays, using percentage and cross tabulations will be used to examine the relationships between events.
Quality Control: Before and during data processing, the information will be checked for completeness and internal consistency. A coding system will be developed by categorizing the answers based on answers and opinions of respondents.
There will be coordinators to control the factors that undermine the informant’s response rate. They will communicate the schools to check the progress of teachers in filling the questionnaire. The principal investigator will do communication with schools for teacher or students for those may have difficulties in doing the questionnaire.
4.1.14 Operational Definitions
Adolescent: Teens with transition age between childhood and adulthood, usually defined as including those ages 10 to 19.
Confidentiality: An agreement between respondents (principals, teachers, youth centers) and investigator that all conversations will be kept private unless they give explicit permission.
Evaluation dimensions: are measure/aspect of spatial extent, or magnitude and scope of program components and will help to make clear indicators, criteria, and parameters of evaluation to be used.
Evaluation matrix: is a tool that will help to consider the most appropriate and feasible data collection method for each of the identified indicators in evaluation plan.
Evaluation parameters: are parameters that indicating the level of implementation (cut-off point) of activities of the program.
Judgment parameter: parameters that are qualifying level of implementation and making conclusion.
Evaluation questions: The questions about the program which stakeholders/evaluation team members want to find answers to during the course of the evaluation. These should not be confused with "interview questions."
Logic Model An organized planning sequence of defining goals, identifying antecedent factors and selecting program activities to influence the antecedents.
Peer: A teen that is of equal standing to another teen, often of the same age (15-19 year), economic background and educational level (9-10 grade).
Stakeholders: Persons or institutions outside the immediate program staff or institutions who have an interest and role in sex education functions and activities.
School: is a place where adolescents are educated and RH education is given to youths. Teacher: is trained person in RH education and imparting RH education in school.
Principal: is a head teacher in a school and provides overall administrative support in particular for teachers and peers engaged in RH education.
Youth: A young person in the transition between childhood and adulthood commonly defined as between the ages of 10 and 24.
4.1.15 Scope and Limitations of the Evaluation
This evaluation aimed at data collection from school principals, teachers and students in order to come up with detailed data about how in-school RH education program is going-on. The problem of getting ample time to interview on the subject matter will also influence the in-depth of information to come out. To minimize problem related to getting details
data, the evaluator and coordinators will communicate school principals in advance to minimize the risk of getting ample time for interview.
In-depth interview might be expensive to implement and analyze data. From the sensitiveness of the topic point of view this technique will be useful to come up with detailed data. There may be a potential bias for interviewer. This can be minimized by having multiple sources of data. Evaluation results are usually not quantifiable to a population in in-depth interview, but, it can produce equally important data like some other designs for evaluation researches. So that technique can satisfy the three tenets of the qualitative method: understanding, describing, and explaining.59
CHAPTER FIVE
5.1
BUDGET
5.1.1 Timeline for Evaluation
Project timeframe is estimated to be less than one year. The survey will start at the beginning of the year 2007 and cover one month. A GANTT chart is developed by using MS Project soft ware for work plan given in the table below.
The accomplishment of each activity will be monitored using this soft ware. The GANTT chart shows: the tasks to be performed; who is responsible for which tasks; and the duration each task is expected to take.
Major tasks are:
Consultation with stakeholders Evaluation plan proposal preparation Submission for ethical clearance Securing budget for evaluation Mobilization
Data collection
Data analysis and draft report Conduct workshop
Work Plan for an In-depth Interview
ID Task Name Duration Start Finish
1 Consultation with stakholders 24 days Mon 9/4/06 Thu 10/5/06
2 Visit to MoH 5 days Mon 9/4/06 Fri 9/8/06
3 Communicate UN Agencies 2 days Mon 9/11/06 Tue 9/12/06
4 Communicate NGOs working on SBRH 15 days Wed 9/13/06 Tue 10/3/06
5 Communicate RHB 2 days Wed 10/4/06 Thu 10/5/06
6 Proposal 24 days Mon 10/16/06 Thu 11/16/06
7 Prepare evaluation plan proposal 10 days Mon 10/16/06 Fri 10/27/06 8 Submit to advisor for consultation 1 day Mon 10/30/06 Mon 10/30/06
9 Receive comments 5 days Tue 10/31/06 Mon 11/6/06
10 Incorporate comments 3 days Wed 11/8/06 Fri 11/10/06
11 Produce final draft proposal 3 days Tue 11/14/06 Thu 11/16/06
12 Ethical clearance 10 days Tue 11/21/06 Mon 12/4/06
13 Submit for ethical clearance 10 days Tue 11/21/06 Mon 12/4/06
14 Budget 30 days Tue 12/5/06 Mon 1/15/07
15 Submit proposal 1 day Tue 12/5/06 Tue 12/5/06
16 Budget defend and secure budgt 30 days Tue 12/5/06 Mon 1/15/07
17 Mobilization 14 days Tue 1/16/07 Fri 2/2/07
18 Communicate SNNP Health & Education BureaU 9 days Tue 1/16/07 Fri 1/26/07
19 Hire coordinator 5 days Tue 1/23/07 Mon 1/29/07
20 Get list of high schools with RH (sex education) 4 days Tue 1/30/07 Fri 2/2/07
21 Data collection 23 days Mon 2/5/07 Wed 3/7/07
22 Conduct in-depth interview 10 days Mon 2/5/07 Fri 2/16/07
23 Review document 13 days Mon 2/19/07 Wed 3/7/07
24 Data analysis and draft report 97 days Thu 3/8/07 Fri 7/20/07
25 Compile data with statistcian/clerck 30 days Thu 3/8/07 Wed 4/18/07
26 Analize data 30 days Thu 4/19/07 Wed 5/30/07
27 Produce first draft report 15 days Thu 5/31/07 Wed 6/20/07
28 Submit to advisor for consultation 5 days Thu 6/21/07 Wed 6/27/07
29 Receive commnets 2 days Thu 6/28/07 Fri 6/29/07
30 Incoporate comments 10 days Mon 7/2/07 Fri 7/13/07
31 Produce first draft 5 days Mon 7/16/07 Fri 7/20/07
32 Conduct workshop 7 days Mon 7/23/07 Tue 7/31/07
33 Present findings for stakeholders 2 days Mon 7/23/07 Tue 7/24/07
34 Incorporate comments 5 days Wed 7/25/07 Tue 7/31/07
35 Final Report 15 days Wed 8/1/07 Tue 8/21/07
36 Submit to advisor for consultation 5 days Wed 8/1/07 Tue 8/7/07
37 Receive comments 2 days Wed 8/8/07 Thu 8/9/07
38 Incorporate comments 5 days Fri 8/10/07 Thu 8/16/07
39 Produce second draft report 2 days Fri 8/17/07 Mon 8/20/07
40 Submit final report 1 day Tue 8/21/07 Tue 8/21/07
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