Background: In Nigeria, there were 3.5 million people living HIV/AIDS as of 2015 (UNAIDS, 2015). While the prevalence rate at 3.1% is lower than countries in southern Africa such as Zambia (13%), the large Nigerian population means that these figures actually represent the second biggest HIV epidemic in the world. Data from 2014 showed that prevalence among young women aged 15-24 (2.9 per cent is three times higher than among men of the same age (1.1 per cent), according to the National Agency for the Control of AIDS and UNAIDS 2011.
‘Learning about Living’ (LaL) was a multimedia interactive eLearning curriculum and an SMS helpline on topics such as puberty, relationships, self-esteem, HIV/AIDS and gender issues. It was designed to empower adolescents and young people in Nigeria to make well-informed decisions about their personal lives and relationships by utilising ICTs to provide accurate and non-judgemental information about sexual health. Objectives included a measurable positive change in adolescent knowledge, attitudes and practices relating to sexual health.
LaL was initiated in 2006 by OneWorld UK and Butterfly Works, Netherlands, working with key stakeholders’ and partners within the field of sexual and reproductive health across Nigeria. A two-year pilot ran from 2007-2009, followed by a three-year scale-up of which ran from 2009-2011. In 2012, the programme was passed onto local partners and stakeholders to run and manage.
Technology: LaL utilized an interactive eLearning environment on an online website, and a mobile helpline made available across Nigeria and particularly, through 350 schools (90,000 students). In the eLearning environment, virtual peer educators presented 35 sexual/reproductive health and youth topics supported by quizzes, games, and cartoons. This website was custom developed for the LaL project.
Technology Use: For Lal, an interactive e-Learning programme in the form of an electronic version of the Family Life and HIV/Aids Education (FLHE) national curriculum was created in order to teach adolescents about all aspects of reproductive health, including HIV prevention. This was based on the curriculum developed by the National Agency for Curriculum Development in the Nigerian educational sector. The programme was rolled out across over 500 schools and wider reach was later provided by a national mobile phone helpline.
Teachers from each school in the programme received training on how to use LaL – including learning about participatory teaching practices, such as how to encourage and prompt discussion amongst young people in response to the issues raised through LaL. Teachers also received copies of the LaL CD and help with set-up, plus ongoing support provided through local organisations. Some schools were also given computer equipment.
The e-Learning programme featured virtual peer educators who provided interactive information – through games, activities, cartoons, and quizzes – on various sexual and reproductive health issues including HIV prevention as well as wider issues such as self-esteem and how to stay healthy. The mobile phone helpline supported this classroom-based programme as it meant students who had more personal questions they felt uncomfortable asking or discussing in the classroom could call or text the confidential mobile phone helpline or could be referred by their teacher to a local young-people friendly health service.
The interactive eLearning system (eFLHE) had 25 pre-prepared lessons covering the five themes in the FLHE: human development, relationships, personal skills, HIV infection and society and culture. It could be installed on computers or accessed online so that teachers, students and parents could engage with sexual and reproductive health issues via its informative cartoons, educative quizzes and games. There was a dedicated section for teachers which provided them with learning resources and materials to make their preparation easier.
Each lesson was designed as a ‘stand-alone’ and could be taught in and out of classrooms with role plays, quizzes and games to help the students further internalise the key points from the lesson. Using the eLearning programme to address sexual and reproductive health issues in Nigeria had many advantages according to the LAL programme, such as providing a safe environment for discussion of sensitive issues, providing a platform for communication between students and teachers and improving computer skills which in itself is empowering (OneWorld, 2012).
The ‘participatory learning’ approach was used as this approach acknowledges and welcomes existing knowledge, and competence of the students is central in the learning process whereas teachers become facilitators. Students are given space to develop their own viewpoint through active experience.
An SMS hotline was also developed called ‘My Question’ (My Q) – a free mobile phone service that allows adolescents and young people in Nigeria to access accurate, non-judgmental and confidential information anonymously regardless of their location and at their convenience. It uses low-end technology such as SMS to enable young people to send in questions and seek information or counselling on sexual and reproductive health.
The project was handed over to the Nigerian Ministry of Education (HIV/AIDS unit) and is currently implemented by Education as a Vaccine (EVA) with support from Oxfam Novib, the National Agency for the Control of AIDS and Ford Foundation. In addition to My Question, another SMS component was developed and continues to run a monthly competition called ‘My Answer’ (My A), which encourages teenagers to engage with sexual and reproductive issues by offering them a chance to win prizes for correctly answering key questions about their health.
Organization and Partners: OneWorld UK is a non-profit UK-based organisation which develops and creates new media, mobile and web technologies for social good. The LaL project was a multi-partner effort in Nigeria with Action Health Incorporated, NERDC, Education as a Vaccine Against Aids (EVA), Girls’ Power Initiative (GPI) and was supported by the Federal Ministry of Education and the Federal Ministry of Health.
Challenges and Lessons Learned: In the 2012 yearly evaluation, 78% of young people who used the service reported that they passed on the information they received to family and friends. The impact of eFLHE was found to be up to 10-20% more effective as a teaching method when compared to the regular method of teaching the curriculum.
Learning About Living encouraged young people to think about issues relating to sexual health. This is evidenced by the fact that when the mobile phone helpline was launched in November 2007, over 11,000 questions had been sent by the end of January 2008. 27,000 questions had been asked by mid-July 2008. The external evaluation including feedback from students, including one student who said: “I feel free now to talk about issues of sexuality.” The mobile helpline received on average 8000 questions a month over three and half years – with 80% of them from young people aged between 15 and 25 years. Questions were answered by trained knowledge workers within 24 hours and ranged from requests for basic HIV/aids information, STI’s, puberty and body changes to reproductive functions, pregnancy and contraceptive use.
The main barriers to the project included getting mobile network operators (MNOs) on board, covering the initial costs of development, sustaining the provision of free SMS (to remove any financial barriers for young people), and generally working with older minded administrations. The main strategy to address the costs of (start-up) development was making toolkits to assist local partners to develop their own youth-friendly sexual and reproductive health (SRH) digital sites and to set up their own helplines. This would bring down costs and enable more new countries to start a Learning about Living style programme. As the level of technological know-how in target countries rises this becomes easier.
One of the key lessons learnt from the case study is the importance of continuing evaluation. Evaluation in schools highlighted that some students still felt uncomfortable asking certain questions in a class environment. As a result of this, the confidential mobile phone helpline was introduced. In addition, the importance of participation can be seen. Through young people being encouraged to learn actively, they are more likely to share their knowledge with others.
This case study was compiled using the following online information from OneWorld UK and Butterfly Works sources:
- Lessons Learnt and Results from the Scale Up of Learning about Living 2009-2011. Retrieved from http://www.oneworld.org/docs/lal/nigeria/Nigeria_LessonsLearned_Scale-up_2012.pdf. Accessed on 20 March 2017.
- UNAIDS Nigeria HIV and AIDS estimates 2015. Retrieved from http://www.unaids.org/en/regionscountries/countries/nigeria. Accessed on 20 March 2017.
Image source: https://oneworld.org/docs/lal/OneWorld-LaL-2014-01-Slidedeck.pdf