Using Participatory Research and Action to Address the HIV-related Vulnerabilities of Adolescent Girls in Tanzania

"Globally, girls and young women are more likely to be HIV positive than their male peers, due in large part to an array of gender inequalities that negatively impact their mental and physical well being. Protecting girls from this multi-dimensional risk requires understanding how the girls experience vulnerability in their daily lives and developing solutions that are actionable within the community context."

The International Center for Research on Women (ICRW) and Taasisi ya Maendeleo Shirikishi Arusha (TAMASHA), in collaboration with Pact Tanzania, developed a participatory research and action project (Vitu Newala) that aimed to both understand and respond to girls’ HIV-related vulnerabilities. The project was conducted in Newala, Tanzania. This report describes the research processes contributing to project: study design, the formative research, the intervention design, peer education programme development, and the project assessment.

The project, set in 4 rural communities in July and August 2010, was conducted with 82 girls, 12 -17 years old, and around 200 adults. It served as the foundation for designing a peer-delivered life skills education (LSE) programme. This report complements the "Vijana Tunaweza Newala: Findings from a Participatory Research and Action Project in Tanzania" report. [See Related Summaries below.]

The key objectives of this project were:
1. To explore girls’ perspectives of their vulnerabilities in Newala;
2. To develop an intervention to reduce these vulnerabilities;
3. To examine changes in girls’ perspectives of their vulnerabilities following an intervention to address them;
4. To examine changes in self and collective efficacy to protect girls in communities following the intervention.

The selection of research participants prioritised the communities' most vulnerable young people. The secondary research subjects were adult district and community stakeholders familiar with girls’ HIV vulnerabilities and/or with knowledge about services already in place to address the vulnerabilities that older girls face. Qualitative data were collected using participatory learning and action (PLA) techniques through exercises conducted by those trained as "Youth Researchers". PLA techniques are group data collection methods that provide participants a forum to reflect upon their vulnerabilities and to identify solutions to key problems. Examples of the exercises include:

• "Drawing of dreams and aspirations and discussion of obstacles to these dreams
• Voting on statements about gender roles and behaviors in the community
• Free listing and ranking of perceived HIV-related risks
• Mapping of the dangerous areas in the community
• Identifying and prioritizing solutions for reducing these risks"

Researchers also conducted focus group discussions (FGDs) and key informant interviews (KIIs) with adults in each community to find out their views about the girls’ vulnerabilities and the role the community could play in safeguarding girls’ health and wellbeing. The findings from this research were synthesised in feedback workshops in which the youth researchers combined the rankings and weighting exercises across the four wards, re-grouping apparent vulnerabilities and their root causes based on the intervention approach most likely to address them. They also identified and ranked the key solutions they agreed to put forward for the project’s intervention component, which centred on various forms of LSE and empowerment as well as community-based activism.

The researchers were then trained in group facilitation in order to feel comfortable presenting the results to their communities, underscoring "the importance of understanding the educational background and styles of Youth Researchers in order to be able to bridge the gap between traditional didactic teaching approaches and participatory learning and research approaches."

The validation of the research took place in 3 stages:
1) The partner organisations met to review findings and outline a peer intervention strategy and timeline for the LSE project as a response.
2) They then discussed and modified the proposed strategy with the youth researchers.
3) The findings were then presented to stakeholders at the district, ward, and community levels in a validation workshop held in Newala in October 2010.

As the LSE project proceeded, run by trained peer educators, monitoring and project follow-up consisted of implementing more peer education sessions and community mobilisation activities, a refresher training for peer educators, and support for troubleshooting their challenges.

Assessment of the project’s success in reaching adolescents in the four communities and promoting positive change comprised:
1) a series of interviews with youth in the participating communities;
2) a set of endline PLA sessions with the original 82 participants to enable researchers to note changes in their responses; and
3) a validation workshop with the Vitu Newala team and district and ward leaders.

The project’s qualitative assessment suggests that some important changes have occurred at the personal, interpersonal, and community levels. Further, it led to the development of ongoing strategies and solutions formalised into action plans at the district and ward levels.

Lessons learned include the following:
1. Align Project Priorities with Youth Priorities;
2. Relationships Matter - rapport required sustained and frequent contact as well as mutual respect and was fundamental in sustaining the enthusiastic participation of youth;
3. Vulnerable Youth Need Extra Support - multiple opportunities for refresher training and practice to build their sense of self-efficacy, as well as a higher degree of flexibility in scheduling sessions; a welcoming atmosphere for members who became pregnant, got married, or experienced losses; and materials to aid in carrying out Vitu Newala activities, including bicycles for transport, t-shirts for identification with the project, backpacks for training materials, and soccer balls to generate and focus interest in their communities.