AIDS Education in Papua New Guinea Schools
Kenneth Rouse
Abstract
Human sexuality is not a topic which is readily discussed in Papua New
Guinea society. However, the arrival of the AIDS virus in the community has
led to an increased commitment to face the issues involved. Interventions
adopted by the education system are the inclusion of these topics into the
curriculum, textbooks and examinations.
Evaluation of the materials and teaching methods which have arisen from the
WHO/UNESCO School AIDS Education Project has shown that it is possible
to increase students' knowledge about AIDS and to affect their attitudes and
behaviour inclinations in a positive way.
Plans are now underway to introduce topics relating to human sexuality into
the primary school curriculum.
Background
Most Papua New Guineans either ignore or try to avoid discussing sex and
other related topics. This is because these topics are traditionally not for open
discussion, especially in mixed company. They are considered to be both
sensitive and personal. This attitude has created a barrier to the introduction
of sex education into schools. However, with the arrival in the community of
Acquired Immune Deficiency Syndrome (AIDS), has also come the realisation
that it is time to start talking about human sexuality and sexually transmitted
diseases. This realisation has been underscored by the fact that AIDS is a killer
disease which has no cure and that education has been identified as the only
tool we have with which to fight the epidemic.
It is of historical interest that topics related to sexuality were deleted from draft
science materials produced for use at the upper primary level in Papua New
Guinea schools in the late 1960s. Similar material was accepted for use at the
4 4
lower secondary level in the late 1970s, provided that permission was obtained
from the school board of governors. The compulsory inclusion of this material
in all lower secondary science courses was endorsed as recently as 1988.
AIDS education material for secondary schools was first produced by the
Curriculum Unit of the Department of Education in 1985, making Papua New
Guinea an international forerunner in this field. Since then the Departments
of Health and Education have worked closely in developing materials for use
both in schools and with women and youth.
It was a happy coincidence that Papua New Guinea was developing its own
set of science textbooks at this time which were based on the series Fundamen-
tal Science by Anderton. Designed to support and supplement the secondary
science course, the Papua New Guinea series is written for students for whom
English is a second language, and draws upon Pacific examples, giving
recognition and status to traditional knowledge. The textbook project
presented another opportunity to deal with human reproduction, family
planning and sexually transmitted diseases. The inclusion of such culturally
sensitive issues relating to human sexuality is felt to be quite progressive and
ranges from recognising the traditional use of medicinal plants in contracep-
tion to how to use a condom in safer sex.
A further opportunity to ensure that AIDS is taught in schools lies in the
examination system. Clearly stated objectives not only allow teachers to
achieve what is intended, but also allow examiners to effectively test whether
the objectives have been achieved. Since examiners and curriculum develop-
ers recognise that the type of questions appearing in the exam will influence
what a teacher actually teaches in subsequent years, questions on STDs and
AIDS are likely to ensure that these topics are taught. This has proved to be
a useful strategy in Papua New Guinea, which produces its own national
examinations at the grade six, ten and twelve levels.
Papua New Guinea has also been involved in the WHO/UNESCO School
AIDS Education in the Pacific Project. This project was intended to assist
Pacific Island countries in establishing school AIDS education projects, in
developing teaching and learning materials and in teacher training. Funding
45
for the project began in January 1989 and ended in December 1991. Aregional
workshop was organised for curriculum developers and sub-regional work-
shops for teacher trainers. This has resulted in the production of learning
materials designed especially for the Pacific and the development of innova-
tive teaching strategies.
As the project progressed, it became clear that there was a desire to evaluate
it during its three-year life. Some people advised caution in this area, since it
was felt that it was too soon to begin evaluating and that ultimately it is
peoples' behaviour that matters and that this would eventually be shown in the
incidence of STD rates, including AIDS. However, the need to evaluate
remained and representatives from four countries in the region met to develop
the instruments to be used. It would have been too difficult a task to evaluate
the project in every country in the region and so Fiji and Papua New Guinea
became the countries in which the evaluation was carried out.
Experimental and control groups were selected in all evaluation schools and
a pre-test and post-test were administered to the students. Only the experimen-
tal group received the lessons on AIDS, while the control group continued to
receive their normal lessons.
Effects of the AIDS lessons were gauged in terms of the comparative
knowledge change, attitude, values and behaviour inclinations of the control
and experimental groups at the post-test. These were measured through a test
of knowledge and an attitude and perception questionnaire.
Separate questionnaires were also given to teachers and principals and to
parents and community leaders.
Pre-test perceptions
The findings of Ibe (1992) and Kondo (1992) are summarised below and put
in the context of Papua New Guinea.
The experimental and control groups did not differ in age and exposure to
media nor in their sources of AIDS information.
46
HIV/AIDS were perceived as one of the three most serious diseases but fewer
than half of the students admitted discussing AIDS and related topics with
their immediate families.
The preferred methods of obtaining AIDS information were friends and
schoolmates, followed by school and then newspapers and magazines.
However, a large majority of the students thought that AIDS education should
be taught in school.
Specially trained doctors and nurses were perceived as the best persons to care
for AIDS patients by three-quarters of the students, while only one quarter felt
that family members were the best people to provide this care.
The students considered religion an important factor in influencing their
perceptions. This probably reflects the fact that a large number of Christian
denominations are represented in Papua New Guinea and many people belong
to one of these groups.
The Fiji sample had a higher initial knowledge of AIDS than the Papua New
Guinea sample. In the initial test items, the Fiji sample showed more family
orientation than the Papua New Guinea students. The difference could be due
to the extent of media exposure. Fiji had higher self-rated frequency of
exposure and more sources of AIDS information; Papua New Guinea rated
higher on TV exposure and Fiji rated higher on school as an information
source. The higher exposure to television is not surprising since Papua New
Guinea has received Australian television broadcasts via satellite since the
early 1980s and has had its own television broadcasts since 1986.
Post-test results
Significantly more students from the control group than the experimental
group reported newspapers as sources of information about AIDS. There were
no other significant differences in the way that they obtained information
about AIDS.
4 7
A significantly higher percentage of the experimental group than the control
group reported that they discussed what they had learned with their family,
which would appear to indicate the effects of AIDS education. As a result of
the lessons taught in class, the students may have felt less inhibited discussing
these topics with family members. There were also slightly higher percentages
from the experimental group who admitted discussing AIDS learning with
their relatives and other friends, but the percentages are not significantly
higher. A significantly higher percentage of the control group students
admitted discussing AIDS information with their girlfriend or boyfriend.
Since it is not unusual in Papua New Guinea for teenagers to have a boyfriend
or girlfriend from the same grade within the school, then the lower percentage
of experimental students who discussed this information with their girlfriend
or boyfriend can probably be explained by the fact that the information was
discussed in class anyway and so was available to both parties.
In the experimental group, the higher percentages who prefer school or
teachers as a source of information can be taken as an effect of the introduction
of AIDS lessons to this group. It implies the acceptance of discussing sensitive
topics like AIDS in the school. The slightly higher percentage from the
experimental group who prefer friends or schoolmates as a source of AIDS
information also appears to indicate that the students in this group have fewer
inhibitions to discuss AIDS information than students in the control group.
Knowledge of concepts in AIDS education was measured through a 27-item true-
false test and 8 multiple-choice items. The multiple-choice test was given only at the
post-test to avoid overly sensitising the students at the pre-test.
The mean scores of the control and experimental groups in the multiple-choice
test did not differ significantly. However, in the true-false test, the experimen-
tal group scored significantly higher than the control group.
There were more frequent incidences of misconceptions in the control group.
Higher percentages of the control group agreed that a person can catch AIDS
by touching, kissing, eating, using utensils and using the clothes of a person
who has AIDS. Higher percentages of the control group also considered that
HIV and AIDS are the same thing, that a person can get AIDS by being bitten
by a mosquito or other blood-sucking insect and that people who don't have
48
sexual intercourse will not catch HIV.
Positive effects of the AIDS lessons are indicated by significantly higher
percentages from the experimental group who agreed that a person can have
HIV and not have AIDS; that a person can be infected with HIV but not have
any symptoms; and that a person can catch HIV by sharing needles and
syringes with people who have AIDS.
Some interesting differences were observed in the two groups' answers to
certain questions. For example, in response to the question, "Who do you think
should take care of a person who has AIDS?", there were significantly more
students from the experimental group who said that the person's family should
take care of him or her, whereas a higher percentage from the control group
said hospital staff, doctors and nurses especially trained to care for AIDS
patients should take care of a person who has AIDS. The percentage who said
the community should take care of the person with AIDS was also higher in
the experimental group than in the control group.
These answers appear to indicate that the experimental group developed a
more compassionate attitude towards persons affected with AIDS, or realised
the importance of the acceptance of such persons by their families and the
community, whereas students in the control group considered the disease to
be mainly needing medical attention. This position is supported by responses
of the control group to other items in the questionnaire administered at the end
of the experimental study.
Parents and Community leaders perceptions
Despite the apparent reluctance to talk about human sexuality in the family
setting or in mixed company, three out of every four parents agreed that
sexuality and AIDS topics should be taught in school.
About half of the parents and community leaders said the reason young people
get into trouble is that they do not know enough about sex. The majority of
parents admitted that sex was not openly discussed in the family, and that then-
children did not feel free to discuss sex at home. One of the reasons for this lack of
communication is likely to be the parents' own lack of knowledge: parents admitted
4 9
not knowing much about such topics as safer sex, STDs and AIDS.
Although parents reported the same sources of AIDS information as those reported
by the students, parents had less knowledge about ADDS than their children. They
showed higher percentages of "uncertain" and "unsure" responses. When asked who
should provide the required education, parents singled out doctors and health
workers as the best persons to teach topics like STDs and AIDS. Again, this may
be because AIDS is seen mainly as a medical problem.
Principals and Teachers
The principals and teachers had favourable attitudes towards AIDS education.
All responded that sex education and AIDS education should be introduced
into schools.
The samples of principals and teachers were not large enough to warrant a
comparison with the student and parent samples. However, it is clear that all
four groups had favourable attitudes.
Conclusions
The AIDS education materials and teaching methods used in the trial schools
appear to be effective. They resulted in a change in the knowledge of students
about AIDS, in their attitudes towards AIDS, and in their behaviour inclina-
tions. In particular:
Students who were given the lessons had higher knowledge scores than those
who were not.
The experimental group felt more compassion and empathy towards AIDS
victims, and were more family-oriented than the control group.
Students in the experimental group have fewer inhibitions about discussing
sex-related topics than the control group, and are less likely to consider
abortion as a solution to unwanted pregancy.
The classes in which the AIDS lessons were taught were also reported as being
5 0
livelier, more verbally interactive and problem-aware than the control classes.
Although the effects of AIDS lessons in Papua New Guinea and Fiji were
similar, the effects on the Papua New Guinea sample were greater and more
significant. This is due to the Fiji sample's higher initial knowledge and
greater exposure to AIDS information at the start of the evaluation.
Future directions
The effectiveness of the AIDS education materials and teaching methods in
Papua New Guinea and Fiji further supports the case for their adaptation and
adoption or continued use in other Pacific Island countries.
As well as continuing to strengthen the implementation of AIDS education at
the secondary level, it is pertinent to begin to consider the possibility of
extending these activities to the primary level. This need is already apparent
in Papua New Guinea where research carried out by Van der Meijden (1991)
amongst Community School students and their teachers in the Eastern
Highlands Province indicates that significant numbers of young people are
becoming sexually active while still at primary school.
Primary school education about sexuality will be easier to achieve now that
Papua New Guinea has adopted an official population policy. In previous
years, the absence of such a policy, together with traditional family values and
church beliefs, made the production of appropriate materials difficult.
In a climate of widespread occurrence of sexually transmitted diseases,
including AIDS, and with an increasing population, the Board of Studies
(which approves all curricula) has recommended that sex education should
now be included in the curriculum at the upper primary level. This recommen-
dation also has the support of the Churches Education Council. Churches do
however emphasise that it is essential that sex education takes place in the
context of family life and community life education.
In order to achieve this objective, several activities have been initiated. These
include the development of a video programme, student readers on AIDS and
a wide ranging Family Life Project which has been approved for funding by
5 1
the United Nations Family Planning Association. According to Villacorta
(1992), further student materials and an integrated curriculum package for use
in science, language, community life, health and other subjects will be
included in this latter project.
Introducing education about STDs /AIDS into primary schools raises a
number of important practical considerations. It is important that the teacher
is able to talk about human sexuality in a comfortable way without
communicating feelings of shame and embarrassment. Other qualities that are
needed are sensitivity and maturity to create an environment in which the
topics can be dealt with in a frank and open way. Although some people may
be offended by such openness, it is not the intention to cause offence. Early
sexual experience which leads to unwanted pregnancy, the high incidence of
sexually transmitted diseases and even death are clearly more important
issues than the risk of upsetting peoples' sensitivities.
Teachers must also have the required knowledge about human reproduction,
family planning and sexually transmitted diseases; however, it is not enough
to simply tell young people the facts. We also need to develop the values and
attitudes that will lead to safe behaviour. This education should not be seen
as encouraging sexual experimentation and promiscuity, but rather as a way
of getting young people to lead responsible sexual lives and avoid high risk
behaviour. Just as the the use of seat-belts does not appear to encourage
reckless driving, so the use of condoms need not encourage unbridled sex.
Students in grades one to six in primary schools represent about 75 % of all
young people in that age group; the proposed re-structure of the education
system will increase the length of primary education to nine years, increase
access to education and also address the attrition rate. Given that all young
people reach puberty at this age and that most parents do not talk to their own
children about sexuality, primary school teachers are presented with a unique
opportunity and responsibility which cannot be ignored.
5 2
References
Anderton, J. and Papua New Guinea Department of Education (1990)
Fundamental Science for Melanesia Book 3. Longman Cheshire.
Anderton, J. and Papua New Guinea Department of Education (1992, in press)
Fundamental Science for Melanesia Book 4. Longman Cheshire.
Ibe, M. (1992, draft) The Effects of School AIDS Education on Students,
Parents, Teachers and the Community in Fiji and Papua New Guinea.
WHO report.
Kondo, A. (1992, draft) Terminal Report WHO/UNESCO School AIDS
Education in the Pacific. UNESCO report.
Van der Meijden, W.I. (1991) Survey of Community Schools in Eastern
Highlands Province. Department of Health, Papua New Guinea.
Villacorta, J. (1992) Integrated Population Education for the Schools in Papua
New Guinea. Department of Education, Papua New Guinea.
WHO/UNESCO (1989) Education to Prevent AIDSISTDs in the Pacific - A
Guide for Teacher Training.
WHO/UNESCO (1989, revised 1991) Education to Prevent AIDSISTDs in
the Pacific - A Teaching Guide for Secondary Schools. Papua New Guinea
Department of Education, Waigani
5 3
|
