Thursday, December 15, 2011

The HIV/AIDS Situation and Impact in the Education Sector

In order to put the response to the HIV/AIDS epidemic in the education sector described in the previous chapter in its proper context this chapter gives a brief analysis of the situation which calls for the response. This has to do with the plight of the school population both students and teachers with regards to HIV infection and AIDS, and the impact of the HIV/AIDS epidemic on the education sector.

High Risk Behaviour among Primary and secondary School Pupils

Many sexual behaviour studies done in Tanzania over the years have showed the many youths are involved in unprotected sexual activities, and that the age of sexual debut is very low. Regarding the school population a nation – wide survey done as baseline for the FLE programme (MOEC 2001) showed that both primary school pupils and secondary school students indulge in sexual activities quite considerably.

For Primary School pupils three tables in that report (Table A30, A31 and A32) provide most pertinent data.  These tables show that 36.5 per cent of the sub sample of girls reported having been asked for sex, 8.2 per cent reported being asked by teachers and 7.6 per cent by other adults.  Some 10.2 per cent of the girls reported that they agreed to the request or were coerced into submission.  As for secondary school students, the report (Tab B37) shows that they had a mean age of 15.29 and a median of 16.0 years at first sexual intercourse.  A substantial proportion of primary school pupils and secondary school students were thus found to engage in sexual activities which expose them to the risk of HIV infection.

This confirms the belief that sexual activity among adolescents who are in school also begins early.  School pupils too need to be targeted with appropriate education, and not just the out of school youth. No comparable data is available about high risk behaviour for HIV infection among teachers as distinct professional and socio-economic status group.

HIV Infection and AIDS among Primary School Pupils, Secondary School Students and Teachers

HIV/AIDS statistics in Tanzania – as in other countries – are not disaggregated to show the plight of the school population.  Different categories of the school population are subsumed in the other age, and sex groups and therefore they do not feature in their own right.  The 16th report of the National AIDS Control Programme on the state of the epidemic in Tanzania for the year 2001 (MOH 2002) gives the picture about the youth’s plight as reflected tables 4 and 5 in this report.

Table 1
Distribution of Reported AIDS cases by age and sex,
Tanzania 2001

Age
Male
Female
Total

5 – 9
1.9%
1.3%
1.6%
10 – 14
1.1%
1.2%
1.1%
15 – 19
2.2%
5.4%
4.0%
20 - 24
7.7%
14.0%
12.5%

Ex Table 1 NACP 16

Table 2
Age and sex specific case rate of cumulative AIDS cases,
Tanzania 1987 – 2001


MALE
FEMALE
Total
%
Case Rate
%
Case Rate
%


5 – 9
1.0
21.8
1.0
23.5
1.0
23.4
10 – 14
0.5
14.7
0.6
19.3
0.5
17.1
15 – 19
1.6
49.2
4.9
156.2
3.2
102.9
20 - 24
7.7
282.8
17.3
656.8
12.4
470.8

Ex Table 2 NACP 16

The age groups 5-9 and 10-14 cover the primary school going age while the 15-19 and 20 – 24 age groups cover the secondary school going age and above. It is also noteworthy that these figures relate to AIDS a much later manifestation of HIV infection, and would for many of these cases be due to other modes of HIV transmission besides the sexual mode.

Impact of HIV/AIDS

According to the recent UNAIDS annual report (UNAIDS 2002) a decline in school enrolment is one of the most visible effects on the HIV/AIDS epidemic.  Furthermore the loss of teachers and administrators directly affects the quality of education.

The HIV/AIDS epidemic affects Supply, Demand and Quality of Education.

Supply

There is no hard data within the Tanzanian Education Seector on whether the education staff at all levels experience higher levels of illness and death due to HIV/AIDS than the general population.  Numbers of teachers dying in various districts of the country are often bandied around but these are not expressed within the context of the total number of teachers or teachers in the respective districts. The UNAIDS report referred to above notes that illness or death of teachers is especially devastating in rural areas where schools often depend heavily on one or two teachers.

The team is aware of an ongoing collaborative action research programme by the International Institute for Educational Planning supported by UNESCO.  It seek “to develop a data base that tracks patterns and trends in teacher and student absence and abandonment and teacher mortality related to HIV/AIDS and to formulate effective investigation and preventive measures based on qualitative assessment of impact of HIV.AIDS on selected tertiary institutions, schools and their interaction with the surrounding communities".  Results are not yet available.

Demand

It not clear how much the epidemic has so far affected the school enrolment in Tanzania.  It is also not clear how the epidemic has affected the school attendance by pupils.  Quite often children are involved in taking care of sick parents or are required to perform the economic activities of their ailing parents/guardians instead of going to school.  This team is aware of a study (Gould & Huber 2003) which seeks to determine the social demand for schooling in HIV/AIDS affected populations in Tanzania.  Preliminary results of the study indicate that children whose households have been affected by AIDS/TB are not any more likely to drop out of school than those who are not.  Even in high HIV/AIDS prevalence populations it is the household's economic situation which is related to dropout.  Children whose biological parents are alive, but who live with one or none of them are more likely to drop out.  Orphanhood is not perceived by parents or children to be a major factor for drop out, nor is caring for sick relatives.  This is contrary to the results of a study by Economic and Social Research Foundation reviewed below.

Quality of Education

In addition to absenteeism by teachers there is need for information about the extent to which sickly teachers continue to teach below their optimal level.  This phenomenon coupled with irregular attendance by pupils affects both the quality of teaching and learning.

These problems are believed to be affecting Tanzania’s education system.  A recent study done by the Economic and Social Research Foundation (ESRF 2003) is of particular relevance.  The study sought to explore the impact of HIV/AIDS on the Education Sector, and was carried out in 6 districts (Kinondoni, Mbeya Urban, Mbeya Rural, Dodoma Urban, Simanjiro and Kahama) where a total of 43 schools were visited.  On the supply size, the study could not determine the exact number of teachers who died of AIDS during the period of 1999 to 2002 though many deaths of teachers were reported.  This is because there was no known diagnosis of AIDS.

Nevertheless the study concluded that a significant proportion of the deaths were due to AIDS related illnesses.  It demonstrated an adverse effect on productivity and quality of education through higher absenteeism rates of teachers with HIV/AIDS and replacement of experienced teachers with less experienced ones. On the demand side the study found higher absenteeism and dropout rates among orphans compared to other children, with girls being the most affected.    

The HIV/AIDS Coordination Unit has not been unmindful of the importance of having hard data about the impact of the HIV/AIDS epidemic in the education sector. There is an ongoing in-house study (Katabaro & Sawaya n.d.) based in three regions:  Iringa, Dodoma and Musoma.  This study seeks to answer the question "What do we know about the impact of HIV/AIDS on the education system in Tanzania Mainland?".

The objectives of this ongoing study are

·         To establish the nature and extent of the impact of HIV/AIDS on demand for education
·         To assess the perceived morbidity and mortality  levels among teachers and students/pupils in the context of HIV/AIDS
·         To explore the nature and extent of HIV/AIDS on the availability and effective use of resources
·         To assess the response and coping strategies for schools and communities to the impact
·         To assess the MOEC response and coping strategies.

To sum up, while in general terms the school population, comprising of both the students and teachers is believed to be equally if not more at risk for HIV infection than the general population, this has not been clearly demonstrated by hard data.  Evidence that the HIV/AIDS epidemic is having serious impact on the Tanzanian education sector is beginning to come in.

[Extracted from a report titled “Baseline Study: Status of Response to HIV/AIDS in the Education Sector.” By E.P.Y. Muhondwa & E.H. Mhina, in collaboration with MoEC’s CCITWG Study Team. Dar Es Salaam. 5th December, 2003]

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