UNICEF Maldives: Adolescent HIV Prevention

I just wrapped up work with UNICEF and the Ministry of Health in the Maldives to train health care workers on adolescent HIV prevention.

The main struggle that many health care workers in the Maldives face is a tension between their personal beliefs, prevailing religious beliefs, what is legal, what is moral, what the community expects, and what the young person thinks is best. We worked together over the course of the week to build their skills to communicate with young people about HIV and reproductive health, to build a foundation for this work on a human rights platform, and to carefully examine the role they can play to advocate for young people in their communities.

I was also advised that talking about these topics–HIV, sex, reproduction, drug use, and homosexuality, among others–was highly taboo. I thought long and hard about how to ease the participants into the subjects and build their trust in me. One of the strategies I used was to have several activities where they responded to “taboo” questions anonymously. For example, I put several fishbowls at the front of the room and asked them to answer the questions taped to the front with a paper that only said “yes” or “no”.

During the break, I tallied their responses and posted the results. I did take a calculated risk that these figured would come out as I thought they would. For my purpose was to try to build empathy and compassion–as we discussed these topics, I wanted each person to recognize that despite the “taboo” nature of these topics, nearly everyone was affected by them.

Nearly everywhere in the world, young people rarely come to health centers for preventative care, advice, or tools to keep healthy. As such, we also focused on building their skills in community outreach and assessment. I was able to then go and support some of the health care workers as they started their community-based work.

Late in the curriculum development stage, it dawned on me that this training opportunity could give the participants a chance to develop their community interventions. So, I did a lot of shuffling around and restructured the training. I am so glad that I did! On day one, I split the participants into groups that would work together throughout the course of the week. They had to dive deep into one “key population” (knowing that one person can often “fit” into several “populations”) and prepare a presentation that they would deliver on the fifth day along with their proposed intervention. On day two, we focused on human rights and the need for adolescent-friendly health services. In their groups, they examined ways in which the health system does and does not uphold the rights of young people. On day three, they spent the day in their groups practicing community-based-participatory research methods for them to get to know the young people in their communities. On day four, we practiced motivational interviewing all day and they practiced with scenarios that would be relevant to those in their key populations. Finally, on day five, they presented their work from the week to the rest of the participants along with a suggested intervention that they could implement with minimal need for support/funding or resources outside of what they currently have.

In organizing the training like this, they were able to immediately put their learnings into practice and make the lessons immediately applicable to their lives at home. Plus, they came up with great interventions on their own which will serve to build their commitment to their work.

At the very end of the training, I asked the groups to envision an ideal world, one where their work is successful, where human rights are upheld, and where young people are respected. Here is a representation of their work…

To say it was a great training might be an understatement. It was amazing.

You can read more about it on the UNICEF Maldives website.

As always, I am open to new contracts and to working together. Please let me know how I can help you to build effective, exciting, and practice-based trainings.

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