LEARNING MATERIALS ON HIV/AIDS LEVELS 1 AND 2 PROGRAMMES FOR VOCATIONAL TRAINING SECTOR IN BOTSWANA.

INSTRUCTORS’ MANUAL.

SUBMITTED BY

DR MATTHEW GBOKU and DR WAPULA RADITLOANENG

ON BEHALF OF

EDUCATIONAL NETWORK (PTY) LTD

APRIL 2005

TABLE OF CONTENTS

i.ABBREVIATIONS AND ACRONYMS

ii.PREFACE

iii.GLOSSARY

iv.ACKNOWLEDGEMENTS

v.LIST OF TABLES

vi.LIST OF FIGURES

vii.INTRODUCTION TO THE MODULES

viii.INTRODUCTION TO THE INSTRUCTOR’S MANUAL

ix.OBJECTIVES OF THE MANUAL

x.SELECTED TEACHING METHODS

1.0MODULE ONE: BASIC CONCEPTS OF HIV/AIDS

1.1Unit One: Introduction

1.2Unit Two: Common Transmission Modes

2.0MODULE TWO: POSITIVE LIVING

2.1UNIT ONE: PREVENTION

2.2UNIT TWO: AVAILABLE CARE AND SUPPORT

3.0MODULE THREE: EFFECTS OF HIV/AIDS

3.1UNIT ONE: IMPORTANCE OF STATISTICAL FACTS

3.2UNIT TWO: IMPACT OF HIV/AIDS

4.0MODULE FOUR: HIV/AIDS AND THE WORKPLACE

4.1UNIT ONE: TRANSMISSION RISKS

4.2UNIT TWO: OCCUPATIONAL SUPPORT POLICY GUIDELINES

i.ABBREVIATIONS AND ACRONYMS

ABC / Abstain, Be faithful, Condomise or use a Condom.
ACHAP / African Comprehensive HIV/AIDS Programme
AIDS / Acquired Immune Deficiency Syndrome.
ARV / Ante Retroviral Therapy.
AZT / Zidovudine – Type of HIV/AIDS drug
BAIS / Botswana AIDS Impact Survey
BOCAIP / Botswana Christian AIDS Intervention Programme
BONASO / Botswana Network of AIDS Service Organisation
BONELA / Botswana Network of Ethics and Law.
BONEPWA / Botswana Network of People Living With AIDS.
BCL / Botswana Copper Nickel Mining Co. LTD.
BOTA / Botswana Training Authority.
CDC / Center for Disease Control and Prevention
CEYOHO / Center for Youth of Hope
COCEPWA / Coping Centre for People With AIDS
DEBSWANA / De Beers Botswana Mining Company
DMSACs / District Multisectoral AIDS Committees.
DPSM / Directorate of Public Service Management.
FDA / Food and Drug Administration.
GDP / Gross Domestic Product.
HBC / Home Based Care
HIV / Human Immune Deficiency Syndrome
IDCC / Infectious Disease Care Clinic
ILO / International Labour Organization.
IPT / Isoniazid (TB) Prevention Therapy.
KABP / Knowledge, Attitudes, Behaviour and Practices.
KITSO / Knowledge, Innovation Training, Shall Overcome AIDS.
MTCT / Mother-To-Child Transmission.
MFDP / Ministry of Finance and Development Planning.
NACA / National AIDS Coordinating Agency.
NGO / Non- Governmental Organization.
PLWHA / People Living with HIV/AIDS.
PMTCT / Prevention of Mother-To-Child Transmission.
SADC / Southern African Development Community
STDs / Sexually Transmitted Diseases.
STI / Sexually Transmitted Infections.
UNAIDS / United Nations AIDS Programme
UNDP / United Nations Development Programme
VCT / Voluntary Counselling and Testing
WHO / World Health Organization.
YOHO / Youth Health Organization.

ii.PREFACE

Botswana has one of the fastest growing HIV infection rates in the world. According to the Botswana 2003 second generation HIV/AIDS surveillance, it is estimated that about 34.7% of the total population is HIV/AIDS infected. Mostly HIV/AIDS interventions were not addressed in the vocational training sector although sexually active young people are one of the most vulnerable groups in the country (UNAIDS 2002).

In October 2000, the Botswana Government and the German Government agreed during the governmental consultation to add the HIV/AIDS component to the activities of the Botswana Training Authority (BOTA) for implementing HIV/AIDS activities in the vocational training sector. BOTA is the coordinating body of the vocational training sector, with the mandate to standardise and assure the quality, mandated by the Vocational Training Act No. 22 of 1998.

As a result of, among others, BOTA’s efforts, the vocational training institutions have implemented HIV/AIDS activities in line with the National Strategic Plan 2003-2009. BOTA and the Ministry of Education assist the institutions in implementing HIV/AIDS activities with technical, training and financial support. The private training providers in particular have only received support from BOTA.

One of the key functions of BOTA is to guide the development of programmes, curricula and training/learning materials in vocational training (Vocational Training Act No. 22 of 1998). Guidelines for aligning curricula with unit standards have been made available to training institutions. BOTA also coordinates the development of vocational training curricula and training/learning materials.

BOTA could not identify adequate learning material, which covers the requirements of the HIV/AIDS unit standards. The HIV/AIDS Level 1 unit standard is a compulsory generic skill for all Foundation qualifications. BOTA has the responsibility to ensure the implementation of HIV/AIDS unit standards as part of the generic skills through the submission of learning materials.

iii.GLOSSARY

Alcohol and drugs: Alcohol and drugs belong to the same family in HIV transmission as they are habit-forming and can impair people from making reasonable judgments about preventing HIV.

Misconceptions:Refers to common distortions or unfounded fears about what causes AIDS. Because AIDS is caused by HIV which is dangerous to the human race, people can not trust anything about its causes and they develop all kinds of fear-related explanations of other transmission routes that they may think are relevant.

iv.ACKNOWLEDGEMENTS

On behalf of the Educational Development Network (Pty) Limited and the professionals that participated in this consultancy, I wish to extend my appreciation to all those HIV/AIDS institutions and individuals who made various contributions in making this work successful. In particular, my special thanks go to the staff of the Botswana Training Authority (BOTA) in collaboration with the Ministry of Education Curriculum Development Unit, Department of Vocational Education and Training and reference group members from the First National Bank, PMTCT and the United Nations Development Programme (UNDP). In particular, I want to note the institutional support provided by BOTA through the provision of conference rooms, tea breaks and lunch and various times during the duration of this consultancy. I am also sincerely thankful to the members of the consultancy Reference Group comprising of:

  • Ezekiel Thekiso – BOTA – Chairperson of the Reference Group
  • Mothebe Madanika– BOTA – Secretary of the Reference Group
  • Ulla – BOTA
  • Peter Fleming – BOTA
  • Josephine Tlale – PMTCT, Ministry of Health.
  • Kokie Seretse – First National Bank.

The advice and institutional support provided by the members of the reference group was invaluable in bringing this work to completion.

I want to thank the staff of NACA (IEC and resource center), COCEPWA and PMTCT for providing us with the relevant information without which the consultants could not have proceeded. We thank the heads of these organisations, programme managers, for the understanding and hospitality they showed to the research team at various stages of our data collection process.

Last but not the least the management of Educational Development Network (Pty) Limited acknowledges the effort of Mr Mothebe Madanika for all the logistical support in the development of these learning materials. Thanks also to Mr Ezekiel Thekiso for coordinating and supervising the proceedings of the reference group meetings. We believe it was a very challenging task for him to keep the discussion on track with the terms of reference and the initial consultative documents from the stakeholders’ input into the standards expected from the final products of the modules.

Dr Matthew L. S. Gboku

(Research Team Leader)

v.LIST OF TABLES

TABLE / PAGE
1 / Main HIV-1 Subtypes by Region or Country
2 / HIV Prevalence Rate in Selected Countries within Southern Africa
3 / Body fluids and HIV Transmission
4 / Progression of HIV Infection to AIDS
5 / Locations of HIV Support Groups and Centres in Botswana
6 / Public Health Expenditure in Botswana (1990 – 2000)
7 / Core expenditure on HIV and AIDS programmes in Botswana (1999 – 2003)
8 / Comparative Impact of HIV/AIDS on agricultural labour force in the most
affected African countries
9 / Average life expectancy in 11 African Countries
10 / Programmes on HIV/AIDS at the Workplace

vi.LIST OF FIGURES

FIGURE / PAGE

Figure 1: Picture of a healthy looking but HIV infected person

Figure 2: Picture of a Person with AIDS exhibiting many of the symptoms mentioned above

Figure 3:Progression of HIV infection in the human body

Figure 4: HIV/AIDS Education Programmes

vii.INTRODUCTION TO THE MODULES

HIV/AIDS is a national pandemic that robs Botswana of its valuable human resources and workforce. It is very important for everyone to know about HIV/AIDS so that they can individually and collectively prevent, manage and know how to make informed choices in dealing with the infected and affected.

This is a series of 4 modules on HIV AIDS. The first three modules target the foundation programme for the Vocational training sector. Module one focuses on an introduction to the basic facts about HIV/AIDS and how it is transmitted. Module Two deals with positive living,prevention, care and support. Module Three is on Effects of HIV/AIDS which is divided into two units. The first module is on the prevention while the second unit addresses available support systems for HIV/AIDS infected and affected persons. It is hoped that after completing the first three modules, students at the foundation level will have essential information on HIV AIDS. The last module Four gives students information about HIV/AIDS at the workplace. It is hoped that after completing their training, students will be fully equipped with knowledge, skills, positive attitudes and behaviors to join the war against AIDS at their different workplaces.

viii.INTRODUCTION TO THE INSTRUCTOR’SMANUAL

This manual is to be used with a series of 4 modules on HIV and AIDS. Each module has two units. The first three modules target the foundation programme for Vocational training institutes. Module one focuses on an introduction to the basic facts about HIV/AIDS; The meaning of HIV/AIDS and how it is transmitted.

Module Two is on positive living; Prevention, care and Support. Module Three is on Effects of HIV/AIDS: Statistics and impact. It is hoped that after completing the first three modules, students at the foundation level will have essential information on HIV and AIDS.

The fourth and last module of the HIV/AIDS programme gives students information about HIV/AIDS at the workplace. The module is divided into two units, the first dealing with occupational support guidelines, and the second dealing with practice in the workplace. In using these modules, this user friendly guide is expected to be used by the instructors. However, while instructors are expected to use this manual, it is expected that instructors will add value by using their experiences as starting points for teaching. We expect the manual to be a guide, not a blueprint for action. Instructors are advised to be creative and innovative in their teaching and modify the contents of the manual as they see fit.

It is hoped that after completing the training, students will be fully equipped with knowledge, skills and attitudes to join the war against AIDS during their training period and beyond. As they graduate and join their different workplaces, the use of learner centered methods recommended in this manual will give them an opportunity to continue the war against AIDS as lifelong learners.

ix.OBJECTIVES OF THE MANUAL

By using the manual with the 4 modules on HIV/AIDS, it is hoped that:

  1. Students will be empowered with knowledge and skills as individuals and ultimatelyascounsellors and supporters of co-workers in their workplaces.
  1. Students will be empowered as members of families, communities of the infected and affected who need to learn to cope with HIV/AIDS.
  1. Students will demonstrate understanding about how to prevent and manage HIV/AIDS as a psychosocial, and economic issue. They will be able to prevent and live positively with HIV/AIDS for prolonged and good quality of life.

How to use this guide

For each of the units, the instructor has to provide learners with the following:-

  1. Objectives of the session.
  2. Time allotted.
  3. Procedures and Methods of teaching.
  4. Procedures and reference to materials.
  5. Lecturers’ notes for each of the sessions.

We particularly emphasize the lecturer’s notes because the HIV/AIDS situation is very dynamic and changes very fast. While the concepts in the learning materials will remain valid for the next five to ten years, the supporting facts such as infection rates and mortality due to HIV/AIDS will need to be regularly upgraded by the instructor for presentation to the learners. The instructor therefore has responsibility in this regard to visit HIV/AIDS websites and read HIV/AIDS reports to upgrade the information in the learning materials.

x.SELECTED TEACHING METHODS

A number of teaching methods are suitable for teaching the topics in the learning materials developed. We encourage the instructor to use the following methods and techniques of teaching in facilitating the learning processes intended in the learning materials.

  1. Lecture
  2. Case Studies.
  3. Demonstration
  4. Brainstorming
  5. Buzz groups
  6. Debate
  7. Group Discussion/Lecture Discussion
  8. Role play
  9. Listening and observing
  10. Experiential learning
  11. Peer tutoring and mentoring
  12. Poems
  13. Written assignments/Tests/quizzes.

1.0MODULE ONE: BASIC CONCEPTS OF HIV/AIDS

Module Overview

One of the key elements in the war against HIV/AIDS in the vocational training sector is to ensure that you understand the basic concepts of HIV/AIDS so that you can use the knowledge to empower yourself in the prevention and transmission of HIV. In this module, students are expected to learn about the basic concepts of HIV/AIDS.This is the first of the 3-Module and 4-Module learning designed for HIV/AIDS levels 1 and 2 of the vocational training programmes. The HIV/AIDS programmes are intended to arouse awareness as regards he economic and social impact of HIV/AIDS.

The rationale for introducing the HIV/AIDS programmes in vocational training institutions is that it is envisaged that the proposed programmes will bring about behavioural changed in the learners that would result in reduced public spending, growth in skilled workforce emanating from reduced death and infection rates, and overall economic growth. The programme also strives to produce a morally sound and disciplined citizens who are compassionate, responsible, tolerant, healthy and safely conscious.

1.1Unit One: Introduction

In this unit, you must introduce students to the basic concepts of HIV/AIDS including the meaning and facts about HIV/AIDS. An understanding of the basic concepts of HIV/AIDS will give students the opportunity to develop knowledge, skills and positive attitudes towards behavioural change for prevention of HIV/AIDS.

OBJECTIVES

By the end of the unit, learners will be able to:

  1. Explain what the acronym HIV and AIDS stand for
  2. Explain the differences between HIV and AIDS
  3. Recognize common symptoms in HIV and AIDS infected persons
  4. Identify the HIV prevalent type in Botswana and describe its behaviour

TOPICS

  1. Meanings of HIV and AIDS.
  2. The Differences between HIV and AIDS.
  3. Common Symptoms of HIV and AIDS.
  4. The Behaviour of HIV Prevalent type in Botswana.

TEACHING METHODS AND PROCEDURES

  1. Short introductory lectures.
  2. Controlled lecture- discussions.
  3. Brainstorming exercises/Class activities.
  4. Buzz groups/Discussion.

Ask students what each of the acronyms stand for:

AIDS: Acquired Immune Deficiency Syndrome.

HIV: Human Immune Deficiency Syndrome.

HIV1 Subtype 1C: Nomenclature for HIV strain commonly found in Southern Africa.

There are several stages of infection by HIV to AIDS.

Ask students to brainstorm and later discuss what happens during each one of the following stages:

  1. Window Period:
  2. Asymptomatic Period:
  3. Symptomatic:

Ask students to explain the difference between HIV and AIDS with the aid of pictures below:

Picture of a healthy looking but HIV infected person

Figure 1: Picture of a healthy looking but HIV infected person
Picture of a Person with AIDS exhibiting many of the symptoms mentioned above, ask students to do a brainstorming exercise based on an observation of the man pictured below.

Figure 2: Picture of a Person with AIDS exhibiting many of the symptoms mentioned above
CLASS ACTIVITY
?
What is the main difference in meaning between HIV and AIDS?
Which of the symptoms associated with HIV are common in Botswana?
Table 1:

1.2Unit Two: Common Transmission Modes

In this unit, students must learn about four common ways in which HIV/AIDS is spread. An understanding of common transmission modes of HIV/AIDS will give them an opportunity to avoid the most severe modes of transmission and make informed choices about HIV/AIDS prevention. Remember that prevention is better than cure. Infact there is no cure for HIV/AIDS. It is therefore very important to provide enough knowledge to the learners that will help them to avoid contracting the HIV.

OBJECTIVES

By the end of this unit, students will be able to:

  1. Discuss the four major ways in which HIV can be transmitted
  2. Explain the progression of HIV infection in the human body
  3. Discuss the general misconceptions about HIV transmission

TOPICS

  1. Common modes of HIV transmission
  2. Progression of HIV infection into AIDS
  3. General misconceptions about HIV transmission

TEACHING METHODS AND PROCEDURES

  1. Lecture- discussion.
  2. Short interactive lectures
  3. Group discussion
  4. Poems

Figure 1: Use the figure below for students to explain progression of HIV infection in the human body