Straight Talk in Kisoro (2007-2009) : Fostering Adolescent Sexual and Reproductive Well-Being With Communication For Social Change

Octob
ber 200
09
Straaight Talk in Kiisoro
o 200
07‐20
009
Fiinal Acctivity Report
R and Im
mpact Evaluaation
Fosteering
Adollescen
nt Sexual
and R
Reprooductiive
Welllbein
ng withh
Commmunication n
Social Chang
for S ge
Straight Talk Foundation
Plot 4 Acacia Avenue
PO Box 22366
Kampala, UGANDA
+256.312.262030/1
info@straighttalkuganda.org
www.straight-talk-or.ug
Front cover: STF journalist Bernard Sabiti facilitates a focus group discussion at Seseme Girls SS, Kisoro District.
Back cover: Students and their teacher stand proudly in their cabbage garden, which they grew with seeds from STF.
STF Luf
ufumbira journalistt Bernard Sabiiti interviews
i youth inn Kisoro. Sabbiiti facilitates a focus group discussioon with female puppils in Kisoro.
Finaal Activvity Repport andd Impactt Evaluaation
Paatrick Walugem mbe

E
Evelyn Namubbiru
Isaac Kato
B
Bernard Sabiiiti
Ca
Catharine Watstson
Stuart Campo
October 20099
Final Activity Report & Impactt Evaluation: Youtth Radio for Betterr Adolescent Reprooductive Health in Kisoro, Uganda
Straig
ght Talk Found
ndation
2
TABLE OF CONTENTS
Tables and Figures 4
Acronyms 5
EXECUTIVE SUMMARY 6
INTRODUCTION 7
Overview of the Project 7
Background and Context 7
Structure of Report 8
SECTION I: FINAL ACTIVITY REPORT 9

1.1: Radio Programming – “Tuvuge Rwatu” (“Straight Talk”) Lufumbira Radio Show 9
1.1.1: Field interviews – raising young people’s voices 9
1.1.2: Radio programme production – addressing ‘burning issues’ from multiple angles 11
1.2: Youth Listeners’ Groups – In- and Out-of-School Straight Talk Clubs 11
1.3: Beneficiary Feedback Management – Letters from Listeners & Distribution of Prizes 13
1.3.1: Distribution of prizes – encouraging interactive dialogue
1.4: Distribution of IEC Materials – Straight Talk and Young Talk
14
2.1: Identification of Youth-Friendly Services – mapping services in Kisoro 15
2.2: Encourage Young People to Seek VCT, Condoms, Counseling, Family Planning 16
2.3: Meet with Health Workers – Engaging Key Duty-bearers 16
3.1: District Advocacy Meetings – Engaging Opinion Leaders to Improve ASRH 16
4.1: Cost-analysis 17
SECTION II: IMPACT EVALUATION 18

Purpose and Objectives 18
1: Methodology 18
1.1: Research Design 18
1.1.1: Selection of out-of-school 19
1.1.2: Selection of in-school adolescents 19
1.2: Data Collection 19
1.3: Data Analysis 19
1.4: Limitations of Study
1.5: Ethical Considerations
19
19
2: Findings
2.1: Social Demographic Characteristics of Respondents 20
2.1.1: Education status 20
2.2: Sources of Information on Reproductive Health 21
2.2.1: Most important source of information 21
2.2.2: Print sources of reproductive health information 22
2.2.3: Radio sources of reproductive health information 23
2.2.4: Most important source of RH information: person, radio or print 24
2.3: In-school Clubs as Sources of RH Information 24
2.4: Out-of-school Clubs as Sources of RH Information 24
2.5: Exposure to Straight Talk Radio Shows 25
2.6: Awareness of Existing Youth SRH Radio Shows 26
2.7: Listenership to “Tuvuge Rwatu” Radio Show
2.7.1: Ever listened
26
2.7.2: Regular listenership to the “Tuvuge Rwatu” radio show 27
Final Activity Report & Impact Evaluation: Youth Radio for Better Adolescent Reproductive Health in Kisoro, Uganda
3
2.8: Use of Straight Talk Print Materials 27

2.9: Adolescent Sexual and Reproductive Health (ASRH) Knowledge 28
2.10: Knowledge and Attitudes Towards Condoms 29
2.11: Sexuality and Gender Norms 30
2.12: Health-Seeking Behaviour and STIs 33
2.12.1: Use of health facility services
2.12.2: Testing for HIV
34
2.13: Sexual Activity in Adolescents 35
2.14: Communication with Parents and Guardians 35
CONCLUSIONS 37
RECOMMENDATIONS 40
Bibliography 41
Appendix A – Topics Addressed in “Tuvuge Rwatu” (July 2007 – September 2009 42

Appendix B – Sample Scripts from “Tuvuge Rwatu”, Translated to the English 43
Appendix C – Straight Talk clubs in Kisoro District 51
Appendix D – Sample of Letters Received from “Tuvuge Rwatu” Listeners 52
Appendix E – Prizes and Promotional Materials Distributed During Project 55
Appendix F – Referrals by Location and Year from “Tuvuge Rwatu” Shows
and Number of Health Works Featured by Designation and Year
56
4
TABLES AND FIGURES

Figure 1: Straight Talk Clubs in Kisoro District, By the Numbers 12
Figure 2: Graph of ‘Ever Listened’ to Straight Talk Radio Show 26
Table 1: Social demographic characteristics 20
Table 2: Educational characteristics of in-school adolescents 21
Table 3: Highest level of education attained by out-of-school adolescents 21
Table 4: “Which one person has been the most important source of RH information?” (comparison) 21
Table 5: “Which one person has been the most important source of RH information?” 22
Table 6: Newspaper and magazine sources of reproductive health information 23
Table 7: Most important sources of such information in terms of radio show 23
Table 8: Most important source of such information in terms of radio show, by social demographics 23
Table 9: Most important source of RH information: person, radio or print 24
Table 10: “Who organized the health discussion that you attended?” 24
Table 11: “Who organized the youth health discussion in the village?” 25
Table 12: “Which radio shows are you aware of that talk to young people about ASRH?” 25
Table 13: “Which radio shows are you aware of that talk to young people about ASRH?” (comparison) 26
Table 14: Regular listeners to the “Tuvuge Rwatu” radio show 27
Table 15: Ever read Straight Talk / Young Talk by sex and age 27
Table 16: Ever read Straight Talk / Young Talk, 2009 vs. 2005 27
Table 17: Knowledge of basic facts on pregnancy and HIV 28
Table 18: Knowledge of basic pregnancy and HIV facts, by social demographics 29
Table 19: Knowledge and attitudes towards condoms 29
Table 20: Knowledge and attitudes towards condoms, by social demographics 30
Table 21: Attitudes towards gender and sexuality according to gender 31
Table 22: Attitudes towards gender and sexuality according to social demographics 32
Table 23: Visited health facility for ASRH information/services (pregnancy, FP, HIV, HCT) 34
Table 24: Visited health facility for ASRH information/services, ever tested for HIV 34
Table 25: “How did you know about the testing at the health facility?” 34
Table 26: Ever had sex 35
Table 27: Parents ever talked to you about ASRH issues 35
Table 28: Parents ever talked to you about ASRH issues, by social demographics 36
Table 29: Project Indicators: Overall Targets and Achievements 37
5
ACRONYMS
AIDs Acquired Immune Deficiency Syndrome
ASRH Adolescent Sexual and Reproductive Health
CBO Community Based Organization
CDO Community Development Officer
DEO District Education Officer
DIS District Inspector of Schools
HIV Human Immunodeficiency Virus
NGO Non Governmental Organization
SBCC Social and Behaviour Change Communication
SRH Sexual and Reproductive Health
STF Straight Talk Foundation
UDHS Uganda Demographic and Health Survey
VCT Voluntary Counseling and Testing
6
EXECUTIVE SUMMARY
Kisoro is a small and remote district in far south-west Uganda. The language of its inhabitants is
Lufumbira. Until Straight Talk Foundation (STF) began broadcasting its youth radio show in
Lufumbira in July 2007, Kisoro’s young people were largely isolated from STF’s “conversation” on
growing up and staying safe and had low levels of knowledge on HIV and reproductive health and
also held attitudes about condoms and gender which put them at risk. This radio show, supported by
STF newspapers and activities led by STF outreach staff, has catalysed a process of social change in
which young people as well as parents, teachers and health workers have begun to talk about
sexuality, HIV and gender.
Funded by Cordaid ($103,515 over two years), under this project STF produced 104 pre-recorded
half hour radio shows (one a week for two years). Each was broadcast twice for a total of 208
broadcasts over 24 months. After two years, 78% of 10 to 24 year olds surveyed had ever listened to
the show, of whom 69.4% were regular listeners: this is a large increase on the less than 14% of
unmarried adolescents who had ever heard a Straight Talk radio show at the baseline in 2005.
Prior to the project Kisoro was already receiving STF’s newspapers, Straight Talk and Young Talk, but
readership was low (among unmarried adolescents, 26.3% had ever read Straight Talk and 31.1% had
ever read Young Talk). Under the project, readership greatly increased to over 80% of young people
having ever read the papers. STF has seen this synergistic effect with local language radio elsewhere
in Uganda.
Over 7000 young people met face to face with the STF radio journalist and/or counselor/trainers.
Associations of young people, including Straight Talk clubs, formed to talk about adolescent sexual
and reproductive well-being. An estimated 80% of the young people in Kisoro were reached by this
project at a cost per person reached of US cents 78 or UGX 1544 per year. Many of the young
people were reached multiple times by multiple interventions, e.g., radio plus print plus face-to-face.
The impact of this “reach” was extensive: the project was associated with statistically significant
changes in several domains of knowledge and attitudes; many fewer young people reported “no one”
as a source of reproductive health information; talk greatly increased, particularly between parents
and young people, and young and teachers; young people and adult stakeholders, such as health
workers, gained a voice on radio to talk about topics of critical importance to them, some of which
had not been verbalized in the media before, such as the tradition of marriage by abduction.
This report recommends continuing this project to consolidate and increase the gains achieved. It
recommends: more attention to areas such as pregnancy, around which there are many
misconceptions and more knowledge gaps than HIV; ensuring that scarce airtime and resources
focus on the most important “conversations” (for example, young positives); working more
creatively and intensively on gender norms and beliefs and attitudes about condoms; and constantly
renewing and refreshing STF’s discourse in Kisoro by listening to and respecting the people that STF
works for: young people and important people in the lives of young people.
7
INTRODUCTION
Overview of the Project
Between July 2007 and August 2009, Straight Talk Foundation (STF) implemented a project entitled
“Youth Radio for Better Adolescent Reproductive Health” in Kisoro, Uganda. This two-year project,
funded by Cordaid, incorporated a local language youth radio show with complimentary IEC
materials and targeted face-to-face activities—a package of interventions meant to facilitate sustained
and informed conversations amongst adolescents and the adults in their lives about adolescent sexual
and reproductive health (ASRH).
By increasing the quality and frequency of SRH dialogue in Kisoro, the project aimed to contribute
to HIV/AIDS prevention efforts among adolescents and youth. To that end, STF structured the
project interventions around five key objectives:
1. To give young people a voice and to empower them to manage their sexuality more
safely, by delaying sexual debut, reducing numbers of sexual partners, treating STDs,
testing for HIV with their partners, and using family planning (older youth).
2. To encourage youth to have more gender-equitable relationships, in which boys do not
exploit girls and girls do not manipulate boys.
3. To encourage all youth to seek protective environments (e.g. such as remaining in
school, having dialogue with trusted adults like parents, becoming socially connected by
joining clubs).
4. To increase utilization of health services, including VCT, antenatal care and
contraceptive use.
5. To seek support among the opinion leaders by increasing their understanding of youth
SRH related issues.
The achievement of these objectives required a multifaceted programme with both mass media and
face-to-face interventions. Utilizing its three core communication channels—radio, print, and face-
to-face—STF worked to generate conversations around ASRH at multiple levels amongst the
Bafumbira population in Kisoro, engaging adolescents & youth, teachers, health workers, and
parents from multiple angles in the process. Conversations stimulated by the Lufumbira youth radio
show were reinforced through distribution of IEC materials such as Straight Talk and Young Talk; in
turn, mass media interventions were enhanced by face-to-face outreach and advocacy efforts at the
community level. STF chose to utilize this integrated approach because research has proven
interventions that utilize a multiplicity of channels are more effective in promoting behavior change
and HIV prevention than strategies that utilize just one communication channel.1
Background and Context

Kisoro district is home to 80,373 young people aged 10 to 24 years and 58,453 adolescents aged 10
to 19. In 2005, available information showed both good and bad social and health indicators. For
example, the age of first sex was higher and there was less male infidelity in marriage than in the rest
1 See Preventing HIV/AIDS in young people: a systematic review of the evidence from developing countries, WHO/UNAIDS, 2006.
8
of the country. However, findings also showed a bleak adolescent reproductive health environment.
For example, 72% of adolescents in Kisoro had never a conversation with their parents about issues
of sexuality compared to about 50% countrywide; and 35% of adolescents in Kisoro thought of
condoms were ineffective compared to 61% countrywide. Knowledge about HIV prevention was
low in southwest Uganda. According to the UDHS (2006), only 9.1% of girls aged 15-24 in the
southwest who had non-marital sex in the past 12 months had used a condom at first sex compared
to 26% of girls countrywide. HIV prevalence appeared to be increasing: HIV prevalence at Mutolere
Hospital, the main hospital in Kisoro, increased from 1.5% in 2002 to 4.7% in 2005.
Like elsewhere in Uganda, roughly 80% of young adolescents (10-14) in Kisoro are in school, mostly
in primary school; only 18% of the 13-19 year olds are in secondary school and just 30% of 15 to 19
year olds have had any exposure to secondary school. This meant that older adolescents and almost
all youth (20-24) were out of school, either married and/or working. Over 55% of girls are married
by 19, and by 24 almost 100%.
Kisoro enjoyed STF interventions prior to the launch of this project in July 2007. It had received
about 2,500 copies of Young Talk and 1,200 copies of Straight Talk each month for many years. It had
also been receiving weekly broadcasts of STF’s English language “Straight Talk” radio show from
three different radio stations (Capital, Voice of Kabale and Voice of Toro). However, all of these
initiatives were in English, limiting their reach to mainly upper primary and secondary learners; only
13.7% of the adolescents (unmarried 10 to 19 year olds) had listened to an STF radio show at the
time of the Population Council study.
STF uses radio to usher positive social change. The Uganda Demographic and Health Survey (2006)
shows that close to 80% of Ugandans listen to radio daily; it is the most penetrative and cost-
effective medium of communication in Uganda. The Population Council-STF survey (2005) found
that over 75% of adolescents will have “ever” listened to an STF youth radio show in districts where
STF broadcasts in the local language, compared to 13.4% in districts with only an English show.
Based on these conditions, STF decided to launch a local language (Lufumbira) radio show for youth
in Kisoro to ensure maximal uptake and impact.
Structure of Report
The first section of this report presents details on the key components of STF’s integrated program
of communication for social change in Kisoro district, with a focus on the main achivements and
outputs. The second section presents key findings from the impact evaluation conducted at the end
of the project, with a focus on the contribution of the project to improving adolescent sexual and
reproductive health.
9
SECTION I: FINAL ACTIVITY REPORT

The STF-Cordaid intervention in Kisoro was implemented around three core outputs:
• Output 1: Increased opportunities to access reproductive health information, including

HIV/AIDS, by young people in Kisoro.
• Output 2: Increased access to sexual and reproductive health related services by young
people in Kisoro.
• Output 3: Increased advocacy and support for ASRH in project communities.
Project activities were designed and implemented in-line with these outputs, and thus key details
from each activity are presented according to the relevant Output.
Output 1: Increased opportunities to access reproductive health information, including

HIV/AIDS, by young people in Kisoro District
1.1: Radio Programming – “Tuvuge Rwatu” (“Straight Talk”) Lufumbira Radio Show
The core component of the STF intervention in Kisoro District was the local language youth radio
show, “Tuvuge Rwatu” (“Straight Talk”). “Tuvuge Rwatu”, a 30-minute pre-recorded radio show in
Lufumbira language, was broadcast weekly on two radio stations—UBC, the national broadcast
station, and Voice of Muhabura, a local station based in Kisoro—throughout the project. Overall,
104 shows were produced during the two-year project period, covering a range of ASRH and related
topics (e.g. HIV counseling and testing, PMTCT, early sex, relationships, etc.), discussed below. Each
show was broadcast two times, making for a total of 208 broadcasts.
1.1.1 Field interviews – raising young people’s voices

In line with the STF model for field interviews and material collection, field trips for “Tuvuge
Rwatu” were conducted on a quarterly basis throughout the project. STF journalists completed a
total of eight field trips to Kisoro, conducting face-to-face interviews, focus group discussions
(FGDs), Straight Talk Club visits, and facilitated dialogues in a number of different contexts. Though
the target participant group of each field visit was adolescents—with a heavy emphasis on engaging
girls, a typically reticent group—the STF team also made a concerted effort to engage with
community & religious leaders, teachers, health workers, and parents in order to develop thick or
multi-layered conversations around the topics being addressed in the “Tuvuge Rwatu” shows.
Sabiti interviews a young pygmy girl from the Batwa community. Sabiti collects material while meeting with out-of-school youth.
10
In addition to providing rich material for the radio shows, field visits provided the opportunity for
extended face-to-face engagement with beneficiaries. Members of the STF Outreach and Training
Department (OTD) accompanied Bernard Sabiti on field visits to conduct extended face-to-face
outreach and ST club support visits. In the two-year project period, STF Radio and OTD staff met
and interacted with 7,616 young people in Kisoro, of which 3,656 (48%) were female and 3960
(52%) were male. Of this total number, 4,550 (60%) were in-school and 3,046 (40%) were out-of-
school.
Face-to-face interactions during field visits took on a number of forms, ranging from focus group
discussions (FGDs) and community dialogues to one-to-one counseling sessions. Through these
different fora for dialogue, adolescents received counseling and health education and were supported
to engage with one another about the myriad ASRH challenges facing them. Recognizing the
importance of offering adolescents a number of different settings to discuss sensitive issues such as
sexuality and body changes, the STF team always strove to facilitate both same-sex and mixed
FGDs—allowing boys and girls to first discuss sensitive topics amongst themselves before engaging
in dialogue on these topics with peers of the opposite sex. In many of the face-to-face activities,
condom demonstrations were conducted; over the course of the project, 1,200 adolescents were
exposed to such demonstrations.
FGD with out-of-school male adolescents in Kisoro. Sabiti holds an FGD with female pupils at Seseme Girls SS.
Beatrice Baino demonstrates a condom to female adolescents at. An ST Club member shies away from a condom demo after volunteering to
Nyakabonde ST Club participate
11
1.1.2 Radio program production – addressing ‘burning issues’ from multiple angles
Following the completion of each field visit, the STF Lufumbira journalist would return to the STF
studios to prepare his “Tuvuge Rwatu” scripts. Following the STF radio model, each script was
prepared in English and reviewed by a senior member of the STF Radio team; once approved for
content, structure, and social change communication components, the scripts were translated into
Lufumbira and prepared for voicing and production. During the initial phase of the project, scripts
were additionally back translated from Lufumbira to English by an experienced Lufumbira journalist
from Radio Uganda, to ensure accuracy and cultural sensitivity of the local-language conversation, an
important quality control measure when addressing sensitive issues such as sexuality on air. Programs
were produced in the STF studio on a weekly basis, and delivered by bus to stations for broadcasting.
“Tuvuge Rwatu” was built around adolescents’ stories on a wide range of ASRH and related topics
(See Appendix A for complete listing of topics addressed by quarter), and utilized these stories to
generate dialogue driven by and for youth in Kisoro. Customized, local language jingles, sweepers,
intros and outros—designed exclusively for “Tuvuge Rwatu”—were strategically edited into each
program, depending on the topic and tenor of discussion. Recognizing adolescents’ interest in music
and the need to keep a youth radio show ‘fresh’, popular music tracks were also included,
accompanied by dedications to individuals or groups in Kisoro selected for their letters or
participation in another component of the project. To weave these stories and clips together, STF
journalist Bernard Sabiti—himself from Kisoro—narrated each show with an interactive and
informed style. In a way, this narration can be viewed as on-air counseling; each story and clip is
introduced with a sort of road-map for listeners—“let’s hear from xx about her experience with
xx”—and then followed by a brief re-cap, in which listeners are encouraged to reflect on the lesson
from the experience that has just been shared. All of these unique components ultimately came
together to form conversations on-air that would then stimulate conversations of even greater depth
on-the-ground amongst listeners. Appendix B presents two sample scripts—translated from Lufumbira
to English—from shows aired in November 2008 and June 2009 addressing “Challenges of the
Batwa” and “Forced Marriage”, respectively. These scripts are exemplars of the scripts produced for
“Tuvuge Rwatu” throughout the project.
Each broadcast of “Tuvuge Rwatu” featured an average of four adolescents sharing their stories;
over the two-year project period, 416 adolescents were featured in “Tuvuge Rwatu” shows—220
females and 196 males. Additionally, each show featured a health worker or local opinion leader,
adding an additional 104 interviews to the on-air programming throughout the project.
1.2: Youth Listeners’ Groups – In- and Out-of-School Straight Talk Clubs
A key component of ensuring continuity of the conversations initiated in STF radio shows amongst
listeners is the formation of listeners’ groups, also known to as Straight Talk Clubs. These clubs are
typically comprised of young people (boys and girls) who come together every week to listen to and
discuss the ST radio show broadcast in their area—in the case of Kisoro, “Tuvuge Rwatu”. In
addition to being visited by an STF journalist or outreach officer during field visits, these clubs
receive copies of STF English-language newspapers, t-shirts & other promotional items, such as tree
and vegetable seeds, to encourage active participation in club activities and empower club members
to be champions of social change in their communities.
12
Youth at Kisoro Hill ST Club listen attentively during an FGD. Beatrice Bainom meets with Ms. Sylvia, club patron at Seseme Girls SS
During the two-year project period, 32 Straight Talk clubs were formed and maintained throughout
Kisoro District. Of these clubs, 13 are out-of-school groups and 19 are in-school group; the average
club size is 40 members, with a total estimated membership of roughly 1,280 youth in Kisoro ST
Clubs as of the end of the project. The map below displays the spread of ST clubs in Kisoro, where
clubs span eight sub-counties and over 30 communities. See Appendix C for complete details.
Figure 1: Straight Talk Clubs in Kisoro, By the Numbers

+ Total clubs
- 32 clubs in total
- 13 out-of-school
- 19 in-school
+ Average membership
- 30-50 youth
+ Estimated total
membership
- 1,280 youth in district
+ Sub-counties
represented
- 8 sub-counties
represented:
- Bukimbiri (3 clubs)
- Busanza (2 clubs)
- Chahi (1 club)
- Kisoro T/C (8)
- Muramba (4 clubs)
- Nyabwishenya (1 club)
- Nyakabande (1 club)
As social change agents in Kisoro, ST Club members became on-the-ground representatives of STF,
facilitating dialogue and community outreach by and for young people. In-school club members
became role models for their peers, as well as focal persons for the distribution and facilitation of
dialogue around Straight Talk and Young Talk newsletters. Similarly, out-of-school club members
became role models for fellow out-of-school youth in their communities, facilitating contact between
STF and an often difficult-to-reach group. Club patrons—usually a teacher for in-school clubs and a
13
community leader of parent for out-of-school clubs—actively took on responsibility to ensure that
club activities continued and gained support from the local communities.
Club activities ranged widely from one club to another, depending on level of commitment and time
available. At a minimum, all clubs were expected to gather weekly to listen to and discuss “Tuvuge
Rwatu”, completing a simple reporting template during each group discussion to track the issues and
questions raised by members in reaction to the conversation in a given show. More active clubs went
far beyond such weekly dialogues, exploring innovative avenues of positive peer formation with their
in- and out-of-school counterparts. For example, Bitare ST Club in Nyakabande sub-county
organized local inter-club football competitions to facilitate broader interactions with other youth
committed to improved ASRH.
In addition to the active engagement of club members in activities, participation of non-members

expanded the reach and impact of this component of the project. The final project evaluation found
that nearly two-thirds of in-school adolescents (64.1%) had attended a club or group discussion,
showing that the introduction of clubs provided an alternative source of ASRH information for
youth in addition to STF mass media interventions in the district. After two years of steady
engagement, there is evidence of increasing enthusiasm around the ST clubs in Kisoro. The
communities in which they are located seem to increasingly realize the clubs’ role in fostering
positive peer relationships and promoting the role of youth as leaders.
1.3: Beneficiary Feedback Management – Letters from Listeners & Distribution of Prizes
The primary mechanism through which STF monitors the reach of its radio shows and tracks
beneficiary feedback is through listeners’ letters. These letters not only offer listeners a chance to
respond to topics addressed and questions raised in the show, but also to explain their ASRH needs
to STF in their own way. As seen in the scanned images of letters below, letters for “Tuvuge Rwatu”
were received in both English and local language, from in- and out-of-school individuals and groups,
and often contained a great deal of reflection on the topics at hand. See Appendix D for a sampling
of letters in full view.
14
Thee number of letters

l a givenn show receivves is in manyy ways indicaative of that sshow’s strenggth—the
morre captivatingg a show is, thhe more letteers that show will generatee from its targget audience. Between
September 2007 and August 2009, “Tuvuge Rwatu” lissteners sent in n 2,762 letteers. Of these, 1,297
werre from femalles and 1,465 from males. In per capitaa terms, this equates
e to roughly 1 letterr per
everry 30 youth inn Kisoro disttrict received over the entiire project peeriod. Considdering the facct that
2
manny letters receeived were prrepared by multiple

m h writing together, the per capita figure may be
youth
evenn lower than this. The chaart below preesents a detailled breakdow wn of letters rreceived for “Tuvuge
“
Rwaatu” in each month
m of thee project perio
od.
Letters R
L Received
d for Tuvuge Rw
watu, 20
007‐
20099
350
303
300
250
07
20
200 175 8
178
156158
1
150 128119117
1 126120134 128
8
112118
100 84 96 77
5 37 33 4
43
50 28 35
9
0
07
October '07
December '08
February '08
March '08
April '08
June '08
July '08
August '08
October '08
December '08
08
February '09
March '09
April '09
June '09
July '09
August '09
September '07
November '08
January '08
May '08
08
September '08
November '08
January '09
May '09
October
December
May
Thee constant in--flow of letterrs not only prrovided a meeasure of the reach and im mpact of “Tuvvuge
Rwaatu”, but also
o informed th he selection of
o topics and production of o future show ws. If listenerrs
expressed more interest or co onfusion arouund a particular topic, that topic receivved greater attention
in fuuture shows. In addition to
t every letterr being respo
onded, many listeners’ letters were
acknnowledged orr used to spaark dialogue in n the shows themselves,
t k
keeping listen
ners interested d and
ensuuring them thhat their engaagement and feedback plaayed a direct role
r in shapin ng “Tuvuge Rwatu”.
R
1.3.1 Distributio
ion of prizes – encouragi
ging interacti
tive conversaations
In an
a effort to enncourage reggular listeningg and reflectio
on to “Tuvugge Rwatu”, ST TF distributed prizes
to liisteners for writing
w in with
h stories, queestions, and reesponses to on-air
o quizzes throughoutt the
projject period. Winners
W weree selected each month from m the pool of listeners sub
bmitting letteers;
seleections were based
b on demmonstrated un nderstanding of and reflecctions on topics addressed d&
questions raised..
2
Thee population of yo
outh aged 10-24 in
n Kisoro is estimated at roughly 82,500, or 33% of th
he district populatiion. Therefore, 1 letter was
receivved from ~ every 30 youth in the district.
d
Final Activvity Report & Imppact Evaluation: Youth

Y Radio for Beetter Adolescent Reproductive
R Healthh in Kisoro, Ugandda
Strraight Talk Fou
oundation
15
Prizes ranged from STF t-shirts, sporting equipment, and radios to agricultural & tree seeds and
gardening equipment. Over the course of the project, the STF team awarded 300 t-shirts, 35 caps, 35
jerry cans, 30 buckets, 115 sanitary pads, 18kg and 20 sachets of cabbage seed, 30 sachets of tree
seed, and 1 bicycle. In addition, the team distributed a range of promotional materials during face-to-
face outreach and material collection visits: 260 hoes, 300 books, 193 pens, 45 radios, 5 balls, 20
diaries, 169 rulers, 300 stickers, and 2200 calendars. (See Appendix E for complete details by year)
Two listeners selected as winners for writing letter to ST ST Club member and listener Uwamariya Winfred
receive a radio and a T-shirt receives ST F bicycle as top prize for 2008 quiz.
1.4: Distribution of SBC Materials – Straight Talk and Young Talk

Recognizing the importance of a multi-media approach to social and behaviour change (SBC), STF
complimented the radio show with mass distribution of STF print materials, namely Straight Talk and
Young Talk. Besides giving out these papers during the quarterly field visits, STF posted Straight Talk
and Young Talk to 106 primary, 23 secondary schools, 4 CBOs, 33 health centres, and 21 churches
and mosques. Through this network, STF distributed roughly 20,175 copies of Straight Talk and
38,850 copies of Young Talk to Kisoro a year. Thus, over the two years, STF sent about 40,350 copies
of Straight Talk and 77,000 copies of Young Talk to Kisoro. In addition, the STF team physically
handed out 17,000 copies each of Straight Talk and Young Talk in face-to-face activities.
Sabiti distributes Young Talk to pupils in Kisoro. “Straight Talk Available Here” sign at Nyarusiza Health centre.
16
Output 2: Increased access to sexual and reproductive health related services by young
people in Kisoro.
2.1: Identify Youth-Friendly Services

A critical component of effective social and behavior change communication is the provision of
actionable information to empower beneficiaries to act on their improved knowledge and attitudes.
One such category of information is the location and availability of health services in a target area—
in this case, the location and availability of youth-friendly SRH services. In order to help increase
access to such services, STF first had to identify to key service outlets throughout Kisoro district. As
such, the STF team utilized time during the first material collection visit in the district to identify and
vet key health centres to which referrals for youth-friendly services could be made in the radio show.
Through this process, STF identified six sources of youth-friendly services in Kisoro district: Kisoro
Hospital, Mutolere Hospital, Nyarusiza Health Centre III, Muramba Health Centre IV, Nyabihuniko
Health Centre IV, and Rugerageza Clinic.
2.2: Encourage Young People to Seek VCT, Condoms, Counseling, and Family Planning
STF encouraged young people to seek VCT, condoms, family planning and other services through
referrals in radio shows. Over the two years, 202 referrals to hospitals and health centres in Kisoro
were made on air in “Tuvuge Rwatu” (See Appendix F for referrals by location and year). Referrals
made through face-to-face interactions were not captured.
2.3: Meet with Health Workers – Engaging key duty-bearers

In implementing the various components of the project, STF made sure to meet regularly with health
workers and counselors from throughout Kisoro district. These regular meetings served two
purposes: first, they allowed for ongoing material collection from ‘experts’ for inclusion in “Tuvuge
Rwatu” shows; second, they fostered a strong working relationship between STF and health works in
the district, building trust and a sense of collaboration that experience has shown to contribute to
increased dialogue around ASRH and other topics addressed in STF programming between health
workers and the communities where they work.
In line with the STF radio model, each edition of “Tuvuge Rwatu” featured a health worker and/or
local leader. Over the course of the project, 81 interviews with counselors (51), clinical officers (12),
doctors (10), and nurses (8) were featured on-air. (See Appendix F .)
Output 3: Increased advocacy and support for ASRH in project communities.
3.1: District Advocacy Meetings – Engaging opinion leaders in improving ASRH

Prior to the launch of this project, STF had not been a frequent visitor to Kisoro. To gain
understanding and support of the project activities from the district and community leadership, STF
thus held two District Advocacy meetings to start dialogue with local leaders, CBO representatives,
and youth leaders about their role in ensuring impact of STF programming for better ASRH..
The first meeting in April 2008 aimed to acclimatize district leaders with STF activities in Kisoro and
17
to seek their support. Leaders overwhelmingly pledged their support: 47 people attended (9 female,
31 male), including the District Inspector of Schools (DIS), District Health Officer (DHO), and
Community Development Officers (CDO). The second meeting in February 2009 aimed to update
district leaders on the project’s progress and gather recommendations on improving the reach and
impact of STF work: 57 people attended (11 female, 46 male), including the Community
Development Officer (CDO) and District Education Officer (DEO).
Besides official advocacy meetings, STF sought the advice of district and local/community leaders as
often as possible. On every visit to the district, the team first paid courtesy calls at the district, sub-
county and village levels before venturing into the communities. These informal meetings gave STF
an up-to-date understanding of the ASRH situation. Leaders were supportive of the project as can be
seen from this letter from the Kisoro Resident District Commissioner.
4.1 Cost analysis

Kisoro’s population was about 250,000 people in 2009: 24% of these (60,000) are adolescents aged
10-19, while 33% (82,500) are aged 10-24. Estimates that it reached 13% of 10-19 year olds and 9%
of 10-24 year olds through face-to-face interventions: 78% of 10 to 24 year olds had “ever listened”
to radio. Also, 80-90% of young people had ever read an STF newspaper. This suggests that about
80% or 66,000 young people have been exposed to STF’s conversation, with many having multiple
exposures (radio plus print plus face-to-face). The project cost was $103,515 for two years. This
works out at 78 US cents or UGX 1544 a year per young person reached. This is higher than the 10
US cents per unmarried adolescent reached by radio per year, found by the Population Council
research in 2005. This higher cost in Kisoro is probably due to the face-to-face element.
Conclusion
From July 2007 to August 2009, STF implemented “Youth Radio for Better Adolescent
Reproductive Health” in Kisoro. It completed all activities in the workplan, meeting or exceeding the
agreed on deliverables. Section II (below) examines the impact of these interventions in detail, with a
focus on the contribution of the project to improving adolescent sexual and reproductive well being.
18
SECTION II: IMPACT EVALUATION

In August 2009, the STF Monitoring and Evaluation team conducted an end-of-project impact
evaluation for the STF-Cordaid intervention in Kisoro. This section of the report provides details on
the methodology of the exercise as well as the key findings of the evaluation.
Purpose and Objectives

The evaluation focused on assessing the impact of the project on enhancing HIV/AIDS prevention
efforts and sexual and reproductive health (SRH) dialogue among young people.
The evaluation exercise was guided by three core objectives:

1. To examine the current sources of SRH information in Kisoro.
2. To assess current exposure to STF interventions compared to exposure in 2005 before
the intensified STF activities.
3. To assess the contribution of STF activities to improvement of knowledge, attitudes and
beliefs among young people in Kisoro.
By structuring the end-of-project evaluation around these objectives, STF aimed to both measure the
impact of its intervention in Kisoro as comprehensively as possible and collect operational
information to inform plans and modifications for future programming in the area.
1: Methodology
1.1 Research Design

The study was community-based employing a cross sectional research design. It targeted 360 young
people, married and unmarried, between the ages of 10 and 24. This age group is referred to as
“young people”.
The sample size was powered at 80%, with 95% confidence. Out-of-school adolescents were drawn
from 172 households, in-school adolescents from nine secondary and nine primary schools. Since
Kisoro district has one county, three sub counties were selected for data collection based on available
resources and time. In each, two parishes were selected randomly for the study. However, because
not all parishes had schools, additional parishes in which schools were located were enlisted making a
total of ten parishes. The Uganda Bureau of Statistics divides parishes into enumeration areas with a
list of all households. As with the 2005 Population Council survey in 2005 in Kisoro (to which many
references will be made since it serves as a form of baseline), this 2009 survey employed a list of
households complied by the ORC/Macro and Allan Guttmacher Institute to arrive at the final
households in which the respondents, particularly the out-of-school were drawn.
1.1.1 Selection of out-of-school adolescents

In each household, one out-of-school young person was selected. In the event that the household
had more than one eligible young person for the study, random numbers were used to select one to
be interviewed. Alternate households were selected to ensure a balance of sex and the different age
19
groups of interest: 10-14, 15-19 and 20-24 years. In some households, the heads (the father and
mother) were in the target age bracket of the STF interventions and were thus sampled for the study.
This was particularly true for the 20-24 age bracket.
1.1.2 Selection of in-school adolescents

With the help of the administrators, a list of eligible young people who were free was made. Because
of the limited time and school schedule, some young people were selected purposively depending on
availability. Stratified sampling techniques were also employed to choose young people in schools.
1.2 Data Collection

The main research instrument used was an interview schedule for a semi-structured interview. The
interview schedule was divided into sections that captured the social economic background, access to
STF materials, and attitudes and beliefs about key issues in sexual and reproductive health.
1.3 Data Analysis

The data were edited before and after leaving the respondents. We checked for uniformity, accuracy,
consistency, legibility and comprehensibility. It was coded and tabulated using Epidata and SPSS
programme. Chi square tests were calculated using independent variables such as age, sex, level of
education and residence; some of the dependent variables were RH attitudes and beliefs. Pearson
correlation coefficient tests (P=Value) was also used. This facilitated comparisons and in determining
significance of the findings.
1.4 Limitations of Study

This study is comparative with one carried out by Population Council in 2005, but the methodology
used then could not be fully employed in this study. First, the 2005 study was carried out during
holidays, which meant that both in and out of school adolescents were found at home. The 2009
study was carried out during term time which meant different sampling criteria had to be employed
to select the in-school young people. The selection of students was not uniform: the school schedule
meant that in some instances we used stratified random sampling while, in others, purposive
sampling was employed. Second, the 2005 study was carried out strictly among unmarried 10-19 year
olds. However, because the Cordaid-funded STF interventions in Kisoro targeted young people aged
10-24 years, this study had to take care of that. It worked under the assumption that the young
people who were between 10-19 years in 2005 have grown by four years.
1.5 Ethical Considerations

The study sought the approval of the district, local community leaders and school heads. Each
respondent interviewed was provided with written consent prior to commencement of the interview.
The study avoided getting names of the respondents to avoid any possibility of linking information
to particular individuals.
20
2: Findings
2.1 Social Demographic Characteristics of Respondents

Table 1 below presents the social demographic characteristics of the 343 adolescents who were
interviewed during the impact evaluation. There were nearly equal proportions of boys (48.7%) and
girls (51.3%). Sampling according to age followed the “Tuvuge Rwatu” radio show target age group
of 10 to 24 years. The average age of the respondents was 17.26, with girls (17.33) slightly older than
boys (17.18). Nearly a third of respondents (35.9%) were aged between 15-19 years, 32.7% between
10-14, and 31.5% between 20-24 years. Findings also show that slightly more than a half of young
people live with both their parents (53.6%).
As with the 2005 Population Council survey, young people who live with one parent were more
likely to live with a mother than a father (21.6%) although more than a quarter live with at least one
parent. About 6.4% of the young people were living with a partner in either a cohabiting or a
marriage arrangement. The 2005 Population Council survey did not consider married adolescents.
However, since they are beneficiaries of the “Tuvuge Rwatu” radio show, they were considered by
this 2009 survey. Except for those living with partners, the 2005 Population Council survey depicted
almost a similar living pattern for young people.
Table 1: Social demographic characteristics

Characteristics Total Percent
Sex Male 167 48.7
Female 176 51.3
Total 343 100
Age 10-14 112 32.7
15-19 123 35.9
20-24 108 31.5
Total 343 100
Living with Both Parents 184 53.6
Only my mother 74 21.6
Other relatives 33 9.6
Partner 22 6.4
Only my father 17 5.0
Only siblings 6 1.7
Alone 2 0.6
Others 5 1.5
Total 343 100
School status In school 181 52.8
Out of school 162 47.2
2.1.1 Education status

As shown in Table 1 above and Table 2 below, slightly over half of the respondents were currently in
school (52.8%) while 47.2% were out of school. Of young people in school, about a third were in
primary school while 61.9% were in secondary school. About four in five of in school youth were
day scholars.
21
Table 2: Educational characteristics of in-school adolescents

Male Female Total
N % N % N %
Level of Primary 34 40 35 36.5 69 38.1
schooling Secondary 51 60 61 63.5 112 61.9
Total 85 100 96 100 181 100
School Day scholar 72 85.7 76 80 148 82.7
type Border 12 14.3 19 20 31 17.3
Total 84 100 95 100 179 100
Among the out-of-school, 57.4% had dropped out at primary level (nearly two thirds of the boys and
half of the girls). The 2005 Population Council survey showed a similar pattern in unmarried 10 to 19
year olds with over 90% of the out-of-school reporting primary as their highest level of education
before dropping out. About a quarter of the out-of-school adolescents were married or cohabiting
with almost equal proportions of boys and girls.
Table 3: Highest level of education attained by out-of-school adolescents

Male Female Total
N % N % N %
Primary 54 65.9 39 48.8 93 57.4
Secondary 14 17.1 14 17.5 28 17.3
Vocational/college 0 0.0 3 3.8 3 1.8
Never been to 14 17.1 24 30.0 38 23.5
school
Total 82 100 80 100 162 100
Currently married 14 23.0 16 26.2 30 24.6
2.2 Sources of Information on Reproductive Health
2.2.1 Most important source of information

Respondents were asked “which one person” they considered their most important source of
information on body changes, SRH and relationships. As with the Population Council survey, this
was a single response question without a fixed set of answers to choose from.
Table 4: “Which one person has been the most important source of RH information?”
Cordaid 2009 Population Council 2005 P Value
Number Percent Number Percent
Mother 61 17.8 112 31.5 0.06
Father 38 11.1 33 9.3 0.84
Teacher 93 27.1 76 21.3 0.38
Friend 38 11.1 26 7.3 0.96
Aunt/uncle 28 8.2 12 3.4 n/a
ST worker 29 8.5 1 0.3 n/a
Health worker 20 5.8 5 1.4 n/a
No one 9 2.6 73 20.5 0.29
Siblings 13 3.8 3 0.8 n/a
Others 14 4.1 13 2.9 n/a
Total 343 100 356 100
Findings show that there has been a significant fall in adolescents who say that they have “no one”
from 20.6 % in 2005 to 2.6% in 2009. Teachers are playing an increasing role: cited by 21.3% of
22
young people in 2005 and 27.1% in 2009. “Straight Talk worker” has increased from 0.3% in 2005 to
8.5% in 2009, a sign that STF is more on the ground. Health workers are also more cited, up from
1.4% in 2005 to 5.8% in 2009. In general, there seems to be more “talk” in 2009, with more young
people also citing aunts, uncles, friends and peers as well.
Results in Table 5 show teachers have taken over as the most important source for both genders
(from mothers for girls and fathers for boys in 2005) and in all age groups. However, mothers
continue to be hugely important for girls.
Table 5: “Which one person has been the most important source of RH information?”
N Mother Father Teacher Friend Aunt/ ST Health No Siblings Other
uncle worker one
Male 167 10.8 17.4 26.9 13.2 7.8 9.6 3.6 5.4 3.6 1.8
Sex
Female 176 23.9 5.1 24.4 8.0 8.5 9.1 5.7 5.1 4.0 6.3
In 181 18.2 6.6 29.8 11.0 6.6 7.2 5.0 8.3 3.9 3.3
school
School
status
Out of 162 16.7 16.0 21.0 9.9 9.9 11.7 4.3 1.9 3.7 4.9
school
10-14 112 23.2 10.7 32.1 4.5 8.0 3.6 7.1 4.5 2.7 3.6
Age group
15-19 123 14.6 8.9 23.6 13.0 8.9 14.6 2.4 4.1 4.1 5.7
20-24 108 14.8 13.9 21.3 13.9 7.4 9.3 4.6 7.4 4.6 2.8
Day 149 18.8 5.4 30.2 11.4 6.0 6.7 5.4 8.7 4.0 3.4
student
Student
type
Boarde 32 15.6 12.5 28.1 9.4 9.4 9.4 3.1 6.3 3.1 3.1
r
2.2.2. Print sources of reproductive health information

Respondents were asked which newspaper was their most important source of RH information.
76.4% cited either Straight Talk or Young Talk as the single most important print source; 20.7% did
not mention any newspaper; 2.9% knew a newspaper but could not recall the name.
There has clearly been a greatly increased exposure to print materials since 2005. In the 2005
Population Council survey, only 33.1% of adolescents mentioned either Young Talk or Straight Talk.
This significant rise (P=0.0000) suggests that increased STF programming has increased use of STF
print materials. Straight Talk and Young Talk are the only regular printed materials that address ASRH.
23
Table 6: Newspaper and magazine sources of reproductive health information

N Young Straight Doesn’t No
Talk Talk know paper
Sex Male 167 39.5 36.5 2.4 21.6
Female 176 34.1 42.6 3.4 19.9
School status In school 181 39.8 51.4 2.2 6.6
Out of school 162 33.3 26.5 3.7 36.4
Age 10-14 112 67.9 6.3 4.5 21.4
15-19 123 24.4 53.7 3.4 19.5
20-24 108 18.5 58.3 1.9 21.3
2.2.3 Radio sources of reproductive health information

The project has had a large impact on radio as a source of RH information. In 2005, when asked
about their most important radio source of information, 76.8% of adolescents said “no radio
programme” and only 6.6% (mainly in-school adolescents) mentioned Straight Talk, referring to the
English or Runyankole-Rukiga (4Rs) radio shows. In 2009, two years after the introduction of
“Tuvuge Rwatu”, the Rufumbira-language Straight Talk radio show, 74.6% of young people said it
was their most important radio source of RH information. There is a corresponding reduction in
adolescents who did not have any radio source for RH information to 7.4% in 2009. See Table 7.
Table 7: Most important source of such information in terms of radio shows

Source Cordaid 2009 Population Council 2009
Number Percent Number Percent P Value

Straight Talk/Tuvuge Rwatu 256 74.6 24 6.6 0.0000
Other radio show 43 12.5 12 3.3 0.501
Does not know name 20 5.8 56 15.3 0.383
No radio show 24 7.0 273 74.8 0.0000
Total 343 100.0 366 100.0
Table 8 shows that “Tuvuge Rwatu” is a more important source of information for the in school
youth (82.9%) than out-of-school youth (65.4%), who were more likely to say they listened to
another show, did not know the name of the show, or did not know any show. “Tuvuge Rwatu”
appears to be equally important for both boys and girls.
Table 8: Most important source of such information in terms of radio shows, by social
demographics
N Straight Talk / Other radio Doesn’t know No radio
Tuvuge Rwatu show name show
Sex Male 167 75.4 12.6 5.4 6.6
Female 176 73.9 12.5 6.3 7.4
School In school 181 82.9 9.9 1.1 6.1
status Out of 162 65.4 15.4 11.1 8.0
school
Age 10-14 112 75.9 7.1 8.0 8.9
15-19 123 70.7 15.4 7.3 6.5
20-24 108 77.8 14.8 1.9 5.6
24
2.2.4 Most important source of RH information: person, radio or print

Respondents were asked to assess which one source of information—person, radio or print—was
most important overall. There was no change in the pattern found in 2005. Table 9 presents details o
this question by social demographics, and shows that nearly half of young people (46.9%) preferred
“person”, followed by 28.6% who preferred radio; about 12.4% preferred “newspaper”; and 2.3%
noted that all the sources were important.
Table 9: Most important source of RH information: person, radio and print

N Person Newspaper Radio Don’t All
know important
Sex Male 157 48.4 4.5 33.1 5.1 1.9
Female 176 50.6 14.9 27.4 4.2 3.0
School In school 181 40.6 18.8 33.5 4.7 2.4
status Out of 162 59.4 7.1 26.5 4.5 2.6
school
Age 10-14 112 53.2 10.8 29.7 6.3 0.0
15-19 123 50 16.1 27.7 2.7 3.6
20-24 108 45.1 12.7 33.3 4.9 3.9
2.3 In-school Clubs as Sources of RH Information

In this project, STF worked face-to-face in schools and communities, encouraging the formation of
clubs and supporting them with visits, seeds and other inputs. In this 2009 assessment, in-school
respondents were asked if they had attended any organized discussions on RH. All schools visited
evaluated had taken part in STF interventions and were expected to have functional clubs: 61.4% of
in-school young people had attended a club or group discussion—nearly half had attended in 2009.
Clearly, clubs provided an alternative or additional source of RH information to radio and print.
Most of these clubs were formed during the project, and there is no baseline information on them.
However, it seems that clubs are increasingly a source of information. Teachers as club patrons play
the role of guardians of RH efforts in schools. As shown in Table 10, 56.8% of young people
mention “teacher” or “senior woman teacher” as the person organizing the group discussions on
RH. This may explain why young people increasingly cite “teacher” as their major source of RH
information: however, almost 35% of the 133 in-school young people cite ST club chairperson (a
student) as the person organizing the health talks.
Table 10: “Who organized the health discussion that you attended?”
Number Percent
Teacher/senior woman teacher 75 56.4
ST club/chairperson 46 34.6
Others 6 4.5
Student leaders/prefect 5 3.8
Don’t know 1 0.8
Total 133 100
2.4 Out-of-School Clubs as Sources of RH Information

The club model has also been used in the community, which has been encouraged to form
listenership clubs for peer-to-peer learning and dialogue: 12 active community listenership clubs have
formed in Kisoro. Asked if they had attended any health talks organized by an out-of-school group,
25
about 38.3% of out-of-school youth said they had. Close to half of in-school youth (48.8%) also
mentioned these out-of-school clubs as a source of information. Listenership clubs are thus a source
of RH information for both in and out-of-school young people. (Data not shown in a table.)
As shown in Table 11, of 60 out-of-school youth surveyed, 28.3% specifically mentioned attending a
Straight Talk club activity. The 2009 evaluation identified other community groups that supported
the out-of-school young people: women’s groups (13.3%) and church groups (8.3%). STF also found
the Mothers Union, organizations like World Vision, the local council leaders, and health workers
playing a strong role.
Table 11: “Who organized the youth health discussion in the village?”
Organizer Out of school In school
n % n %
Tuvuge Rwatu 17 28.3 21 48.8
Village youth groups 14 23.3 2 14.0
Community women groups 8 13.3 0 0
Church groups 5 8.3 4 9.3
LCs 4 6.7 6 14.0
Community health worker 3 5.0 2 4.7
Others 9 15 4 9.3
Total 60 100 43 100
About a third of in-school youth surveyed (35.2%) reported ever attending health dialogues in the
villages. Nearly half mentioned the “Tuvuge Rwatu” clubs as the organizers of these health
dialogues.
2.5 Exposure to Straight Talk Radio Shows

To assess exposure to Straight Talk radio shows, STF used two categories of questions. First, youth
(10-24) were asked to spontaneously mention any youth ASRH radio shows they might be aware of.
Second, youth were asked direct prompted questions about “Tuvuge Rwatu”.
2.6 Awareness of Existing Youth SRH Radio Shows

Asked to mention any radio shows for adolescents about RH issues that could be heard in Kisoro
district, 86.6% of young people were aware of at least one. Table 12 lists the radio shows, the
number of times each show was mentioned, and the percentage out of the total number mentioned.
Table 12: “Which radio shows are you aware of that talk about young people and ASRH?” *
Radio show Number of times Percentage
mentioned
“Tuvuge Rwatu” 230 63.7
Rock Point 32 8.9
Amugo Yacu 24 6.6
Tusheeshure (STF 2 Rs radio show) 24 6.6
Straight Talk radio show 14 3.9
Tusungurane Ebitekerezo 10 2.8
Marie Stope 9 2.5
Voice of Parents 6 1.7
Others 12 3.3
Total 361 100
*Multiple response table.
26
“Tuvuge Rwatu” is overwhelmingly the leading radio show cited by 63.7% of young people. In
addition, “Tusheeshure” (STF’s Runyankole/Rukiga show) received 24 out of the 361 mentions
(6.6%); the Straight Talk English radio show received 14 out of 361 mentions (3.9%). In total,
therefore, 74.2% of the spontaneous mentions were “Straight Talk” radio shows. “Tuvuge Rwatu”
has grown in importance since the 2008 midterm, in which it received 32.2% of spontaneous
mentions. This growth has led to fewer youth mentioning “Tusheeshure” and “Straight Talk”
English radio show. Table 13 compares those shows mentioned in the evaluation and the midterm.
Table 13: Which radio shows are you aware of that talk to young people about ASRH
Radio Show Evaluation 2009 Midterm 2008
“Tuvuge Rwatu” 63.7 33.2
Rock Point 8.9 5.3
Amugo Yacu 6.6 0.0
Tusheeshure 6.6 17.3
Straight Talk radio show 3.9 7.5
Tusungurane Ebitekerezo 2.8 0.0
Marie Stope 2.5 6.2
Voice of Parents 1.7 0.0
Others3 3.3 30.5
Total 100 100
2.7 Listenership to “Tuvuge Rwatu” Radio Show
2.7.1 Ever listened

When asked if they “ever listened” to an STF radio show called “Tuvuge Rwatu”, 78% of
respondents said they had. This is an increase of 14% over the 63.8% “ever listened” in 2008. This
increase over 18 months indicates that radio shows gradually build listenership.
Proportion of Adolescents that "Ever
Listened" to ST Radio Show
100.00%
80.00% 78%
60.00% 63.80%
40.00%
20.00% 13.70%
0.00%
Population Cordaid Midterm Cordaid
Council (2005) Assessment FinalEvaluation
(2008) (2009)
The 2005 Population Council survey found that in “high intensity” districts over 76% of unmarried
10 to 19 year olds had “ever listened” to a Straight Talk radio show. In contrast, in “low intensity”
districts, the figure was just 13.4%. At that time Kisoro was a low intensity district, receiving only the
English and Runyankole-Rukiga Straight Talk shows: ever listened was 13.7%. In 2009, with 78% of
Kisoro youth surveyed saying that they have “ever listened” to a Straight Talk radio programme after
the introduction of “Tuvuge Rwatu,” the district is clearly no longer “low intensity”.
3
Others includes shows like Nshwenkazi, Impanuro, Akaniko, TASO radio program
27
2.7.2 Regular listenership to the “Tuvuge Rwatu” radio show

This study defines a regular listener as a person who is able to mention the name of the show, the
radio station on which it is aired, and the day on which it is aired. Findings show that of the 78% of
young people who had “ever listened” to “Tuvuge Rwatu”, 69.4% were regular listeners. Females,
out of school and older youth were most likely to be regular listeners. Table 14 shows the findings.
Table 14: Regular listeners to the “Tuvuge Rwatu” radio show

“Ever listened” to Tuvuge Rwatu Regular listeners, Tuvuge Rwatu
N % N %
Sex Male 167 86.8 145 64.7
Female 176 90.0 160 73.9
School In school 181 90.1 163 64.6
status Out of 162 87.7 142 74.7
school
Age 10-14 112 85.7 96 68.8
groups 15-19 123 88.6 109 67.3
20-24 108 92.6 100 72.2
2.8 Use of Straight Talk Print Materials

To determine if STF’s increased investment in Kisoro would improve use of STF print materials, in-
school youth were asked whether they had ever read Straight Talk or Young Talk. “Ever read” Straight
Talk was over 80% and “ever read” Young Talk was over 70% for all age groups and both genders.
This is a great increase on readership in 2005 when the Population Council found that of unmarried
10 to 19 year olds in Kisoro, 26.3% had read Straight Talk and 31.1% had read Young Talk. See Tables
15 and 16.
Table 15: Ever read Straight Talk /Young Talk by sex and age
N Straight Talk Young Talk
Sex Male 167 88.8 70.7
Female 176 94.5 75.6
Age 10-14 112 83.3 71.6
15-20 123 94.7 73.1
21-24 108 96.9 80.0
Table 16: Ever read Straight Talk/Young Talk, 2009 vs. 2005
Straight Talk Young Talk
Cordaid Evaluation 190 75
2009 (10-24 year olds) 91.8 % 72.8%
Population Council 2005 95 112
(10-19 year olds) 26.3% 31.1%
P Value 0.0000 0.0000
This increase in “ever read” Straight Talk newspapers suggests that STF’s intensified activities in
Kisoro were strongly beneficial for readership. The radio shows promote the papers, remind schools
and individuals to look for them, and say where they can be found. Each year STF posts about
39,000 copies of Young Talk and 21,000 Straight Talk to schools, CBOs, churches and health centres
in Kisoro. In addition, the STF radio journalist and the STF outreach staff also carry copies with
them on each field trip, resulting in about 7000 extra copies of Young Talk and Straight Talk a year.
28
However, other factors, such as increased enrolment in secondary school due to Universal Secondary
Education, could have played a role in increasing readership.
Of those who had read Young Talk, 92.5 percent had accessed it in the year preceding the study.
Likewise, all the respondents who had read Straight Talk had seen it in 2008.
2.9 Adolescent Sexual and Reproductive Health (ASRH) Knowledge

Respondents were asked a series of true/false questions about ASRH. Findings show a general
increase in knowledge, although there is room for improvement.
Compared with the 2005 Population Council survey, there has been an increase from 43 % to 52.2%
in the proportion of adolescents who correctly note that a girl can get pregnant the first time she has
sex, although 48.8% of respondents do not know this fact. Similarly, the per cent of respondents
who are aware that a girl can get pregnant if she has sex while standing has increased significantly
from 38.3% to 54.2 % (p=005), although the proportion who are not aware – 45.6% – remains high.
The proportion of young people who know that a person who looks healthy can be living with HIV
also increased significantly from 69.1% to 78.4%. But one in five adolescents interviewed do not
know this basic fact.
Significant improvements were observed in the proportion of young people who are aware that the
virus can be transmitted from a mother to a child -- from 55.5% to 67.9% (p=0.009). There was a
statistically insignificant decrease in the proportion that believes AIDS can be cured.
Table 17: Knowledge of basic facts on pregnancy and HIV*

Cordaid 2009 Population Council P value
2005
n % n %
A girl cannot get pregnant the first 179 52.2 156 43.0 0.099
time she has sex
A girl cannot get pregnant if she has 186 54.2 140 38.3 0.005
sex while standing up
A person who looks healthy can be 269 78.4 253 69.1 0.02
infected with AIDS virus
It is possible to cure AIDS 284 82.8 304 83.1 0.88
The AIDS virus can be passed from 233 67.9 203 55.5 0.009
a pregnant mother, if she is infected
with HIV to her unborn child.
*There are differences in the two study populations (Population Council interviewed unmarried 10-19 year olds;
Cordaid evaluation interviewed 10-24 year olds)
These changes cannot be solely attributed to the STF. However, because high proportions of young
people say that STF shows are a major source of ASRH information, association seems likely.
There was little difference between the knowledge of males and females. This suggests improvement
on the part of females since males were significantly more knowledgeable than females in the 2005
Population Council survey, except about vertical transmission of HIV. See Table 18.
29
Table 18: Knowledge of basic pregnancy and HIV facts by social demographics
N A girl A girl A person It is The AIDS virus
cannot get cannot get who looks possible can be passed
pregnant pregnant if healthy can to cure from a pregnant
the first she has sex be infected AIDS mother, if she is
time she while with AIDS infected with
has sex standing up virus HIV to her
unborn child.
Sex Male 167 48.5 56.3 78.4 83.2 68.3
Female 176 55.7 52.3 78.4 82.4 67.6
School In 181 55.8 54.7 80.7 77.3 72.9
status school
Out of 162 48.1 53.7 75.9 88.9 62.3
school
Age 10-14 112 42 44.6 71.4 83.9 66.1
15-20 123 56.9 54.5 78.9 81.3 65.9
21-24 108 57.4 63.9 85.2 83.3 72.2
In general, young people know more about HIV than about RH issues like pregnancy. This study
therefore recommends increased emphasis on these issues while maintaining the communication
effort on HIV.
2.10 Knowledge and Attitudes Towards Condoms

Respondents were asked knowledge and attitude questions about condoms. They were required to
agree, disagree or state if they were not sure or did not know the right answer. There have been
significant improvements in the knowledge and attitudes of young people towards condoms
compared to the 2005 baseline: 65.6% of young people in 2009 compared to 35.2% in 2005 agreed
that condoms are an effective way of protecting against STIs (P= 0.0000). Similarly, there has been a
significant increase in the proportion of young people who disagree that buying condoms is a
responsibility of males from 23.2% in 2005 to 58.3% in 2009 (p=0.000). In addition, those who
disagree that using a condom is a sign of mistrust rose from 15.3% in 2005 to 32.7 percent in 2009
(p=0.02).
An insignificant difference was observed in the proportion of young people who disagree that girls
carry who carry condoms are loose from 12% in 2005 to 26.5% in 2009. See Table 19.
Table 19: Knowledge and attitudes towards condoms

Condoms are an Girls who carry Buying condoms Using a condom
effective way of condoms are is a is a sign that
protecting against loose responsibility of your partner
STIs (% disagree) males only does not trust
(% agree) (% disagree) you (% disagree)
Cordaid 225 91 200 112
Evaluation 2009 65.6 26.5 58.3 32.7
Population 129 44 85 56
Council 2005 35.2 12.0 23.2 15.3
P Value 0.0000 0.067 0.0000 0.02
30
Despite these improvements, large proportions of young people still exhibit problematic knowledge
and attitudes towards condoms. For instance, 34.4% still believe that condoms are not effective in
protecting against STIs, and 73.5% think that girls who carry condoms are loose. This suggests both
lack of knowledge and harmful gender stereotypes. Asked if buying condoms is the responsibility of
males only, 41.7% either agree or do not know. Two thirds (67.3%) think that using a condom is a
sign that one does not trust their partner. In short, youth hold many beliefs that may discourage
them from condom use.
Table 20: Knowledge/attitudes towards condoms by social demographics

N Condoms are Girls who Buying condoms Using a condom
effective carry is a responsibility is a sign that
protection against condoms of males only your partner
STIs (% agree) are loose (% disagree) doesn’t trust you
(% disagree) (% disagree)
Sex Male 167 66.5 27.5 60.5 33.5
Female 176 64.8 25.6 56.3 31.8
School In 181 70.7 34.3 68.0 40.3
status school
Out of 162 59.9 17.9 47.5 24.1
school
Age 10-14 112 61.6 16.1 48.2 23.2
15-20 123 64.2 30.1 61.8 30.9
21-24 108 71.3 33.3 64.8 44.4
Table 20 shows that males are slightly more knowledgeable than females. Also, in-school youth are
significantly more knowledgeable and have healthier attitudes towards condoms than the out-of-
school. Older youth aged 15 to 24 had more knowledge and more positive attitudes towards
condoms than younger ones. More work is therefore needed among females, the out of school and
possibly younger adolescents.
2.11 Sexuality and Gender Norms

To assess respondents’ knowledge and attitudes about gender, sexuality and community/social
norms, a series of agree-disagree statements were read to them. The 2005 Population Council survey
posed the same questions. Findings show that, compared to other areas, there have been fewer
changes around gender. Table 21 presents details of respondents’ attitudes for each norm by gender,
while Table 22 presents details of these attitudes according to social demographics.
Overall, significant changes were observed in two of the ten attitudes and beliefs. There was a
significant increase (p=0.003)—from 27% in 2005 to 45.8% in 2009—in the proportion of young
people who disagree with the statement that the man who should have the final word on sex. A
similar increase was seen in the proportion of young people who disagree with the statement that
boys who have many girl friends are “powerful”. However, many youth still have beliefs that put
them at risk (e.g. 54.2% either do not know or agree with the statement that men have the final say in
matters of sex).
31
Table 21: Attitudes towards gender and sexuality according to gender

When It is OK for It is OK for Girls are A woman When it There are A girl who Boys who A school
money is boys to girls to have generally should comes to times when becomes have many boy who
scarce and have sex sex before not as tolerate sex, it is the women pregnant girl friends makes a
the family before marriage. intelligent abuse from man who deserve to while in are school girl
cannot send getting as boys. her should have be beaten school powerful. pregnant
all children married. husband in the final by should be while he is
to school, order to word. husbands. expelled. in school
boys should keep her should be
be sent family expelled.
before girls together.
Cordaid 80 141 148 66 55 77 81 46 106 49

Evaluation
2009 (167) 47.9 84.4 88.6 39.5 32.9 46.1 48.5 27.5 63.5 29.3
Males
Population 78 169 172 66 95 66 100 34 99 50

Council
2005 (182) 42.9 92.9 94.5 36.3 52.2 36.3 54.9 18.7 54.4 27.5
P Value 0.5112 0.020 0.041 0.719 0.018 0.271 0.358 0.270 0.208 0.949
Cordaid 93 158 164 78 61 80 92 40 138 43

Evaluation
2009 (176) 52.8 89.8 93.2 44.3 34.7 45.5 52.3 22.7 78.4 24.4
Females
Population 106 165 170 81 68 33 81 24 78 22

Council
2005 (184) 57.6 89.7 92.4 44.0 37.0 17.9 44.0 13.0 42.4 12.0
P Value 0.492 0.958 0.739 0.957 0.782 0.007 0.310 0.508 0.0000 0.555
32
Table 22: Attitudes towards gender and sexuality according to social demographics
When money It is OK It is OK Girls are A woman When it There are A girl who Boys who A school boy
N is scarce and for boys to for girls to generally should comes to times when becomes have many who makes a
the family have sex have sex not as tolerate sex, it is women pregnant girl friends school girl
cannot send before before intelligent abuse from the man deserve to be while in are pregnant
all children to getting marriage as boys. her husband who beaten by school powerful while he is in
school, boys married. in order to should husbands. should be school
should be keep her have the expelled. should be
sent before family final expelled.
girls together word.
Male 167 47.9 84.4 88.6 39.5 32.9 46.1 48.5 27.5 63.5 29.3
Sex
Female 176 52.8 89.8 93.2 44.3 34.7 45.5 52.3 22.7 78.4 24.4
In 181 60.8 84.0 87.3 48.6 33.7 42.5 51.9 31.5 70.2 30.9
School status
school
Out of 162 38.9 90.7 95.1 34.6 34.0 49.4 48.8 17.9 72.2 22.2
school
10-14 112 34.8 90.2 92.0 33.0 25.9 33.9 42.9 15.2 63.4 19.6
15-20 123 54.5 88.6 91.9 43.9 31.7 41.5 56.9 26.8 78.9 30.9
Age
21-24 108 62.0 82.4 88.9 49.1 44.4 63.0 50.9 33.3 70.4 29.6
33
No change was observed in the proportion of young people who believe that when money is scarce
in the family, boys should be sent first to school: 50.3% disagreed in 2005 compared to a similar
proportion in 2009.
When the data is disaggregated by gender, however, there have been four significant changes. In
2009, boys are significantly more likely to disagree that it is OK for boys or girls to have sex than
they were in 2005. They are also significantly more likely to disagree with the statement that a woman
should tolerate abuse from her husband to keep the family together (p=0.018) than in 2005.
In 2009, girls were significantly more likely to agree with the statement that the man should have the
final say on sex (p=0.007) than in 2005 (45.5% disagreeing compared to 17.9%). In 2009 girls were
also significantly more likely to disagree that boys who have many girlfriends are powerful (p=0.000)
(78.4% disagreeing compared to 43.4%). 2009 study shows that there has been some change, with
more females disagreeing with those statements posed to them.
In terms of schooling status, findings were inconsistent. Notably, 38.9% of the out-of-school
disagreed with the statement that in case of lack of money, the boy who should be sent to school,
compared to 60.8% of the in-school. Also, 17.9% of the out-of-school compared to 31.5% of the in-
school disagree with the statement that a girl who becomes pregnant while in school should be
expelled. Thus, STF’s discourse on its radio shows and in face-to face activities seems to having
some impact gender attitudes and beliefs.
2.12 Health-Seeking Behavior and STIs
2.12.1 Use of health facility services

To assess changes in health seeking behaviours, the young people were asked if they had visited a
health facility for information on HIV or family planning or for HCT or a pregnancy test. The
findings show little change since 2005, although the numbers who went to health centres or who are
sexually active are small which limits meaningful statistical interpretation. The 2005 Population
Council survey shows that about 24.8% of unmarried 10-19 year olds had visited a health facility for
this information compared to exactly the same proportion, 24.8%, of the young people aged 10 – 24
surveyed in this current evaluation.
In addition, when disaggregated by social demographics, it is clear that 61.2% of young people
visiting a health facility were aged 21-24, compared to only about a quarter of the those aged between
15 and 20, and only 9.4% of those aged between 10 and 14. The 21-24 year olds were also more
likely to have had sex (see section on sexual behavior), which supports the argument that low
proportion of sexually-experienced youth is realted to the low proportion of those seeking going
SRH services at health facilities. Also, the increased ASRH information in the district due to the STF
project might also mean that fewer adolescents seeks information from health centers; the figure
above could be a reflection of those seeking services only.
More females (57%) sought information or services from facilities than males (42.6%) and more in-
school adolescents (63.5%) than out-of-school adolescents (36.5%). See Table 23.
34
Table 23: Visited health facility for ASRH information/services (pregnancy, FP, HIV, HCT)
Number Percent
Sex Male 167 42.4
Female 176 57.6
Age 10-14 112 9.4
15-20 123 29.4
21-24 108 61.2
2.12.2 Testing for HIV

Increased information through radio has contributed to the increased proportion of young people
who have undergone HCT. In the 2005 Population Council survey, only 3.2% of those surveyed
(unmarried adolescents aged 10 to 19) had tested; by 2009, this had increased to 6.6% for the 10-14
year olds; 21% for the 15-19 year olds and 44.8% for the 20-24 year olds.
Table 24: Visited health facility for ASRH information/services, ever tested for HIV
Number Ever tested for HIV
Sex Male 167 21.7
Female 176 26.6
Age 10-14 112 6.6
15-20 123 21.0
21-24 108 44.8
Young people who had tested were asked how they knew about the services of the testing site. This
is a proxy measure for the contribution of STF interventions: 40.9% of the young people who had
tested had learnt about the services from radio: 7.6% specifically mentioned “Straight Talk”. Other
major sources of information were schools, community health educators, mobile health services like
blood donations and health fairs. Table 25 shows the details.
Table 25: “How did you know about the testing at the health facility?”
Source of Information Frequency Percent
Radio 27 40.9
School 9 13.6
Community health educator 7 10.6
Friends 6 9.1
Straight Talk 5 7.6
Mobile health services 4 6.1
Sign posts on facility 1 1.5
Others 7 10.6
Total 66 100.0
35
2.13 Sexual Activity in Adolescents4

Asked if they had ever had a boy or girlfriend, 41% of respondents answered affirmatively. Asked if
they had ever had sex, 16.7% answered affirmatively. This is higher than the 5.8% in the 2005
Population Council survey, which interviewed only unmarried 10-19 year olds. This can be explained
by the inclusion in the 2009 survey of the 20-24 age group as well as some married youth. In 2009,
4.6% of the 10-14 year olds, 15.3% of the 15-19 year olds, and 33% of the 20-24 year olds reported
to have ever had sex. Almost equal proportions of males (17.1%) and females 16.1%) and in school
(16.3%) and out-of-school youth (17.2%) reported to have had sex. No meaningful interpretation
can be drawn from these findings: sexual intercourse is a higher level and long term result of an
intervention, upon which it is not possible to argue that the programs have had a direct impact.
Table 26: Ever had sex

Number Ever had sex
Sex Male 167 17.1
Female 176 16.1
Age 10-14 112 4.6
15-20 123 15.3
21-24 108 33.0
Condom use seemed to have increased. Asked if a condom was used at the last sexual engagement,
15.7% of the young people said they had used a condom at last sex, compared to 9.1% in the 2005
Population Council survey. However, the denominator for these figures in both surveys was too
small to allow meaningful statistical interpretation.
2.14 Communication with Parents and Guardians

To assess the effects of STF activities on parent-child communication, questions assessing the
respondents’ opinions of parents’ knowledge, confidence and frequency of communication were
asked. The 2005 Population Council survey asked similar questions.
Respondents were asked if any of their parents or guardians had ever talked to them about sexuality,
growing up and relationships between boys and girls. Findings show a significant increase (p=0.000)
in the proportion of young people whose parents have talked to them about the above, with 64.7%
reporting this compared to 28.2% in the 2005 Population Council survey. It can be concluded that
the increased dialogue and demand for RH information could have impacted on the adolescents’
confidence to ask parents questions, and that parents indirectly benefit from “Tuvuge Rwatu.”
Table 27: Parents ever talked to you about ASRH issues

Source Parent/Guardian ever talked about ASRH
Cordaid Evaluation 2009 222
64.7%
Population Council 2005 102
28.2%
P Value 0.0000
4
Analysis of this section has been limited by the small denominators, which do not allow meaningful statistical interpretation. Thus, the
discussion of transactional exchanges and condom use has been excluded but figures are presented in the annex. In addition, they are
behavior changes whose attribution is difficult to discuss given the short-term nature of the project.
36
As with the Population Council survey, the end-of-project evaluation found more females (69.9%)
had been talked to by their parents than males (59.3%). But there has been a significant increase in
the proportions of males reporting parental conversations about issues of sexuality—from 23.9% in
2005 to 59.3% in 2009 (p=0.00006). There have been no significant increases according to schooling
status or age group.
Table 28: Parents ever talked to you about ASRH issues, by social demographics
N Parent/Guardian Ever talked about ASRH
Sex Male 167 59.3
Female 176 69.9
Age 10-14 112 68.8
15-29 123 58.5
21-24 108 67.6
37
CONCLUSIONS
STF has made a substantial impact on young people aged 10 to 24 in Kisoro district. It reached an
estimated 80% of 10 to 24 year olds with at least some social and behavioural change materials: 78%
said they had “ever listened” to the show and over 90% claimed to have ever read Straight Talk
newspaper. Many will have had repeated “hits” of these materials, e.g., of those who said they had
“ever listened” to Tuvuge Rwatu, 69.4% were regular listeners, tuning in several times a month. A
substantial number of young people (7616) also had face-to-face contact with an STF member of
staff, either the radio journalist or a counselor/trainer. Thus tens of thousands of young people –
possibly over 60,000 of the 82,500 young people in Kisoro – were exposed to STF’s newspapers and
radio shows. In addition, over 7500 received interpersonal “talk” in addition to the radio show and
print materials. The cost of this per person reached was just 78 US cents (UGX 1544) a year.
Of 14 targets set in the project proposal, STF was able to exceed eight. For example, STF hoped that
60% of young people would have ever listened to any Straight Talk radio show in any language: the
evaluation found 88.9% had done so. STF also hoped that by the end of the project period only 10%
of young people would say they did not know where to go for information about growing up; in fact,
just 3.3% said they did not know. In addition, there was far greater change than hoped for in the
percentage of young people saying they felt that their parents were knowledgeable about sexuality
and growing up. Of the six remaining targets, STF met four, although the sample size was small in two
cases. Just two targets were not met. There was a smaller than hoped for increase in the per cent of
young people knowing about mother to child transmission of HIV (although it had significantly
increased); and a lower per cent than hoped for of the sexually active respondents said they had used
a condom at last sex.
STF also broadly met its objectives as outlined in the proposal, although it was not able to measure
all (such as antenatal attendance).
The first objective was to give young people a voice and to empower them to manage their
sexuality more safely by delaying sexual debut, reducing numbers of sexual partners,
treating STDs, testing for HIV with their partners and using family planning. STF
resoundingly succeeded in giving young people a voice. Hundreds of young people spoke and heard
themselves on the STF radio shows, including members of the deeply marginalized Batwa group.
Furthermore, interpersonal “talk” clearly increased: 61.4% of in-school had attended an in-school
club or group discussion about reproductive health, while 38.3% of out-of-school young people had
attended an out-of-school discussion. Many young people attended more than one or even regular
discussions in different settings: 49% of in-school young people reported also having attended an
out-of-school group talk.
Furthermore, only 2.6% of young people said they had no interpersonal source of information on
RH compared to 20.5% in 2005. As a result of this decline, “human” sources of RH information
were far more varied and prominent than in 2005, with many more young people citing teachers,
STF workers, aunts, uncles, friends and peers. Communication for social change theory argues that it
38
is community dialogue that sustains healthy behaviours. Such dialogue seems to have greatly
increased in Kisoro since the advent of the STF-Cordaid intervention.
Table 29: Project Indicators: Overall Targets and Achievements

Indicator Baseline Target Actual
Comment
(2005)
Ever listened to radio show called Straight Talk? 13.7% 60% 88.9% Exceeded target
Most important source of sexuality information in
75% 20% 7.0% Exceeded target
term of radio: % answering “No show”
If you needed information about growing up, where
would you go. % answering “Don’t know”
Condoms are an effective way of protecting against
35% 60% 65.6% Met target
STDs: % answering “yes”
Condoms are an effective way of protecting against
STDs: % answering “don’t know”
The last time I had sex, a condom was used. Did not meet
9.1% 45% 15.7% target. Sample size
small
My last sexual partner had tested for HIV. Met target but
5% 20% 22.8%
sample size small
Apart from HIV are there any other diseases a
person can get from sexual intercourse: % 40% 75% 75.8% Met target
answering yes
HIV can be passed from a pregnant mother to an Did not meet
55% 80% 67.9%
unborn child: % answering yes target
HIV can be passed from a pregnant mother to an Exceeded
33% 15% 7.0%
unborn child: % answering don’t know target
In the past 12 months, % that have has sex for Met target but
64% 30% 34.0%
money or gifts (of those who are sexually active) sample size small
My parents have ever talked to me about growing
28.5% 60% 64.7% Exceeded target
up and sex: % answering yes
My mother is very knowledgeable about sexuality
4.7% 25% 33.5% Exceeded target
and growing up: % answering yes
My father is very knowledgeable about sexuality and
6% 20% 41.7 % Exceeded target
growing up: % answering yes
With hindsight, the second part of Objective 1 – to empower young people to manage their sexuality more
safely by delaying sexual debut, reducing numbers of sexual partners, treating STDs, testing for HIV with their
partners and using family planning – was mis-phrased and over-ambitious. These are long-term outcomes
that are hard to achieve in two years and difficult to measure. However, STF’s intervention is
associated with more HIV testing and with “empowerment” through increased knowledge and
changed attitudes. There were statistically significant improvements in the percent of young people
who knew that a girl can get pregnant if she has sex while standing; that a healthy person can be
living with HIV; that a mother can pass HIV to her baby; and that a condom is an effective way to
prevent STDs.
Statistically significant changes in attitudes included: many more young people who do not think that
buying a condom is the sole responsibility of males; boys being much more likely to disagree with the
statement that a woman should tolerate domestic violence to keep her family together; and girls
39
being more likely to disagree with the statements that men should have the last word on sex and that
boys who have many girlfriends are powerful.
The second objective – to encourage youth to have more gender-equitable relationships, in

which boys do not exploit girls and girls do not manipulate boys – appears to have been at least
partly met (see above). Certainly the STF discourse “encouraged” dignity in girl-boy relationships
and discouraged exploitation. (See the script on marriage by abduction in Appendix B.)
The third objective – to encourage all youth to seek protective environments (e.g. such as
remaining in school, having dialogue with trusted adults like parents, becoming socially
connected by joining clubs) – was again partly hard to measure (e.g., staying in school). But there
was greatly increased parent talk, with almost 65% of young people saying their parents had ever
talked with them about growing up and sex compared to about 29% in 2005, as well as increased talk
with teachers. Teachers have overtaken parents as the most important source of RH information.
Most respondents had taken part in club activities (see discussion of Objective 1 above).
The fourth objective – to increase utilization of health services, including VCT, antenatal care
and contraceptive use – was not evaluated, although questions were asked about VCT. There
seemed to have been a substantial increase in young people testing, from 3.2% of unmarried 10 to 19
year olds having tested in 2005, to 6.6% of 10-14 year olds, 21% of 15-19 year olds and 44.8% of 20-
24 year olds in 2009. This increase may be in part due to STF efforts, particularly as “radio” was the
main source of information about testing and STF shows were the most mentioned and listened to
shows.
The fifth objective – to seek support among opinion leaders by increasing their understanding
of youth SRH-related issues – was addressed through two district meetings, attended by a total of
104 leaders: the radio show aired 81 interviews with health workers, a mark of their support.
40
RECOMMENDATIONS
There is a new sexual generation every five years, and children enter adolescence daily. So the
foremost recommendation is that STF’s work in Kisoro needs to go on. To stop now would risk
losing the gains of the last two years. It would jeopardize the communication for social change
process for which STF has been the catalyst. This process of increased dialogue – in families,
schools, communities, between partners and between parents and offspring – underpins and sustains
all individual behaviour change.
Second, from the findings, it is clear that knowledge around HIV is higher than knowledge around
pregnancy. More needs to be done to promote an understanding of reproductive health.
Third, unprotected sex is one of the greatest risks faced by adolescents. Attitudes about condoms,
though more positive than in 2005, are still fairly reserved, e.g., 73.5% of young people think that a
girl who carries condoms is loose and 34.4% do not think that condoms are an effective way of
protecting against STDs. More needs to be done to humanize and create confidence in condoms,
while not detracting from delayed sex as a protective behaviour.
Fourth, gender attitudes are deeply entrenched and complex, and many young people appear to
adhere to gender norms that seem to undermine adolescent and adult well-being. STF needs to
continually seek to understand the nature of masculinity and femininity and find new and better ways
to help communities articulate and manage the challenge of gender.
Fifth, certain key issues were under-addressed by this project, such as the presence of adolescents
who were born with HIV. This group is beginning their sexual and relational lives, in an
environment of stigma, with little community discussion on how they can build the marriages and
families they, like all people, need but without infecting others. STF needs to make sure it holds such
key “conversations” which are far more vital than some topics addressed by its radio show from
2007 to 2009, e.g., urinary tract infections.
Finally, to prevent the STF discourse from becoming stale or monotonous and, conversely, to make
sure that its discourse is always compelling, startling, useful, bright, beautiful and relevant, STF has to
keep abreast of new thinking in HIV, adolescent well-being, poverty and much more. It needs to
continually refresh and renew itself.
STF can do this by being humble, always listening to and respecting the distress, excitement, dreams,
longings and stories of the young people that it serves as well as their families, teachers and others in
their communities.
41
BIBLIOGRAPHY
Adamchak, Susan E et al. 2007. “The Straight Talk Campaign in Uganda: Impact of Mass Media
Intiatives – Summary Report,” Horizons Final Report. Washington, DC: Population Council.
Figueroa, Maria Elena et al. 2002. Communication for Social Change: An Integrated Model for
Measuring the Process and Its Outcomes. The Rockefeller Foundation and Johns Hopkins
University Center for Communication Programs. New York.
Freire, Paulo. 1970. Pedagogy of the Oppressed. New York. Herder and Herder
Uganda Bureau of Statistics (UBOS) and Macro International inc. 2007. Uganda Demographic and
Health Survey 2006. Calverton, Maryland, USA: UBOS and Macro International Inc.
42
APPENDIX A. TOPICS ADDRESSED IN “TUVUGE RWATU” (JULY 2007 – SEPTEMBER 2009)

Period Topics Addressed
July – • HIV transmission • Family Planning • Body changes
September • Delaying sex • Condoms • Doctor programs
2007 • STDs • Early marriage
October – • Menstruation • Work • VCT
December • Sex and relationships • Virginity • Personal hygiene
2007 • Candida • Condoms • Doctor programs
• Alcohol and staying in • Caring for the HIV- • HIV testing
school affected • Menstruation
January -
• Alcohol and violence • Parent-child comm.. • Doctor programs
May 2008
• Responsible drinking • Early marriage
• Condoms • Communication in
relationships
June – • Sex and poverty • Sex for marriage • Condoms
September • Casual sex • Managing sexual urges • Menstruation
2008 • Sex for fun • Palliative care • Alcohol
• Sex at first sight • Circumcision • Gender roles
• Sex for adventure—girls • Challenges faced by the • Discordance
October -
December • Sex for adventure—boys Batwa • Alcohol
2008 • Sex for revenge • Sex without love • Doctor programs
• Child prostitution in • Post-exposure
Kisoro prophylaxis
• Physical beauty • Disclosure (HIV status) • Rape
• HIV vs. pregnancy • Gender roles • Early marriage
January –
March 2009 • Teenage pregnancy • Child labour • Prostitution
• Your Life, Your Future • HIV discordance • Doctor programs
• Self esteem
• Early marriage • Preparing for marriage • Girl-child
• Family planning • Sexual Feelings education
• Parent-child comm. • Virginity • Achieving one’s
April - June dreams
• Science of HIV • Parents’ role in
2009 • Girl-boy
transmission children’s marriage
relationships
• Doctor programs
• Malaria • UTIs • Circumcision
July –
• Multiple partners • Beauty • Condom usage
September
2009 • Bride price • Alcoholism • Famine
• Entrepreneurship • Abortion • Doctor programs
43
APPENDIX B. SAMPLE SCRIPTS FROM “TUVUGE RWATU” TRANSLATED TO ENGLISH
44
45
46
47
48
49
50
51
APPENDIX C. STRAIGHT TALK CLUBS IN KISORO DISTRICT
Club Name Sub-county Designation

Iryaruvumba High school Bukimbiri In-school
Muhanga SS Bukimbiri In-school
St. Joseph’s Rubuguri SS Bukimbiri In-school
Busanza SS Busanza In-school
St Peter’s Rwanzu SS Busanza In-school
Chahi Seed SS Chahi In-school
Comprehensive SS Kisoro Town Council In-school
Kisoro High school Kisoro Town Council In-school
Kisoro Hill Kisoro Town Council Out-of-School
Kisoro Millennium college Kisoro Town Council In-school
Kisoro Vision school Kisoro Town Council In-school
Seseme Girls Kisoro Town Council In-school
St. Andrew’s academy Kisoro Town Council In-school
Chahi Kisoro Town Council Out-of-School
Bitare-Rugalama Muramba Out-of-School
Kanyenka Muramba Out-of-School
Mugwata Muramba Out-of-School
Muramba Seed SS Muramba In-school
Rutaka Community SS Nyabwishenya In-school
Bufumbira College Nyakabande In-school
Kisoro Technical institute Nyakabande In-school
Mutorele SS Nyakabande In-school
Nyakabande Nyakabande Out-of-School
St. Gertrude’s Vocational SS Nyakabande In-school
Kasemisego Nyakinama Out-of-School
Nturo T/C Nyakinama Out-of-School
Gasiza Nyarusiza Out-of-School
Kabindi SS Nyarusiza In-school
Kudisi Nyarusiza Out-of-School
Musasa Nyarusiza Out-of-School
Nyarusiza Nyarusiza Out-of-School
Park Trading Center Nyarusiza Out-of-School
52
APPENDIX D. SAMPLE OF LETTERS RECEIVED FROM “TUVUGE RWATU” LISTENERS
53
54
55
APPENDIX E. PRIZES AND PROMOTIONAL MATERIALS DISTRIBUTED DURING

PROJECT
Item Year
2007 2008 2009 Total
T-shirts 25 160 115 300
Caps - 20 15 35
Seeds (cabbages) 18kg 10 pcs 10pcs 18kg, 20 sachets
Jerry cans - 35 - 35
Pads - 100 15 115
Buckets - - 30 30
Bicycle - 1 - 1
Hoes 240 10 10 260
Books - - 300 300
Pens 48 120 25 193
Radios 10 20 15 45
Balls - - 5 5
Diaries - - 20 20
Rulers 65 84 20 169
stickers - 300 - 300
Calendars - 1200 1000 2200
Tree seeds - 20 10 30
Young Talk 3000 8000 6000 17000
Straight Talk 3000 8000 6000 17000
APPENDIX F. REFERRALS BY LOCATION AND YEAR FROM “TUVUGE RWATU” SHOWS
56
Referrals by Location and Year

Site Referrals
2007 2008 2009 Total
Kisoro Hospital 31 22 9 62
Muramba Health Centre IV 9 20 9 38
Mutolere Hospital 31 22 9 62
Nyabihuniko Health Centre IV 1 - - 1
Nyarusiza Health Centre III 9 20 9 38
Rugerageza Clinic 1 - - 1
Total 82 84 36 202
Health Workers Featured on “Tuvuge Rwatu”

Designation Number of Interviews Featured
2007 2008 2009 Total
Clinical Officer 9 - 3 12
Counselor 20 26 5 51
Doctor - 7 3 10
Nurse 3 5 - 8
Total 32 38 11 81

Straight Talk in Kisoro (2007-2009) : Fostering Adolescent Sexual and Reproductive Well-Being With Communication For Social Change

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Straight Talk in Kisoro (2007-2009) : Fostering Adolescent Sexual and Reproductive Well-Being With Communication For Social Change

Transféré par

Droits d'auteur :

Formats disponibles

Octob

Finaal Activvity Repport andd Impactt Evaluaation

Paatrick Walugem mbe

SECTION I: FINAL ACTIVITY REPORT 9

SECTION II: IMPACT EVALUATION 18

2.8: Use of Straight Talk Print Materials 27

Appendix A – Topics Addressed in “Tuvuge Rwatu” (July 2007 – September 2009 42

TABLES AND FIGURES

Background and Context

SECTION I: FINAL ACTIVITY REPORT

• Output 1: Increased opportunities to access reproductive health information, including

Output 1: Increased opportunities to access reproductive health information, including

1.1.1 Field interviews – raising young people’s voices

Figure 1: Straight Talk Clubs in Kisoro, By the Numbers

In addition to the active engagement of club members in activities, participation of non-members

Thee number of letters

manny letters receeived were prrepared by multiple

Final Activvity Report & Imppact Evaluation: Youth

1.4: Distribution of SBC Materials – Straight Talk and Young Talk

2.1: Identify Youth-Friendly Services

2.3: Meet with Health Workers – Engaging key duty-bearers

Output 3: Increased advocacy and support for ASRH in project communities.

3.1: District Advocacy Meetings – Engaging opinion leaders in improving ASRH

4.1 Cost analysis

SECTION II: IMPACT EVALUATION

Purpose and Objectives

The evaluation exercise was guided by three core objectives:

1.1 Research Design

1.1.1 Selection of out-of-school adolescents

1.1.2 Selection of in-school adolescents

1.2 Data Collection

1.3 Data Analysis

1.4 Limitations of Study

1.5 Ethical Considerations

2.1 Social Demographic Characteristics of Respondents

Table 1: Social demographic characteristics

2.1.1 Education status

Table 2: Educational characteristics of in-school adolescents

Table 3: Highest level of education attained by out-of-school adolescents

2.2 Sources of Information on Reproductive Health

2.2.1 Most important source of information

2.2.2. Print sources of reproductive health information

Table 6: Newspaper and magazine sources of reproductive health information

2.2.3 Radio sources of reproductive health information

Table 7: Most important source of such information in terms of radio shows

Number Percent Number Percent P Value

2.2.4 Most important source of RH information: person, radio or print

Table 9: Most important source of RH information: person, radio and print

2.3 In-school Clubs as Sources of RH Information

2.4 Out-of-School Clubs as Sources of RH Information

2.5 Exposure to Straight Talk Radio Shows

2.6 Awareness of Existing Youth SRH Radio Shows

2.7 Listenership to “Tuvuge Rwatu” Radio Show

2.7.1 Ever listened

2.7.2 Regular listenership to the “Tuvuge Rwatu” radio show

Table 14: Regular listeners to the “Tuvuge Rwatu” radio show

2.8 Use of Straight Talk Print Materials

2.9 Adolescent Sexual and Reproductive Health (ASRH) Knowledge

Table 17: Knowledge of basic facts on pregnancy and HIV*

2.10 Knowledge and Attitudes Towards Condoms

Table 19: Knowledge and attitudes towards condoms

Table 20: Knowledge/attitudes towards condoms by social demographics

2.11 Sexuality and Gender Norms