In recent years, South Africa has seen an influx of initiatives aimed at reducing HIV infection, often geared toward the younger population.  And yet HIV prevalence among South Africans remains relatively stable.

Marcus McGilvray, founder and CEO of streetfootballworld network member Africaid and its youth programme, WhizzKids United, knows why: “so many people have good intentions.  They give out condoms, raise awareness, but they’re bound to fail.  You’re trying to change behaviour and that is a long-term process.”

Indeed, in a country where a quarter of men are known to have sexually assaulted someone at least once, and where even babies can be victims of rape, knowledge and awareness simply aren’t enough.

WhizzKids United’s approach to decreasing HIV/AIDS in Africa is a three-pronged programme aimed directly at behaviour change.  With a strong foundation in existing theory and research, each part addresses a different stage in changing behaviour: the organisation provides the motivation for behaviour change through the Life Skills Football programme, enables participants to change their behaviour through Peer Education, and reinforces the new behaviour in Health Academies.  Since 2006 over 10,000 young people have taken part in WhizzKids United. 

Twelve girls and twelve boys meet on the pitch to play football, but there are no goalposts.  They are not sure how to score, how to play.  After ten minutes, the game ends and the young people are asked to reflect on the need to be able to score a goal in football.

The conclusion: without a goal, there’s nothing to play for.  Their trainer draws the same connection offered to many other young people in similar sessions: “That’s exactly the same in life.  Without a goal we lack direction or purpose.”

Sport as a metaphor for life
The Life Skills programme is aimed at students between the ages of 10 and 18+.  Carried out in schools in order to maximise participation, it gets students on a football pitch to teach them how to achieve their goals.  Using the sport as a metaphor for life, WhizzKids brings home to young people the importance of setting goals, overcoming obstacles, keeping focused and staying in control of situations.  Football makes otherwise standard life lessons meaningful; it also gives participants the chance to get out of the classroom and onto the pitch.

“We’re doing life as a game of football,” explains Mr. McGilvray, an HIV Nurse Specialist with over 10 years of experience working in HIV/AIDS around the world.  Encouraging young people to become goal-oriented is a primary objective of the Life Skills Football sessions; HIV/AIDS is portrayed as a major obstacle to achieving a dream.

The confidence to stay focused
Aside from helping young people prepare to overcome obstacles and achieve their goals, Life Skills Football also helps participants feel confident in their abilities to stick to their plans even under pressure.  Negotiating condom use or remaining abstinent, for example, can be difficult, but are necessary skills for ensuring that one remains healthy enough to achieve one’s goals.

WhizzKids United also aims to affect young people’s general attitudes toward each other.  “All our sessions are 50% male and 50% female,” notes Mr. McGilvray.  “It’s good for the boys to understand the challenges the girls are facing and vice versa.”  It also makes an important statement about gender norms.

A public celebration
Upon completion of the 10-hour course, all participants play in a WhizzKids United World Cup football tournament, where they and their achievements are celebrated publicly.  According to Mr. McGilvray, “one of the biggest problems for young people in Africa is that kids aren’t rewarded for what they do.”  By offering a venue where young people can be publicly recognised as having done something positive, WhizzKids United aims to build their self-confidence one step further.

Yet challenges do remain: though participants are asked to encourage their parents to come to recognise the importance of what the young people have achieved, Mr. McGilvray estimates that less than 10% of parents attend each event.

Once young people are aware that they can and should adapt their behaviour, they move to the next step in the programme.  For Peer Education, one boy and one girl from each class are selected and trained to run 14 workshops throughout the year.  The workshops focus more directly on topics that are only touched upon in Life Skills Football, such as relationship building, negotiation skills and avoiding sexually transmitted infections.

Over these sessions, peer educators do more than simply inform their classmates—they foster an open atmosphere that adults might not be able to create.  As Mr. McGilvray points out, the principle is simple: “kids relate more to other kids.”  At this stage, the focus is on adapting the social dynamics of the group and building the life skills that will help young people to deal with the pressures and temptations that could endanger their goals.

The final step in the process is found in the WKU Health Academies; one will open in early 2010 in South Africa to support young people in holding on to their goals and resisting any pressure that might lead them down a different path.

A new feature for WhizzKids United is one-to-one counselling.  “You can collectively teach fifty kids,” explains Mr. McGilvray, “but they’ll all be at different stages of development in terms of relationships, sex, abstinence—you need to see where each kid is, then ask yourself how you can help them to abstain or delay, to use condoms or get tested.”  The academies also feature couple counselling and group counselling, the latter enabling young people to understand that the problems they may have are shared by their peers.  In short, they are not alone.

The clinic that isn't a clinic
Of course, the academies have an important clinical function: HIV and STI testing is available, along with rape counselling, antiretroviral treatment, psychosocial support, pregnancy testing and a feeding scheme for orphans and vulnerable children. The word ‘clinic’, however, is never mentioned.  While a young person might be unwilling to visit a clinic or a hospital, a Health Academy imports a sense of importance and relevance.  This is where young people go to stay healthy enough to play football like a pro.

Career guidance is also available to help young people continue to focus on their goals and gain self-confidence.  The logic, according to Mr. McGilvray, is that “the more self-assured and focused on long-term goals a kid is, the more he or she will look at their health.”

Bringing the community in
The services offered in the academies may not be enough to get young people in the doors, so alongside holding school assemblies and tours of the buildings—both of which familiarise students with the people and the premises—WhizzKids United is also bringing football back into the offer, with a football pitch just outside the academies.

WhizzKids United hopes that adults will also accept and support the Health Academies and the organisation’s mission.  Without community buy-in, the programmes will struggle to have the desired effect.  Mr. McGilvray offers an example: “at age twelve, a kid can go into an HIV centre and get tested without parental consent,” which is, in many ways, a positive step forward.  But it is often helpful to include parents in the process.  “They need to know that their kid could test positive, and it could be through birth, through the mother.  They need to think about what they’ll do, how they’ll deal with it.”

Mr. McGilvray believes that discrimination tends to come from parents, not children, so in order to spark and maintain behaviour change, WhizzKids United cannot afford to leave adults out of the equation.  Getting their buy-in for the Health Academies will be very important.

WhizzKids United has done its homework.  It has a solid foundation in social theories and scientific studies.  It intervenes early in individuals’ lives, when opinions and prejudices are not yet fully formed and young people are just entering puberty.  It strives to not only provide important information, but also to support young people in incorporating what they learn into their lives and sticking to their new approach.  Counsellors are open and ready to discuss difficult topics honestly.  Group dynamics help young people collectively establish social identities, while individual counselling targets an individual’s specific stage of development.

WhizzKids United is acutely aware of the social context, and incorporates the reality of young Africans’ lives into sessions so that participants can apply what they learn without having to reach for impossible solutions.

A major challenge
With all this in place, and with WhizzKids United constantly developing and improving its programme, one major question remains for Mr. McGilvray.  “One of our biggest challenges is, ‘how do you know there’s been behaviour change?’”

WhizzKids United already uses pre- and post-programme questionnaires and attendance statistics—the programme is not compulsory—to measure how much participants have learned.  The results are good, but the approach is limited.  “It looks at knowledge, attitudes, beliefs, but that’s not rigorous enough.  You can’t write it up and put it in a medical journal,” Mr. McGilvray explains.

He also notes that the information the organisation gathers does not translate into knowledge about behaviour change.  A young girl can be aware of the danger of HIV/AIDS and know how to protect herself but still engage in unprotected sex.

In order to measure whether it is indeed providing not just knowledge on HIV transmission, but also the skills to act more safely, WhizzKids United has recently received support from Harvard University to set up an M&E study.  A Monitoring and Evaluation Officer will work with the organisation to develop meaningful ways of measuring behaviour change amongst participants, and by 2011 the data will be ready.  Mr. McGilvray is confident.  Given the organisation’s multi-pronged, analytic, realistic approach, it’s hard not to share his sentiments.

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