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Table of ContentsPreface . iiiMessage by Secretary, MOWCD . vMessage by Additional Secretary, NACO . viiForeword . ixAbbreviations .xiiiPART ONEIntroduction to the Life Skills Education Toolkit . 1-7PART TWOFacilitator’s Guide . 1-60PART THREEDesign of the Modules . 1Module Plan Overview . 4Module One – Getting Started . 1-12Module Two – Knowing Myself . 1-20Module Three – Communication . 1-20Module Four – Relationships . 1-32Module Five – Decision-Making . 1-28Module Six – Coping with Emotions . 1-36Module Seven – Growing Up . 1-20Module Eight – Preventing and Living with HIV . 1-28Module Nine – Substance Use . 1-20Module Ten – Reaching My Goals: Energizers, Warm-ups and Relaxation . 1-16PART FOUR: BACKGROUND READINGInformation Sheet 1: Children’s Rights and HIV/AIDS . 15Information Sheet 2: HIV/AIDS . 19Information Sheet 3: Sexually Transmitted Infections . 21Information Sheet 4: Preventing Sexual Transmission of HIV Through the ABC Approach . 23Information Sheet 5: HIV Information Needs of Children . 27Information Sheet 6: Helping Children to Cope with Grief . 33Information Sheet 7: Additional Warm-ups and Energizers . 35References for Exercises/Activities . 39Useful Resources/References . 41

RTSTITOTUNAIDSUNICEFUSAIDWHOWINSYWCAAbstinence, Be Faithful and Use CondomsAcquired Immunodeficiency SyndromeAntiretroviralCommitted Communities Development TrustThe Center for Development and Population ActivitiesCommunity Health Education SocietyCatholic Relief ServicesChild to Child ApproachFocus Group DiscussionFamily Health InternationalHuman Immunodeficiency VirusInjecting Drug UserImplementing AIDS Prevention and Care ProjectKey Informant InterviewLife Skills EducationNational AIDS Control OrganizationNon Governmental OrganizationOral Rehydration SaltOrphans and Vulnerable ChildrenProject Concern InternationalPeer EducatorPeople Living with HIV/AIDSSociety for All Round DevelopmentSocial Educational and Economic Development SocietySociety for Development Research and TrainingSexually Transmitted InfectionTraining of TrainersJoint United National Program on HIV/AIDSThe United Nation’s Children’s FundUnited States Agency for International DevelopmentWorld Health OrganizationWomen’s InitiativesYoung Women’s Christian Association

IntroductionsPart OneINTRODUCTION TOTHE LIFE SKILLSEDUCATION TOOLKIT

LIFE SKILLS EDUCATION TOOLKITFOR ORPHANS AND VULNERABLE CHILDREN IN INDIAIntroduction to theLife Skills Education ToolkitFAMILY HEALTH INTERNATIONAL (FHI), INDIA COUNTRY OFFICE

ContentsPart One: Introduction to the Toolkit Why was the toolkit Developed?How was the toolkit Developed?What is in the toolkit?Who will find the toolkit useful?“This resource is funded by the President’s Emergency Plan for AIDS Relief through the U. S. Agency forInternational Development (USAID), under the terms Cooperative Agreement # HRN-A00-97-00017-00 toFamily Health International. The opinions expressed herein are those of the author(s) and do not necessarilyreflect the views of Family Health International or the U.S. Agency for International Development.”

LIFE SKILLS EDUCATION TOOLKIT FOR ORPHANS AND VULNERABLE CHILDREN IN INDIA PART ONE: Introduction to theLife Skills Education ToolkitThe “Making one Billion Count” report of the United Nations Population Fund cautionsthat the world is now home to the largest generation of adolescents in history. Of theglobal population counting 6.3 billion people, 1.2 billion are between the ages of10 and 19—with many facing the risks of disease, unwanted pregnancy and poverty.HIV/AIDS has emerged as one of the greatest threats to adolescents; this age group now accounts forhalf of all new cases of the disease. Alarmingly, every 14 seconds a young person between the ages of15 and 24 becomes infected. In addition, AIDS related deaths have orphaned 13 million childrenunder the age of 15. In sub-Saharan Africa, home to youth with the greatest numbers of HIV/AIDS,nearly 8.6 million people have HIV/AIDS—two-thirds of whom are female. In South Asia, 1.1 millionyouths are infected—62 percent are female. The rate of new infections is also growing rapidly inmany other countries including India. Discussing sexual behavior is a taboo in many countries; as aresult, many young people do not know how to protect themselves.If these trends continue, the next generation of adults will face greater poverty and difficultsocioeconomic circumstances. The report estimates the economic benefit of a single avertedHIV/AIDS infection is 34,600 for a poor country, and the social benefits are even greater. Moreinvestment must be made in youth-friendly services, family planning and education programs toaddress the reproductive health issues of young people. Their educational and health status,readiness to take on adult roles and responsibilities, and the support they receive from theirfamilies, communities and governments will determine their own future and the future oftheir countries.Source: United Nations Population Fund, State of the World’s Population Report, 2003Young people hold the promise of our future. Working with and helping young people have always been apriority across time and cultures. The HIV/AIDS epidemic has challenged us in exceptional ways to find themeans to protect and empower our young people to help them become happy, healthy adults. Life skillsoffer an approach to contribute to the well being of our young and help them meet life’s many challenges.1

2 PART ONE: INTRODUCTION TO THE LIFE SKILLS EDUCATION TOOLKITWhy was the Life Skills EducationToolkit developed?Family Health International (FHI), throughfunding from the United States Agency forInternational Development (USAID), works with 37projects in India reaching approximately 50,000orphans and vulnerable children (OVC).Organizations working with OVC expressed a needto develop a toolkit to provide essential skills forchildren in the project areas to prevent them fromacquiring STIs/HIV/AIDS and to help them copewith HIV infection. Existing Life skills educationmanuals were found to deal only with preventiveskills; more was needed to provide criticalinformation on the coping skills needed for youthaffected by and infected with HIV/AIDS. Toaccomplish this goal, FHI commissioned aconsultant to develop this Life Skills EducationToolkit.In the Indian context, vulnerable children are thosewho are at risk of acquiring HIV and may not beHIV infected or affected. The Life Skills EducationToolkit was developed to address the risk of HIV forvulnerable children; and children infected andaffected by HIV/AIDS. A variety of programs forchildren from diverse settings were involved in thecreation of the Toolkit. These included programesthat worked with children living in shelter homes,the streets, communities, and urban and rural redlight areas. Children involved included those livingwith parents with HIV or orphaned by AIDS,children of sex workers, and those frommarginalized communities or migrant populations.For the purpose of this document ‘vulnerablechildren’; and children infected and affected byHIV/AIDS are referred to as OVC.THE NEEDS ARE GREAT—CHILDREN ARE NOW ATTHE CENTER OF THE EPIDEMIC1. It is estimated that more than 50 percent of allnew infections affect young people betweenthe ages of 15 and 29.2. In low prevalence areas, there is an urgentneed to target young people to prevent HIVand address risk behavior.3. In places with high rates of HIV infection,there is an urgent need to address orphansand vulnerable children. Children areespecially vulnerable when parents are livingwith HIV or have died of AIDS.

LIFE SKILLS EDUCATION TOOLKIT FOR ORPHANS AND VULNERABLE CHILDREN IN INDIA DEFINING THE YOUNG The terms “adolescents,” “youth,” and “young people” are used differently in differentsocieties. These categories are often associatedwith varying roles, responsibilities and agesdepending on the local context.Key life events—marriage, sexual debut (firstsexual intercourse), employment,childbearing, acceptance in adultorganizations and political participation—also occur at different times between andwithin societies.National programs and policies often makedifferent distinctions among these categoriesas well. In India, for example, the country’sYouth Policy includes people up to the ageof 35. Commonly used definitions acrossdemographic, policy and social contexts include:– Adolescents: 10-19 years of age (earlyadolescence, 10-1; late adolescence, 15-19) ;– Youth: 15-24 years of age;– Young people: 10-24 years of age;– Child: From the ages of birth throughadolescence. As per the Juvenile Justice Act2000, “child” is defined as an individualbelow 18 years of age;– Vulnerable Child: A child living in ahousehold with a chronically ill parent/caregiver in a high-risk setting due to HIVprevalence or proximity to high-riskbehaviors. In the Indian context,“vulnerable children” are those who are atrisk of acquiring HIV infection; and– Orphan: A child who has lost one orboth parents.This document uses USAID definitions in its Orphanand Vulnerable Children projects and young people andchildren are used synonymously.CHILDREN NEED BOTH HIV PREVENTION ANDCARE AND SUPPORTHIV/AIDS programs must address the diversevulnerabilities of children, including: Children of sex workers and othermarginalized communities, such as ragpickers and street children, who are inexploitive situations and are especiallyvulnerable to HIV; Girls who are increasingly at risk because ofmyths surrounding sexuality and STIs/HIV,such as the belief that if a man has sex with avirgin girl, he can be cured of STIs/HIV; Media messages particularlycommunicated through adult programsand literature like movies and magazinesthat glamorize alcohol, sex and richlifestyles tempting young people tosuccumb to potentially risky situations; Substance use among young people,which makes them vulnerable to riskybehavior and HIV; Young boys and girls who are unaware ofreproductive health issues and safe sexpractices may experiment with unprotectedsex and expose themselves to STIs/HIV; and Children who are caregivers ofHIV-affected parents, and thus haveexperienced trauma and the loss ofchildhood, may also be infected by HIV.Over the years better understanding of the HIVepidemic has emphasized the need to sensitize andeducate service providers to respond urgently andmore effectively to the needs of orphans andchildren who are vulnerable, infected and affectedby HIV/AIDS.3

4 PART ONE: INTRODUCTION TO THE LIFE SKILLS EDUCATION TOOLKITNEED FOR LIFE SKILLS EDUCATIONRESOURCES THAT ADDRESS BOTH HIVPREVENTION AND CARE AND SUPPORT ISSUESWestern countries need to include ways in whichboth children and the community can contributeto the learning of life skills.This Life Skills Education Toolkit addresses differentgroups of children in different contexts for bothHIV prevention and care and support. The Toolkitcan be used by projects that aim to:This Life Skills Education Toolkit provides aframework and methodology for children toparticipate in the learning of life skills and for adultsto facilitate this process in the context of thesocieties in which they live, be it a slum community,a village, a street or an institution. Prevent HIV infection; Manage and cope with risky situationsrelated to HIV; and Help cope with issues related to HIVinfection and care and support.The Life Skills Education sessions encourageschildren to acquire psychosocial skills, enablingthem to acquire the following abilities: Understand sexual issues and sexuality inorder to reduce their vulnerability to HIV;NEED FOR LIFE SKILLS EDUCATIONRESOURCES TO PROMOTE CHILDREN’SPARTICIPATION Cope effectively with risky situations;Life skills education manuals generally provide abag of activities to pick and choose from. Somemanuals are more instructional and didactic intheir approach rather than anchored in theprinciples of children’s participation. Availablemanuals do not provide a conceptual frameworkfor how young people participate and learn safebehavior. For example, in many cultures familyand community are important players in decisionmaking processes. Social relationships in thesecultures influence decisions. However, in Westernsocieties, decision-making are often linear,individualistic and rational.1 Programs in non- Learn how to help and support other children.1 Practice safe sex behavior to reduce HIVrisks; andChildren can acquire these skills only if they areable to learn and practice them in a supportiveenvironment of peers and family. This toolkitbuilds on many decades of program experiencethat promote children’s participation andchildren’s rights. The Life Skills approachadvocated in this toolkit helps children learn,recognize and integrate lessons learned inlearning centers through real-life situations. Inthis way, children are able to practice new, safeand healthy behaviors and build confidence intheir day-to-day lives.For an excellent discussion on emerging communication frameworks for HIV/AIDS see UNAIDS/Penn State Project,“Communication Framework for HIV/AIDS,” 1999 and Richard Parker and Peter Aggleton, “HIV and AIDS related stigma anddiscrimination: a conceptual framework and implications for action,” Social Science and Medicine 57 (2003) 13-24, www.elsevier.com/locate/socscimed.

LIFE SKILLS EDUCATION TOOLKIT FOR ORPHANS AND VULNERABLE CHILDREN IN INDIA How was the Toolkit Developed?The development of the toolkit, which took a yearto complete, included an assessment of the needsfor life skills in OVC programs in India.Organizations2 that were working on HIV/AIDS indifferent states in India participated throughquestionnaires and workshops that assessed whylife skills were needed, how children could beinvolved in the learning process and whatbehavioral changes in children were expected fromthe Life Skills Education Program. Results wereused to help define the goals and objectives of theLife Skills Education Program. The contents of thetoolkit were developed after an exhaustive reviewof literature that included children’s participation,child rights, reproductive health, the psychosocialdevelopment of children and Life skills educationmanuals from India and other countries. Selectedactivities from these manuals were adapted andnew ones were developed and integrated to addressthe goals of the Life Skills Education Program.Field-based organizations working on OVC issuesfrom different parts of India participated in2conceptualizing, pilot testing, reviewing andadapting the toolkit. The toolkit has undergoneseveral revisions with feedback from the field,and will continue to be enriched and revised withexperience.A skill-building workshop in child participatorymethodologies and life skills was held for allparticipating organizations in the developmentof the Toolkit. On-site support during pilottesting was provided to six organizations and anexhaustive activity-by-activity feedback and reviewwas given to all organizations. Contents of the Lifeskills education toolkit working draft were sharedat skill building workshops. Feedback was receivedthrough various channels: e-group sharedexperiences, onsite visits were made, and partnerNGOs contributed by participating in the fieldtesting. After six months of pilot testing, a nationallevel workshop was held to synthesize the learningand incorporate feedback and experiences. Thisedition of the Life Skills Education Toolkitincorporates these experiences.CCDT and Prerana in Mumbai: SARD, YWCA, PCI, Salaam Baalak Trust in Delhi, CHES, Positive living project (Namakkal) inTamil Nadu, SFDRT in pondicherry; SEEDS, WINS and World Vision in Andhra Pradesh and DSSS (CRS Manipur).5

6 PART ONE: INTRODUCTION TO THE LIFE SKILLS EDUCATION TOOLKITWhat is in the Tookit?The Toolkit is a comprehensive package comprisedof a Facilitator’s Guide, Life skills educationModules, Information Sheets and a list ofResources for further reading and reference.The Facilitator’s Guide provides a rationale forbehavior change through child participation, howchildren can participate, what facilitation andsupport is required by significant adults and thewider

India Country Office 16, Sunder Nagar New Delhi 110 003, India Tel: (91 11) 4150 7444/7555 Fax: (91 11) 2435 8366 www.fhi.org PREFACE This Life Skills Education (LSE) To