Children of the sug: a study of the daily lives of street children in Khartoum, Sudan, with intervention recommendations.

OBJECTIVES: The study examines street children's daily lives in Khartoum, Sudan to recommend ways to improve their conditions and to successfully assist them off the streets. METHODS: In 2000-2001, eight researchers conducted participant observation for 7 weeks; 20 groups of children engaged in role-plays and drawing activities; over 500 children participated in qualitative group and individual interviews; and 872 current and former street children were surveyed. RESULTS: Approximately half of children were 14 years old or younger. Daily life focused on eating, sucking glue-soaked rags, obtaining money, and sometimes movies or games; many children valued their freedom and relatively abundant food on the streets. Boys engaged in odd jobs, and sometimes theft, begging, or sex work. Girls had fewer work opportunities and primarily obtained money through begging and sex work. Almost half of children saw their families weekly. Children belonged to same-sex groups of common geographic origin, which shared food, shelter, and care when sick; boys' group leaders could be both protectors and aggressors. Most girls had a boyfriend who financially assisted and protected her. Girls frequently were raped by street boys, police, or other men. Children feared routine capture, beating and incarceration by authorities. Former street children were housed in large camps where abuse was common, or costly small residencies. CONCLUSIONS: Street-based services to improve children's health and safety are urgently needed. Re-integration programs may help large numbers of children voluntarily and permanently leave the streets. Advocacy campaigns and collaborative efforts with the police, judiciary and legislature should be intensified. PRACTICE IMPLICATIONS: The paper highlights important challenges facing street children in Khartoum, and provides specific recommendations for how they might be better assisted while on the streets and successfully helped off of the streets through community re-integration, rather than current (1) large-scale beating and incarceration by government authorities, or (2) small-scale and costly residential housing by NGOs. The findings have already been used in a sustained advocacy campaign that has resulted in a number of positive legislative changes for street children, such as parliamentary endorsement of a new bill that improves street children's legal status.

Are schools a good setting for adolescent sexual health promotion in rural Africa? A qualitative assessment from Tanzania.

African adolescents are at high risk of poor sexual health. School-based interventions could reach many adolescents in a sustainable and replicable way, if enrolment, funding and infrastructure are adequate. This study examined pupils', recent school leavers', parents' and teachers' views and experiences of rural Tanzanian primary schools, focusing on the implications for potential sexual health programmes. From 1999 to 2002, participant observation was conducted in nine villages for 158 person-weeks. Half of Year 7 pupils were 15-17 years old, and few went on to secondary school, suggesting that primary schools may be a good venue for such programmes. However, serious challenges include low enrolment and attendance rates, limited teacher training, little access to teaching resources and official and unofficial practices that may alienate pupils and their parents, e.g. corporal punishment, pupils being made to do unpaid work, forced pregnancy examinations, and some teachers' alcohol or sexual abuse. At a national level, improved teacher training and supervision are critical, as well as policies that better prevent, identify and correct undesired practices. At a programme level, intervention developers need to simplify the subject matter, introduce alternative teaching methods, help improve teacher-pupil and teacher-community relationships, and closely supervise and appropriately respond to undesired practices.

Farming with your hoe in a sack: condom attitudes, access, and use in rural Tanzania.

This study examines condom knowledge, attitudes, access, and practices in rural Mwanza, Tanzania. From 1999-2002, six researchers carried out participant observation in nine villagesfor a total of 158 person-weeks. Many villagers perceived condoms negatively for multiple reasons, for example, the method's association with infection or promiscuity, reduced male sexual pleasure, and cultural understandings of meaningful sex. Men controlled the terms of sexual encounters and reported that they would use condoms only with risky partners, but few perceived their partners as such. Use of condoms appeared to be very low, primarily as a result of limited demand, although barriers to access also existed. These qualitative findings contrast with inconsistent survey reports of relatively high condom use in the same population. Intervention efforts should address the tradeoff between possible short- and long-term consequences of condom use, particularly for men, for example, reduced pleasure versus reduced HIV risk. If possible, surveys should assess the validity of reported condom use through comparison with other data, including qualitative findings and distribution/sales records.