Summary

A gender transformation programme designed to build knowledge of sexual health, awareness of risks and consequences of risk taking and provide opportunity for self-reflection of sexual behaviour.

Type of intervention

Classroom setting, group work

Target groups, level of prevention and subgroups

• Additional Resource | Classroom setting, group work | Luganda, Swahili, Estonian, Russian, Kyrgyz, French, Portuguese

Target population

Stepping Stones is a programme designed to enable women and men of all ages to explore their social, sexual and psychological needs, to analyse the communication blocks they face and to practice different ways of behaving in relationships. It targets individuals, their peers and their communities. Literacy is not required. It aims to reduce male perpetration of intimate partner violence and sexual risk taking that can lead to HIV/AIDS. Originally designed to prevent HIV/AIDS, rigorous evaluations have shown it is also effective in changing attitudes and behaviour in relation to sexual violence against women and girls.

Originally developed in 1994 by Dr Alice Welbourn for use in Uganda and sub-Sahara Africa, it has been used in over 40 countries, in at least 17 different settings and has been translated into 13 languages.

Delivery organisation

Stepping Stones is being delivered by many different organisations around the world. The original manual and video were published in 1994 by Action Aid and Strategies for Hope. Strategies for Hope (www.stratshope.org) and the Salamander Trust (www.salamandertrust.net) work together to promote and support the use of the Stepping Stones programme, which also has a dedicated website: www.steppingstonesfeedback.org. In addition, Acord, an international non-governmental organisation working to promote social justice and gender equality in Sub Saharan Africa, has published guidance on implementing the programme.

Mode and context of delivery

Stepping Stones consists of a 240 page training manual and an accompanying video of 15 five minute clips. Full instructions are provided for delivery of around 60 hours of workshop sessions. It uses participatory learning approaches including critical reflection, role play and drama, with peer groups from the same community. It is a gender transformation programme that aims to change behaviour, improve sexual health through building more gender-equitable relationships, with better communication between partners. Most sessions are for people in small groups of 10-20, of their own age and gender. Occasional sessions bring everyone together. Although originally designed with HIV/AIDS in mind, it covers many related topics such as gender violence and has been recommended by the WHO as an effective prevention tool for gender-based violence.

Level/nature of staff expertise required

Community facilitators are trained to deliver the programme with the support of the manual and can come from a variety of backgrounds. A professional background is not required. Personal qualities and facilitation skills are more important. Experienced trainers should be able to use the programme with the support of the manual only.

Intensity/extent of engagement with target group(s)

The training process is designed to take place over 12-18 weeks, with workshop sessions each lasting three hours. A preliminary and a final community meeting are recommended as part of the Stepping Stones process. The training manual has 240 pages of detailed instructions and the video has 15 five minute sessions.

Description of intervention

Stepping Stones is a gender transformation programme designed originally to prevent HIV/AIDS and improve sexual health through building stronger more gender-equitable relationships with better communication between partners. It uses participatory learning approaches to build knowledge of sexual health, awareness of risks and consequences of risk taking and communication skills and to provide opportunity for facilitated self-reflection on sexual behaviour. Originally designed by Dr Alice Welbourn in 1994 for use in Uganda, it has now been used in over 40 countries. It has been extensively evaluated and shown in a randomised controlled trial to be effective in changing young men's sexual practices and perpetration of violence.

It is designed for use by a team of skilled people (ideally two males and two females) who work with peer groups of community members. Most sessions are for groups of 10-20 people of their own age and gender. Occasional sessions bring peer groups together.

The intervention consists of 13 three hour sessions, delivered to single gender groups by someone of the same gender. This can be delivered in schools, but also in other settings. These sessions are followed by three peer group meetings and a final community meeting. Drama and role play are used in the sessions. Groups explore and develop the ability to look critically at societal norms and values affecting their own attitudes and behaviour and help participants to identify ways in which their behaviour may need to change. They also focus on improving communication and caring for others. The sessions include:

• Listening and communication
• How we act and what shapes our perceptions
• Contraception, conception and menstruation
• Taking risks, sexual problems and unwanted pregnancy
• STDs and HIV
• Gender based violence
• Motivations for sexual behaviour- let’s look deeper
• Let’s support ourselves
• Let’s assert ourselves
• Let’s change ourselves
• Let’s work together
• Preparing for the future

In addition to the training manual and video, a guide on implementation has been published and there is a website and a community of practice supporting implementation.

Evaluations

Extensively evaluated in different countries this programme has been recommended by the WHO as effective in the prevention of gender based violence. A number of evaluations can be accessed through the website www.steppingstonesfeedback.org

A randomised controlled evaluation has been carried out: Evaluation of Stepping Stones: A gender transformative HIV prevention intervention by Jewkes, R., Nduna, M., Levin, J., Jama, N., Wood, K., Koss, M., Puren, A., Duvvury, N. This found evidence of the programme’s effectiveness in reducing male perpetration of intimate partner violence. It also helped people become better friends, partners and parents.

References

Manual and DVD: Stepping Stones Training on Gender, HIV, Communication and Relationship Skills (1995) Welbourn, A. can be purchased online from www.talcuk.org.

Stepping Stones Plus (2009).

Joining Hands Integrating Gender and HIV/AIDS: Report of an ACORD Project using Stepping Stones in Angola, Tanzania and Uganda. Akullu, Hadjipateras and Owero (2006). Download from https://commons.clarku.edu/cgi/viewcontent.cgi?article=1080&context=idce_masters_papers

Contact details

Dedicated website: www.steppingstonesfeedback.org.
See also websites of Strategies for Hope: www.stratshope.org and www.salamandertrust.net.

INFORMATION CORRECT AT MARCH 2020

RATING: Effective