Educators’ perceptions of the life orientation programme in schools and its effect on HIV/AIDS

The life orientation programme (LOP) was introduced to all schools in South Africa to help learners to, among others, take cognisance of their sexual lives. Before the programme was introduced in the 2006, many learners had become infected with human immunodeficiency virus (HIV). The programme was introduced based on the perceptions that some learners were struggling as a result of the epidemic. The main aim of this study was to evaluate educators’ perceptions of their ability to successfully implement the objectives of the programme. In the study we used open-ended questions to explore 8 educators’ perceptions on the programme. Of the 8 educators who responded to the questions in the questionnaire, only 2 were interviewed based on their willingness and commitment to life orientation (LO) in schools. The findings suggest that only 1 of the 8 educators had the relevant training and qualification to teach LO at school. Although the educators considered the programme to have a moderate influence on the learners’ sexual behaviour, we highlight compromise and uncertainty about the veracity of such claims. The introduction of LO to South African schools cannot be underestimated because of its well-timed intervention. However, all involved must be committed to ensure successful implementation of the programme.


Introduction
The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is one of the most dreadful pandemics that have affected a great number of people over the last three decades or soespecially in developing countries. HIV/AIDS is an infectious disease caused by HIV. HIV/AIDS, a poorly known disease for more than two decades, is currently a pandemic that has devastated many lives and shattered the dreams, hopes and aspirations of many people around the world (Kuo, LoVette, Pellowski, Harrison, Mathews, Operario, Beardslee, Stein & Brown, 2019). Despite spirited efforts by many developing countries, non-governmental organisations and various United Nations (UN) bodies to bring the disease under control, new cases are being reported daily.
According to Mathenjwa, Khidir, Milford, Mosery, Greener, Pratt, O'Neil, Harrison, Bangsberg, Safren, Smit, Psaros and Matthews (2022), South Africa has the largest population of the people living with HIV/AIDS in the world. Likewise, Kharsany and Karim (2016) indicate that in 2013 approximately 35 million people around the world lived with HIV/AIDS. In reality, considering the stigma usually attached to the disease, especially in African traditional societies, the reported figures may be far below the actual number. Steinbrook (2016) reports that in 2015 there were approximately 2.1 million new HIV infections and 1.1 million HIV/AIDS-related deaths globally. Beyond statistics, however, it must be noted that the bulk of this number represents mostly young people with great potential to contribute to the socio-economic development of their respective countries. It is against this background that we undertook this study as part of the efforts directed at exploring the efficacy of the programmes aimed at increasing the awareness of school-going youth about the enormous challenge facing them relative to the disease. The aim of this study was to evaluate the perceptions of educators about the life orientation programme (LOP) at a Western Cape high school (fictitiously named Dynamic High School). More specifically, we attempted to determine the educators' perceptions in terms of the effectiveness, efficiency, relevance and impact of the LOP at reducing the spread of HIV/AIDS among learners in the participating school.

Research Design and Method
The earlier debates in South Africa about whether or not HIV/AIDS was worth all the attention has since been replaced with government policies and programmes of action specifically formulated to find the most effective ways to curb the high rates in which the disease has been spreading among the youth (Adejumo, Malee, Ryscavage, Hunter & Taiwo, 2015;Mabaso, Sokhela, Mohlabane, Chibi, Zuma & Simbayi, 2018). As Poon, Swapna and Chong (2013) note, the best indicator of any programme is the correlation between the aims and the outcomes of that programme. In order to investigate whether there is a correlation between the aims and outcomes of LOP in South African schools, appropriate methods of data collection and analysis must be employed.
In the study we involved eight educators of five Grade 8 classes in a school in the northern school district of Cape Town. Data were collected using questionnaires and interviews. A questionnaire comprising questions on the following themes was developed: perceptions, qualifications, successes and failures of LO and educators. The draft questionnaire was reviewed by a panel consisting of science educators who were well-informed about the LOP. The panel of experts was asked to rate the quality of the items on a scale of 1 to 5 (1 = poor and 5 = excellent). The interview questions were validated by a professor of science education and recommendations for improvement of the questions were made. The questions were duly altered in line with his recommendations before it was administered.
Written consent was obtained from the school administrator. The rights of the participants were guaranteed as the researchers and the participating educators agreed on an ethics statement. The participants were informed of their right to withhold any information if they felt uncomfortable to speak out, and to withdraw from the study at any time if they wished to do so. The participants were assured of the confidentiality of the research data and that the researchers had fully disclosed what the research study was about (Andrew, Pedersen & McEvoy, 2019). Furthermore, the participants were assured that their anonymity was guaranteed.

Data Collection and Analysis
All participating educators (eight) answered the questions in the questionnaires. However, only two of the eight educators were interviewed. These two educators were chosen based on their qualifications, availability and the researchers' judgement that they would be able to respond adequately to the questions. The educators were both interviewed for 45 minutes.
The data collected from these sources were then analysed to determine the perceptions of the individual educators about the effectiveness, efficiency, relevance and impact of the programme (Andrew et al., 2019). In the study we focused on the experiences and training undergone by the eight LO educators.
Data were gathered from educators at Dynamic High School situated in a low-income community in Cape Town, South Africa. The selection of the purposive sample was based on the participants' willingness to participate and the fact that LO was presented at the school. Eight LO educators participated in the study. Questions were designed in order to extract information about the LOP from the educators. The question items focused on the educators' knowledge of the content of the LOP, the confidence they had gathered thus far in implementing the programme, their experiences in the LO classrooms, and perceptions of their own competence to implement the programme. A focus group discussion was conducted to allow educators to discuss their views about the programme extensively and in depth.
Qualitative data analysis followed the guiding principle that was suggested by Milgrom, Foreman, Standeven, Engsberg and Morgan (2016). The participants' responses were categorised under effectiveness, efficiency, relevance and impact in order to evaluate the perceptions. At the end of the processes, the comparison lists were combined to construct the final list that served as the research findings.

Literature Review
The HIV/AIDS pandemic is known to be one of the greatest health challenges faced by most African countries (Steinbrook, 2016). The rapid spread of HIV/AIDS in the world has brought with it the realisation that the disease was more complex and extensive than imagined (Kharsany & Karim, 2016). The alarming increase in the rate of infections, combined with the fact that researchers had not found a cure, has considerable socioeconomic implications. Although the HIV/AIDS pandemic appears to have stabilised in most countries due to different prevention and intervention programmes, HIV prevalence has been observed to increase in Eastern Europe and in parts of Asia (Steinbrook, 2016). Sub-Saharan Africa has been observed to be the most heavily affected region, with South Africa having one of the highest rates of HIV prevalence in the world (Kharsany & Karim, 2016). According to Woollett, Pahad and Black (2021), the largest percentage of the Sub-Saharan population living with HIV is teenagers. They further noted that in most countries the infection rate among adolescents was highest, with debilitating effects on the educational sector of these countries.
The spread of HIV/AIDS in South Africa has continued to be highest (Steinbrook, 2016) and according to Aventin, Gordon, Laurenzi, Rabie, Tomlinson, Lohan, Stewart, Thurston, Lohfeld, Melendez-Torres, Makhetha, Chideya and Skeen's study, South Africa has the highest number of HIV infection cases in the world (Aventin et al., 2021). Young South Africans in the age group of 15 to 29 years account for half of all new HIV infections (Mabaso et al., 2018) and this could be attributed to the fact that at least 50% of young people are sexually active by the of age 16 (Steinbrook, 2016). A significant percentage of people at this age (15-19 years) attend school, where they spend a substantial part of their time. In the survey carried out by Mabaso et al. (2018), more young women were found to be infected with HIV than their male counterparts (Filiatreau, Pettifor, Edwards, Masilela, Twine, Gómez-Olivé, Haberland, Kabudula, Lippman & Kahn, 2021). These researchers observed an increase in the percentage of HIV prevalence among 15 to 16-year-old females.
In order to assist learners in schools, the South African government introduced the HIV prevention programme in schools through LOP in the late 1990s with HIV/AIDS and sex education as key components (Department of Education [DoE], 2002;Rooth, 2005). This programme was designed for youths with a view to equipping them with the knowledge and skills they needed to make healthy choices, especially about their sexual lives (Msutwana, 2021).
LOP was introduced based on the assumption that efficient education on HIV/AIDS prevention was possible only when learners had the opportunity to acquire functional knowledge about HIV/AIDS. Mabaso et al. (2018) consider some ideas that support healthy behaviour related to HIV/AIDS and they proposed some basic skills to support such healthy behaviour and practices. Some of the items covered in the LOP include: guidance, life skills education, health promotion, physical development and movement, environmental education, citizenship and human rights education, and religious education (Msutwana, 2021).
Educators are given a considerable amount of responsibility and autonomy concerning the implementation of LOP in schools (Steinbrook, 2016). Apart from this, the LO educators were equipped with knowledge of HIV/AIDS and sex education (Msutwana, 2021 , 2018). The ability of LO educators to adequately impart knowledge and the confidence to teach the said "mandatory subject" in order to achieve the purpose of the LOP cannot be overemphasised. Helleve, Flisher, Onya, Kaaya, Mukoma, Swai and Klepp (2009) investigated educators' confidence in teaching HIV/AIDS and sexuality in South African and Tanzanian schools. They observed that South African and Tanzanian educators were fairly confident in teaching HIV/AIDS and sexuality. Apart from the confidence to teach, the willingness and the seriousness put into the teaching by the educators had to be considered if the purpose of the programme was to be achieved. However, educators cannot succeed on their own without the support of school administrators. The role of the school principals in ensuring that the programme was successful is also an important factor to be considered. In another study by Helleve et al. (2009), educators' perceptions and practice of teaching HIV/AIDS and sexuality were explored from a cultural perspective. Findings of the study show that educators perceived teaching sexuality and HIV/AIDS as a challenge because of the language and communication norms, and the need to convince learners about the reality of AIDS.
Despite studies that have been carried out on teaching sexuality and HIV/AIDS in South African schools, there are more questions that have not been adequately answered, which this study tends to provide answers to. These questions include the following: i) What are the perceptions of the educators about the LOP in Dynamic High School? ii) Are the educators in the school well-qualified to implement the LOP in their classrooms? iii) To what extent could the LOP at the school be considered successful or otherwise? Providing answers to these questions will give insight into the perceptions of educators on the LOP and how it affects the sexual behaviour of learners.

Conceptual Framework
The conceptual framework for the study is based on the evaluation theory designed and modified by Fatoba (2013). The parameters or indicators used to collect information on the programme (LOP) in order to determine its quality, included effectiveness, efficiency, relevance and impact. These parameters were found to be useful for evaluating programmes (Fatoba, 2013). The output represents the collected and analysed data or information which was used to interpret the responses.
Effectiveness is regarded as the level to which the set goals of the programme have been achieved. Efficiency has to do with the connection between the quantity and quality of goods and services made available for the recipients which have to do with the method and process of acquisition. Relevance is the link between the goals of the programme and the necessity or demand to be met by the recipients. Fatoba (2013) appropriates the definitions of Masala (2002) and Ogunniyi (2004) when she describes evaluation as a practice or methodical way of appraising the impact of a programme, project or a policy when the programme is still functioning or after the programme has ended. This has to do with the critical analysis of the programme through a thorough review of effectiveness, efficiency, relevance and its impact. Interviews were conducted with the participants to generate responses which were transcribed verbatim and the interpretations were written from our own perspectives. Moreover, the information gathered was categorised under the parameters chosen as a guide to the study i.e., effectiveness, efficiency, relevance and impact.

Results and Discussions
With the first research question we sought to elicit the perceptions of the educators about the LOP. The educators' perceptions of the programme were not unanimous. While some of them found the programme useful, others did not think it was. One of the educators was of the opinion that the programme was useful. She substantiated her stance by saying that the learners had greater knowledge of HIV prevention than they had before the introduction of the programme. Also, in her view, the learners' knowledge about sex education had increased as a result of the knowledge acquired through the LOP.
Mrs Jeffson: They do enjoy discussing sex with us. A lot of them do not feel free to talk to their parents and, and, and, they do come to us, um, I try to teach them about sex and they do come to us um, I, I, don't then think that it is a taboo, um it is a subject they must be free to discuss what they do, can stand before choices I'm sure ...
[that] what we have discussed in class have made a difference compared to when they were ignorant of that information.
Another educator also confirmed this.
Yes um ---, if you are just talking about HIV now, or in general, um --, if I compare the knowledge of learners before we started LOP. When we started um --, the knowledge now compared to grade now and grade 8, 5 or 6 years ago, there is vast difference. Grade 8 learners now know how to prevent themselves from HIV. They know um ---, they even know like when you contract HIV, um --, that it is important to have a healthy lifestyle. Um ---, they are very knowledgeable in all aspects of HIV, yes. Yes, um ---because you teach them that they should take responsibilities and consequences of their actions. Through this teaching, many of them act responsibly. They are these (few) percentage who will engage in risky behaviour, but umm ---, I don't believe that it is majority of them, I think is a minority.
However, both educators were of the opinion that the programme was not so useful because the pregnancy rate among the learners was still on the increase in spite of the fact that they were taught various methods of safe sex and the use of contraceptives. In addition, they argued that the rate of HIV among the youth did not seem to be decreasing nationally. One of the educators pointed out that learners did not take LO classes very seriously. As a result, the classes are always noisy, rowdy, and the educators often found themselves incapable of controlling the situation. In other cases the learners believed that they knew better than the educator. This made the LOP less effective than it should have been.
Mrs Clarke: Some of them don't, because if you see the number of girls that are pregnant in the school, they are about like 5 or 6 and they will be complaining, then you will know that they have not implemented the knowledge.
Some of the educators were of the opinion that the LOP had so many setbacks making it less useful and ineffective. Firstly, LO does not have any weighting in the final examinations (Matric). This causes learners to not take the subject seriously. Secondly, most of the educators who taught LO were trained to teach other subjects, but the teaching of LO was added in order to complete their work allocation. So, the school administrators and/or the DoE seemed to create the impression that the LO content was not so specialised, and hence anybody could teach it. All these factors could possibly contribute to the high rate of absenteeism noticed among LO educators. The excerpts below explain some of the challenges of LO educators at Dynamic High School. It seems from the foregoing that the acquired training of the programme had been seriously compromised. The experience, ease and confidence required to implement a new programme like LO cannot emerge from a vacuum. It should have arisen through training, re-training and upgrading of those required to implement that programme. LO is an empowering programme that can equip learners with the knowledge and skills to make wise decisions on critical life issues. As a matter of fact, the knowledge and skills acquired in the programme have the potential to save learners from contracting HIV/AIDS, a life-threatening scourge in many developing countries, with South Africa at the forefront. In other words, Mrs Jeffson seemed to have built up her confidence in teaching LO over time, even though she was not formally trained in the implementation thereof. Also, as indicated earlier, the programme was underfunded and this automatically affected the efficiency and use of scarce human and material resources. Training the educators would have afforded them the needed knowledge and skills to implement LOP more confidently and efficaciously than was the case when the study was conducted. Resource availability, both human and material, is important in implementing any programme if the desired goal is to be achieved (Fatoba, 2013). However, if the resources are scarce or limited, the expected outcome will not be achieved (Andrew et al., 2019).
From the educators' comments it became clear that fewer lesson periods were allocated to LO at Dynamic High School. Furthermore, educators not trained in the subject were required to teach it. It appears that the LOP at Dynamic High School is regarded no man's landa subject that can be taught by any educatorqualified or not. Under such circumstance it is near impossible to run a programme efficiently and effectively and for it to have a noticeable impact on the lives of the learners at the school. Hence, the implemented LOP at the school was a far cry from what the developers intended, which is expounded by the following: "Only one. I would like to have more periods if they want to give more because ... though it was just to add to my total period for the year, so they only give me one class" (Mrs Jeffson).
The second research question was about the educators' capacity to implement the LOP. Their responses to the questionnaire revealed that only one of the eight educators was formally trained. Although some of the educators had been teaching LO since 2004, one cannot completely rely on experience and skills acquired on the job in the absence of a professional qualification. The results of the study show that most of the educators in Dynamic High School were not initially trained to teach LO, which may affect their performance in the classroom negatively. The responses of most of the educators to the 10-item questionnaire show that they were uncomfortable to teach and discuss HIV/AIDS or sex education in the class because of the sensitivity of the issue. Moreover, one of the educators confessed that she was not comfortable enough teaching sensitive areas of LO such as sex education. This may be understandable because in many African cultures sex is a sensitive topic which is not usually taught to teenagers for fear that they would be encouraged to become promiscuous. However, their comments on the challenges they faced during the LOP classes seemed to reveal the effect of not being properly trained.

Responses from the Educators
As indicated earlier, only one of the eight educators specialised in the teaching of LO while the remaining seven were trained to teach subjects like English, mathematics, technology, geography, history, and Afrikaans. The one trained LO educator in the school lamented the lack of educators who could competently teach the subject. The excerpt below shows the educator's frustration concerning the teaching of LO at the school. From the participants' responses we also concluded that the educators responsible for teaching LO did not do as required. While some of the educators indicated that they taught LO for two lesson periods per week, some of them acknowledged that they only taught one LO lesson per yearobviously not effective teaching of such an important subject.
Based on the responses quoted above, it is difficult, if not impossible, to achieve the aim of the LOP at Dynamic High School. In a situation where 50% of the educators did not go to their classes regularly, where the programme was poorly monitored by the school administrators, where only 16.6% of the educators rated the programme as relevant, and 50% considered it as moderately relevant, one could predict that the programme could not be as effective as it should be.
Educator (T1): I am not comfortable at all, because learners always laugh during the lessons and not taking the subject serious. Educator (T2): I am not comfortable because some of the learners are unruly and believed that they know more than their teachers. Andrew et al. (2019) reveal that one of the problems associated with the execution of a programme is the match and mismatch between the executors and the goals of the programme itself. The mismatch that might have occurred in this context was the presumption of the educators and the goals of the programme. Basically, the paramount idea of most of the LO educators at Dynamic High School was that LO was added to their workload to fill up their quota of teaching periods. This seemed to be more about filling their teaching quota than effectively imparting knowledge that would influence learners' lives positively. In general, most of the educators rated the programme to be moderately successful probably because of the challenges mentioned before. For instance, Mrs Jeffson who had indicated her interest in teaching LO could be encouraged by allowing her to attend educational training, seminars, conferences and workshops in order to improve her skills in the subject. As can be seen from their responses, most of the participating educators were reluctant to teach LO since that was not their area of expertise. It is normal for educators to feel this way when LO serves as an additional responsibility to them. They may feel indifferent about making an effort with a subject that they are not trained in. However, the implication of this is that only those educators who have the knowledge of the subject and have received proper training should be allowed to teach LO. Moreover, training, retraining and workshops should be arranged from time to time.
Another challenge that was raised was the issue of punctuality. The principal should take up the duty of moving around from time to time to ensure that LO is taught as it is supposed to.
With the third research question we examined the extent to which the LOP at Dynamic High School could be considered successful or otherwise. To provide answers to this question, the educators' responses to the questionnaire and the interview were used (Table 1). The educators were asked to rate the efficiency, effectiveness, relevance, and impact of the programme as low, moderate, high or very high ( Table 1). Three of the eight educators rated efficiency of the programme as moderate while five rated it as low (Table 1). This seems to corroborate the comments of the HOD during the interview on how the programme was being run. With regard to the effectiveness of the programme, three of the educators rated it as moderate while five rated it as low. Looking at the educators' responses regarding effectiveness, it was observed that the sexual behaviour of the learners had not reduced as was expected: "There are still too many girls that fall pregnant." One can, therefore, conclude that the programme was not as effective as it should have been. Regarding relevance of the programme, one person rated it as high, three rated it as moderate while four rated it as low. With regard to this particular criterion, one of the LO educators commented that new ways of teaching learners about HIV/AIDS needed to be explored. In other words, it seemed as though the learners did not respond to the programme as it was envisaged. This may indicate that the programme was not attractive to them or that the approach of the programme was not structured or designed in a way that would have the desired results. With regard to the impact of the programme, answers varied even more. One educator rated it as very high, one rated it as high, two rated it as moderate while four of the educators rated it as low.
The two LO opinions of the two educators in the interviews were different from the responses to the questionnaire. The two educators expressed their optimism about LOP.
Mrs Clarke: Um …, we, we, we, try to teach the necessary skills in life to actually see they make the right choices later on. Yes, um ---because you teach them that they should take responsibilities and consequences of their actions. Through this teaching, many of them act responsibly. They are these (few) percentage who will engage in risky behaviour, but umm ---, I don't believe that it is majority of them, I think is a minority. The responses to the questionnaire contradicted the responses to the interviews in that the interviewees' responses were positive while the responses to the questionnaires were gloomy and negative. This may be because the interviews were conducted one-on-one and the interviewees were trying to create a positive impression since they might have been conscious of possible consequence that their responses might have entailed.

Conclusion and Recommendations
In this study we highlighted educators' positive and negative perceptions about the LOP. The findings show that the educators had mixed perceptions of the effectiveness of the LOP at Dynamic High School. Most of them thought that the programme was partially effective because it resulted in the learners gaining knowledge in many areas, for example sex education, where cultural background put them at a disadvantage. On the other hand, some of them argued that the programme did not really meet the purpose for which it was designed as the rate of pregnancy was still high, despite the knowledge imparted to the learners. This group of educators thought that the programme had not achieved its purpose. This corroborates the findings of Nguyen, De Villiers, Fourie and Hendricks (2017) who found that LO did not achieve its goal in three school districts in the Western Cape as most of the educators teaching the subject were not trained to do so. Of the eight LO educators who participated in this study, only one was trained to teach the subject. The rest were asked to teach it in order to complete their workloads. This calls for the urgent attention of the Department of Basic Education to train and employ qualified LO educators. As long as the subject was taught by unqualified educators the purpose of introducing the programme into schools would remain compromised. Moreover, constant professional development of the educators teaching LO is necessary for them to gain more knowledge of the subject and thus have a greater positive impact on learners' sexual behaviour (Zakeyo & Nyashanu 2021). The lack of proper monitoring of the LOP by the school administrator and the educators' negative attitudes towards the programme contributed greatly to the overall ineffectiveness, inefficiency and poor impact of the programme (Msutwana, 2021).
It seems imperative for the Department of Basic Education to equip LO teachers with diverse and relevant teaching aids in order to make the teaching of LO effective. Educators should be provided with teaching aids to illustrate diverse areas of the LO curriculum to enable them to teach the content in a manner compatible with the overall aim of the programme. Educators should be trained to motivate and involve learners in their teaching and curriculum plans and create a dynamic atmosphere that could easily capture learners' attention. Educators must equally have some interesting characteristics and attributes that will stimulate learners to learn the unique subject.
To stem the tide of the spread of HIV/AIDS among school children, a more effective programme of action would need to be put in place. This would entail proper training or retraining of educators, responsible administrative support, adequate supply of instructional materials, and periodic evaluation of the programme to determine its relevance, effectiveness, efficiency and impact. The establishment of LO in South African schools is one of the achievements that should be lauded because of its timely intervention. However, the need to ensure the success of the programme cannot be overemphasised. All stakeholders in the programme need to work together to ensure the successful implementation of the programme.