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TAI believes in a rights-based approach which dictates that we do not present predefined solutions, but rather facilitate a process whereby communities identify their own solutions. This involves: the provision of information; the development of skills and refinement of self-motivation; providing a platform for reflection on attitudes, values and beliefs; advocating for changes in the environment that promote the wellbeing of communities. TAI implements intensive programmes that function on a number of interrelated and supportive levels, starting with the peer group. TAI supports the use of intensive programmes that promote profound and long-lasting societal change.
the kamsee model
The core model in our well-being promotion programmes is the KAMSEE model. This model recognises that promoting changes in behaviour is about more than just sharing information and distributing materials. Rather, the entire context of the individual needs to be examined so that they may come up with realistic strategies for identifying behaviours that will promote their well-being, in their specific context. The model can be described as follows, using HIV prevention as the point of reference. It can be adjusted to any key issue.
table 1: explanation of the kamsee model
| K |
Knowledge |
- What does the individual know about HIV and AIDS?
- What do they know about HIV spread and prevention?
- What information do we need to share to enable them to make informed choices? This could include information relating to puberty and the workings of the human reproductive system.
- What information does the individual have that could place them at increased risk? Such as myths about sexuality and sexual development
|
| A |
Attitudes, values and beliefs |
- What attitudes, values and beliefs does the individual have that could be strengthened to reduce their vulnerability to HIV infection?
- What attitudes, values and beliefs does the individual have that create vulnerability for themselves? Such as the belief that “real men” should have multiple concurrent partners.
- What attitudes, values and beliefs does the individual have that create vulnerability in others? Such as the belief that men should make decisions about sex and are within their rights to refuse condom use. This places women at risk.
- What activities can we engage the individual in to allow them to examine their values, attitudes and beliefs and to strengthen those that promote well-being and lessen those that create vulnerability?
|
| M |
Motivation |
- What will motivate the individual to change from behaviours that create risk to behaviours that promote well-being? These should be internal sources of motivation.
- What activities can we engage the individual in to build on internal motivation to make the change in behaviour? This could be through a process of identifying goals for your future; understanding how becoming HIV positive could impact on you achieving those goals; understanding the implication of your actions on others
|
| S |
Skills |
- What skills does the individual need in to effectively implement the changes in behaviour that they have identified?
- A range of skills need to be built such as effective condom use; negotiating condom use with your partner; understanding and withstanding peer pressure when you begin to deviate from the norm; communication skills to engage community members; how to effectively access services (eg STI treatment)
|
| EE |
Enabling Environment |
- It must be understood that individuals function within a broader system and that this system also creates vulnerability.
- What can the programme developers do to create an environment that supports behaviours that promote well-being? For example, your intervention focuses on condom use but there are no free condoms within the area. Or you promote STI treatment but when young people access the service from the local clinic, the nurse is derisive and threatens to tell their parents.
- What can programme developers do to assist the individual to influence their environment in a way that better support behaviours that promote well-being? This could include lobbying and advocacy skills to engage with service delivering structures, or communication skills to engage with parents on issues around sexuality.
- For example, an individual has decided to reduce the number of partners they have, however he now faces tremendous pressure from his father who now feels that something is wrong with his son because he doesn't have many girlfriends.
|
In our experience, if programme developers integrate all of these factors in their programme, there is a greatly increased chance of assisting individuals to shift from behaviours that create vulnerability to those that promote well-being.
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