WHO/ MSD/ MDP/ 00.

17
Original: English
Distribution: Limited

PRIMARY
PREVENTION
OF SUBSTANCE
ABUSE
A WORKBOOK FOR
PROJECT OPERATORS

Department of Mental Health and Substance Dependence

Noncommunicable Diseases and Mental Health
World Health Organization
Geneva

Demand Reduction Section

Division for Operations and Analysis
United Nations International Drug Control Programme
Vienna

Primary Prevention of Substance Abuse ♦ A Workbook for Project Operators

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Text only version including minor formatting modifications

© World Health Organization, 2000

This document is not issued to the general public, and all rights are reserved by the World
Health Organization (WHO). The document may not be reviewed, abstracted, quoted,
reproduced or translated, in part or in whole, without the prior written permission of WHO. No
part of this document may be stored in a retrieval system or transmitted in any form or by any
means - electronic, mechanical or other – without the prior written permission of WHO. The
views expressed in documents by named authors are solely the responsibility of those authors.

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Background
The United Nations International Drug Control Programme and the World
Health Organization (UNDCP/ WHO) Global Initiative Project on Primary
Prevention of Substance Abuse endeavours to contribute to the prevention and
reduction of psychoactive substance abuse among young people, through
community mobilisation, development and dissemination of good practices. As
used in this workbook, the term psychoactive substance refers to any substance
that when taken by a person, can modify perception, mood, cognition, behaviour
or motor functions. These substances have devastating consequences for the
person using them, their family and the community as a whole. Many countries
recognise that the use of substances by young people is a serious health and
social problem. Use of substances robs young people of their childhood and
leaves them little chance to have a healthy lifestyle in the future. Primary
prevention is a universal priority for enhancing the health of young people and
can be applied to prevention of psychoactive substance abuse.

Young people are particularly at risk for substance use, as they are in a period
of life when patterns of behaviour are being formed and they are most likely to
be influenced by peers and role models who may be involved in the use of
substances. It is thus an important period in life when behaviours can be
influenced for the benefit of long-term good health. Although the direct
beneficiaries of this initiative are young people and those who play a significant
role in their lives, primary prevention efforts can also have a positive wider
impact on communities where the projects are implemented.

The role of the community in preventing substance abuse should be

participatory and not merely that of responding to services planned and
designed by external agencies or individuals. The community should actively
participate in determining the problems and needs, developing solutions, and
implementing and evaluating interventions. Primary prevention should be
comprehensive and should draw on existing human, financial and material
resources to strengthen self-help and community participation. This is the
underlying principle behind the UNDCP/ WHO Global Initiative on Primary
Prevention of Substance Abuse.

This workbook and the facilitator guide have been developed for project
operators involved in the Global Initiative Project on Primary Prevention of

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Substance Abuse (Global Initiative). However, others involved in similar
prevention work can use these training materials.

Acknowledgements
We would like to express our gratitude to the Norwegian government for the
financial support that made development of this workbook and the companion
facilitator guide possible. In addition we would like to acknowledge the technical
contribution of colleagues in UNDCP, WHO, South African Alliance on the
Prevention of Substance Abuse (SAAPSA) and the regional offices of WHO and
UNDCP in the three regions of implementation: Central and Eastern Europe,
Southern Africa and South-east Asia. In particular we would like to thank
participants in the three regional workshops for their contribution during field-
testing of this workbook and facilitator guide. We would also like to thank Ms.
Tecla Butau, WHO African Regional Office for her diligent contribution to the
revision of these training materials.

Secretariat (HQ)
Shekhar Saxena WHO, Geneva
Mwansa Nkowane WHO, Geneva
Christina Oguz UNDCP, Vienna
Giovanna Campello UNDCP, Vienna

Text
Mwansa Nkowane

Illustrations
Harry McConville

Layout and design

Jhilmil Bahl and Tim Martindale

Editing
Sarah B. Assamagan

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Table of contents

Introduction......................................................................................................................................

Operational definitions ..................................................................................................................

Module 1
Psychoactive substances ................................................................................................................

Module 2
Psychoactive substance use among young people .....................................................................

Module 3
Ways of responding to psychoactive substance use ...............................................................

Module 4
A project development approach .................................................................................................

Module 5
Local situation assessment ............................................................................................................

Module 6
Implementing the project .............................................................................................................

Module 7
Monitoring and impact evaluation ................................................................................................

Further reading

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Introduction

1. Addressing psychoactive substance use

among young people
The reasons why young people use or experiment with psychoactive substances
vary. One important set of reasons is closely tied to adolescent development
itself. Adolescents are faced with the complex and emotionally charged task of
developing a personal identity (a sense of who they are). Sometimes they may
not have anyone with whom they can talk about their concerns. They are highly
prone to peer pressure and often disregard parental guidance. Their larger
social and environmental context is also an important factor. Studies have shown
that involvement with psychoactive substances during this period is associated
with other risk behaviours. Young people are not only vulnerable to the
consequences of psychoactive substance use, but also to unprotected sex and
other risk behaviours. Ways must be found to address substance use among
young people that also help them develop attitudes and social practices that
promote health and social progress.

2. The workbook
This. workbook is for project operators involved in the Global Initiative. A
Project Operator is an individual designing or organising activities as part of the
Global Initiative. They may be youths, parents, youth leaders, teachers, social
workers or health workers. Most of the project work should take place in the
community, bringing prevention measures home to individuals, families and the
community as a whole. Others involved in prevention work can also use the
workbook.

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3. Importance of the workbook for project
operators
Building capacity within the local community is an effective way of ensuring that
limited resources are efficiently used. The ultimate aim of the workbook is to
ensure that project operators are equipped with the necessary skills,
knowledge, attitudes and training capabilities to be able to effectively impart
relevant knowledge and skills to others. In this way communities can become
responsive, develop and grow stronger and take effective collective action to
reduce the vulnerability of young people to psychoactive substance use and its
consequences. By using this workbook the project operator can gain or build on
the following:
• An understanding of objectives and principles in primary prevention
• Basic knowledge about the needs of young people
• Basic skills in project development and implementation
• Awareness of networks and the importance of the role of volunteers
• A sense of when it is time to consult or refer young people for further
support and care

While many ideas, models and examples of prevention exist; this workbook
addresses only the basic issues in primary prevention, project development and
community mobilisation. The intent is not to train experts; but simply to provide
a reasonable foundation for effective work, to stimulate innovative and creative
thinking and to equip people to train others. This workbook should not be
considered a textbook.

4. How to use the workbook

Individual learners, who can read the text and go through the exercises that
are provided or following a self-guided training course, can use this workbook.
The workbook can also be used to structure a group training course. When the
workbook is used in group training, exercises should be carried out in
accordance with the trainer's preparation of the material. Active participation
is encouraged, as it is known to enhance learning.

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5. How this workbook is organised
The workbook is divided into 7 modules.

Module 1 Psychoactive substances

Provides basic information on common psychoactive substances.

Module 2 Psychoactive substance use among young people

Discusses reasons why young people use substances, and outlines risk factors
and protective factors associated with substance use.

Module 3 Ways of responding to psychoactive substance use

Proposes a comprehensive way of addressing primary prevention of substance
abuse among young people.

Module 4 A project development approach

Gives a step by step process for designing a project and explains the importance
of each step.

Module 5 Local situation assessment

Emphasises the importance of initial assessment as a guide to effective project
development and implementation. Common methods for collecting information
are also outlined.

Module 6 Implementing a project

Offers specific ideas on how a project can be implemented and strengthened
through human resource mobilisation.

Module 7 Monitoring and impact evaluation

Addresses the importance of conducting monitoring and impact evaluation, and
gives some guidelines on how to conduct them.

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6. The structure of the workbook modules
Each workbook module begins with a list of learning outcomes. The learning
outcomes should be the basis for evaluating knowledge and skills learnt at the
end of each module. Exercises are provided and are designed to give the
workbook user(s) the opportunity to enhance learning and to actively interact
with others, if the setting is group training, or to stimulate creative thinking,
when working alone. Lastly, a brief summary of key learning points is provided at
the end of each module. This provides an opportunity for quick review and for
reflection on the key messages of each module.

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Operational definitions
Abuse
Using a substance continuously, even with the knowledge that it causes serious
problems.

Community
A group of people sharing ideas and having common problems, concerns, hopes
and modes of behaviour; which give them a sense of belonging to each other,
although they may not necessarily be bound by geographical boundaries. A
community also has leaders, ways of communicating ideas, activities and rules
and ways of dividing work and participating in its functions, that are all
important to its members.

Community-based action
This occurs when the community takes the centre stage in deciding on priority
problems and implementing chosen actions. Community-based action provides an
opportunity to create a social environment in which young people's lifestyles and
immediate living conditions can be positively modified, using means that are
available and acceptable to the community.

Community development
A dynamic process in which individuals and communities grow stronger and are
able to enjoy fuller and more productive lives. Community development efforts
are devoted to empowering the community to take control of its affairs through
decision making, self-education and information, resource sharing and improved
relations among members. In the long run when community development takes
place, the quality of life of the community as a whole improves. This contributes
to the lessening of the vulnerability of young people to psychoactive substance
use.

Community involvement
The process by which partnership is established in all phases of project
development. This allows the community to benefit from all aspects of
implementation, for example, information technology and infrastructure
development. Community involvement is a broader concept than community
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participation. Through community involvement the community and individual
actors assume responsibility for their own health and welfare and develop the
capacity to contribute to their own development and that of others.

Dependent use
This occurs when the individual taking a substance has a strong desire to take
the substance, and cannot control the desire or the use. Dependence is often
associated with tolerance.

Intoxication
The temporary state that results in changes in the person's alertness,
perceptions, decision making, judgement, emotions and behaviour due to their
use of a substance.

Health
WHO defines health as, "a state of complete physical and social well-being, and
not merely an absence of disease or infirmity". This definition goes beyond
looking at health in terms of disease alone.

Health education
A way of communicating information concerning social, economic and other
environmental conditions that have an impact on health, including risk factors
and risk behaviours.

Health promotion
A process of enabling people to exercise control over and improve their health.
Health promotion is concerned not only with individuals and what information
they may require to lead a healthy lifestyle. It is also concerned with the ways
governments, communities and others can make changes that make it easier for
individuals to make healthy choices.

Polysubstance use
The use of more than one substance at the same time. The combined effects of
the substance makes them even more dangerous.

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Primary prevention of substance abuse
A way of preventing initiation of psychoactive substance use or delaying the age
at which use begins.

Psychoactive substance
Any substance that when taken by a person, modifies perception, mood,
cognition, and behaviour or motor functions.

Secondary prevention
Intervention aimed at individuals in the early stages of psychoactive substance
use, in order to prevent substance use becoming a problem and thereby limit the
degree of damage to the individual.

Self-reliance
This results from the recognition that people can identify and determine ways
and means to solve their own problems. Self-reliance is an important aspect of
community development and is aided by activities that build capacity (for
health) within the community. Capacity building activities for project operators
include providing guidance, meeting local people to discuss their efforts and
progress and facilitating discussions that lead to action.

Tertiary prevention
This aims at ending dependence and minimising problems resulting from use/
abuse. This type of prevention strives to enable the individual to achieve and
maintain improved levels of functioning and health. Sometimes tertiary
prevention is called rehabilitation and relapse prevention.

Tolerance
A state which develops in the individual using a substance that requires them to
take progressively larger amounts of the substance in order to produce the
same effect.

Withdrawal
When an individual has dependence problems, stopping substance use may lead
to withdrawal reactions, which cause discomfort and pain. These reactions may
include: restlessness, insomnia, depression, tremors and chills, muscle cramps
and sometimes convulsions.

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Module 1
Psychoactive
substances

1. Introduction
This module provides basic knowledge about psychoactive substances, types,
effects and consequences. Having adequate knowledge can help motivate you and
others to respond in appropriate ways. Understanding what you will be dealing
with will help you appreciate the complexity of the problem.

Learning outcomes
By the end of this module you should be able to:
• Define a psychoactive substance
• Identify types of psychoactive substances used in your community
• Describe methods used to take substances
• Explain the consequences of psychoactive substance use in your community

2. What are psychoactive substances?

A psychoactive substance is any substance that when taken by a person modifies
perception, mood, cognition, behaviour or motor functions. This definition is
broad; it includes licit and illicit substances, those that can lead to dependence
(of the individual) as well as those that do not bring about dependence, and
other substances that people may not consider harmful. To streamline the text
in these modules the term “substance(s)” is frequently used in place of
“psychoactive substance(s)”.

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What substances do people use?
The volume of information on substances is too large to include all of it in this
Module. What may be a popular substance in one community, may not be used at
all in another. In addition, substances are usually known by different names. It
is common to find that a substance has a generic name, a trade and at least one
street name. Each substance has a generic name. For example, the generic name
for heroin is diacetlymorphine and diazepan is the generic name for valium (a
trade name). Trade names are not necessarily the same everywhere. Most
substances also have street names. “Brown sugar” and “Smack” are some of the
common street names for heroin, while “V”, “Vals” are some of the street names
for valium. Table 1 shows popular substances, as they are commonly known.
Sometimes substances are referred to or grouped by their effects. What is
important is to be able to recognise the local substances.

Table 1 • Types of psychoactive substances

Name* Examples
Alcohol Wine, beer, spirits, home-brew, some medicinal tonics and syrups
(e.g. cough syrups), some toiletries and industrial products (e.g.
aftershave)
Nicotine Cigarettes, cigars, pipe tobacco, chewed tobacco, snuff
Cannabis Marijuana, ganja, hashish, bhang
Stimulants Cocaine, crack, khat and "designer" substances such as
amphetamines
Opioids Codeine, heroin, morphine, opium, buprenorphine, methadone,
pethidine
Depressants Sleeping pills, benzodiazepine, methaqualone, barbiturates, chloral
hydrate
Hallucinogens LSD, mescaline, psilocybin, peyote, ayahuasca
Volatile inhalants Aerosol sprays, butane gas, petrol/ gasoline, glue, paint thinners,
solvents, nitrites
*column includes effects

Remember!

Not all substances presented in the Table will be a problem in your

community. Only by assessing the local situation can you know which
substances to address in primary prevention activities.

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3. Methods of use
Substances can be taken into the body by many different means. The methods
by which substances are taken influence how quickly the substance can produce
its effects and also the different health consequences that the individual may
experience. It is important to note that the same type of substance may
produce the effect faster or more slowly depending on where, specifically, the
substance is introduced. For example, injecting the substance into the muscle
will not produce the effect as quickly as injecting it into the vein. Absorption
through the mucous membrane of the nose is faster than absorption through
other mucous membranes. Below are common ways in which people can take
substances, given in general order of how quickly the method allows effects to
be felt (fastest methods first).
• Injected with a needle under the skin, into a vein or muscle
• Smoked or inhaled through the mouth or nose, or inhaled by placing a bag
over the head ("bagging")
• Placed on a mucous membrane (such as inside the anus or vagina, the nose or
under the eyelid)
• Chewed, swallowed or dissolved slowly in the mouth
• Rubbed into the skin.

Remember!

Common types of substances, effects and methods used can be determined

by doing a local situation assessment!

Exercise 1
a) In your own words define the term "psychoactive substance" (substance)

b) Substances used in your community

Sometimes a small group of people or a community which uses substances will
have a special name for a substance that only they use. It will be important
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 to know the names of specific substances in your community. List the
commonly used substances in your community.
Substance Commonly used name

c) Methods of use
Describe the most common methods young people use to take substances in
your community.

4. Effects of psychoactive substances

Psychoactive substances have many effects that are the result of direct
exposure or use. The effects of psychoactive substances can be short or long-
term.

Short-term effects occur shortly after the substance is taken. They are
influenced by the dose, the way the substance is introduced into the body and
whether or not the substance is used with another substance. Short-term
effects may include a temporary feeling of confidence and loss of inhibitions. It
is important to remember that among the short-term effects, there are also
unpleasant and dangerous possible effects, such as loss of memory and
overdose. The long-term effects are usually caused by progressive damage to
body organs, such as the liver and lungs, that result from prolonged use.

The four examples given on the following pages further illustrate effects of
substances.

Alcohol
Studies have shown that alcohol is the most widely used substance among young
people. The effects of alcohol depend on the type of beverage; how much is
drunk and how quickly it is drunk; and the body mass, age and drinking
experience of the individual. After one or two drinks, alcohol increases
talkativeness and general activity, as a result of lessening of anxiety and
inhibitions. Alcohol slows down thought, judgement and reactions. It causes
blurred vision, loss of balance and sleepiness. Large doses can result in death as
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they cause the brain's control over breathing to decrease. With long-term use,
alcohol can cause liver and brain damage as well as dependence problems. Few
young people show these long-term problems as they manifest themselves only
after prolonged use.

Cannabis
The cannabis plant grows wild in almost all parts of the world and is widely
available. Cannabis products include marijuana and hashish (see Table 1), which
are usually smoked in cigarettes or pipes and are sometimes added to food.
Smoking cannabis produces more rapid effects than when ingested. The main
short-term effects are heightened sensations, increased pulse rate, impaired
short-term memory, reddened eyes, problems with learning, thinking and
problem-solving, impaired muscle coordination and balance. Regular use over a
long time increases chances of dependence and may worsen existing mental
problems.

Heroin
Heroin is produced by chemical modification of morphine. In its pure form it is a
white powder which is injected. This form is sometimes known on the street as
“H”, “junk” or “white lady”. There is a less pure form which looks like small
chunks that are different shades of brown; it is commonly known on the street
as “brown sugar”, “dust”, “smack”, “black tar”. This form is normally sniffed,
smoked or swallowed. With short-term use this substance tends to produce a
relaxing, peaceful, happy feeling. It can also produce drowsiness; hinder
concentration and vision; and cause nausea, vomiting and sweating. In higher
doses, heroin can produce deep sleep, or even loss of consciousness and death.
With long-term use, heroin can produce dependence and consequently
withdrawal symptoms.

Remember!

When an attempt is made to resolve dependence problems, withdrawal

symptoms such as anxiety, depression, tremors, chills and muscle cramps
result.

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Volatile inhalants
There are a wide range of industrial products (as shown in Table 1) which have
toxic effects when inhaled. These products are inhaled to produce desired
short-term effects, which may include feelings of happiness or euphoria,
stunning fantasies and other effects similar to those of alcohol. There is also
the danger of a “sudden sniffing death”. Long-term use may lead to nose bleeds,
skin rashes around the mouth and nose, loss of appetite, lack of motivation,
kidney, heart, lung and liver damage.

Methamphetamine
This substance is known by the names “black beauties”, “crystal MTH” and “ice”.
The desired effects of methamphetamine are similar to those of cocaine. These
are: a feeling of physical and mental well-being, increased alertness and energy,
improved performance at manual and intellectual tasks, and loss of appetite.
Methamphetamine can also cause an increase in breathing, blood pressure and
heart rates. With excessive doses, convulsions, seizures and death can occur.
Continued use can result in tolerance and mental health problems.

Remember!

Effects caused by substance use can be similar to signs and symptoms

caused by some health conditions. It is always important to seek expert
support when assisting young people in need.

5. Important factors that influence the

effects
The effects of a substance differ for each individual and from occasion to
occasion. They depend on a variety of factors involving the individual, the
substance and the environment. Some effects are "desirable" to the individual
using the substance. For example, the immediate feelings of exaggerated
confidence and happiness, loss of inhibitions, desire to sleep and reduction of
pain or fear. These desired effects are short-lived and are outweighed by the
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enormous problems that result from the use of these substances. The desired
effects can also lead to serious health and social consequences. For example,
substance-induced loss of inhibitions could cause an individual to engage in risky
behaviour that they would not normally have undertaken. Although some effects
are desired, in the sense that they are sought after, they are not desirable in
the more general sense. Below is an illustration on how these factors may
interact.

The individual(s)
Factors that influence the effects of substances include the person's age,
gender, physical condition and state of mental health; the person's expectations
about the substance; the effect of the substance; and the person's past
experiences with the substance.

The substance
The type of substance, the dose, how it is taken and whether it is used in
conjunction with another substance (polysubstance use) all influence the effect.
The combined effects of substances makes them even more dangerous.

The environment
The social and physical setting where the substance is taken also influences the
effect. This includes the interpersonal atmosphere and group expectations. For
example, if the setting is a group of young people at a disco, some of them may
have the primary objective of being there to “enjoy” themselves which for them
includes using substances. Others may be influenced to experiment. The social
and physical setting will have an influence on how much is taken, by what means
and in what combination, to produce the desired effect. The substance
commonly known as ecstasy has been shown to have enhanced adverse effects
when taken in confined hot environments such as discos. This is another more
specific example of how the environment may influence the effects of
substances.

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Examples of other effects
Use of substances may cause other problems related to nutrition, pregnancy and
mental status.

Malnutrition
In general, any person using substances frequently can easily overlook the
importance of good nutrition. Some young people, especially street children, use
substances to relieve hunger. This can lead to further malnutrition.

Mental problems
Some psychoactive substances are used in the treatment of mental health
problems. However, if the same substances are used outside supervised health
care, or in combination with other substances, this could result in a worsening of
the mental condition. Substance use also limits the development of constructive
coping strategies, making the individual more vulnerable to crime and other
forms of abuse.

Pregnancy
All psychoactive substances taken by the mother during pregnancy can reach
the unborn baby. These substances can have effects on the mother, the unborn
baby and the newborn. A few of these problems are discussed in the following
section.

Effects on the mother

No safe levels of alcohol intake during pregnancy have been established.
Drinking alcohol during pregnancy can lead to miscarriage. LSD can increase the
chance of miscarriage and complications during pregnancy. If the mother stops
using opioids suddenly she could experience withdrawal problems.

Effects on the unborn baby and newborn

It is possible that the baby of a mother using psychoactive substances may be
born with physical deformities. Drinking alcohol during pregnancy can cause
slowed development in the unborn baby and mental disabilities in the newborn
(“foetal alcohol syndrome”). Smoking during pregnancy can reduce the amount
of oxygen available to the unborn baby and may affect growth and development
before and after birth, resulting in low birth weight. If a mother who is
pregnant or breastfeeding suddenly stops using an opioid, the baby may
experience withdrawal. Withdrawal in a newborn is a serious problem.

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Exercise 2
a) What are some desired effects and problematic effects of substances
among the individuals using them in your community?

b) From your observations in the community, write down the effects of four
commonly used substances.
Substance Desired Effects Problems

6. Consequences
In addition to the direct effects that substances have on the body, their use
can have many other consequences. Some of these may be serious. Consequences
can occur at the individual level, family and community level. Presented below
are some examples.

Individual
• An intoxicated person can express aggressive behaviour and may injure
himself or others
• A person intoxicated with alcohol and driving can cause harm to himself and
others
• Injecting substances can cause infections at the injection sites
• Sharing contaminated injecting equipment can result in blood borne diseases
such as hepatitis B and C and HIV
• Tobacco smoking can cause lung cancer

Remember!

The lives of individuals who continue to use substances frequently begin to

revolve around substance use. They may spend most of their time involved in
activities such as earning or trading sex for substances, buying substances,
using them, thinking about them, and trying to get more and more of them.

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At the family level
Families can be affected if someone in the family is using substances. For
example:
• Conflict between family members can become emotionally or physically
destructive
• The constant demand for money to spend on substances can cause family
disagreements
• Spending money on substances can take essential resources away from other
family needs. This can cause or worsen economic hardships
• Family money and human resources may be diverted into paying for
treatment or providing care when individuals using substances develop
adverse health effects

At the community level

Some of the consequences of substance use in the community are described
below:
• Young people using or abusing substances may steal, use violence to get
money or engage in other illegal activities in order to obtain the substance
• Members of drug syndicates may commit violent crimes
• Some drug syndicates actively recruit young people to participate in illegal
activities
• The increased violence and illegal activity that may accompany increased
substance use harms individuals and contributes to a climate of mistrust
among community members

Exercise 3
a) In small groups, discuss or write down health and social problems resulting
from substance use that you have observed at the following levels:
• Individual level
• Family level
• Community level

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7. Summary
The different types of substances that young people can use largely
depend on what is available locally and the situations young people find
themselves in.

Substances affect the thinking, feelings, perceptions and physical

functions of the individual using them.

Substances can be taken in a variety of ways, such as by smoking,

swallowing, injecting or bagging.

There are desired effects that individuals using substances seek. These
and other less pleasant effects are short-term. Substances also have
long-term effects that damage body organs.

Use of substances often leads to consequences in the individual, family

and the community as a whole.

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Module 2
Psychoactive
substance use among
young people

1. Introduction
In almost all cultures since the earliest times, people have used some kinds of
substances. The use of substances has continued over generations. However,
today, use of these substances has increased and has led to an increase in the
consequences. As you will learn in this module, young people use substances for a
variety of reasons. Use has increased not only in terms of the types and
quantities of substances consumed, but also in the expansion of use to other
population groups, including women and young people.

Learning outcomes
By the end of this module you should be able to:
• Explain the reasons why young people may use substances
• Identify factors that can increase the risk of substance use among young
people in your community
• Describe factors that can protect young people from substance use in your
community

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2. Why young people use substances
There are many reasons why young people may use substances. In the first
module it was shown that the effects psychoactive substances have on
individuals depend on at least three things: the individual, the substance and the
environment (the “context of use”). This is the Public Health Model, which also
shows how the use of substances is a result of interactions between the
individual, the substance and the environment.

The individual(s )
The knowledge and attitude the individual may have about substances and their
effects can influence use. The individual's present coping skills with respect to
the difficulties of life and peer pressure may also influence their decision to
use substances. (Note that here the term “individual” can also be replaced with
terms like “user”, “peers” and “the group”).

The substance(s)
The existence of a substance creates a fundamental risk factor. The
composition and nature of the substance can influence use. The percentage of
ethanol in alcoholic drinks and their cost, for example, can influence the
decision as to whether or not to use the substances.

The environment (context)

Within the environment a variety of factors may influence use of substances.
These include: existing cultural norms; general and peer-group attitudes about
substance use, behaviours of parents, peers and role models, marketing
strategies used for the promotion of the substances, laws, policies and
regulations that limit the availability and accessibility of substances,
possibilities (and perceived possibilities) for livelihood and personal
development.

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Remember!

The use of substances is a result of interactions between the individual,

the substance and the environment.

Exercise 1
Why do young people use substances in your community?

3. Risk and protective factors

Factors that increase individual risk for substance use are known as risk
factors and those that decrease the risk are called protective factors. Risk
factors have a tendency to push an individual toward using substances while
protective factors do the opposite. Identifying the risk and protective factors
for substance use in a community is an important step in determining how one
can respond to this problem. Although various studies have identified specific
individual and environmental factors that usually have a risk and protective
influence, these are not exhaustive or absolute. What may be a risk for one
young person may not be a risk for another. A summary of likely risk and
protective factors is presented in Table 2.

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 Table 2 • Risk and protective factors
Risk Factors Protective Factors
At the level of the individual
Poor social skills, physical and mental Good social skills e.g. life skills (decision
problems, overly dependent child, low self- making, problem solving, coping skills,
esteem, sensation seeking: willingness to interpersonal/ social skills), independence
take physical and social risks for the sake and ability to cope with stress, good
of experiencing new sensation temperament and personality (optimism,
empathy, insight, intellectual competence,
self-esteem, life direction or mission,
determination and perseverance)

Early exposure to substance use, being a

child of a substance abuser
Lack of religious beliefs
Dislike of school, poor school performance, Desire to be in school, good performance in
school dropout school
Having positive perceptions of substance Healthy expectations
use behaviour

At the level of the environment

Family Attachments
Family disruptions/ absenteeism caused by Positive attachments that encourage caring
separation, divorce or death, poor parenting and bonding (families, social and religious
skills, parents and siblings who use attachments), few stressful life events
substances, family violence and rejection,
Skills
extreme economic deprivation leading to
lack of basic resources such as shelter, Parental monitoring, structured and
opportunities for education, reduced access supportive family environments, effective
to health and social services parenting skills
Resources
Little material conflict, adequate income,
shelter

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 Risk Factors Protective Factors
Community Community resources
Lack of recreational activities, lack of Availability of recreational activities,
reinforcement of cultural and religious availability of adequate health and social
values, presence of substance use services, availability of employment
behaviours, peers using substances, lack of opportunities and of economic enhancement,
positive school values, lack of existence of and access to health and social
reinforcement of existing laws and norms, services, favourable neighbourhood
extreme economic deprivation (high
Cultural and/ or religious norms
unemployment, inadequate housing, high
crime) Positive value reinforcing norms

Availability, accessibility of substance(s) Effective policies and law enforcement that

and low cost (cheap), no age limit to the limit availability of substances; control
purchase of substances advertising; taxation and substance free
spaces (e.g. non-smoking areas)

4. A special note on young people

Young people have particular characteristics that make them especially
vulnerable to substance use. Physical and psychological development occurs
during this period of life. The physical and social transitions that occur have a
major influence on how behaviour patterns develop. Most of the risk-related
characteristics have to do with identity seeking. As young people mature, they
enter into new social roles. There is pressure to establish their new social
identity, to seek new role models and to not miss out on opportunities. Shaping
of the personality occurs, and young people are driven to seek a new self/ body
image, as they strive to attain socially defined roles. Their identification with
certain role models, in particular, may directly or indirectly lead to substance
use problems. Other risk related characteristics include:

Experimentation
Young people are curious and are often influenced by peers. They are likely to
end up with peers who may not necessarily be good role models. These peers
may expose them to unhealthy behaviours. Young people tend to rely on peers as
sources of information and in forming their behaviours, values, beliefs,
attitudes, personal self-concept and general lifestyle. This information may not
be correct or appropriate.

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Independence and rebelliousness
Young people want to establish independence and separation from family, gain
a sense of self-determination, choose an occupation and develop their own
personal values. In the attempt to achieve all of these, they can become
rebellious and experience low self-esteem. Turning to substance use may be a
way of coping with these challenges.

Need to belong and to be accepted

Young people are constantly striving to be accepted by others. Use of
substances may be a way of showing that they are mature (becoming a man or
woman). For example, in some cultures, drinking and smoking is a way of showing
that one is mature. Young people may also use substances to show that they are
not afraid to be a member of a group.

They are energetic

Young people get bored easily, especially when they have nothing to do. Being
out of school and bored can be a risk factor. For those in school, feelings of
inadequacy or anticipation of failure in school performance may lead to use of
substances as a way of coping.

5. A special note on substance use among

girls
In the past not many young girls used substances. This trend is changing in
almost all parts of the world. More and more young girls are using some type of
substance. It is crucial that equal attention is paid to both girls and boys. By
including girls in prevention activities, you can help reduce their vulnerability.
Giving them assistance increases the chances of breaking the pattern of
vulnerability. Young girls using substances are more vulnerable to nutritional
deficiencies, prostitution and sexual abuse. This reality often leads to unwanted
and high-risk pregnancies, sexually transmitted diseases including HIV/ AIDS.
This has implications for future generations.

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Remember!

It is important to never assume that girls and boys use substances for
the same reasons or that they have the same needs. However, don't fall
into the trap of calling for stricter controls for girls' way of life. Both
girls and boys should be encouraged to take advantage of new
opportunities to develop healthy lifestyles.

Exercise 2 • Risk and protective factors

a) What special characteristics of young people contribute to substance use in
your community?

b) Describe what you know of the situation among young girls in your community.

c) A Story
Joseph and John have just moved into your community. They come from a
rural area, which is about 300 kilometres away from the main city. They
believed that if they moved to a town community their living standards would
improve. Upon arrival in your community their hopes quickly became distant
dreams. They have nowhere to live but in the streets. They have no money to
buy food, and you have often seen them begging for money at the city
centre. You have also seen them spending time in the city areas where drug
trafficking and other negative social activities take place. Describe Joseph
and John’s risk factors for substance use.

Based on the risks you have identified, describe factors that may protect
Joseph and John against substance use.

d) Explain the problem of substance use among young girls in your community.

e) You are planning to implement primary prevention activities among young

people in your community. Describe the various activities that would help
influence the following:
• The individual
• The substance
• The environment

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6. Summary
Different aspects of the individual and the broader environment can
either make people more vulnerable to substance use or protect them.
Depending on their effect, these aspects are called either risk or
protective factors.

Young people are in a period of life that naturally involves making choices
among various lifestyle alternatives, and in which development involves
the consolidation of health impacting behaviour.

No single factor alone has been shown to cause the use of substances in
an individual or in a community.

Equal attention should be paid to the realities and risks for both boys and
girls. This is especially necessary since there are indications that girls
use different substances, and start using them for different reasons
than boys.

Girls are more vulnerable to social and health consequences, including

malnutrition, Sexually Transmitted Diseases and early pregnancies.

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Module 3
Ways of responding to
psychoactive
substance use

1. Introduction
The public health model demonstrates that substance use; its effects, risks and
protective factors are a result of the interplay between the individual, the
substance and the environment. Therefore, effective responses to psychoactive
substance use must be comprehensive and take into account all of the factors at
work. In determining ways of preventing or reducing substance use among young
people, it is always important to understand the local context.

As the two preceding modules have shown, substance use among young people
needs to be taken seriously. Although most young people may grow out of the
“urge to experiment”, some may not and could develop serious patterns of use.
Young people are in a period of life when their basic attitudes and belief system
are being shaped. This makes it an opportune time when behaviour can be
influenced for the long-term benefit of health.

Learning outcomes
By the end of this module you should be able to:
• Name ways of preventing substance use among young people
• Give examples of feasible kinds of primary prevention approaches that can
be used in your community
• Name settings where prevention activities can take place

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2. Primary prevention
Although there are different levels of prevention, this module focuses on
primary prevention. The main goals of primary prevention are to:
• Target young people before they start using substances
• Discourage or stop use in those young people who are already experimenting
or using

In one of the Global Initiative regional training sessions, some participants gave
the following responses as to why primary prevention was so important:
• “An ounce of prevention is worth a pound of cure”
• Primary prevention is less expensive than cure
• Primary prevention is the first line of defence
• Primary prevention can take place in the community
• The success rate of treatment is low

3. Why should primary prevention approaches

be comprehensive?
The World Health Organization defines health as "a state of complete physical
and social well-being, and not merely an absence of disease or infirmity". This
definition goes beyond looking at substance use related illnesses; it includes all
factors that can affect health. In responding to substance use, the health
promotion concept is employed. This concept implies that people have the
capacity to influence their own health and quality of life when empowered
with the appropriate means, skills or information. They can make decisions
and take action to improve their own health, and that of the community.
The comprehensive approach is based on the concept of health promotion which
is in line with the public health model. It entails making a contribution toward
building healthy public policies, creating a safe and supportive environment,
strengthening community action, developing personal skills and re-orienting
services.

Chosen approaches should aim at reducing risk factors and strengthening

protective factors at the individual and environmental levels.

For primary prevention to be effective, ways need to be sought and found for
governments, communities and others to make changes so that individuals will
find it easier to make healthy choices. This may sound too ambitious. However,
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as project operators you can contribute to making primary prevention work in
your local areas within the limits of your resources and capabilities. In line with
the public health model and health promotion concept, primary prevention
interventions should always be complimented by referring young people needing
it to appropriate support and care services.

Examples of primary prevention approaches

Individual Approaches
Young people should be given the necessary knowledge, skills, and resources; and
be exposed to positive attachments.

Information
Providing information can increase knowledge and awareness of the
consequences of substance use. It can also change values, attitudes and beliefs.
Although information alone is not sufficient to prevent substance use, it is
important as it provides the facts.

Peer education, in particular, has been shown to be useful. Providing information

is especially beneficial if young people are involved in the process, both as
receivers and providers of information.

Skills
Building social and personal/ cognitive skills improves young people's abilities to
interact socially, clarifies values and improves self awareness. These skills can
be developed through discussions of feelings, values and perception through role
play, participation in group projects and leadership opportunities. Involvement in
activities like these can help reduce social influence; motivate young people to
resist external pressure; and teach them skills such as decision making, problem
solving and goal setting.

Enhancing performance related vocational and livelihood skills can increase work
opportunities for young people, and increase independence and the ability to
resist harmful relationships. Young people can learn a craft or trade to earn a
living through apprenticeships, group and individual instruction, formal and
informal learning (including trial and error). These skills indirectly enhance
positive attitudes towards coping when work is not readily available.

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Environmental Approaches
The environment can increase or decrease the risks for substance use among
young people. Promoting safe and supportive environments includes promoting
positive social norms.

Alternative activities and youth groups

Providing interesting recreational activities can divert the attention of young
people away from substance use toward more positive physical and social
outlets. The participation of youth groups in community service projects and
awareness campaigns should also be encouraged. Involving them strengthens
protective factors and social bonding.

Attachments
Positive attachments can help reinforce protective factors. Encouraging
presence of caring family members, friends and other adults interested in their
well-being provides support and role models to young people. Child-parent
relationships have been shown to improve when the entire family is involved.
Positive peer relationships should also be encouraged. Other positive
attachments that could be encouraged are through schools or religion
(depending on the local context).

Resources
Young people in need should be directed toward appropriate available resources,
such as social services, educational and health facilities.

The family
Strengthening parent-child communication can lead to better reinforcement of
prevention work in the home, with parents serving as role models. Parental skills
can be strengthened through family skills training, parent support groups,
parent peer groups and family counselling.

Local community
Participation by key persons in various sectors such as the schools, families,
workplaces, churches, government and the mass media is essential. Local
communities can undertake activities that emphasise the prevention of
substance use problems, health promotion and community development. Local
community action includes setting priorities, making decisions, planning and
implementing activities and projects; in order to achieve better health.

Orienting services towards young people

The community and professionals working within it have shared responsibility
for health promotion. Health care workers need to be updated regularly, and
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health and other services should be re-oriented to better meet the needs of
the young people. They must be made to feel welcome and accepted when they
seek help. Although the focus here is on primary prevention, the importance of
appropriate referral (for those needing further assistance) must also be
stressed. This will ensure the comprehensiveness of the interventions.

Remember!

The most important resource is the individual who can promote his or her
own health. Laws and regulations have been shown to shape behaviours but
they do not eliminate them.

Exercise 1
a) Review the information given on possible primary prevention approaches.
Then for each of the categories below enter your thoughts on what
prevention measures might be undertaken in your community.
Individual Environment
Information Creating a safe and supportive environment

Skills Alternative activities and youth groups

Family based

Attachments

Resources

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 Individual Environment
Local community action

Orienting services

b) Give the characteristics of effective community-based primary prevention

projects.

4. Settings for primary prevention activities

From the information provided in the previous section, it is clear that primary
prevention should take place in a variety of settings.

In the family
In the family, primary prevention measures may include: parent education,
parent/ family skills training, parent peer groups for dealing with problem young
people, parent self-help groups and involvement of parents in primary prevention
project initiatives.

In schools
Within schools information can be provided on the consequences of substance
use. Interpersonal, personal/ cognitive and vocational/ performance skills can be
taught. Substance use topics can be added to the curriculum and peer
counselling can also be used. Games and interactive educational tools have also
been shown to be effective in teaching young people both the harmful effects
of substance use and coping mechanisms.

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Remember!

School and educational social policies are important tools for primary
prevention. Where feasible, re-designing educational curricula to
incorporate substance use prevention and training young people in (inter-)
personal/ cognitive skills (e.g. self-assurance, decision-making) can be useful.

In the community
Within the community, prevention measures can include: public awareness
campaigns; creating alternatives for the youth such as music, dance, drama,
sports, games and fun fetes; and re-orientation and vocational training for out-
of-school youth.

In the workplace
The workplace and other social settings, can be important locations to address
substance use problems.

Remember!

Because primary prevention of substance use takes place in a variety of

settings, collaborative efforts by many key persons is essential.

Examples of interventions in different settings

(examples collected from various WHO reports and websites on young people
and substance use).

In schools
In some schools in the USA, a policy to ensure that teachers receive training on
substance use and how they can identify young people using substances has led
to early identification of individuals using substances.

Mohammad Ibrahim Sobhan of Bangladesh introduced a series of reforms in the

public schools, such as: more efficient use of class time and school-based

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economic projects that educate children in small moneymaking ventures, giving
them financial incentives to stay in school. These reforms have significantly
increased the enrolment rate, decreased the drop-out rate and made education
more accessible to many poor children. These changes decrease the chances of
young people using substances.

In Brazil, through games and other alternative educational tools, Carlos Bezerra
demonstrates to children the harmful effects of sniffing glue and abusing
lighter fluid and cough medicine.

In Mt. Carmel schools in Wabash County Illinois, USA, two student groups
sponsor various community projects and entertainment options for high school
and younger students. Some students also work with the school faculty to
provide prevention information and training for younger students. A “Big Buddy”
project provides one-to-one relationships between individual students who are
at risk and adults in the community who serve as older friends, mentors and
advisors.

Remember!

Anything taught in schools or other places where young people receive

instruction should be reinforced in the home and in the community by
parents, social policies and the media.

In the community
In Thailand, Utis Buddhasud has created a model project that enables villagers
to keep their families together and work towards a healthier future, by
providing co-operative childcare, early childhood education and village-based
career opportunities for the youth.

In South Africa, some organisations working on preventing substance use have

created resource centres that are accessible to community members and young
people in particular. However, these need to be further developed under the
umbrella of a comprehensive approach.

In Bolivia, the Academia de Futbol “Tahuichi Aguilera” has used soccer as a

viable alternative to substance use for almost 20 years. The Academia engages
children and adolescents 6-19 years old in a variety of activities including
training, seasonal soccer camps and competitions.
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Since 1984, the All Stars Talent Show Network has used performance to open
the door to personal development for Black and Latino young people living in
some of the most disadvantaged neighbourhoods of New York and other large
US urban areas. Activities include personal development workshops, auditions
and talent shows.

The Society for Theatre and Education Programme (STEP) has worked in the
slums and underdeveloped neighbourhoods of New Delhi in India since 1993.
STEP uses street theatre to promote substance free living and to create a
favourable atmosphere for discussion of substance related problems. The
project targets youth and adolescents 13-25 years old, and is run totally by
young people from the local community themselves.

Vineet Khanna developed a job placement project that includes technical on-the-
job training for unskilled and unemployed youth from rural and urban areas in
India. It has been in operation since 1993.

Since 1992, the Kuleana Street Children Centre in Tanzania has worked to
reintegrate street children (5-18 years olds) back into their communities.
Kuleana offers a youth outreach and a residential assistance project for
children in transition between the streets and home. Substance use prevention
related activities focus on teaching life skills, with children divided by age and
ability levels.

Other places in the community

In Sweden, two girls in 1996 established an organisation for girls called “United
Sisters”. The project has now expanded to four other locations in Sweden. The
participants of each United Sisters group sign a contract to support and stand
by each other, which is renewed each year. During the year they work on issues
related to personal development and organise and undertake various activities
such as camping, theatre, climbing, study travel. From the second year onwards,
they start to act as “junior leaders” and can establish other groups.

Remember!

Promoting young people’s rights at all societal levels will help gain support
for them.

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A family approach
In Slovakia, Marek Rohacek has developed a project to take abandoned children
out of institutions and place them in loving family homes. The project also
prepares prospective foster parents, supports families in crisis and transforms
orphanages into family-based institutions.

Exercise 2
a) It has become apparent that in your community the number of people dealing
in substances has increased. Children walking to and from school are
frequently approached by dealers, trying to get them to sell substances on
their behalf. The community is concerned about this problem and wants to
make the environment safe. What options exist in your community that could
be used to make the environment safe for young people?

List some vocational skills and recreational activities that young people in
your community can learn and become involved in.

Existing services
b) What services exist in your community that can be used in the prevention of
substance use?

Are these services accessible to young people? Explain.

How can these services be re-oriented to meet the needs of young people?

c) What other services do you think are needed in your community to help
prevent or reduce substance use among young people?

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5. Summary
Primary prevention of substance use among young people can only be
effective when a comprehensive approach encompassing a variety of
activities is used.

Primary prevention initiatives should be carried out in a variety of

settings such as within families, within the schools and in other places
that are accessible to young people.

To be effective, collaboration between different sectors of society is

crucial.

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Module 4
A project development
approach

1. Introduction
Project development follows a systematic process that involves first
determining the needs and problems, then planning, implementing and evaluating
the project activities. It entails ensuring that the resources needed for all
project activities are available and in the right place at the right time. This
module gives an overview of project development. You will learn the phases
involved in project development, as well as the elements of a project proposal.
You will begin to apply the project development approach to primary prevention.

Learning outcomes
By the end of this module you should be able to:
• Describe the project cycle
• Identify key elements of project development
• Develop an outline of a Project Plan

2. What is a project?
A project is a time-limited initiative that is undertaken to create a unique
service. A combination of resources are pulled together and channelled into a
temporally structure in order to achieve a specific goal. Although the term
“time-limited” can imply “short in duration”, here it is used to convey the fact
that the project has a definite beginning and end. Some projects can be

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continued or converted into other projects; you will learn more about this in
Module 7.

3. A project development approach to

primary prevention
Project development involves a series of phases, which are continuous. The main
phases are illustrated on the next page. Although the illustration may suggest
that the phases are separate, there is usually overlap. Together, phases can be
seen as cyclical, and the whole process is called a project cycle.

4. The project cycle

Local situation Formulate a Implement
Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Exercise 1
a) What is a project?

b) Identify at least 7 key phases of the project development approach

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5. The phases of the project cycle
The phases of the project cycle involve a variety of activities. Although in
reality these phases usually overlap somewhat, the chronological order of the
phases should be maintained. Also note that before project development can
begin, time needs to be devoted to establishing transparent and responsible
agreements on the division of labour among professionals and different
community members working on the project. Some mechanisms for doing this
will be explained in Module 6.

Remember!

The problem of lack of coordination is a serious barrier to cooperative work

among different service providers and organisations.

Phase 1 • Local situation assessment

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

In the context of the Global Initiative, the baseline assessment or situation

analysis is called the local situation assessment. Knowing what is happening in
your community is a crucial starting point in identifying the type of intervention
project to be developed. Conducting a local situation assessment helps to define
the actual problems and needs of young people in your community in relation to
substance use. The next module will discuss how to carry out the local situation
assessment. This assessment is important for the following reasons:
• Situations (problems, resources, etc.) are not necessarily the same in every
community
• Assessing the situation at the beginning will help you evaluate the
effectiveness of the interventions at the end of the project
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Remember!

Interventions based on the realities of the local situation are more

effective!

Exercise 2
a) Explain why a local situation assessment is important before implementing a
project

b) What other experiences have you had in conducting local situation

assessments?

c) If you feel that you need more skills or need to be assisted in conducting a
local situation assessment, who in the community can assist you?

Phase 2 • Formulation of a project

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

The local situation assessment will have provided you with an understanding of
the problems and needs of young people in your community. Through the
situation assessment you will also have learnt about the existing resources. This
information is vital in designing appropriate interventions, including their scope
and focus. During this phase you and the community should decide what project
you intend to achieve, by what means and with the help of whom. There are a
wide range of primary prevention options, as outlined in Module 3, that should
be considered. The chosen interventions should be feasible locally, given
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available resources. Your plans will need to be documented; therefore, a project
plan should be developed. The project plan will guide all project activities and
should include statements of all the following items.

The objectives
What the project is intended to achieve.

The activities
What is to be done. These should be closely linked to the objectives and have
indicators. Indicators are results that show the activity is taking place or an
objective is achieved. For each objective and activity there should be an
indicator to help you know what has been achieved. More on indicators on the
next page.

A timeframe
When activities are to be carried out and objectives achieved.

The resources
Financial, material and human (including skilled people) and other resources such
as “time”.

A plan for monitoring

Checking how the planned objectives and activities are being undertaken and
achieved, and how resources are being used, including when they are being used
and any deviations from the original plan. Indicators will be of important use.
Monitoring must be done from time to time, throughout the course of project
implementation.

A plan for evaluation

Checking what has or has not been achieved based on the objectives, activities,
resources, timeframe and monitoring records. Again, indicators are an important
gauge.

Some clarifying points on objectives and indicators

The objectives will set the overall direction for the project. Each objective
should be: Specific, Measurable, Achievable, Realistic and must give a
Timeframe, within which to accomplish the activities (SMART). For example, the
Global Initiative could set the following objective: “By December 2001
implement peer education activities in four schools in the local area.”

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Indicators give required evidence showing that the objectives are being
achieved and that activities are successful. Indicators should be:
• Relevant (essential to the successful implementation of primary prevention
activities)
• Reliable (yielding consistent responses to the same question, in determining
whether set objectives have been achieved)
• Verifiable (they can be measured or observed at a reasonable cost)

You should have at least one indicator for each project objective. For the
sample objective given above, examples of indicators could be:
• Existence and use of a project plan in implementing activities
• Number of schools reached
• Age/ gender of students reached
• Knowledge and skills attained, (e.g. percentage of students with knowledge
about substance use and its consequences, % of students with peer education
skills, % of students benefiting from peer education)

Exercise 3
a) Explain the importance of setting objectives for a project on prevention of
substance abuse

b) You are the coordinator of a proposed primary prevention project on

substance use among 11- 13 year-old school children. Describe the steps you
would follow in formulating specific objectives for the project.

Set specific objectives for the primary prevention cited above, and specify
possible indicator(s) for each objective.

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Phase 3 • Mobilisation of resources

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

The local situation assessment will have given you an idea of the resources that
exist in the community. However, you may need additional resources. Resources
include people (Mobilisers), Moment (Time), Materials and Money. These are also
called the 4 Ms. Some people may want to help with the project, but they may
also need to fit their involvement into busy schedules. If time is not organised
properly you could experience problems in the implementation of the project. It
is essential that all resources be made available in the right amount and at the
right time. Community support and commitment can be strengthened if plans
that have been made are followed.

Exercise 4
a) Preventive activities in your project will require many resources. The
greatest resource that may be available to you is the time and effort of
community members. Describe possible ways of tapping into this resource
and identify potential sources of possible funding within your community.

b) Your project can also raise funds by sponsoring events that bring attention
to the project and that also raise money. Identify activities that would help
you to get attention from the community and raise your own funds.

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Phase 4 • Implementation

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

During this phase, project plans that have been developed are concretely
interpreted and put into motion. The process aims at achieving what has been
planned. This phase is made easier when a clear project plan has been prepared
and can be followed. Having a team of people who can work together will also
make your work easier. Members of the community are willing to assist if they
are convinced of the benefits of the project to the community. This phase
demands the most in terms of how well you organise and manage the whole
process. Effective implementation will involve working through and with other
people and organisations and establishing effective relationships among people.
Effective leadership will be an integral part of moving the project forward.
More information on how to implement the project and how to motivate the
community is provided in Module 6.

Exercise 5
a) To implement a project you need a clear plan. Why is making a project plan
important in project development?

b) What relevant information should go into the plan, and how can this
information be used in the future of the project?

c) Apart from other management skills that are needed to implement a project
effectively, why is strong leadership important in this phase of the project?

d) Explain why community participation in all phases of project development and

implementation is important.

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Phase 5 • Monitoring (process evaluation)

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Monitoring will provide you with continuous feedback on the work being
carried out. Monitoring enables you to determine whether the objectives are
being met or if they need to be modified in order to stay on course. The plan
for monitoring developed in the second phase of project development should
now be followed. Specific instruments or forms will need to be developed in
advance for use in collecting the relevant information. To have a workable
monitoring system, you will need a well-formulated monitoring plan.

The monitoring plan must:

• Be developed through a consultative process
• Be understood by all those who will use it
• Be in accordance with the way the project is organised
• Be used in a timely manner to report deviations from the agreed on course
• Be flexible enough to remain useful over the lifecycle of the project
• Indicate the nature of action that can be taken when the project is not on
course
• Include not only words but pictures or other symbols that are easy to
interpret
• Not be expensive to implement (cost to implement the plan must be
reasonable)

Monitoring methods are discussed in Module 7.

Exercise 6
a) Using the information provided in phase 5 of the project development
approach, explain how a monitoring plan helps keep the project on course.
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b) In the following box list the people who should be involved, in order to make
the monitoring process participatory.
Who should be involved Why they should be involved

c) Discuss some of the key reports that could come out of project monitoring?

d) List important questions that should be answered in monitoring a community

preventive project.

Phase 6 • Impact evaluation

Local situation Formulate a implement the

Mobilise resources
assessment project project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Conducting impact evaluation provides an opportunity to look back at all the

work that has been done over a fixed period of time, and determine the
effectiveness of the project. The problems and successes of the project are
identified. All the information gathered from monitoring and evaluation should
provide an objective basis for making changes in the future, as necessary. It
may be determined through evaluation that some objectives of the project in
fact had little chance of success, or that others simply need to be improved
upon (there is always room for improvement on any given project). It may also
be determined that there was more impact than expected.

Lessons learnt through monitoring and evaluation could be used to rewrite the
plan, to make it more relevant and feasible, or to review the situation and
determine newly emerging needs and problems.

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Exercise 7
a) What is the relationship between local situation assessment and impact
evaluation?

b) Explain why information collected from the monitoring process should be

included in impact evaluation.

6. Tips on writing a project proposal

A project proposal is closely linked to phase 2 of project development
(Formulating a project). As explained in phase 2, the project plan provides
necessary guidance for all participants developing the project, and forms the
basis for all project operations. In addition, the plan can also be used for
promoting the image of the project and as a tool for fundraising. Many styles of
project proposal writing exist. For the sake of consistency, the style suggested
in this module is one frequently used by organisations working at the grassroots
level. It is regarded as adequate for small projects. The basics that the project
proposal should include are:

A project summary
The summary should be brief (2-3 pages) but should include sufficient
information to ensure understanding by the target audience: for example, the
project team or funding agencies. It should specify:
• The main objectives of the project
• What the project will do and when
• Who it will reach
• The geographical area of work
• The total budget
• What financial and other resources are available, and the contributions
expected from the community
• The amount being requested
• Project team/ structure (who will do what)

An introduction
The introduction should be based on the local situation assessment and include:
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• The justification for the project (the need for it)
• A description of previous activities undertaken (if any)
• Information on how the project fits into the overall objectives of the global
initiative project
• The beneficiaries of the project

Remember!

In the Global Initiative Project a local situation assessment is a

prerequisite for the submission of a project proposal for funding.

The “project plan”

This is a detailed plan of activities. It should be organised such that the
related activities follow each of the stated headings.

Objectives of the project

Included in this part should be a statement of the problems that the project
will address, the timeframe and the indicators for achievement of these goals.
A clear aim will help in prioritising activities, and should be based on the local
situation assessment. The objectives give the direction to the project. Make
sure that all objectives are “SMART”.

Activities/ budget/ responsibilities

Make a list of activities for each objective. Place the activities in order of
priority. For each activity indicate a timeframe (when it will be done), a budget
(with which resources), and the responsible person (by whom).

Budget
Although a budget is specified for each project activity, it is important to also
provide a summary of all the financial requirements for the project, in the form
of a total budget.

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Monitoring and evaluation
Specify a monitoring and evaluation scheme. The plan for evaluation should
include the participation of people who are not involved in the implementation,
(for example, external experts or other community members).

Project management
Although the responsible persons are specified under project activities, it is
always a good idea to emphasise this aspect. Key players and potential donors
will want to know how the project will be managed. Explain who will be
responsible for the overall project, who is on the project team, how young
people will be involved, what sort of collaboration is intended and other
participatory means of involvement of community groups.

Future plans and project sustainability

It is important to indicate what will happen after the project ends, in terms of
the project's results and impact. Ideally, activities should continue as long as
the need exists. The more support a project has in the community and the more
resources made available for the project, the more sustainable the project is
likely to be. Projects have been found to be more sustainable if they are
integrated within or associated with existing local organisational structures.

Remember!

Following the project cycle makes it easier to implement and keep track of
activities, and to know what has worked and what has not worked. It also
helps with writing a project proposal. A well structured proposal that
provides the essential details has a better chance of being funded!

Exercise 8
In this exercise you will be given (if in a group training session) a project
proposal that has been written for other purposes. Based on the knowledge
you have acquired and with the help of the facilitator, review the proposal
and make changes that would make it appropriate for a primary prevention
project. If you already have a proposal that you have used in the past, or one
in the making, you can practice revising it according to the given guidelines.
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7. Summary
Project development follows a systematic process which involves project
identification through a local situation assessment, project formulation,
resource mobilisation, implementation, monitoring and impact evaluation.

Any worthwhile project should begin with a local situation assessment

(baseline assessment) in order to identify the problems, needs and other
important factors for the development of appropriate interventions.

Processes for monitoring and evaluation should be outlined during the

project formulation phase.

A well-written project proposal can be a useful tool for monitoring and

for fundraising.

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Module 5
Local situation
assessment

1. Introduction
A local situation assessment is a process by which information is obtained on a
problem or need to be addressed by a project. The assessment includes
studying all factors in the community that have a bearing on the problem and
the needs of the target group.

Learning outcomes
By the end of this module you should be able to:
• Identify sources of information for a local situation assessment
• Describe ways of collecting information on substance use among young people
• Demonstrate at least two methods of conducting a situation assessment
• Experiment with analysing information
• Explain the importance of disseminating findings from the situation
assessment

Local situation Formulate a Implement

Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

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2. What is the purpose of the local situation
assessment?
By carrying out a local situation assessment, insight is gained into the extent of
the problem, the nature of existing and needed activities and the people or
organisations with whom to develop partnerships. Specifically, for a project
within the Global Initiative the situation assessment should enable you to:
• Determine the problem
• Mobilise the local community and young people by tapping into their
knowledge and at the same time, raising awareness about the needs and
problems and what can be done

Information gathering is a continuous process. When the situation among young

people has changed or needs further understanding, more information should be
collected.

3. Types of information that can be gathered

In trying to understand the local situation, you will need to gather information
that will clarify issues such as the nature, extent, trends and patterns of use.
You will also need information about existing structures and resources (social,
economic and health, related to substance use, prior interventions including
policies). There are two general types of information: quantitative and
qualitative.

Quantitative information
This type of information provides concrete facts and numbers about the
situation such as:
• Age of young people at risk
• Numbers of young people in school or out of school
• Substances used, where substances are taken
• Numbers taking substances
• Duration or extent of use

Qualitative information
This is descriptive information that helps in understanding the causes behind
the facts, the perceptions and views surrounding a problem. For example:

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• Reasons young people take substances
• Community views on substance use

Remember!

Quantitative information alone is not sufficient for you to develop an

appropriate prevention project. A combination of quantitative and
qualitative information will give you adequate information for project
development. Quantitative information also makes it easier for donors and
politicians to grasp the information, while qualitative information gives an in-
depth understanding about the experiences and feelings of those involved.

4. Steps in conducting the local situation

assessment
A lot of effort must be devoted to ensuring that a useful situation assessment
is conducted. You will need to go through following steps:
• Planning and deciding the purpose and scope of the situation assessment
• Collecting existing information
• Selecting the methods for collecting new information
• Collecting the new information
• Compiling and analysing the information
• Drawing conclusions
• Disseminating information and taking action

Step 1 • Planning and deciding the purpose and scope of

the assessment
Planning is a crucial step in local situation assessment. The first step is
clarifying what should be done. A good plan can contribute to a successful local
situation assessment. You will need to involve people in the community such as
those on the Community Advisory Committee (explained in Module 6). The
process of getting the community involved is usually slow, but will make
participants feel more involved and committed to the goals of the project. To
help you get started with planning, consider these questions:
• What will be the purpose of the situation assessment?
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• What needs to be known?
• Where can the information be obtained?
• What resources are needed to conduct the assessment?
• Who will be involved in the assessment, e.g. clientele, project managers, key
people in the community, others?
• Who will gather the information?
• How will it be gathered?
• What will be the responsibilities of the Project Team (see Module 6) in the
situation assessment?
• What procedures or steps will be followed?
• What will be the timetable?
• What logistical support is needed and where will it come from? (This is very
important, as it will determine the scope of the assessment, as well as the
time factor)
• Who will analyse the information?
• How can this information best be used and shared?

Step 2 • Collecting existing information

You can gather information from existing studies, official statistics and
previous field research. Information that may be useful to you, may have
already been collected for other purposes (secondary data). For example,
surveys may have been conducted in order to develop government policy
statements and professional guidelines. You can get this information by
reviewing documents like government registers, court proceedings related to
substance use and clinic records. Information can also be obtained from
unofficial sources such as, television and radio programmes, books,
presentations at professional conferences, and notes taken at community
forums or city meetings that are open to the public.

This information may not be sufficient to grasp the full scope of the situation.
Make direct contact with people; talk to them and interview them (primary
data).

Exercise 1
a) From your understanding of the preceding text, define local situation
assessment.

b) What is the difference between quantitative and qualitative information?

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c) Describe the process of local situation assessment.

d) With whom can you achieve step 1 “planning for the assessment”, and why is
this important?

e) Where are you likely to get existing information about young people and
substance use in your community?

f) Describe how you would help a community assess the needs for a primary
prevention project on substance use among the young people.

g) Describe the key initial steps involved in developing questions that you will
need to ask about the problem you are assessing.

Step 3 • Selecting the methods for collecting new

information
Existing information may not provide you with sufficient information about the
local situation. You will need to gather new information on the local context of
substance use among young people. The methods you choose should give you
information quickly, flexibly and cost-effectively. Keep in mind the goals of the
project. Also keep in mind two basic questions:
• What specific information about the problems should the assessment
determine?
• How will the information obtained be used?

The answer to the above questions should be closely linked to the conclusions
reached by the working group developing the project.

Some common methods of collecting new information (primary data) data)

Include Focus Group Discussions, Key Informant Interviews,Surveys,
Observations, Case Studies and Narrative Method. These methods are
explained in summary in the next two pages. Selected methods are also
discussed in more detail in the Facilitator Guide.

Focus Group Discussions (FGD)

This is an organised discussion in which 6-12 individuals discuss a single topic
in-depth, for a limited amount of time. FGDs are conducted with people who are
similar with respect to age, interests and relevant experiences. Sometimes they
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are of the same sex. The participants can represent a target group. Using this
method enables you to collect qualitative data (e.g. expressed feelings and
perceptions of a group). The method permits active participation and encourages
ordinary dialogue among members of the group. More information on this
method is presented in the Facilitator Guide.

Remember!

FGDs will enable you to collect qualitative information, but they can be time
consuming and can be rendered ineffective if not properly conducted.

Key Informant Interviews

A Key Informant Interview involves interviewing key individuals who have first
hand information about young people and those who interact with them.
These individuals can be parents, teachers, resource persons in the government
(such as Ministers of Health or Education) or workers in health facilities and
other service organisations in the community. Interviews may be self-
administered or administered by the interviewer. They may only require a yes or
no answer or be in-depth, with initial questions followed by more intensive
probing.

Remember!

Some key informants may hold biased views about young people. It will be
important to verify the information gathered through other methods.

Surveys
A survey is an interview given to a relatively large number of people.
Surveys are useful when numerical information about a topic is needed, for
example, the number of different substances young people use. Once you have
prepared the instruments (questionnaires), you will need to field test or pilot
them. This will ensure that the questions asked are culturally sensitive and the
language used is appropriate and results in appropriate responses. You will need
support from experts in the development of questionnaires for surveys and in
the selection of the sample population.

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Remember!

A useful survey requires the participation of a large number of people. It

may require a lot of resources.

Observation
With this method, an observer watches a specific group of young people at
some location without trying to attract any attention. The method is time
consuming. However, it is a good technique for coming up with new ideas about
the ways that young people obtain substances, and for understanding what
happens when young people are under the influence of substances. As many
observations as possible should be entered in a field diary or a notebook. The
observations create a detailed picture of the behaviour of the group. This
method offers an opportunity to observe, listen and learn. Some people refer to
this as the LLL (Look, Listen and Learn) method. It is also a good way of
making sure that information collected by interviews or questionnaires is
correct (cross-checking). A lot of information can be obtained through simply
observing how people interact.

Case studies
These are detailed descriptions of one person or one group's experience with an
issue or problem. A description of how one young person began experimenting
with substances and became a heavy user, for example, would be very useful for
developing prevention activities. Case studies help to put pieces of information
together into a complete picture. These studies are also a good way to describe
and better understand individuals or subgroups who do not fit the typical
pattern of behaviour. If it is unusual for girls to use substances you could
develop case studies of some of the girls, rather than studying them together
and in less detail as a group.

The narrative method

This method is designed to examine the sequence of events involved in
behaviour. This method is a good way to study a topic that is a process, rather
than a simple single behaviour; for example, learning to use substances. With
narrative research, the person under study re-creates a true-to-life story that
takes place in their normal environment. Role play is used to develop a detailed
story line that reflects a typical pattern of events, for example events that led
to a particular young person using substances for the first time. After the
story is recorded, it can be used as the basis for a questionnaire that can be
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administered to other young people so that general information can be collected
about the process of starting and continuing to use substances. Just like all
other instruments used in collecting information, questionnaires developed from
the narrative method should be piloted before being administered to young
people.

Step 4 • Collecting the new information

To determine the local situation, target conditions (the ones you would like to
achieve) have to be compared with actual ones. Collecting new information
creates an opportunity to get closer to the target group. Make contact with the
people you are going to engage in the local situation assessment. People you can
contact might include:
• Young people and their families
• People who provide services, such as health care workers

There are various ways of collecting the information. These are explained in
previous pages of the module. Asking the right type of questions is crucial to
getting the right kind of information. In the Facilitator Guide there are some
sample questions. They offer a starting point that can be adapted or
reformulated based on the type of information to be gathered. Asking questions
well is an important skill in your work, especially when conducting a situation
assessment. Learn to formulate questions in ways that will help you to get the
correct information.

Asking questions
Carefully plan questions and how they should be asked. There are two basic
types of questions, closed and open-ended.

Closed questions
These types of questions are designed to give you a simple yes or no answer, or
a simple statement or short phrase in response. These questions can stop or
block a conversation as they discourage the more active participation of the
person being questioned. Although these types of questions are easier to answer
and analyse (good for surveys), they do not provide in-depth information.
Examples of closed questions:

• Do you smoke marijuana? Yes/ No

• How many packs of cigarettes do you smoke each day? Number ………

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Open ended questions
These questions encourage further conversation and the sharing of more
information about a situation. Open-ended questions should be phrased in such a
way that they sound as natural as possible. The process should be guided and
kept focused on the topic being asked about. An example of an open-ended
question could be:
• How did you start to use cannabis?

To ensure that the questions for interviews are effective, you should:
• Categorise the questions by topic
• Keep the questions clear and simple
• Avoid asking offensive questions
• Make sure instructions are clear and concise
• Explain the purpose of the interview
• Avoid leading the individual
• Limit the number of questions
• Maintain the confidentiality of information collected, the identity of the
person should not be revealed

In the sample questions in the Facilitator Guide both closed and open questions
are provided.

Exercise 2
a) Substance use among young people has become common in your community.
Your initial plan is to conduct a local situation assessment. You have selected
Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) as the
appropriate methods for gathering information. Guided by a trainer,
demonstrate how you would prepare and conduct a FGD or a KII. This
exercise is only possible if done in a group or supported training context.
Tips for carrying out FGDs and KIIs are in the Facilitator Guide.
• Plan and conduct a FGD among a group of in-school young people
• Plan and conduct KIIs among teachers at a local school
(Participants in the training can play the role of in-school young people and
teachers).

b) Develop two open-ended and two closed questions on substance use.

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Step 5 • Compiling and analysing the information
Collected information must be put together, organised and analysed. If need be,
seek help from professionals, especially for interpreting the findings. The
central aim is to get an understanding of the problems and needs of local young
people as they relate to substance use. It is always important to cross check
information obtained from one method with information obtained through
others.

Step 6 • Drawing conclusions

Every community has special features. What may be a cause of substance use in
one community may not play the same role in another community. The findings
drawn from the analysis of the information will usually be formulated as
problems, needs, risks, and protective factors. This analysis will provide the
basis for developing the project. If there are no resources available, you should
explain this in your findings. Involve the Community Advisory Committee in
formulating the objectives. Tips on how to make decisions in a participatory
manner can be found in the Facilitator Guide, Module 5.

Remember!

While all goals are important, they may not all be equally important. Goals
should be prioritised or ranked during the group meeting.

Exercise 3
Review the information provided in the FGD example which was used in the
Regional Global Initiative Training Workshop in Hanoi (See Facilitator Guide).

a) Explain what conclusions can be drawn from the information provided in this
FGD

b) What type of project could you implement based on information given in the
FGD results example from the Hanoi workshop?

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c) Role play
If in a group training session proceed with the following role play exercise.
The participants should play the roles of persons representing different
segments of the community, such as parents, teachers, young people and
health professionals, who together must decide on the project objective for
a primary prevention initiative based on the Focus Group Discussion used in
the Regional Global Initiative Training Workshop in Hanoi. This role play
allows you to practise decision-making through a consultative (or consensus)
process. There is more information on role-playing in section 6.7 of the
Facilitator Guide.

Step 7 • Disseminate the information and take action

It is crucial at this point that you go back to the community and share the
findings and analyses with them. This will enable them to have a clearer picture
of the problems and needs of young people in the community and why the
project should be implemented. This helps to promote both community
involvement and a sense of project ownership.

Who can you share this information with?

Share the information with:
• Local community members
• Young people and local organisations
• Institutions working on issues affecting young people
• Politicians and relevant government ministries
• The international community
Key information in the assessment should include background information,
identified problems and needs, protective factors and available resources.

Remember!

Information from the local situation assessment can be used to advocate

for primary prevention activities and to mobilise communities.

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5. Writing a report about the local situation
assessment
A well-written report can be a powerful communication tool. Dividing the report
into several smaller sections will enhance the presentation and facilitate
reading. The report should include:
• The background
• The findings (problems and needs, risk and protective factors, and
resources)
• The recommendations (proposed activities)

Background
The background information should describe the purpose of the assessment and
the methods used to collect the information on young people.

Findings
Findings should include:
• The problems and needs: communities at risk for substance use, young people
who are affected, those already using, the extent of use, problems being
experienced, feelings people have regarding substance use.
• Risk and protective factors: factors that put young people at risk and
protective factors such as values, norms and sanctions regarding substance
abuse, quality of life considerations, resources, economic factors, healthy
alternatives and attachments.
• Resources: available resources and how they can be used in prevention of
substance abuse. Making an estimate of resources required can help you
determine whether your project is feasible and sustainable. If not, you may
need to re-think your planned interventions.

Recommendations
The recommendations state what needs to be done in response to the findings.
The proposed activities (and how they will help meet the needs and solve the
problems) should be clearly outlined here.

Exercise 4
a) Make a list of potential persons and organisations that you feel should learn
about the findings of your local situation assessment.

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6. Summary
A local situation assessment provides a concrete understanding of the
risks, needs and problems related to substance use among young people,
within a given context.

The methods chosen for the assessment should be appropriate with

respect to the information needed and available resources.

The community, young people, experts and other resource persons have a
major role to play in planning and conducting the local situation
assessment.

The findings of the local situation assessment should be analysed and

presented to the community and all key stakeholders. Their
recommendations should then be translated into a project plan.

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Module 6
Implementing the
project

1. Introduction
During this phase, project plans that have been developed are interpreted and
put into motion. All the resources (people, money, time and materials) are put
into full use. The work is arranged so that the right people do the right things,
and the right resources are in the right place at the right time. Although in
community-based work, modification and innovation are frequent, a well written
project plan with built-in monitoring and evaluation will help in implementing the
project effectively and efficiently. This module presents a range of issues
related to implementing a project. They include community participation,
fundraising, networking and the securing of technical and financial resources.

Learning outcomes
Bythe end of this module you should be able to:
• Explain the importance of community-based action and participation
• Describe general guidelines for motivating the community
• Propose ways of involving young people in prevention work
• Identify existing community resources
• Describe feasible fundraising activities that can be done within the
community
• Explain the process of identifying and managing volunteers
• Explain the importance of networking

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Local situation Formulate a Implement
Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

2. Community-based action
The implementation of projects for primary prevention of substance abuse
among young people takes place within the community. The community in which
the targeted young people are found will take centre stage both in deciding the
priority problems to be addressed (local situation assessment) and in
implementing the chosen actions. Community-based action provides an
opportunity to create a social environment in which lifestyles and problems
associated with substance use can be modified, using means available and
acceptable to the community. The participation and involvement of young people
themselves is crucial in community-based action. Your activities will also include
targeting local politicians, social and traditional leaders, and local government
and non-government organisations; to encourage their participation in the
activities of the project.

3. What is community participation and

involvement?
Community participation implies encouraging the community to plan and manage
primary prevention activities. Through community involvement you will establish
partnerships in all phases of project development and implementation. This will
ensure that community members, including young people, support the project,
assume responsibility for prevention work and develop the capacity to
contribute to their own development. Human resource capacity building is
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essential. Required knowledge and skills will have to be identified in order to
build these skills and capabilities in individuals, so that they can make a useful
contribution to prevention work.

4. Mobilising human resources for community

work
It is unrealistic to expect that community members (including young people) will
automatically come forward to provide support for the project. You will need to
find ways to motivate them. For communities to be involved they must be
mobilised and motivated. When communities are motivated they will support
your project. This in turn will increase the capacity of your project. There are
many ways to motivate the community. Whichever methods you use, it should be
appropriate and acceptable within the given cultural setting. Observing the
following guidelines will help you motivate the community.

Encourage participation at all levels

Everybody can play a role in preventing substance use.

Approach the community with great respect and humility

There is always something to learn from its members, and being open to learning
will allow you to work more effectively.

Establish and maintain good relationships

This may be difficult in the beginning, but once you know how the community
functions, you will find it easy and fulfilling.

Give community members responsibilities

Many community members like to take control of situations. Some of them hold
responsible positions in the community. They can make useful contributions.

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Avoid prejudice
Cultures and traditions bind communities together. Appreciating the norms and
traditions of the community is a sign of respect. Community members will not
appreciate attempts at intimidation or “talking down to them”.

Remember!

A great deal of patience and persistence may be required to mobilise the

community. Ensure that all key political and economic forces, as well as the
broader community are involved.

5. Why is it important to involve young

people?
Young people have a unique potential to contribute to improved health and
development. The involvement of young people offers them possibilities for
realising some of their personal goals. This in turn can contribute to the long-
term development of local capacities and future resources. The participation of
young people promotes the relevancy and legitimacy of project efforts. Building
partnership between adults and young people will ensure that the young people
are properly guided. Adults and young people alike need to develop ways of
sharing responsibilities and collective decision-making. Young people can
participate in any of the project activities. In particular, young people often
enjoy and perform well at tasks that are goal oriented and serve a specific
purpose.

Remember!

Young people and all others involved should be trained and supervised when
they implement project activities.

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Ladder of participation
The ladder illustrated in the next page shows that participation of young people
in activities is a process which takes place at different levels and requires adult
support!

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The ladder of participation
Level 8
Youth
initiated,
shared
decisions with
DEGREES OF PARTICIPATION

adults
Level 7
Youth
initiated and
directed
Level 6
Adult
initiated,
shared
decision with
youth
Level 5
Consulted and
informed
Level 4
Assigned by
informed
NON-PARTICIPATION

Level 3
Tokenism
Level 2
Decoration
Level 1
Manipulation
Level 0
Spectator

Source of the illustration: The McCreary Centre Society (1996) British

Columbia youth health action handbook. Burnaby, B. C., Canada. Adapted from
Roger A. Hart. Children's participation: from tokenism to citizenship. Florence,
Italy, UNICEF International Child Development Centre (Innocenti Essays NO. 4)

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as presented in WHO Coming Of Age: from Facts to Action for Adolescent
Sexual and Reproductive Health, 1997.

6. Involving the community

By involving the community you will achieve shared results.

Shared Shared Results Shared

Decisions Accountability

Remember!

The process of implementing a community-based project should be as

participatory as possible. However, the number of people involved must be
kept manageable. A large group could pose difficulties for the project,
especially for decision making.

Some ways to structure participation and involvement

The following groups can be established to encourage community participation
and involvement.

The Community Advisory Committee

The Community Advisory Committee is a steering committee for the project. It
should include 12-20 interested individuals from the community, including young
people and influential members from different sectors. The purpose of the
group is to enlist the support of the whole community for the project, and to
give the project a base of “consensus” for it's overall direction.

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The Project Team
The Project Team ensures that project activities are actually carried out. It
should be composed of a few committed individuals including young people.

The Activity Team

In a larger project, one person in the Project Team might need to oversee a
parallel smaller group tasked with carrying out a specific activity, an Activity
Team. An Activity Team is comprised of a few committed individuals including
young people. For a larger project, there may be more than one Activity Team.

Exercise 1
Using the information above and from the Focus Group Discussion process
used in the Regional Global Initiative Training Workshop in Hanoi which is
outlined in the Facilitator Guide, list the type of people that should be
involved in a prevention project.
• As advisory group members
• As project team members
• As activity team members

Exercise 2 • Motivating the community

Jama is working on the Global Initiative Project on Primary Prevention of
Substance Abuse Among Young People. He joins the project at the time when
sponsoring international organisations are enthusiastic and committed to
assisting by providing limited material and financial support. Jama draws up
an activity plan for the first 6 months of work. Some of the key items in his
activity plan are:
• Organising meetings to inform the community about substance use
• Visiting schools to talk about how to prevent substance use
• Developing a list of policies that have been proven to work for primary
prevention and giving them to policy makers to implement
• Offering counselling services for young people abusing substances
• Disseminating materials developed by international organisations on the
risk factors for substance use among young people

After implementing all these activities, Jama goes back to monitor progress
in the community after three months. To his surprise, Jama finds that only a
handful of teachers, students and other community members understand the

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 magnitude of substance use in their community and the need to intervene.
Policy makers are not interested and have not moved an inch to review and
reformulate policies. Reading materials have not been used and more and
more young people are using substances.

a) Give a possible explanation for why Jama has not succeeded in his work. If
you were Jama, what would you do to become effective?

b) Propose ways of raising awareness in the community to improve motivation.

c) Involving young people

Khadja and Mina are both 16 years of age. They belong to a young people's
club that promotes art skills. When they are not in school they spend their
time talking to young people in their neighbourhood, finding out what art
skills children have and providing information on contact persons for this
activity. On many occasions you have observed them in various locations such
as the market, city centres and community town halls where they make
presentations on what their young people's club stands for. Mina has been
the one to select the venues for meetings and ensure that events take place.
Khadja on the other hand, responds to questions and determines whether a
particular artwork should be forwarded to the club for consideration.

Since you are planning to implement a project on primary prevention of

psychoactive substance abuse, what potential contribution from these
adolescents can you foresee? Explain how they could participate in your
project.

Propose other ways of involving young people in your project.

7. Fundraising
Using locally available resources can help to sustain projects over a longer
period of time. You will need to actively conduct fundraising activities. These
activities are essential to your project. Their success relies on hard work and
good preparation. Preparations should begin well in advance of your embarking on
any fundraising activity. Proposed in the subsequent pages are 6 essential steps.

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Step 1 • Set goals and timelines
Establish the project's financial needs. These should be closely linked to the
objectives and be reflected in the budget. Before making a commitment to any
budget or fundraising plan, involve key people in your project, especially the
Community Advisory Committee. Have them review and agree on the fundraising
goals. The goals should be realistic and achievable.

Step 2 • Identify potential funding sources

Create a list of potential sources of funding for your project. Possibilities
include grant and non-grant fundraising. Collect information and learn as much
as you can about the fundraising sources. The Table before Exercise 3 of this
module shows potential grant and non-grant sources of funds.

Step 3 • Create a record-keeplng system

You will need a system for managing the information you compile about funding
resources. This information should be kept within easy reach at all times, be
updated regularly and kept in a good filing system. This information is critical to
the future of your project and will hold many clues to understanding problems
related to securing funds from particular sources.

Step 4 • Develop a fundraising calendar

Fundraising requires advance planning. You will need to begin at least three
months in advance. A calendar that spans over a 15-month time period is useful.
Every aspect of fundraising should be included within the project activities and
timetable, for example, writing proposals, letters, and newsletters; and
committee/ individual meeting reports. Important dates and deadlines should be
recorded in the calendar. Plans for fundraising activities should be integrated
into the project plan.

Step 5 • Estimate income projections

Take precautions not to overestimate the potential funding from any particular
source. It is also important to have current information on which to base your
estimates of likely funding. Remember that you are developing a plan that should
continually be monitored to determine progress.
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Step 6 • Prepare the income cash flow projections
Prepare an accounting sheet with 12 columns for the 12 calendar months. List
sources of income in the rows, and fill in the monthly projections for each
potential source (consult with someone skilled in this area if you need help).
While planning alone cannot guarantee funding success, it will better your
chances and enhance the orderliness of your project.

8. Potential sources of funds

Examples:
Grant Sources Non-Grant Sources
Foundations, corporations, government Individual solicitation
organisations, religious organisations,
Personal requests, telemarketing, mail
labour organisations, professional
appeals, mailgrams/ electronic mail, radio
associations, local organisations,
or TV appeals, workplace, special events
anonymous individuals
Planned gifts
Donations of real estate, art, etc.
Earned income
Sales of products, fees for services

Exercise 3 • Identifying local resources

a) Following a visit to the community, list below the existing resources in your
community that could be useful for a project on primary prevention of
psychoactive substance abuse.
Human/ people Type Location Address Contact person

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Material/ facilities Type Location Contact person

Financial How much Location Accessibility Contact person

Time
a) Indicate how much time community members are willing to devote to
supporting your work.
Community member Number of hours Days of the week Type of work

b) Explain how you might motivate community members to volunteer time for
substance abuse prevention activities in their community.

c) What fundraising activities can you carry out in your community?

9. Human resources needed to implement a

project
To implement a good project you will need a variety of people possessing
different skills. Young people and adults should be encouraged to participate in
the project activities. Most of the people you will work with will be volunteers
who are interested in making a positive contribution to the community.

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Working with volunteers for primary prevention activities in the
community
In order to carry out the project, you will inevitably need the help of
volunteers. They can help in the many areas, such as mobilization of the
community and implementing activities. Managing volunteers is the same as
managing other staff, however, they will need extra motivation to maintain
them.

Who are volunteers?

Volunteers are individuals who are willing to offer time and skills to help prevent
or reduce substance use among young people. Committed volunteers will make
primary prevention activities work. Managing volunteers is a challenge. It
includes the following aspects: recruiting and interviewing, selecting and giving
appropriate tasks, orienting and training, supervising and evaluating.

Remember!

Volunteers have come forward on their own free will. They require your
unfailing support. You will need to continually motivate them.

Although you may find other innovative ways of accessing volunteers, an example
of a standard process is given below.

10. The process of identifying and managing

volunteers
Recruitment
Make a recruitment plan. The plan should include the tasks; number of
volunteers needed; skills and abilities, and training required; and the method of
recruitment. The persons to be recruited should be decided on and the duration
of their intended assignment specified.

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Interviewing
The purpose of interviewing is to match the volunteer with the best-suited team
and activities. The interview and subsequent selection must be based on clear
selection criteria.

Selection criteria
The community must be involved in the selection of volunteers for community
work. The criteria should be clear. It should include the desirable age and
competencies, including literacy level, and states of physical and mental well-
being. Young people and those who have a direct influence on their lives, such as
parents, teachers, and religious leaders; should be given priority. Once selected,
volunteers should be given information on the tasks and activities to be carried
out. Where possible, they should be assigned tasks.

Registration form
It is always wise to develop a registration form. This will assist in keeping track
of all volunteers and how they can be reached. Include all useful information
about the volunteers. For example: name, address, date of birth, education,
employer (if employed), special skills (communication, languages, leadership and
research skills, etc), experience, areas of interest, availability and names of
people who can give references.

Orientation and training

Those selected should be given a thorough briefing on the project goals,
activities and expected outcomes. Whenever training is to be conducted, it
should be based on an analysis of training needs.

Motivation
Volunteers who are supported and recognized are likely to continue assisting in
prevention work. Here are some things that can be done to help them stay
motivated: involve them in planning, and let them know why things are done
differently at times; give them challenging work and increase their
responsibilities gradually; give them incentives, such as solid training,
certificates of recognition and invitations to special events whenever possible.

Evaluation
Evaluating volunteers' work will help to improve their performances, (and this
improves the quality of the services delivered by the project). The main
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questions to answer in the evaluation are: What are the volunteer's views about
the project? What suggestions do they have? What are their views on their
support and training, and on the general project communication processes? How
can their work be made more effective?

Ending the services of a volunteer

There may come a time when a volunteer's services have to be terminated. This
may be because the volunteer is not following the project procedures, or his/
her behaviour is tarnishing the name and image of the project, or because the
project has come to an end. Even under unfavourable circumstances, be sure to
continue to show respect and sensitivity. Maintain confidentiality throughout
the whole process, especially concerning their performance and what led to the
termination of services. Avoid being judgmental and allow the volunteer to
express and discuss their feelings. You may need to ask yourself some
questions: Did I give this volunteer the right tasks? Did I provide the right
support? Was the training provided sufficient for the work assigned? What
suggestions can I offer as alternatives once the volunteer is no longer serving
the project? Who can provide me support in the absence of the volunteer?
What lessons have I learnt from this experience? If the termination is as a
result of ending the project, acknowledge the volunteer's contribution and
prepare a reference letter for him/ her.
(adapted from the Harder M. Volunteer Service. Current Status Report.
Volunteer Cycle. Geneva, Henry Dunant Institute, 1992)

11. Building skills and following-up

Training is part of human resources development. It involves structured
learning for immediate application in the work or service areas. Development, on
the other hand, refers to the gradual general improvement of overall decision-
making and interpersonal skills of a relatively unstructured nature. Train people
including young people on specific issues and tasks related to the project.

You will need to use interactive training methods, some of which are described
in the Facilitator Guide. At the same time, support and encourage their
development. Through training and development activities, you can build skills of
people assisting in the project as well as the target group.

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Following-up with all individuals in the community helping in prevention activities
is important. It is a way of both supporting participants in the project and
ensuring that the interventions are benefiting young people and the community.
Training and follow up overlap with and are a part of monitoring. Activities that
are a part of monitoring should be properly planned, and the information
collected during follow up visits should be recorded. Make follow up through
written reports, telephone calls, visits and/ or networking with other
organizations or individuals working in the same area. Some activities that you
would have achieved during follow up are presented below.

Preparation
• Objectives set
• Information materials available
• Community or individuals informed about the visit
• Transport arrangements for the visit made

Follow-up
• Performance observed
• Discussions held
• Questions answered
• Issues clarified
• Needs, expectations addressed
• Notes on the visit recorded

Feedback
• Information collected analysed
• Needs and problems prioritized
• Action to be taken together with the community or individuals, as project
operators determined
• Action taken
• Records kept for later reference
• Relevant partners such and UNDCP/ WHO focal points at regional offices
informed

Exercise 4
a) Why are training, supervision and follow up important in community work?

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b) What type of information and skills would people supporting the project
need?

12. Networking
Networking can improve the capacity of the project. Networks can be defined
as people talking to each other, sharing ideas, information and resources; or
working for a similar cause. Networks exist to foster self-help, change society
and improve project performance. It is possible to establish links with many
organizations and individuals through the process of networking. Different
groups of people and organizations collectively can influence specific policies,
attitudes and practices, in support of the health and well-being of young people.

Why is networking important?

Isolated efforts by individual organizations and people may not be effective in
bringing about lasting change in the community. You might also need training,
materials or funds. Other organizations might need the same. You can exchange
information and resources or carry out joint planning that could be of benefit to
all.

Networking Tips
Networking will require the use of all relevant channels of communication, both
formal and informal. Below are useful tips on networking.

• Don't be afraid to take the first step. Become comfortable introducing

yourself and taking the lead socially.
• After making an important contact, follow up with a call, letter or an
invitation to lunch.
• Maintain your network. People connections need ongoing attention. Remain
available for others in the network. Don't be active only when you need help.
• Join professional organizations and societies that provide opportunities, to
meet others with similar needs and interests.
• Make your networking base as broad as possible. Don't rely on only a few
contacts.

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• Periodically evaluate your network. You can't keep in touch with everyone you
meet. But are you keeping in touch with the key contacts?
• Remember that networking is like a barter system. You are trading
information. Keep your end of the deal. Continue to put new and valuable
information into your network.
• A strong network is built on trust, and at times confidentiality. Respect and
honour those expectations.
• Use networks to implement agendas.
• Establish and maintain a file of business cards with personal notes on the
back.
• Learn people's names and family information.
• Share information in a positive, constructive way. Gossiping and backbiting do
not develop a strong network.
• Don't send hordes of people running to your network. Use discretion when
sending someone to a friend for assistance. Don't overload members of your
network.
• Review your system of keeping track of people in your network. Is the
information required to make contact with all the people complete and easily
accessible? If not, work on developing a better system, which need not be
complex. In fact, the simpler, the better.
• Have fun. Enjoy each person. The joy of networking is learning and sharing
new things with all kinds of people.

Exercise 5 • Building a network

Write your name in a circle in the centre of the page. Draw surrounding
circles and, using either initials or last names (and an organization indicator,
where desired), indicate individuals who could assist with some major activity
for your project. As you progress with the exercise, you will be sketching
your potential coordinating/ networking system.

Exercise 6
Nana is a new project operator. She needs to establish networks to
facilitate her work in the area. As her first task, Nana wants to visit the
local NGOs to inform them about her project and the need to work together.
She wants to secure collaborations and commitment. Role play this situation.
Players: Nana and NGOs-Officials.

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13. Summary
Motivating the community entails establishing a good relationship,
communicating clear messages, encouraging participation and avoiding
prejudice.

Use of locally available resources is the key to sustainable community

development.

Community-based projects should strengthen the ability of people to solve

their problems using their own resources. Using local resources gives the
people a feeling of project ownership and helps to effectively mobilize the
community for action.

The participation of young people offers possibilities for them to make a

contribution to issues that affect them. They can acquire important
knowledge and skills for present and future application.

Networking is an important aspect of community work as it can contribute

to strengthening support from various community segments including NGOs
and government institutions.

Extra effort should be made to motivate volunteers, as they are a crucial

human resource in community-based activities.

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Module 7
Monitoring and impact
evaluation

1. Introduction
There are two levels of evaluation that are described in this module: process
evaluation or monitoring, and "terminal" or impact evaluation. These activities
are essential for understanding what is happening in the community as a result
of the activities being implemented. Monitoring makes it possible to effectively
revise plans when appropriate, while evaluation tells you if your project
objectives have been achieved. Decisions concerning how activities will be
monitored and evaluated, (how often, by whom and when), should be made
during development of the project plans. This ensures that proper evaluation
mechanisms and tools are designed, in accordance with the project objectives. A
good situation assessment provides a basis for evaluating the impact of the
project. Questions of focus vary at each level; so do indicators and methods for
identifying these indicators. In this module the focus is on monitoring and
impact evaluation.

Learning outcomes
By the end of this module you should be able to:
• Explain the importance of monitoring
• Outline key project areas to be monitored
• Give examples of methods of collecting information for monitoring
• Describe the importance of record keeping
• Define impact evaluation
• Outline key questions for impact evaluation

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2. What is monitoring?
Local situation Formulate a Implement
Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Project monitoring is the systematic and continuous assessment of progress

over a given period of time. It takes place throughout the implementation phase.
Monitoring is also known as process evaluation. When conducting process
evaluation these questions should be asked, “Are the prevention activities being
carried out in the manner that was initially intended in the project plan?/ Are
they taking place as planned?”

The purpose of monitoring

Monitoring means checking to see whether activities are being implemented well
and as planned. Through monitoring you will be able to:
• Spot problems early and take corrective action.
• Provide good feedback on progress. Feedback is crucial in motivating
participants in the project.
• Gather information for writing reports about the project. The information
also provides a link with impact evaluation, (determining what was done, how
and the impact it had).

3. Types of information to be collected

Information that is collected during monitoring should be quantitative and
qualitative (as defined in Module 4). All aspects of project development and
management should be monitored.

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What should be monitored and how?

Resources

Financial
Monitoring finances means determining whether project expenditures are in line
with the project budget. You will need to do simple bookkeeping using specific
tools such as invoices, cash receipts, cash books and financial statements.
Keeping good track of how the funds are being spent is very important as this
has implications for the progress of activities. In addition, donors are usually
interested in knowing how funds are being spent in relation to the agreed on
plan.

Remember!

To avoid confusion keep track of donated funds separately and always keep
receipts.

Human resources
In community-based work it is inevitable that you will rely more and more on
volunteers. Having an understanding of how they are conducting their tasks,
their experiences and the community's responses to their work will assist you in
determining how you can keep them motivated. It will also help them develop
toward more effective prevention work. During monitoring observe their
performance and pay attention to their requests.

Material resources
Monitor how materials designated for use in the project are being utilized. For
example, if you produced materials for information sharing about substance use
among young people, questions of interest will be, are these materials reaching
the target group? and are they being utilized? You may also have acquired some
basic equipment for the project. These can be monitored through log-books and
inventory records.

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Moment/ Time
Use the project plan to check whether activities are being undertaken as
planned. Determine whether there are obstacles that may delay the completion
of the project on time.

Activities
Monitor achievement of objectives, output and participation of young people and
communities. Also monitor shortcomings and additional achievements. Collecting
information for the purpose of monitoring can be done “on-the-spot”. When
doing so, determine the following:
• Whether planned activities are being carried out
• Who is involved at the organizational level, and their participation (age and
gender)
• What they think about the activities (feedback)

Table 1 • An example of on-the-spot monitoring of an activity

Activity
Street theatre play to motivate people to come to the youth centre.
Information How information will Who collects it? What will he/ she
be obtained? need?
How many people are Observation. Somebody should try A very small fee for
there? What is their to observe how many the observer(s).
age? sex? people stopped to
look, and record
their apparent age
and gender. The
actors can take
turns.
How many people By asking them when The workers at the
come to the youth they come. youth centre should
centre? have a chat with the
new comers and ask
them where they
heard about the
centre.

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4. How to collect the information during
monitoring
As noted in Module 4, monitoring plans should be made during project
development. Monitoring is closely linked to the set objectives and indicators.
Recall that indicators provide evidence that objectives are being achieved and
activities implemented; refer back to Module 4, as needed. There should be at
least one indicator for each objective and activity. The process of gathering
information for monitoring purposes is similar to that of the local situation
assessment. It will involve:
• Planning
• Gathering the information
• Analysing the information
• Disseminating (sharing) the information

On the following page is an example of a plan for monitoring and how the
information obtained can be compiled.

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 Monitoring questions Project variables Method of gathering Method of analysing
information information
Activities
What activities were planned as Activities that were included in Review project plan Make a list of the project
part of the project? the project plan activities that were planned
Are the activities taking place? Activities that have taken place Review activities records and At the end of 3 months, make a
If not, why not? What other during the last 3 months. minutes of any meetings held. list of the activities that
activities are taking place? Obstacles to holding activities. Unstructured interviews with actually took place, and compare
the people involved about it to the list of planned
activities. activities. Explain why some
planned activities were not
conducted.
What do participants think Feelings of participants about Focus Group Discussions with Summarize the discussion in
about project activities? activities. Appeal, value and participants. Structured writing. List all the important
convenience of each activity to interviews for as many comments about the project
participants. participants as possible. Self- that participants made during
administered questionnaires. the discussions. Summarize
ratings that participants give to
each activity on the
questionnaire.
Do participants appear to be Opinions of participants about Focus Group Discussions with Summarize the discussions. List
changing as a result of the the changes taking place. participants. Structured changes that young people
project? In what ways? interviews for as many believe they have undergone.
participants as possible. Summarize the opinions and
Unstructured interviews with observations of people working
people working in the project. with/ supporting the project.

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 Monitoring questions Project variables Method of gathering Method of analysing
information information
Finances
How much money has been Funds that have been included Review project budget. Review Make a list of budget plans for
allocated for the activities? in the project plan. of expenditures. each activity. Make a list of
expenditures. Any short-falls,
over-expenditure and other
income.
Human Resources
What types of students Number of students in each Review of activity records. Count the number of students
participate in the school activity. Age, gender, living Review individual school records for each activity. Prepare a
activities? situation, educational level and for background. table showing the age, gender,
extracurricular activities of the living situation, educational
students. background and extracurricular
activities of the students.
Why do many people supporting Opinions of people currently Unstructured interviews with Summarize in writing the
the project leave? What can be supporting the project people currently supporting the problems that people working on
done to keep them supporting concerning the difficulties of project. Self-administered the project identify, and the
the project? working for the project. questionnaire for those who reasons why others discontinue
Statements of people who have have left. their support. Make a list of the
stopped supporting the project most frequently mentioned
and their reasons why. problems.
Time
Are activities occuring on time Time allocated to each activity Review activity records. Record the number of
as planned? and the timeframe. Unstructured interviews with activities. List the most
those supporting the frequently mentioned problems

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 Monitoring questions Project variables Method of gathering Method of analysing
information information
implementation. related to time.
Other material resources
Are materials required for the Types of material resources Conduct an inventory of existing List of materials available. List
project available? required. Types available. materials. Unstructured of materials not available. List
interviews with those of materials needed. Summarize
supporting the implementation, problems related to material
on how materials are being used. resources.

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Questions for process evaluation/ monitoring
In summary, monitoring will help you answer these questions:
• Are activities taking place as planned?
• Are there enough resources to carry out the activities, (e.g. money, human,
material and time)?
• Are specific segments of the community involved and participating in the
activities, (e.g. teachers, health workers, law enforcement officers, young
people, family members, politicians)?
• Are the activities reaching young people?
• Are there problems with the approach or materials being used?
• Are there difficulties in the management of the project?

Documentation and record keeping

All activities undertaken and efforts made throughout project implementation
should be properly documented. You will need to ensure that good records are kept
and clear reports made. Whatever methods you use for record keeping, they
should be of value to the project. The information should:
• Be clear and easily understood
• Be presented logically
• Not contain unnecessary details
• Highlight the important points
• Not be excessively long or repetitious
• Not have complicated terms

Exercise 1 • Monitoring/ process evaluation

a) What is monitoring?

b) Why is project monitoring essential?

c) Using the project you identified in Module 5, develop an objective, activity and
indicator for monitoring.
• Objective
• Activity
• Indicator

d) Provide information on how you are going to monitor this project.

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5. What is impact evaluation?
Local situation Formulate a Implement
Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Impact evaluation is the overall assessment of whether the activities implemented

in the project have made a difference in the lives of young people and for the local
community as a whole. Often impact evaluation is also called terminal evaluation.
Impact evaluation enables you to determine the effect the activities carried out
had on the target group. A plan for impact evaluation should be specified in the
project development phase, it is an integral part of the project plan.

The importance of impact evaluation

This evaluation takes into account both the process of project development and
implementation. There are several reasons why impact evaluation is important.
Some of these are:
• It will help you measure the effect of the project on the knowledge, attitudes
and behaviour, and skills; that offer protection from substance use. This in
turn allows you to assess whether the project has succeeded in achieving all its
objectives.
• Sometimes impact evaluation may show that the project has not been
successful. This information is still useful for developing new and more
effective ways to work in the future.
• It provides essential information on what works and what does not work. This is
useful for future direction and for others who may want to undertake similar
projects.
• Evaluation can be a motivator to all involved in the project, young people,
community members and those that provided services and support. They will
want to know what worked and to be involved in finding solutions to the
problems.
• It provides proof that efforts have been worthwhile.
• It proves credibility and helps secure future funding.

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At the conclusion of the evaluation you need to know the effects the activities
carried out had on the target group. You should be able to answer the following
questions:
• Where you are in terms of what the project intended?
• What has been achieved?
• What has and has not been done?
• What should be done next?

Remember!

Impact evaluation is essential for determining whether your project has

made a difference among young people and the community. It can also help
convince others, such as policy makers, sceptical community members and
funding agencies.

6. Types of information to collect and

indicators
In trying to determine the impact of the project on the intended beneficiaries,
one must look at the information gathered before the project began. Without the
baseline information acquired through the local situation assessment, it is
extremely difficult to assess the project's impact. To enhance the objectivity of
the process, involve external experts, young people and selected community
members. As suggested with monitoring, indicators are needed to gauge what
change has taken place. Although behaviour is the easiest indicator, it is also the
most resource intensive and difficult to verify, within the scope of small
community-based initiatives. Below are some individual-based indicators:
• Knowledge
• Attitudes and beliefs
• Age of initiation into use

Since impact evaluation is closely linked to the initial situation assessment, the
indicators will also be closely linked to the assessment findings and to the project
objectives.

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Remember!

Increased or improved knowledge about substance use is not an indicator of

positive behavioural change or attitude change. These take a long time to be
evident, and could also be a result of other cofactors. However, it is still
worthwhile to know the contribution your project has made to preventing
substance use.

7. Steps to follow when carrying out impact

evaluation
These steps are similar to those followed when conducting the local situation
assessment.

Step 1 • Decide what to evaluate

Plans should be closely linked to objectives and activities of the project.

Step 2 • Use indicators set down in the project plan

For example:
• Attitudes towards substance use
• Number of young people using/ not using substances
• Number of young people wanting to avoid use

Step 3 • Select method for collecting the information

The method selected will depend on the indicators being measured. The example
on the next page is adapted from the WHO Street Children Manual on Monitoring
and Evaluation of Street Children Projects.

Type of indicator Example of indicator Appropriate method of

data collection
Indicators of behaviour. Snorting of cocaine. Observations.
Questionnaires. Interviews.
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 Type of indicator Example of indicator Appropriate method of
data collection
Indicators of beliefs or Expressed opinions about Informal conversations.
attitudes. smoking and drinking alcohol. Unstructured interviews1.
Semi-structured
interviews2. Focus Group
Discussions.
Indicators of the number of The percentage of young Questionnaires or
people who hold a certain people (target group) structured3 interviews with
belief or behave in a certain participating in the project a sample of participants who
way. who inhale solvents. are representative of the
entire group.
Indicators of the reasons Reasons given for why young Interviews (unstructured,
for certain behaviours. people targeted by the semi-structured or
project do not participate in structured). Focus Group
the project activities. Discussions.

1
Unstructured interview: the interviewer may ask the respondent any question that seems
important at the time, and the respondent is free to answer how he or she wishes.
2
Semi-structured interview: questions are written down in advance, but respondents can answer the
questions in any manner they choose.
3
Structured interviews: interviewers ask questions that have been written down in advance, and
respondents must choose from a limited number of possible responses that have also been selected
in advance.

Step 4 • Conduct the evaluation

• Prepare well in advance all what is essential for carrying out the impact
evaluation
• Prepare the necessary forms, identify and train individuals to assist in the
evaluation, plan for time when this should be done, and all other logistics. Once
the plans and materials are in place, you can carry out the evaluation.
Below is an example of a plan for evaluation (adapted from the WHO
Street Children Manual on Monitoring and Evaluation).

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 Project objectives Indicators Data collection Data analysis
methods method
To achieve 30% The number of young Baseline review (the Calculate the
increase in the people who have local situation proportion of
number of young asked for help. assessment). satisfied young
people satisfied with Number of young Interviews at people at initial
services offered for people satisfied with terminal evaluation. assessment and
primary prevention the services. terminal evaluation.
of substance abuse. Compare the two
figures.
Specific objectives
To achieve a 60% Number of young Individual interviews Calculate the
increase in the people who can with young people. proportion of young
number of young identify 5 dangers people, and their
people who are of substance use knowledge base at
informed about the practices. initial assessment
dangers of and terminal
substance abuse evaluation. Compare.
practices.

Step 5 • Analyse information

During this process, look for patterns among the responses to various questions.
Remember to validate information from one source by cross-checking with another
source or methodology, if you are uncertain of the conclusions. Once you are
certain of the conclusions, decide on the most effective way to present the
information, (e.g. using graphs, charts for numbers, or exact quotations from
FGDs).

In brief, impact evaluation will help you answer the questions presented below:
• Has the project met its set objectives?
• What obstacles were encountered during implementation of the project?
• How can these obstacles be overcome in the future?
• Have the interventions been effective?
• How can the needs of young people be optimally met?
• How long did it take to implement the project?
• How many young people did the project reach?
• Did the project increase awareness of the consequences of substance use?
• Did the project reduce the risk of substance use?

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Methods for gaining feedback from participants in the
evaluation process
It will be useful to get feedback from participants in the evaluation process itself.
Examples of some methods for doing so are given on this page and the next. They
include for both formative and summative evaluation methods. Formative methods
can provide information throughout the given process, and are associated with
monitoring. Summative methods provide information on the "sum effect" and so
are used mostly for overall or terminal evaluation. These methods can also be used
to gain feedback in other contexts.

Before-and-after questionnaires
People directly involved in commissioning and managing the evaluation fill in a
questionnaire both before and after the evaluation. They describe their views of
the issues that the evaluation is seeking to address. The responses are collected
and an analysis is made of the results. This is a summative evaluation method.

Intervention review sheets

With the help of a resource person, people fill in a form sheet at the end of an
interview, discussion or event, describing how they felt about what had happened.
The forms are collected and analysed. Interview review sheets are useful for both
formative and summative evaluation.

Diary review sheets

People fill in a diary sheet, on a weekly or monthly basis, that describes their
perceptions of change or development that has occurred during and after the
evaluation process. Diary review sheets are useful for both formative and
summative evaluation.

Talking wall
People fill in a “talking wall” about the evaluation. This means a number of
incomplete statements are posted on flipcharts (or the like) and left for the
participants to complete. The statements might, for example, begin as follows:
“What I valued most about the evaluation was ...”, “Something I would have liked
done differently was ...”, “The main thing I am taking away as a result of the
evaluation is ...”. The talking wall method is most often used for summative
evaluation.

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Sample interviews
A sample group of people is interviewed to find out their views on the experience
and their perceptions of the changes that have taken place. This can be formative
or summative depending on when it takes place.

Community feedback
The views of young people, youth leaders or agencies included in or affected by
the evaluation can be collected using simple information gathering methods. These
can include: a questionnaire mailed to agencies seeking their reactions to the new
ways of doing things, a “tick-the-box” wall chart for young people at a centre, used
to assess whether they have noticed any changes and to gather their opinions, a
committee meeting that receives presentations from people about action they
have taken and the effects these have had, an “opinion poll” survey of young
people.

Reviewer's feedback
The people conducting the evaluation will have views on the finished product, the
process and the effects of the evaluation. They will have had feedback on a
regular basis during the evaluation. At the end, they can be asked to summarize
their assessment of the work.
(adapted from Youth Health Analysis and Action, distributed by the
Commonwealth Youth Programme)

Step 6 • Take action

Use the information collected for the improvement of the project. Decisions that
can be made following impact evaluation might be:
• To change the project
• To include other activities (or)
• To use other approaches
• To end the project
• To disseminate lessons learnt

Based on the results of the evaluation and the interest the findings generate
among key players, you can reformulate your plans and begin the project
development cycle anew.

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Local situation Formulate a Implement
Mobilise resources
assessment project the project

THE PROJECT CYCLE

Evaluate project Monitor the
Replan
impact project

Remember!

Share the information gathered from the impact evaluation with the project
beneficiaries and other interested partners, including donors.

Exercise 2 • Impact evaluation

a) Explain the importance of impact evaluation.

b) What methods can you use to conduct impact evaluation?

c) Review Module 5 and identify appropriate indicators based on the type of

project you have selected.

d) List people you think would be interested or who can benefit from the findings
of your evaluation.

e) Make an outline of the headings you would include when reporting the findings
of the impact evaluation.

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7. Summary
Project monitoring is a systematic and continuous assessment of the
progress of a project over a given period of time.

A project plan provides a basis for monitoring the project.

Documentation of information about the project is an important

communication tool. Whatever information is documented must be clear,
accessible and easily understood; and must be shared.

Impact evaluation is a comprehensive review of activities implemented in the

project. It helps to determine whether the project has had an effect on the
lives of young people and that of the community.

Information obtained from the monitoring process forms a key component

of impact evaluation.

Involvement of experts can ensure that the process of evaluation is

objective, thereby making the information obtained more meaningful.

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Further reading
The materials used in the development of this document may assist you in learning
more about working with young people. Some useful addresses are also given.

Children's Hospital Los Angeles, Division of Adolescent Medicine M/ S/ 2 1996,

Facing The Challenge: A Workbook For Building Program For Street Youth. Los
Angeles, Redwood Press.

Commonwealth Youth Programme (1995) Youth Health Analysis And Action. London,
Commonwealth Secretariat.

Harder M. Volunteer Service (1992) Current Status Report. Volunteer Cycle.

Geneva, Henry Dunant Institute.

International Federation of Red Cross and Red Crescent Societies (1995) A

Manual For Trainers Of Red Cross And Red Crescent Volunteers In Africa. Geneva.

Kaseje M. (1990) Community Based Development. A Manual For Facilitators. HDI

Studies On Development, No 6. Geneva, Henry Dunant Institute.

National Institute of Health (1997) Drug Abuse Prevention: What Works.

Rockville, MD, Office of Science Policy and Communications.

Morojele N.K., Parry C. D.H. (1997) Monitoring And Evaluation. Tygerberg, South
Africa, National Urbanisation and Health Research Programme, Medical Research
Council.

UNICEF (1995) Working With Young People. A Guide To Preventing

HIV/ AIDS And STDs. London, Commonwealth Secretariat.

WHO (in press) Working With Street Children: A Training Package On Substance
Use, Sexual And Reproductive Health Including HIV/ AIDS And STDs. Geneva,
World Health Organization.

WHO (1999) Programming for Adolescent Health and Development.

Report of a WHO/ UNFPA/ UNICEF Study Group on Programming for Adolescent
Health. Geneva, World Health Organization.

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WHO (1999) Young People And Substance Use. A Manual. Create, Use And
Evaluate Educational Materials And Activities. Geneva, World Health Organization,
Substance Abuse Department.

WHO (1997) Coming Of Age. From Facts To Action For Adolescent Sexual And
Reproductive Health. Geneva, World Health Organization.

WHO (1995 draft) Street Children, Substance Use And Health: Monitoring And
Evaluation Of Street Children Projects, 1995draft. Geneva, World Health
Organization.

Useful addresses
World Health Organization
Department of Mental Health and Substance Dependence
Mental Health Determinants and Populations
Avenue Appia 20, Ch-1211 Geneva 27, Switzerland

United Nations International Drug Control Programme

Demand Reduction Section
Division for Operations and Analysis
P.O. Box 500
A-1400 Vienna
Austria

International Federation of the Red Cross and Red Crescent Societies

17, Chemin des Cretes, Petit-Saconnex
P.O. Box 372, CH-1211, Geneva
Switzerland

National Institute on Drug Abuse

Office of Science Policy and Communications
Public Information Branch
5600 Fishers Lane
Rockville, MD 20857 USA

National Urbanisation and Health Research Programme

Medical Research Council
P. 0. Box 19070
Tygerberg 7505
South Africa

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Commonwealth Secretariat
Marlborough House
Pall Mall, London SW 1Y 5HX
United Kingdom

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