How to apply the Stepping Stones Method with children and caregivers affected by HIV

Advocates faced multiple challenges especially while raising awareness on HIV among caregivers. This was due to the fact that people were afraid to be identified as people living with HIV based on the misconceptions in society. In addition, there was no simple way to disclose such information to children without them feeling like this was a death sentence leading to poor adherence. Messaging on HIV had always been somewhat a cause of stigma such as “AIDS Kills” and therefore rewriting the narrative made the conversations tough due to the general societal belief around HIV/AIDS.

To address the challenges, we utilized the Stepping Stones with Children and their Caregivers social norms transformation programme to make intergenerational conversations around SRHR and HIV easy. This programme follows a building blocks approach starting with relationship and trust building within community and among peer groups.

We start with open community meetings where we engage stakeholders and introduce them to the approach and then encourage people to volunteer to participate in the workshops. We then work with these volunteers through a two-part workshop covering different issues around communication, SRHR, HIV, GBV, mental health using practical exercises.

The volunteers work in small peer groups that are divided by age namely 5-8 year olds, 9-14 year olds and caregivers. The same information is shared among the peer groups in ways that are age appropriate. This is also done at the same pace so that assignments to practice what is learnt during the workshops are the same and are done together as a family. The peer groups also allow for free sharing and engagement.

Starting with basic information such as what they already know, and then building on that knowledge in practical ways that they can practice as families when they get home not only eases their understanding and improves communication on these issues but also creates habits that are sustained among the families.

We also acknowledge that changes do not happen overnight but require time but require practice by making small changes that eventually build into bigger changes and habits which can be sustained.

Advocates learned several critical lessons from this experience:

1. Community Trust Is Essential: Lasting change in social norms requires deep trust within communities. Advocates realized that working through respected local figures—such as parents, allies, and grassroots mobilizers/leaders—was more effective than relying solely on external messaging or formal authority.
2. Language Matters: Using culturally sensitive, non-confrontational language that centers shared values like protection, family, and dignity was far more impactful than technical or rights-heavy terms, which often alienated participants.
3. Safety Must Be Prioritized: Creating physically and emotionally safe spaces was a prerequisite for open dialogue. Advocates learned that participants are more willing to engage when they feel secure and their confidentiality is respected.
4. Working in small peer groups over time supports impactful change: By working with the same small peer groups, it is easy to follow up on assignments, build trust, while encouraging participants to make small changes.
5. Practice makes progress: Through the practical exercises conducted during the workshops, we noted that participants had not just acquired knowledge but learnt how to apply it. They always used the same knowledge together at their homes and eventually these became new practices in households
6. Families are the real way to cause change: The programme works with the family as a unit namely the children and their caregivers and having a couple of families participate in the programme had impact that was felt within the communities.
7. Capitalise on partnership: Partners not only help in terms of resource efficiency but also assist with relationship building. Our partner was based on ground and also brought more visibility to the programme that engagement with stakeholders became easy which led to a buy-in

Here are key tips for anyone facing similar challenges in advocating for SRHR and transforming harmful social norms, especially in restrictive or hostile environments:

1. Start with Values People Already Hold: Frame your message around shared cultural values such as love, protection, family, and dignity. This helps reduce defensiveness and opens people up to new perspectives.
2. Work Through Trusted Messengers: Collaborate with partners who already have a presence as well as families without isolating your main people of interest. Engage with the leadership and community on ground and keep them in the loop
3. Prioritize Safety and Confidentiality: Always assess and mitigate risks. Choose secure venues, use discreet communication channels, and be clear with participants about how their privacy will be protected.
4. Use Inclusive and Simple Language: Avoid jargon or overly technical terms. Use language that is accessible, affirming, and free of assumptions about gender, sexuality, or family structure. Make the language simple enough for different age groups or audiences
5. Be Patient and Consistent: Changing norms takes time. Focus on gradual, meaningful engagement rather than quick wins. Celebrate small shifts in attitude and behavior as progress.
6. Tailor Messages to Lived Realities: Understand the local context, including religious, cultural, and political dynamics. Your messaging will be more effective when grounded in people’s actual experiences.
7. Create Intentionally Safe Learning Circles: Encourage small group sessions or peer circles where people feel safe to ask questions, unlearn bias, and build confidence in new knowledge.
8. Encourage community action: While it may be our default to give information, create moments to learn from community members while encouraging them to come up with context specific actions to some of the challenges they identify.
9. Equip People with Tools, Not Just Information: Offer practical tools and skills. Provide simple assignments which can be followed up on in the future
10. Document and Reflect Often: Keep track of what works and what doesn’t. Reflection helps refine your approach and builds a library of lived strategies that others can learn from.

1. Messaging is important: It is important to have the same message across the board. When messages are different, they may cause harm. The message shared with parents should be the same with children and the message shared with females should be similar with the one shared with females.
2. Mental Health and Healing Spaces Are important: Shifting harmful norms can be emotionally draining for both advocates and communities. Incorporating collective healing, trauma-informed care, and emotional support into advocacy helps sustain the work.
3. Everyone participates: Working in isolation makes stigma worse. It is important for everyone to be brought on board; whether they are living with HIV or not.
4. Sustained Funding and Donor Flexibility: For long-term impact, donors should invest in core support, not just short-term projects. Flexibility in reporting and reallocation, safety considerations, and acknowledging the risks grassroots advocates take are essential.