Lessons learned implementing SKILLZ programming among youth with intellectual disabilities in South Africa, Nigeria, and Namibia

DETAILED SUMMARY

Importance

• Youth with intellectual disabilities are at much higher risk of violence, sexual abuse, are especially vulnerable to HIV infection, and are subject to discrimination. They are also often excluded from HIV intervention programs and have limited access to education and health services.

Objective

• To evaluate whether SKILLZ for Life can be successfully implemented and scaled among youth with intellectual disabilities in school and camp settings in Nigeria, Namibia, and South Africa over the 2017-2017 internal evaluation period.

Study details

• Study design: Mixed methods study (no control group)
• Data collection tools: Pre- and post-questionnaires; 7 focus group discussions; 10 in-depth interviews; 3 semi-structured observation visits
• Participants: 1,932 mixed gender participants with intellectual disabilities (“Athletes”) and without intellectual disabilities (“Partners”), Special Olympic program staff, grant managers, coaches, teachers, parents of participants
• Implementation setting: Schools and camp in South Africa (Cape Town, Johannesburg), Nigeria (Lagos, Enugu) and Namibia
• Study period: Namibia (2009-2010), South Africa (since 2014), Nigeria (since 2016), internal evaluation conducted from 2017-2018

Intervention

• SKILLZ for Life: Six 60 minute sports-based sessions delivered by trained Coaches working in pairs to groups of approximately 15 Special Olympics Athletes (youth with intellectual disabilities) and Partners (youth without intellectual disabilities), as well as a graduate and Family Health Forum event providing information and health services (HIV Testing Services).

Lessons learned

• Invest early and engage stakeholders: Programs need multi-year funding (≥3 years) and early stakeholder involvement.
• Adapt delivery to learner needs: Use simple, multi-sensory, and iterative curricula tailored to athlete capacity.
• Prioritize inclusion and access: Involving partners and families reduces stigma and improves outcomes.
• Use accessible evaluation and training: Apply adapted M&E methods and train staff/stakeholders to work effectively with youth with intellectual disabilities.

Conclusions and implications

• Lessons from SKILLZ for Life show that supporting youth with intellectual disabilities requires early investment in staff, training, and engaging families and community partners. 
• Simplifying the curriculum, using repetition and multi-sensory teaching, and incorporating image-based monitoring may improve participant understanding.