Steps to Healthy Living

SAPTA’s  Steps to Healthy Living Program,

an alcohol/drugs/HIV risk reduction

psycho-educational program

What is Steps to Healthy Living Program? (Click here to download this document)

Steps is 12 psycho-educational lessons of 1 ½ hours each intended to be delivered over a six week period (that is, two lessons given per week).  It incorporates evidence based substance abuse practices, namely, motivational interviewing, cognitive behavioral coping skills (e.g., drink refusal skills), introduction to Alcoholics Anonymous, and relapse prevention.  It also contains lessons on alcohol and risky sexual behavior, alcohol and ART, and how to engage in a healthy living lifestyle.

Who are the intended audiences?

Anyone who has a problem with alcohol or drugs can benefit from this program.  The original format was designed for an adult heterosexual audience.  However, with some adaptation the images and messages can be adapted for a female sex worker or men who have sex with men/male sex worker population. 

The format is intended to be a group presentation with 8 to 10 people per group as the ideal number for a group presentation.

It would be helpful with other groups who have an alcohol problem: PWLHA who are drinking; male teachers; policemen; fisherfolk; and youth.

Who facilitates the lessons?

Peer educators who either do not have current problem with alcohol or drugs can facilitate the program.  Also anyone in recovery from alcohol or drug abuse with six months of sobriety can also facilitate the program.  Who also might benefit from the training?  ART adherence counselors would find the training helpful to offer

The training of peer educators

The peer educators are trained by SAPTA trainers in a five day training program. The first 2 days gives the participants the basic knowledge of the effects of alcohol and drugs, their relationship to risky sexual behavior and ART, an introduction to Alcoholics Anonymous and the first 3 steps, and the healthy living. In the last 3 days of the training the peer educators are taken through each of the lessons in order to know how to present them.

A manualized approach      

The Steps uses a manualized approach so that the peer educators can be guided to give an evidence based presentation.  They will have two manuals to guide them.  One, a larger version, gives them a more detailed information background on alcohol and drugs.  Another, a shorter version, will be able to be used in the group presentations.

What are the Evidence Based Substance Abuse Practices used in Steps?

Why task shift from addiction counselors to peer educators?

In sub-Saharan African countries either there are few addiction treatment centers or they are too expensive for most affected people. 

Will people drop out of the lessons?

Possibly some participants will.  Persons who are affected by substance use disorders especially in more severe forms are prone to relapse.  However they should be contacted and encouraged to come back again at a later time when the program is offered again.

Will people relapse after attending the program?

Probably some participants will relapse.  People who are affected by substance abuse disorders often relapse after going through either inpatient or outpatient addiction treatment programs.  They should be encouraged to go through the Steps program again when the program is offered.

How is this program related to Alcoholics Anonymous?

Steps is NOT primarily an AA program.  It is an evidence based informed alcohol and drug risk reduction program.  However, in order to encourage group support after the completion of the 12 lessons the participants are introduced to AA and the 12 step program.


‘The Steps” are presented in A3 laminated flipchart form of 100 pages: 50 in front and then 50 at the back. The flipchart comes with its own stand so that it can sit on a table or chair. It is meant for a group presentation: 10 to 12 participants.  Also the flipchart comes with its own carrying case.

Training of Peer Educators:

The training takes place over 5 full days: the first two days focus on giving the participants a background on the effects of alcohol and drugs, the range of alcohol/drug abuse to addiction, the relationship of alcohol to risky sexual behavior and ART drugs; and the last three days focus on training the peer educators on how to conduct the 12 lessons.

Training manual:

The program also comes with a very detailed training manual (in English) which will assist the peer educator to have a sufficient background on alcohol/drugs/HIV as well a manualized approach to the lessons.

Delivery of Flipchart and training manuals:

Those who purchase the training program will also be responsible for the costs of the delivery of the flipcharts and manuals.


SAPTA trainers would prefer to train 10 peer educators at a time. The cost of training will be negotiated with the NGO or company based on standard rates.

What does the Organization get for the training package?

The organization gets the five days of training, two copies of the ‘Steps To Health Living” flipchart program, two carrying cases, 100 copies of the AUDIT (Alcohol Use Disorder Identification Test), the DAST (Drug Abuse Screening Test), 100 copies of the weekly tracking form and monitoring material. The flipcharts can either be 2 in English, 1 English and 1 Kiswahili or 2 in Kiswahili. Two carrying cases are provided. Additional copies of the flipchart can be purchased at Ksh 12,000 for 1 flipchart and 1 carrying case.

The peer educators are given two manuals: one, has a more in-depth study of the topics to be covered in the training; the other manual includes what they are to train on. The training is in a manualized form, meaning that each step of the lesson is clearly laid out as to what they are to present to those who have an alcohol and drug problem.

Reporting to SAPTA:

The peer educators are expected to report to SAPTA the following information: how many started each program and how many completed the program: what were the participants’ scores for the Alcohol Use Disorder Test (at the beginning and when completing the program) and the Drug Abuse Screening Test (at the beginning and competing of the program.)

Support for Trainers:

After the training, the peer educators can contact SAPTA main office via email to discuss any problems or challenges they are facing.

For further information contact:

Dr. William Sinkele, executive director, SAPTA