This is an evaluation of the Soul City Regional Programme (SCRP), an HIV/AIDS communication project which involves 8 southern African countries and combined the adaptation of local communication materials with a large-scale capacity building programme. The Soul City Institute for Health and Development Communication identified local partners in each country who then, with support from Soul City, set up their own health communication programme. The 8 countries produced a total of 20 titles in the 5-year period from 2002 to 2007. Approximately 20 million copies of these were distributed in the region. In addition, the SCRP produced a total of 11 radio drama series and 14 television documentaries/talk shows. The aim of this evaluation was to investigate the impact of the local communication interventions in each country on individuals and communities.
The 8 country programmes involved in the evaluation are: Choose Life! in Botswana, Phela in Lesotho, Pakachere in Malawi, Nweti in Mozambique, Desert Soul in Namibia, Lusweti in Swaziland, Kwatu in Zambia, and Action in Zimbabwe.
The overall SCRP objectives for the five years from 2002 to 2007 were:
- to reach 40% of the total population in each country;
- that 15% of the exposed people show positive behavioural change;
- that 20% of the population show increased knowledge; and
- that 15% of the exposed show improved attitudes towards those affected by HIV and AIDS.
A baseline survey was conducted in 2002 in each of the 8 countries. This was followed by a mid-term study conducted in 2004, which collected qualitative audience reception data, again in all 8 countries. Finally, in 2007, an impact evaluation was conducted, consisting of a national quantitative survey in each of the 8 countries. The results of these surveys are summarised in this report.
Cross-sectional analytic studies were conducted in each of the 8 countries. Adults (aged 16–60 years) were surveyed using a national household survey, while a school-based survey collected data on children and youth aged 8–17 years. Within each country a stratified cluster sample was drawn to ensure rural and urban representation. The surveys collected data on exposure to each of the partner media interventions, other similar non-partner programmes, knowledge, attitudes, self-efficacy, collective efficacy, and behaviours related to the themes of the interventions. Data were entered and analysed in Epi-Info software. Population weights were applied to the estimates. Associations were assessed for significance at the 99% confidence level. Multivariate analysis was conducted among those that were significant. In this way, the confounding effects of socio-demographic factors and other mass media were assessed.
Overall, the 5-year evaluation of the SCRP has shown substantial reach and impact of local media interventions on individuals and communities in the 8 southern African countries. According to the report, a striking finding was a clear shift in HIV testing in all countries from 2002 to 2007, with exposure to Soul City partner interventions associated with testing in all settings. This included respondents having been tested in the preceding 12 months and asking a partner to go for an HIV test. Similarly, in all 8 countries the media interventions were clearly associated with knowledge about antiretroviral treatment (ART) including knowing that one can still transmit HIV while on ART, knowing that a person can live longer on ART, and knowing that antiretroviral drugs (ARVs) do not permanently cure AIDS. This indicates that the HIV testing and AIDS treatment messages were particularly effective in the media interventions in the region. In all of the 8 countries, stigma reduction associated with one or more of the media interventions was measured suggesting the messages were effective in shifting attitudes.
The evaluation findings show that the following was achieved in relation to the overall programme objectives for each country:
- To reach 40% of the total population in each country - According to the evaluation, this objective was achieved and far exceeded in most countries. In all 8 countries more than 60% of youth were exposed to the local health-communication brand. Phela reached about 65% of adults in Lesotho, in Malawi 97% of males and 90% of females were exposed to Pakachere, and Lusweti in Swaziland reached over 80% of adults and youth.
- 15% of the exposed people show positive behavioural change - Overall this was achieved. Among more educated women in Zambia, 18% of those who had no exposure to Kwatu used condoms with their non-regular partner, compared with 40% of those who had high access to Kwatu. In Namibia, 80% of men with low education and high exposure to Desert Soul consistently used condoms with their regular partner, while only 20% of those with no exposure did.
- 20% of the population show increased knowledge - This was achieved in most countries. In Zimbabwe, 81% of adults who were exposed to Action knew that ARVs do not permanently cure AIDS as opposed to only 68% who were not exposed to Action. In Botswana, 63% of those who were exposed to Choose Life! knew that always using a condom can prevent HIV, compared with 49% of those who were not exposed.
- 15% show an improved attitude towards those affected by HIV and AIDS - Again, this objective was achieved and exceeded in most countries. For example, 85% of adults who had listened to Nweti radio disagreed that HIV and AIDS are a punishment for sinning compared to 59% who had not heard Nweti.
Soul City website on November 20 2008.