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This issue of the Drum Beat highlights just a few of the myriad ways in which communication strategies are being used around the world to address Millennium Development Goal (MDG) #6, an effort to curb the spread or incidence of HIV/AIDS, malaria, tuberculosis (TB) and other major diseases by 2015. Various indicators have been introduced to measure progress toward this goal, such as condom use rate, ratio of school attendance of AIDS orphans to non-orphans, proportion of the population in malaria-risk areas using effective prevention and treatment measures, and proportion of TB cases detected and cured under directly observed treatment, short-course (DOTS); to explore all 7 indicators, click here.
The specific focus in this issue is on our most recent additions to the CI website, with an emphasis on the concrete impact that communication strategies and activities are having on reaching the Goal (and approaches and challenges associated with measuring that impact). To view our many additional materials related to MDG #6, please use our Custom Search tool and select the keyword for this MDG. Please also visit our MDG Impact section for further examples.
Next month we will focus on MDG #7: Ensuring Environmental Sustainability. Please send your projects, articles, events, etc. to Deborah Heimann dheimann@comminit.com
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CONTEXT
1. A Few Health Facts
According to the Kaiser Family Foundation, there are 40,300,000 people with HIV/AIDS in the world, 408,388,001 with malaria, and 15,430,000 with TB.
2. Unwind the Red Ribbon - i4d Vol. III No. 12, Dec. 2005 [PDF]
by Saswati Paik
A Nov. 2005 UNAIDS/WHO report indicates that approximately 95% of people with HIV/AIDS live in developing nations. Despite decreases in the rate of infection in some countries (attributed in part to changes in behaviour), the overall number of people living with HIV has continued to increase in all regions except the Caribbean; there were an additional 5 million new infections in 2005. Of 6.5 million people who need life-saving AIDS drugs, only 1 million receive them. The Millennium Development Goals Report 2005 notes only 21% of young women and 30% of young men in sub-Saharan Africa know how to avoid infection; surveys of young women in South-Eastern Asia show even lower levels of knowledge.
3. Promises to Deal with AIDS, TB & Malaria: Resolutions & Reality - Part 2 of 2
According to the US government's National Intelligence Council, "The number of people with HIV/AIDS will grow significantly by the end of the decade. The increase will be driven by the spread of the disease in five populous countries - Nigeria, Ethiopia, Russia, India, and China - where the number of infected people will grow from around 14 to 23 million currently to an estimated 50 to 75 million by 2010."
4. Malaria and Africa
There are at least 300 million acute cases of malaria each year resulting in over 1 million deaths, about 90% of which are in Africa. Malaria is Africa's leading cause of under-5 mortality and accounts for 40% of public health expenditure, 30 to 50% of inpatient visits, and up to 50% of outpatient visits in high malaria transmission areas.
5. Department for International Development (DFID) Factsheet (TB) - September 2005 [PDF]
Although TB prevalence rates are falling globally, there have been some steep regional increases. In sub-Saharan Africa this has been due to AIDS and multi-drug resistant TB, and in the European countries of the Commonwealth of Independent States it has been due to falling living standards and failing public health systems. TB prevalence rates are almost 15 times higher in developing regions than in developed ones.
6. TB: The Ignored Disease
One in 3 deaths of people with HIV/AIDS is caused by TB. There have been 21 new HIV drugs for every one new TB drug since 1986; the test for TB is 100 years old, and the vaccine being used today is the same as it was 80 years ago.
See Also:
LOCAL MEDIA, MARKETING & MOBILISATION
7. The Impact on Condom Use of the "100% Jeune" Social Marketing Program in Cameroon
by Dominique Meekers, Sohail Agha & Megan Klein
100% Jeune was a social marketing programme that promoted adolescent reproductive health through peer education in and out of schools, a monthly magazine, and an 18-episode radio drama with weekly call-in shows. These activities were supported by integrated television, radio, and billboard campaigns and by a network of branded youth-friendly condom outlets. The percentage of youth who used a condom in last sex with their regular partner increased from 32% to 45% for females and from 44% to 61% for males.
8. Dabbawalla Lunchbox Campaign - India
Developed to capitalise on the attention generated by World AIDS Day 2005, this campaign provided red ribbons and HIV/AIDS messages (coasters and other materials) within lunchboxes, which 5,000 or so dabbawalas pick up from homes and deliver to approximately 200,000 workers as part of a century-old institution. In addition to participation on the part of dabbawalas and high-profile political figures, an interactive awareness campaign was launched on a local FM radio station ("We cannot ask these questions to just anyone...but feel comfortable asking Radio City!"). 84% of the respondents recalled one message or the other on the coaster.
Contact Sonalini Mirchandani sonalini@jhuhcpindia.org
9. Kenya: Evaluation of the Nimechill Campaign to Promote Abstinence among Urban Youth 10-14
Supported by the President's Emergency Plan for AIDS Relief through USAID Kenya, the "Nimechill" (Swahili-English slang meaning "I have chilled" or "I am abstaining") campaign aimed to delay teen sexual debut by changing social norms and reducing peer pressure; creating stigma regarding irresponsible, early sex; and making abstinence a "cool", smart, responsible choice. A multiple regression analysis revealed that youth exposed to 3 or more channels (e.g., TV, radio, print, billboard, or poster) were 12 times more likely than youth who had not seen any Chill ads to strongly agree that "I will abstain from sex until marriage."
10. Kartada Tres - Philippines
Launched by the non-governmental organisation (NGO) Population Services Pilipinas Inc., Kartada Tres is an effort to prevent HIV/AIDS among adolescents in the economically poor provinces of Lanao del Norte and Misamis Oriental in Mindanao, the Philippines. The model works within the existing public health structure and involves developing the capacity of youth as peer educators/advocates while strengthening relationships between youth, the government, and NGOs. Due to the initiative of youth council officials, both provinces approved legislation supporting HIV/AIDS prevention education, with corresponding budget allocation.
Contact Virgilio Pernito bod@pspi.org
11. Reducing the Risk of HIV Transmission among Adolescents in Zambia: Psychosocial and Behavioral Correlates of Viewing a Risk-reduction Media Campaign
by Carol Underwood, Ph.D., Holo Hachonda, Elizabeth Serlemitsos, M.P.H., M.B.A. & Uttara Bharath-Kumar, M.H.S.
This paper summarises a study evaluating Phase I of Zambia's Helping Each other Act Responsibly Together (HEART) campaign. Viewership of HEART TV spots was "positively and significantly associated with high levels of efficacy to use condoms as well as with ever use of condoms, holding background variables constant." Compared with nonviewers, campaign viewers were 1.61 times more likely to report primary or secondary abstinence and 2.38 times more likely to have ever used a condom.
12. Impact Data - No Rubba, No Hubba Hubba - New Zealand
Launched by the Ministry of Health in an effort to reduce high rates of sexually transmitted infections among New Zealand's teenagers, this initiative used a variety of media, including television, cinema, radio, outdoor advertising, magazines, print resources and a website. The proportion of respondents who said they would still have sex if no condom was available decreased significantly (6%, down from 36%); 49% of Mâori respondents said that as a result of exposure to the campaign they are more likely to use condoms in the future.
13. Freeplay Lifeline Radios - Rwanda
This project provides orphaned child heads of households in Rwanda with a self-powered radio that is designed to provide distance education covering topics such as how to prevent disease, increase garden yields, and maintain goats. The radio is constructed to operate in harsh conditions and climates for many hours on wind-up energy or solar power; organisers describe it as colourful, easy to use, and able to receive excellent reception. Orphans were consulted throughout the design and development process...
Contact Kristine Pearson kpearson@freeplayfoundation.org
14. Reducing the Impact of HIV/AIDS on Orphans and Vulnerable Children and Older Caregivers - Cambodia
Family Health International (FHI) uses child-centred strategies in its efforts to raise awareness and promote non-discrimination through HIV prevention and impact mitigation activities held during events such as World AIDS Day, Children's Day and the Water Festival. Printed materials promote the role of older caregivers and share positive coping strategies; a key focus has been producing educational items for those who cannot read or see small pictures. A radio spot has been developed to promote these materials and models.
Contact Caroline Francis caroline@fhi.org.kh
15. The Economics of Social Marketing: The Case of Mosquito Nets in Tanzania
by Nassor Kikumbih, Kara Hanson, Anne Mills, Hadji Mponda & Joanna Armstrong Schellenberg
In an effort to combat malaria, this social marketing project promoted mosquito net use on billboard ads and sales agent bicycles, as well as through events such as video shows. In addition, community leaders were sensitised and a voucher scheme was developed. In the intervention area, the proportion of households with at least one net rose from 37% in 1996 to 72% in 1999, comparing positively to the changes in the control area during the same period, from 21% to 28%.
See Also:
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ARTS & EDUTAINMENT
17. Freedom HIV/AIDS Game - India
This initiative draws on the intense and increasing popularity of mobile phones to create and deliver interactive, entertaining learning solutions to teach people about HIV/AIDS. A key strategy for this role-play-based game involves capitalising on the popularity of the sport of cricket in India. The games were made available free to 9 million subscribers on World AIDS Day 2005. ZQM Software Systems hopes to spread the message beyond India, shaping content and language to meet the specific needs of users in Africa, South America, Eastern Europe and South-East Asia.
Contact Bhanu Sahni zmq@vsnl.com
18. Impact Data - Soul Buddyz 2 - South Africa
This edutainment initiative was launched by Soul City to educate children in the 8-12 year age group. 86% of children with high exposure to Soul Buddyz 2 multimedia said they know what AIDS vs. 60% of those with no exposure. 68% of children exposed to the print materials said that a person with HIV can look healthy vs. 49% of those with no exposure. There was an increase from 32% to 43% in children saying that abstaining from sex can prevent HIV infection, and from 49% to 57% who knew that consistent condom use can prevent infection.
19. Rap-It-Up - United States
This collaboration between the Kaiser Family Foundation and Black Entertainment Television (BET) draws on public service advertisements, long-form documentary and entertainment programming, and free printed and online resources. Community/grassroots events and contests are also central. Among the 18- to 24-year-old African Americans who had seen BET's HIV-related programming, half said they had talked with a partner about safer sex, and approximately 77% of those who were sexually active said they were more likely to use a condom. Nearly 40% said they had visited a doctor or been tested for HIV.
Contact Lyntina Townsend lyntina.townsend@bet.net OR Rob Graham rgraham@kff.org
20. Employment of Live Mass Information/Entertainment in Terms of Broad Principles of Entertainment Education
by Alan Finlay
Implemented by the KwaZulu-Natal Department of Education and Culture Life Skills Division, the JAE (Just About Education) HIV/AIDS Information Tour centres around the participation of "Jae", a pop star who spreads the HIV/AIDS message and promotes positive lifestyles at schools in Cape Town, Johannesburg and Durban. Actors and popular radio disc jockeys also educate learners about AIDS and communicate through song, dance, narration and drama. "The once-off JAE performance was not sufficient to create an attitude and behaviour change....Long-term support from various government departments is essential for the success of a strategy in creating behaviour change."
21. Inner Circle: Changing Times - Alaska
This theatre project aimed to raise awareness about and prevention of HIV and AIDS among Alaskan youth. The initiative centred around a 45-minute play followed by a Q & A session, which relied on the full participation of youth: a touring ensemble of teenage actors who delivers life-saving messages to their peers in an effort to encourage them to look, listen and learn. One 15-year-old boy said, "The Inner Circle was performed on a level that I as a teen can relate to. It was inspiring and makes you think about your actions before you do them. I'd love to see this play go global."
Contact Christian Heppinstall machhe@gmail.com
22. Impact Data - HIV Prevention Education for High School Students - Nigeria
Drawing on behaviour change theory, this in-school health education programme uses role-plays, stories, songs, debates, and essays, as well as films and more traditional lectures and a demonstration on the proper use of condoms. At 6 months post-intervention, 95% of intervention youth knew that HIV could be transmitted from a pregnant woman to her unborn child, versus 43% of comparison youth, and 96% of intervention youth knew that using condoms decreases the risk of HIV transmission, versus 63% of comparison youth. A higher proportion of sexually experienced intervention students than comparisons reported condom use at last intercourse (54% versus 43%).
23. Getting the Message Across: The Mass Media and the Response to AIDS - UNAIDS Best Practice Collection
"For this report, a UNAIDS consultant visited South Africa to interview a wide range of people working on the frontline, from project managers, researchers and media executives, to film-makers, audience groups, and people living with HIV who present their own programmes." Sesame Workshop's South Africa multimedia edutainment programming is one example of the many experiences highlighted in the report: "Besides providing pioneering radio programmes, Takalani was the first Sesame project to tackle the issue of HIV and AIDS. In September 2002, a five-year old girl Muppet with golden fur called Kami joined the show. Kami is an HIV-positive orphan whose mother died of AIDS. Her primary role is to humanize and destigmatize people living with HIV, and to open up discussion about issues such as coping with illness and loss."
24. Project Dancing Feat: Evaluation Research Report
Committed Communities Development Trust and Shiamak Davar Institute for the Performing Arts are using the medium of dance to reach high-risk, vulnerable children and youth in Mumbai, India by enhancing their ability to respond to situations that place them at risk of HIV/AIDS, as well as to cope with emotions surrounding the losses and discrimination that they may experience. Some have actively taken steps to prevent themselves from being infected with HIV: tell the barber to change blades, plan to get tested before marriage, tell the doctor to use clean needles. For 56% of the respondents, there has been a situation in which they have done something differently because of what they have learned in life skills education, which draws on puppets, drama, stories, and role-plays.
See Also:
GLOBAL AWARENESS
25. Unite for Children. Unite Against AIDS - Global
In October 2005, UNICEF, UNAIDS, and various partners launched a 5-year global campaign to urge those fighting AIDS to consider children and youth as they work to meet MDG #6. In addition to events involving high-profile personnel such as celebrities, the interactive campaign website features information and campaigning resources designed to spur citizen participation and action.
Contact Gerrit Beger gbeger@unicef.org OR Matthew Cortellesi mcortellesi@unicef.org OR Oliver Phillips ophillips@unicef.org
26. Soccer Aid - Global
Developed by UNICEF, Soccer Aid centred around a TV show leading up to a football (soccer) match broadcast in the UK for one week in May 2006. The initiative also involved public service announcements shared in part through a website which also featured ideas for community-based sports activities to spur awareness about, and donation of funds for, UNICEF's work such as: 1) looking after children orphaned by AIDS in Umbumbulu, South Africa - 17 community members were trained to work daily with families in their homes by helping with food preparation, supervising homework, facilitating grief work, promoting healthy practices, teaching life skills, growing food gardens, fostering access to grants, and ensuring that children are enrolled in schools, and 2) protecting children against malaria on Sebang Island in Aceh province, Indonesia - 15,000 ITNs were distributed to families at risk of malaria; the rate of infection dropped by 72.7% just one month later.
Contact David Bull info@unicef.org.uk OR ITV dutyoffice@itv.com
27. Dunk Malaria - Global
This grassroots initiative urges people all over the world to "shoot a basket for the eradication of malaria" on March 19, Malaria Action Day (MAD). An email discussion list was set up to enable the sharing of ideas and experiences; those taking part in MAD are asked to tell their family, friends and neighbours about their engagement and to encourage them to also take part - such as by uploading a photo of their basketball shot to the project website. Dunk Malaria is using the funds raised through these grassroots efforts to distribute bednets and initial mosquito spraying in 3 villages in Ghana.
Contact dunkmalaria@gmail.com
28. Advocacy, Communications and Social Mobilization to Fight TB: A Ten-year Framework for Action
This document sets out a 10-year strategic framework for country-level advocacy, communication and social mobilisation (ACSM) activities as a complement to strategic work at the global level designed to exert pressure on governments and other high-level authorities to prioritise TB control. There is "a substantial body of good practice to draw upon in designing effective TB communication programming"; a key strategic lesson is that ACSM strategies are most effective when their design is led by and appropriate to specific country processes and experiences. A few general principles are offered, such as: 1) Build national and subnational ACSM capacity 2) Foster inclusion of patients and affected communities 3) Ensure political commitment and accountability 4) Forge country-level ACSM partnerships 5) Learn, adapt and build on good ACSM practice.
See Also:
RESEARCH & INFORMATION
29. Impact of Sex and HIV Education Programs on Sexual Behaviors of Youth in Developing and Developed Countries
by Douglas Kirby, B.A. Laris & Lori Rolleri
Published by Family Health International, this report summarises a review of 83 evaluations of sex and HIV education programmes that are based on a written curriculum and that are implemented among groups of youth in schools, clinics, or other community settings. Among the recommendations: more rigourous studies - particularly those using randomised experimental designs - of promising programmes should be conducted in developing countries.
30. Reducing Vertical Transmission of HIV/AIDS in El Salvador: Barriers and Supportive Factors - Executive Summary
USAID/El Salvador funded this study to assist in the development of a national strategy to prevent maternal-to-child transmission of HIV/AIDS. The study sought to examine "factors that influence key behaviors related to HIV testing during pregnancy....The study revealed strong support to offer universal HIV testing to pregnant women." Among the recommendations: improve logistics/supplies to assure the availability of tests, and disseminate existing protocols/establish referral protocols.
31. South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey 2005
In 2002, the Nelson Mandela Foundation commissioned a national, household sero-prevalence survey of HIV/AIDS in South Africa. This document shares the results from a 2005 follow-up survey. Among the findings: Some HIV/AIDS communication campaigns have been successful in reaching audiences; other key sources for HIV/AIDS information include talk shows, dramas, feature articles, and entertainment programmes. People also learn about HIV/AIDS through forms of direct exposure, such as knowing someone with the disease or school programming. There are challenges associated with measuring communication impacts and responses due to an overlap between campaigns, as well as influence from sources of information beyond campaigns.
32. Fulfilling Reproductive Rights for Women Affected by HIV/AIDS: A Tool for Monitoring Progress toward Three Millennium Development Goals
by Maria de Bruyn
This document is designed to foster collection of data on areas of reproductive health that are at the heart of 3 of the MDGs, including MDG #6. The idea is that even those organisations that do not have the capacity and/or human resources to carry out formal evaluations can use this tool to collect information (through both quantitative and qualitative means) that is useful for assessing whether progress has been made in fulfilling reproductive rights for women affected by HIV and AIDS. In addition to fostering research, the resource is intended to be used for advocacy and monitoring purposes in conjunction with regional or governmental agencies.
33. Deadline for Health: The Media's Response to Covering HIV/AIDS, TB and Malaria in Africa
by Lisa Woll
The aim of this study was to assess media coverage of HIV/AIDS, TB and malaria in Botswana, Cameroon, Kenya, Malawi and Senegal. Among the findings: While articles about HIV/AIDS overwhelmingly dominate health coverage, the frequency of public health coverage in general was alarmingly inadequate. Although insufficient, the focus on HIV/AIDS has been to the detriment of coverage on other public health concerns such as malaria, TB, diabetes, yellow fever, hepatitis, immunisation and maternal and child health.
34. Networking Computers to Help Combat Disease
Grid computing is being used in developing countries worldwide to stimulate new approaches to collaborative large-scale science, to discover new drugs, and to better understand the nature of diseases such as malaria and Dengue. In contrast to in vitro and in vivo approaches (through which can take 10 years to discover a drug and another 10 to get it approved), with this new type of research it takes between a few seconds and a few minutes to model a possible match between a protein from the malarial parasite to a ligand.
35. Malaria Knowledge Programme: Gender Perspectives - Ghana
The Malaria Knowledge Programme at the Liverpool School of Tropical Hygiene uses interpersonal communication in an effort to transform vulnerability to malaria into resilience. In the Volta Region of Ghana, the team trained district-level health workers to carry out qualitative and participatory research on gender equity aspects to health care for malaria, which included meetings with opinion leaders and involvement of community members in role-plays and drama.
Contact Rachel Tolhurst r.j.tolhurst@liv.ac.uk
36. Spatial Development Initiative (SDI) - Mozambique, South Africa and Swaziland
A geographical information system (GIS)-based project that uses software to generate risk maps, graphs and tables about malaria, which are then posted online so users can consult them to determine malaria risk and plan malaria control.
Contact info@intermap.co.za
See Also:
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This issue was written by Kier Olsen DeVries.
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The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
Please send material for The Drum Beat to the Editor - Deborah Heimann dheimann@comminit.com
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