HIV-Related Discrimination among Grade Six Students in Nine Southern African Countries

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Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support

 

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In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key Populations in National AIDS Strategic Plans

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Enhancing Benefits or Increasing Harms: Community Responses for HIV among Men Who Have Sex With Men, Transgender Women, Female Sex Workers, and People Who Inject Drugs

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The Communication Initiative Network and Partnership convenes the communication and media for development, social and behavioural change community to share knowledge, connect, debate relevant issues, and critically review each other's work in order to advance effective development action across and between all development priorities. Contact Warren

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TackleAfrica

Communication Strategies: 

TackleAfrica projects include:

HIV Awareness Football Tour - West and East Africa, 2003/4

Twenty volunteers from across the UK set off on a six-month HIV/AIDS awareness football tour of West and East Africa. Over the course of the six months, the project's team took part in 16 different HIV awareness events and played more than 40 games of football. The team also took part in HIV awareness seminars and workshops, street parades, cultural evenings, and schools visits - all designed to increase people's awareness and understanding of HIV/AIDS and to challenge people to take positive steps to protect themselves against HIV/AIDS.

The team distributed leaflets, posters, and other materials to help raise HIV/AIDS awareness, and also distributed sports equipment (as an incentive) - hoping to help local partners continue to run similar events in the future, and encouraging the local community to take part in the activities. The tour was held between September 2003 and April 2004 in the following countries: Morocco, Senegal, Mali, Burkina Faso, Ghana, Togo, Nigeria, Cameroon, Ethiopia, Kenya, Uganda, and Tanzania.

The Mbale Sports Centre

TackleAfrica teamed up with a local partner, AIDS Care Education and Training (ACET), on this project to help stop the spread of HIV/AIDS among young people in Uganda. The project built a Sport and HIV/AIDS Education Centre in the country. The Centre is used to reach young people with information about HIV/AIDS prevention.

PfP HIV/AIDS Awareness Project with 'Kabaa Young Cobras' and 'Tulula Youth United' Football Clubs, in Machakos District Kenya

In central Kenya TackleAfrica teamed up with Partnerships for Peace (PfP) to run a project in the Machakos district. Fifty members of the Kabaa Young Cobras Football Club and Tulila United Football Club, aged 15-24 years, were trained as peer educators to be able to inform young people about HIV/AIDS at football events. The project activities were expected to reach an additional 10,000 young people aged five to 30 years old.

The project involved eight one-day training seminars for all club members to equip them with accurate and relevant information about HIV/AIDS. The seminars were also used to plan the events and help the members design the messages and methods of delivery that they would use during the sporting activities.

The objective of the project was to promote positive behaviour change among young people by providing them with information about HIV/AIDS and reproductive health so that they could make informed decisions.

CCFMC Youth HIV/AIDS Behaviour Change Project

The organisation worked with the Comprehensive Course on the Franciscan Mission Charism (CCFMC), a Kenyan non-governmental organisation (NGO), on a youth HIV/AIDS behaviour change project. The project used the popularity of football among the youth to pass on HIV/AIDS messages. It aimed to equip youth and the community with knowledge and skills for curbing the spread of HIV/AIDS, and to facilitate, establish, and support activities among youth that would enhance their active participation in efforts to fight the spread of HIV/AIDS. CCFMC used the project to address socio-cultural issues that relate to HIV/AIDS and to help reduce the rate of teenage pregnancy amongst adolescents in Kenya.

The project was based on a tournament model, with build-up taking place in two areas - Siaya and Chiga - with a series of nine build-up events at a sub-parish level followed by final matches between the winning teams.

During these events, HIV/AIDS messages were passed on through printed T-shirts and caps, posters and banners, as well as through guest speakers from local government. CCFMC activities also included:

  • peer education activities in groups;
  • facilitating youth groups and interschool competitions;
  • coordinating with local health facilities to monitor treatment seeking behaviour change among the youth;
  • promoting of information through football, songs, and poems among the youth;
  • distributing of information, education, and communication (IEC) materials; and
  • promoting voluntary counselling and testing for HIV/AIDS.
Development Issues: 

HIV/AIDS, Youth, Children.

Key Points: 

TackleAfrica was founded in May 2002 by a group of young people from the UK who had all lived or worked in Africa at some point in their lives. The organisation was awarded charitable status in October 2002. According to TackleAfrica, their work focuses on Sub-Saharan Africa, the part of the world most affected by HIV/ AIDS. They note that an estimated 24.5 million people were living with HIV at the end of 2005 with approximately 2.7 million new infections occurring during that year. TackleAfrica believes that the 18-35 years age group are the most affected - an indication that it is the economically productive segment of the population which is hardest hit.

Partner Text: 

Accenture, Football Association, Professional Footballers Association, Siren TV, Christian Aid and Concern, AIDS Care Education and Training (ACET), Comprehensive Course on the Franciscan Mission Charism (CCFMC).

Contact Information: 
Source: 

Development Gateway dgCommunities: HIV/AIDS February 28 2007 and Tackle Africa website on May 7 2007 and July 27 2009.

Gugar Goge ("Tell me Straight")

In 2006, the United States (US)-based Population Media Center (PMC) produced a 70-episode radio serial drama project in northern Nigeria with the aim of improving maternal health and preventing obstet
Communication Strategies: 

According to PMC, the programme aims to raise awareness and encourage behaviour change by modeling behaviour that will prevent obstetric fistula, reduce stigma, and encourage fistula victims to seek help for the treatable problem. Obstetric fistula is a condition commonly resulting from adolescent childbirth that makes its victims chronically incontinent. The programme was created in Hausa, the most widely spoken language in northern Nigeria and neighbouring countries, and was aired in Kano and Kaduna states. on Radio Nigeria-Hausa Service and FM 96.5. Click here to listen to a selection of the episodes online.

According to PMC, entertainment-education is at the heart of all of its work, including this programme. This methodology involves creating serial soap operas that are customised for the needs and circumstances of specific regions. Organisers believe that the concept of social learning means that humans adopt many of their values and learn much of their behaviour from role models. Long-running serial dramas contain plots and sub-plots that unfold over many months, with "good" and "bad" role models through whom audience members can gradually learn the consequences of decisions they may make.

PMC uses what they call the Whole Society Strategy, which is a technique that combines audience research with as many channels of communication as possible in order to reach an entire society with messages and role models that promote positive behaviour.

Development Issues: 

Health, Reproductive Health, Women.

Key Points: 

In order to evaluate the effects of the serial drama, PMC partnered with Planned Parenthood Federation of Nigeria to conduct a preliminary monitoring report based on client exit interviews at three clinics, one hospital, and one basic health post in Kano and Kaduna states. The purpose of the study was to assess the effects of the serial drama on demand for reproductive health services. By mid-September of 2006, 47% of new reproductive health clients indicated they were listening to the programme. Clinic monitoring data indicated that "Gugar Goge" served as the primary motivation to seek health care services for 33% of family planning/reproductive health clients and 54% of fistula clients.

PMC is an international nonprofit organisation with headquarters in Shelburne, Vermont, US. The organisation uses entertainment broadcasting to change cultural attitudes and individual behaviour with regard to health and social issues in various developing countries. "PMC has completed projects in Burkina Faso, Ethiopia, Ivory Coast, Mali, Niger, the Philippines, and Sudan with very impressive results and currently has programmes either broadcasting or developing in Democratic Republic of the Congo, Egypt, Ethiopia, Guatemala, Honduras, Kenya, Madagascar, Morocco, Mozambique, Niger, Nigeria, Rwanda, Sudan, Tanzania, Brazil, Jamaica, Mexico, China, Vietnam and the US."

Partner Text: 

PMC, RFPD, the David and Lucile Packard Foundation, and the Conservation, Food and Health Foundation.

Source: 

PMC Nigeria website on February 6 2007 and September 5 2008; and RFPD website on September 5 2008.

A Community-Based Health Education Programme for Bio-Environmental Control of Malaria through Folk Theatre (Kalajatha) in Rural India

Author: 
Susanta K Ghosh
Rajan R Patil
Satyanarayan Tiwari
Aditya P Dash
Publication Date
January 1, 2006
2006
Affiliation: 

National Institute of Malaria Research (ICMR), Bangalore, India (Gosh and Tiwari); Community Health Cell, Bangalore, India (Patil); National Institute of Malaria Research (ICMR), Delhi, India (Dash); Integrated Disease Surveillance Programme [WHO, UNDP], Orissa, India (Patil)

According to this research, Kalajatha, a popular, traditional art form of folk theatre depicting various life processes of a local socio-cultural setting, is an effective medium of mass communication in the Indian sub-continent, especially in rural areas. The document describes using this medium to carry out a community-based health education programme for bio-environmental malaria control.

Contact Information: 
Source: 

Malaria Journal, 5:123, 2006.

http://www.malariajournal.com/content/figures/1475-2875-5-123-1.gif

Fight Fistula! Campaign

Communication Strategies: 

As the campaign is based on the idea that prevention is the key to fighting fistula, the campaign's main strategies are to promote awareness of fistula and improve family planning services. The organisers believe that peer-to-peer communication, supported by the provision of good health services, can be an effective way to encourage young women to take control of their sexual and reproductive health, thereby preventing incidences of fistula.

The campaign uses peer education as a means to engage young people and trains former fistula sufferers to conduct home visits and raise awareness about reproductive health issues through youth clubs. At the same time, the training of former fistula patients aims to assist in their reintegration, help reduce stigma by normalising the condition, and give other members of the youth clubs the opportunity to talk openly with someone who understands their concerns and experiences.

As part of the project, DSW is also working to increase the organisational and management capacity of 15 youth clubs that focus on young women. This includes establishing a referral system between youth clubs and health facilities to help improve access to reproductive health services. Local nurses, who have been trained on the treatment of fistula, liaise with the youth clubs, provide counselling services, and educate the community (notably, parents and religious leaders) about topics linked to the prevention and treatment of fistula.

Through the mass edutainment aspect of the campaign, the project aims to engage a more diverse and wider audience than can be reached through the youth clubs. According to the organisers, the youth clubs are using folk media methods - including music, dance, and drama - to promote social values, raise awareness, disseminate information, provide role models, and encourage positive attitudes and behaviour change.

Development Issues: 

Women, Reproductive Health, Maternal Health, Youth.

Key Points: 

Fistula is a childbirth injury that can leave women incontinent, ashamed, and ostracised from society. An obstetric fistula is a hole, caused by prolonged obstructed labour, leading to damages to the tissues of the vagina, the bladder, and rectum. Apart from leaving women incontinent, women may also suffer nerve damage to lower extremities after prolonged labour in a squatting position and significant emotional damage from both the death of the baby, which happens in most cases, and the stigma that accompanies fistula.

DSW says that in Ethiopia alone there are an estimated 100,000 women suffering with untreated fistula, either due to lack of awareness or shame derived from social stigma. Each year, another 9,000 women develop fistula, representing the highest prevalence of fistula worldwide. Fistula occurs disproportionately among impoverished girls and women, especially those living far from medical services. The Fight Fistula! campaign aims to reach an estimated half a million people in the region.

Partner Text: 

Addis Ababa Fistula Hospital and DSW.

Contact Information: 
Source: 

Youth to Youth website; DSW Fast Facts [PDF] on May 6 2008; and email from Tirsit Grishaw to The Communication Initiative on November 6 2009.

Together We Can

Communication Strategies: 

Recognising that young people feel more at ease when talking to their peers, Together We Can places an emphasis during peer educator training on helping young people (aged 13 and 19 years) develop the necessary skills to conduct different learning techniques. These are meant to be dynamic interactive educational techniques such as: role-playing, group discussions, quizzes, etc. using a non-judgmental approach. Participants are encouraged (and supervised) to act as information disseminators and behavioural change agents.

 

The core areas of training include knowledge (e.g., identifying family planning clinics, STI clinics, health centres, and pharmacies as places to get condoms), attitudes (e.g., expressing a willingness to interact in everyday situations with people living with HIV and AIDS), and skills (e.g., demonstrating the ability to tell others how HIV is transmitted and prevented).

 

An interactive online forum was set up to act as a place where young Together We Can participants can exchange experiences, discuss issues, continue friendships, and engage in moderated sessions. The use of the internet here is a tool for - it is hoped - reducing the numbers of young people being infected with HIV while promoting care and support to those who have been infected and affected.

Development Issues: 

HIV/AIDS, Children, Youth.

Key Points: 

The following statistics are drawn from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in the report titled "2008 Report on the Global AIDS Epidemic":

Caribbean:

  • An estimated 230,000 [210,000-270,000] people were living with HIV in the Caribbean in 2007 (about three-quarters of them in the Dominican Republic and Haiti).
  • An estimated 20,000 [16,000-25,000] people were newly infected with HIV in this region.
  • Some 14,000 [11,000-16,000] people died of AIDS in 2007.

Latin America:

  • There were an estimated 140,000 [88,000-190,000] new HIV infections in this region in 2007.
  • The number of people living with HIV in this region is approximately 1.7 million [1.5 million-2.1 million].
  • An estimated 63,000 [49,000-98,000] people died of AIDS in 2007.

In 2004, a consultancy firm (Itaca Assesorias) was hired to develop a monitoring and evaluation Together We Can toolkit to be implemented in all National Societies in the Caribbean and Central America in 2005. This toolkit is designed to measure impact in Together We Can programmes in the region.

In Suriname, where the programme was launched in 2007, by the end of that year approximately 4,000 young people were reached, most of whom are between the ages of 15 and 25 years. Sahida Leerdam (age 21), a public administration student in Suriname who participates in Together We Can, says, "We use the same vocabulary as our peers. When trainers and trainees use the same language, you get this relaxed atmosphere where everybody feels on the same level....In my circle of friends and fellow students, I notice that HIV/STI only becomes a topic when they are somehow involved in working for an organization like Red Cross, or another voluntary job. That's why I think the educational materials we produce should be made in such a way that they have a strong impact. Is a brochure colourful, does it lead to action? I like the infomercials the region shows on television, as a young woman I feel connected, right then and there. A line like: 'Make your next date special. Get tested.' I love it!..."

Partner Text: 

Jamaica Red Cross, the Norwegian Red Cross, Netherlands Red Cross, the Norwegian Agency for Development (NORAD), the United Nations Children's Fund (UNICEF).

Source: 

Tabiki Productions' "Young in the Caribbean: The Caribbean Children & Youth Development Bulletin" [Vol. 5 (2007), No. 2 (December)] - forwarded from Marieke Visser to The Communication Initiative on January 9 2008; Together We Can: The Methodology - Youth Peer Education [PDF]; Caribbean Red Cross website; and emails from Mrs. Norma García de Paredes and Marie Louise Belanger to The Communication Initiative on May 2 2008 and November 10 2008, respectively.

Project BudBurst

Communication Strategies: 

This initiative is designed to galvanise members of the public (of all ages) in conducting research about climate change, and in sharing this information - through the use of an interactive website - with others. In short, by drawing on the participation of people who are privy to potentially useful data (e.g., in their backyards), the thought is that scientists can learn about the responses of individual plant species to climatic variation locally, regionally, and nationally as part of their quest to detect longer-term impacts of climate change.

In-person events were central in "kicking off" the campaign. According to organisers, the 2007 inaugural event "drew thousands of people of all ages taking careful observations of the phenological events such as the first bud burst, first leafing, first flower, and seed or fruit dispersal of a diversity of tree and flower species, including weeds and ornamentals. The citizen science observations and records were entered into the BudBurst data base."

This effort to foster understanding of how the biosphere is changing by bringing local knowledge into scientists' observations is facilitated through an interactive the website. Here, participants can access various guides to provide them with the necessary information to conduct research - such as by beginning to check their plants at least a week prior to the average date of budburst, and then continuing to observe the tree or flower for later events, such as the first leaf, first flower and, eventually, seed dispersal. When participants submit their records online, they can view maps of these phenological events across the United States. The project website suggests more than 60 widely distributed trees and flowers for citizen scientists to observe, with information on each; users may add their own choices. A Project BudBurst email list offers updates and announcements.

In addition to the dedicated student and teacher sections of the project website that provide ideas for classroom activities, the use of rewards and recognition is a feature of this initiative. For instance, during the week of Earth Day (April 22) 2008, Project BudBurst collaborated with the Institute for Global Environmental Strategies (IGES) to engage children and youth in IGES' Annual Earth Day Photo Contest. Middle school students were invited (through a call for participation on the Project BudBurst website) to take a photograph of the plants that are changing in their local environment, and then to research and write a scientific explanation.

Development Issues: 

Environment.

Key Points: 

Organisers explain that many species are being affected by climate change throughout the world. For instance, the Intergovernmental Panel on Climate Change predicts that 20 to 30 percent of all plant and animal species that researchers study will likely be at increased risk of extinction, should global temperatures rise by between 2.7 and 4.5 degrees Fahrenheit this century.

Partner Text: 

UCAR, in collaboration with the Chicago Botanic Garden, the Plant Conservation Alliance, the USA-National Phenology Network, and the following universities: Montana; Arizona; California, Santa Barbara; Wisconsin-Milwaukee; and Wisconsin-Madison. Project BudBurst was funded with a grant from the U.S. Bureau of Land Management and the National Fish and Wildlife Foundation, and is also being supported by the National Science Foundation (NSF) and Windows to the Universe.

Contact Information: 

Point-of-Use Water Disinfection and Zinc Treatment (POUZN) Project

Communication Strategies: 

This diarrhoea prevention and treatment project draws centrally upon social marketing and BCC implemented through mass media and interpersonal communication (IPC) in an effort to encourage healthy behaviours - POU water disinfection and zinc treatment. Amongst the communication tools developed by each of the country programmes to increase knowledge of the correct treatment of diarrhoea and to create demand for all of the products are the following: television and radio commercials, mobile video shows, song contests, community theater performances, and point of sales materials. Improved health practices are also promoted through home visits and edutainment sessions. Programme communications also underscore the importance of hand washing, continued feeding practices, and other elements of proper diarrhoea management and hygiene practices.

Partnership has been a key strategy in developing these messages. POUZN field offices have mobilised private-sector distribution networks in an effort to make high-quality water treatment, ORS, and zinc products available to low-income people at affordable prices. In addition, POUZN country teams have worked with local partner non-governmental organisations (NGOs) to develop information, education, and communication (IEC) materials such as banners and pamphlets with graphic demonstrations on the use of the product. According to organisers, shop owners, health centre volunteers, and community-based care groups are using these materials in their promotions, demonstrations, health days, and health education sessions. POUZN country teams also developed training curriculum for a series of personnel. Training of trainers programmes were launched with NGO partners and Ministry of Health counterparts. Participants then trained public sector health centre staff, pharmacists, community health workers, and community volunteers; private sector providers, pharmacists/chemists; and partner NGO community mobilisers and staff. All programmes have worked closely and collaboratively with Ministry of Health counterparts to develop strong public/private partnerships for health.

Development Issues: 

Children, Health, Diarrhoea Prevention and Treatment.

Key Points: 

Highlight on the Nepal Diarrhea Treatment Program:

Beginning in 2005, Nepal's Ministry of Health and Population embraced the WHO/UNICEF recommendation to integrate zinc into its diarrhoea management programme, encouraging the launch of zinc treatment programmes through both public health facilities and private sector channels. The Ministry requested support from USAID through the POUZN Project to introduce zinc through the private sector. Multiple communications channels were designed to ensure that caregivers and providers understood that zinc together with ORT/ORS is the appropriate treatment for uncomplicated diarrhoea and that inappropriate diarrhoea treatments may be harmful, and that they knew where to obtain zinc. Initially, no appropriate zinc products were available in Nepal, but collaboration with local pharmaceutical manufactures resulted in 3 companies producing and introducing quality, affordable zinc tablets.

Key results: After 6 months of nationwide activity, the POUZN programme in Nepal contributed to an increase in zinc use from 0.4% in 2005 to 15.4% in 2008. Of users, 78% correctly took zinc and ORS together, 64% correctly took zinc for the full 10 days, and 53% correctly used zinc for the full 10 days along with ORS. Mass media was essential in increasing knowledge and use, with organisers identifying television and radio as the most effective means of transmitting key messages to the population. Fifty-three percent of respondents had heard about a zinc product - 50% on the radio and 85% via the television commercial. POUZN messages have reinforced this correct behaviour by instructing caregivers to "use ORS and Zinc tablets - the most effective diarrhea treatment for children under 5." Research also found that caregivers exposed to specific media messages were more than twice as likely to have treated their children with zinc and to have used it correctly for 10 days along with ORS or ORT. They were also much more likely to know where to purchase zinc (77% of those exposed vs. 2% of those not exposed). Organisers stress that zinc promotion through mass media has been essential not only in creating demand but also in providing consumers with information about zinc, its correct use, and access points. Those who had heard POUZN's radio or television messages were 4 times more likely to use zinc during the diarrhoea episode, provide the child with ORS along with the zinc, and provide the zinc for the full 10 days. Several chemists reported having also seen and heard the media spots, motivating them to obtain stocks of the products.

Partner Text: 

Abt Associates, Population Services International, Procter and Gamble, Medentech, Nutriset. Ministries of Health.

Contact Information: 
Source: 

Emails from Angela Milton and Ashleigh Hodge to The Communication Initiative on December 17 2007 and April 28 2009, respectively; Private-Sector Partnerships (PSP) for Better Health-One [PSP-One] website; and "Social Marketing Zinc to Improve Diarrhea Treatment Practices - Findings and Lessons Learned from Cambodia", by POUZN, October 2007.

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HIV/AIDS Research