Basic HIV Course and Basic HIV Course and MobilisationMobilisationToolkit on HIV Prevention, Treatment, Toolkit on HIV Prevention, Treatment, Care and SupportCare and Support

Prevention is Better than Cure

Prathima Naidoo

Health Behaviour Intervention ManagerBroadReach Healthcare

2 December 20095th SAHARA Conference

© 2009 BroadReach Healthcare (Pty)Ltd4

ContentsContents

• About BroadReach Healthcare (BRHC)• Situation Analysis: Status of Health Education and

Community Dialogue• The BRHC Basic HIV Course and Mobilisation Toolkit• Roll-out Strategy• Monitoring and Evaluation • Results up to 30 November 2009• Next Steps

About About BroadReachBroadReach HealthcareHealthcare

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About About BroadReachBroadReach HealthcareHealthcare

• Global healthcare solutions company• PEPFAR Partner• SA: 4 provinces

• 21 hospitals• 10 CHCs• 128 PHCs

• Key focus in SA:– Health systems strengthening– Capacity building– Health behavioural interventions

• Staff compliment: just over 100

Situation AnalysisSituation AnalysisStatus of HIV Health Education and Community DialogueStatus of HIV Health Education and Community Dialogue

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Situation Analysis: HIV EducationSituation Analysis: HIV Education

• While much has been accomplished in terms of basic education and information dissemination regarding HIV –recent evidence suggests that there is a decrease in knowledge and the quality of education

• Interviews with district health teams, healthcare professionals and NGOs indicated a need for basic HIV knowledge that is comprehensive and ‘integrated’ –targeted towards volunteer community health workers

• There was a strong need for tools that did not ‘dil ute’messages and which facilitated community dialogue

9

Correct Knowledge about Prevention and Correct Knowledge about Prevention and Rejection of MisconceptionsRejection of Misconceptions

• South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008

The BRHC Basic HIV Course and The BRHC Basic HIV Course and Mobilisation ToolkitMobilisation Toolkit

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Overall AimOverall Aim

• Capacitate and empower community mobilisers to generate open and ‘de-stigmatising’ community dialogue that supports preventative behaviour and promotes early access to care

• Increase the efficacy of government, NGOs, CBOs and other community volunteers to deliver ‘integrated’messages on prevention, treatment, care and support

• Capacitate volunteers and community healthcare workers to implement face-to-face education to scale, using participatory and entertaining methods

• Encourage networking and collaboration between volunteers

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• The BRHC technical

team consulted

• Healthcare

professionals and

district health staff

health educators,

social mobilisers and

home-based carers

• BRHC observation

and need

assessment

documents

CONSULTATION

CORE REFERENCES

PRE-TESTING

REVIEW/

CLINICAL APPROVAL

• South African

clinical guidelines

and policies

• The Centre for

Disease Control

(CDC)

• The World Health

Organization (WHO)

• UNAIDS

• Thebody.com

• Avert.com

• Piet Retief

• Heidelberg

• Workshop: Piet

Retief technical

team

• 2nd review by BRHC

technical team

• 3rd review by BRHC

clinical team and

Piet Retief team

• External editing and

proofing

• Sign-off on

translations (2

modules) per

district

Development processDevelopment process

SCB LINK

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Target Audiences for the Course and ToolkitTarget Audiences for the Course and Toolkit

Primary AudienceMobilisers with little to

no comprehensive knowledge about HIV

and AIDS who conduct HIV

education in the

community – and have no ‘tools’

Secondary AudienceMobilisers with some

comprehensive

knowledge about HIV and AIDS – where the

curriculum will act

as a refresher course and offer ‘tools’

End RecipientsFamilies/household

Men in work placecommunity at large

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Course and Toolkit ContentCourse and Toolkit Content

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What does the curriculum look likeWhat does the curriculum look like

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Structure of the ModulesStructure of the Modules

• What is the ‘condition’• How do you get it• How to prevent getting it and infecting others • What are the signs and symptoms • What actions to take if you have it • How to treat it • Advantages of knowing if you have it• Benefits of seeking healthcare intervention early• How to benefit from treatment

RollRoll--out Strategyout Strategy

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RollRoll --out Strategy: TOT out Strategy: TOT

300 or more Mobilisers

300 or more Mobilisers

100 or more Mobilisers

2 or 4 Master of MastersTrainers

Mpumalanga: 6 Master Trainers

Gauteng:2 Master Trainers

KZN:6 Master Trainers

Eastern Cape:

6 Master Trainers

300 or more Mobilisers

All Communities in the 4 Districts

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Training Sessions Training Sessions

• TOT held in JHB for all provinces in September 09– 7 Day in-house training– Accommodation and meals provided

• Trainings held in various provinces in October and November– 5 day resident courses– Accommodation and meals provided – Transportation provided by District Health – Allowance of R50 per day for incidentals

© 2009 BroadReach Healthcare (Pty)Ltd20

Innovations in ImplementationInnovations in Implementation

• Roll out at scale: ‘speed of lightening’• Capacitate and utilise existing resources in the

community• Full partnership with district health teams• Method of implementation allows better understanding of

community mobilisation mechanisms to build more ‘involved programming that links the community to healthcare services that is measurable’

• External company to manage logistics and toolkit distribution

Monitoring and EvaluationMonitoring and Evaluation

© 2009 BroadReach Healthcare (Pty)Ltd22

Technology to Monitor and EvaluateTechnology to Monitor and Evaluate

• External company to develop database, capture data and produce reports

• External company to manage payments of all allowances – 1000 bank accounts

• Paper based and WAP enabled cell technology to capture education sessions

• Duplicate ‘paper based’ – posted to one destination with self addressed envelopes

• Signatures of recipients of education• Information captured and reported ‘real-time’ from cells

and district health has access to dashboard

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Mobile AccessibilityMobile Accessibility

• Mobilisers Trained on Project 999 • Number of Data Cards Distributed 970

Results: 12 October Results: 12 October –– 30 November 30 November 20092009

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Mobilization Toolkit projected reachMobilization Toolkit projected reachTotal number of Community members reached after 6 months =

337,500Projected reach in KZN, EC and Mpumalanga = 85,000 each

Projected reach in Gauteng = 82,500

Oct Nov Dec Jan Feb Mar Apr

Master Trainers 4 4

Mobilisers 400 200

(Total) 400 600 600 600 600 600 600

Community 10000 15000 15000 15000 15000 15000

(Total) 10000 25000 40000 55000 70000 85000

Oct Nov Dec Jan Feb Mar Apr

Master Trainers 3 3

Mobilisers 300 300

(Total) 300 600 600 600 600 600 600

Community 7500 15000 15000 15000 15000 15000

(Total) 7500 22500 37500 52500 67500 82500

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Cadres of Cadres of MobilisersMobilisers trainedtrained

Traditional Healers and ward counselors form part of the ‘Other’ category – 3

27

Total Education Sessions in Community Total Education Sessions in Community (12 Oct to 30 Nov)(12 Oct to 30 Nov)

• Total number of sessions to date: 5,316

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Where do Education Sessions Take PlaceWhere do Education Sessions Take Place(Summary 12 Oct to 20 Nov)(Summary 12 Oct to 20 Nov)

29

Education Topics CoveredEducation Topics Covered(Summary 12 Oct to 30 Nov)(Summary 12 Oct to 30 Nov)

30

People Reached per Region People Reached per Region (Summary 12 Oct to 30 Nov)(Summary 12 Oct to 30 Nov)

• Total number of people reached to date: 44,362

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Gender Breakdown of People EducatedGender Breakdown of People Educated(Summary 12 Oct to 30 Nov) (Summary 12 Oct to 30 Nov)

• Average time spent in a session is 42 minutes• Number of condoms distributed 124,235

NEXT STEPS NEXT STEPS

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Next Steps: Beyond EducationNext Steps: Beyond Education

• Extend training of mobilisers and toolkits to include more ward counsellors, spiritual leaders, facility based health promoters and traditional healers

• Implement verbal screening tools for primary prevention for TB, PMTCT, VCT and high risk negatives

• Referral system between community and healthcare facility for those screening ‘positive’ to seek early healthcare intervention – secondary prevention

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Next Steps: Prevention is Better than CureNext Steps: Prevention is Better than Cure

Encouraging early health seeking behaviours and primary prevention

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Reaching families with integrated education Reaching families with integrated education

Back to Basics

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AcknowledgementsAcknowledgements

• BRHC HBI team, clinical, PM and management

• PEPFAR

• Piet Retief and Heidelberg hospital staff , HBCs and

support groups

• Fleishman-Hillard SA

• Ngikwazi and Avo Vision

• All Master Trainers (they worked tirelessly)

• District Health Teams

© 2009 BroadReach Healthcare (Pty)Ltd37

THANK YOU

• WWW.BRHC.COM

Prathima Naidoo011 482 7596

Prathima.naidoo@brhc.com