Communication for HIV/AIDS: Challenges and opportunities By Kindyomunda Rosemary M, Uganda AIDS...
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Transcript of Communication for HIV/AIDS: Challenges and opportunities By Kindyomunda Rosemary M, Uganda AIDS...
Communication for HIV/AIDS: Challenges
and opportunities
By Kindyomunda Rosemary M,
Uganda AIDS Commission
4th Partnership Forum, 31 Jan 06
Presentation outline Background – Communication contexts
Epidemiological, Programmatic
Why communicate? About what?
Communication approaches
Communication and knowledge management
Communication challenges
Opportunities for expansion
Proposals for way forward
Communication context:Epidemiological
Routes of transmission Heterosexual contact >80%, Mother to child about
25%, blood borne <2%
Mature generalized epidemic No longer driven by risk populations alone
Over 800,000 HIV+ - need care
Majority HIV free – but at risk, vulnerable and
affected
Communication context:Epidemiological
Variations in HIV prevalence Geographical, demographic
Differences in drivers of epidemic or causes of
vulnerability
Un answered questions e.g. The shift - when do adults get infected?
What happens to those infected through MTCT
Communication context:Programmatic
Multisectoral approach Not a domain of a single sector
Approaches from different angles, levels Health, social, economic, political
Ideological influences Religious, cultural, etc
Differences in messaging and channeling Social, economic status of audience
Determines the approaches
Why Communicate?
To influence behaviours Prevent contracting/transmitting HIV
Enhance health care seeking behaviours
Enhance service uptake Prevention, care and support
Health, social, spiritual etc
Lobby for scaled HIV/AIDS actions Policy, programming, resources
Equity and quality service delivery
Communication to influence behaviours
Adopting safe Sexual behaviour Abstaining – primary, secondary
Being faithful to one partner - knowledge of sero-status
Correct consistent condom use – casual partner, already infected
Preventing mother to child transmission (MTCT) Awareness about MTCT, opportunities for preventing it
Preventing blood borne transmission Awareness about routes, PEP, blood donation
Counter Myths, misconceptions, misinformation
Communicate about what? Enhance health care seeking behaviours and
service uptake (prevention & care) Benefits of the various services – key promise Availability of the services Stigma and discrimination
Communication for reduction of risk, vulnerability and impact mitigation
Communication approaches IEC – Information, Education and
Communication Mass media: print, electronic, sermons, drama
BCC – Behaviour Change Communication (individual) One to one, life skills dev’t, etc
Communication for individual and social change Focus on the individual and environments Policies, laws, socio-economic aspects, social
norms, services, support systems etc
Communication and Information seeking behaviour theories
Information only sought/used when the individual registers a need Risk perception Info relevancy, applicability, timeliness
Information/exposure/experience act as triggers for an information need Individual follows-up to satisfy need Challenges of accessibility to timely, accurate info Trigger can be +ve or -ve
Communication and Information seeking behaviour theories
Individual’s knowledge used to seek, evaluate source & info, process and utilize info
What builds individual knowledge Indigenous knowledge: values, norms, beliefs, Education status, Previous experiences, etc
Information push and information pull Opportunities and obstacles to communication More attention on push than responding to need
Communication & the knowledge cycle
Bliss in ignorance Individual not aware of need, low risk perception IEC, experience etc triggers need
Conscious incompetence recognizes need, seeks and evaluates info
Conscious Competence Apply info (+ve or -ve), develop skills, change
behaviour Unconscious competence
Utilize skills instinctively, sustain behaviour
Status Bliss in ignorance
Conscious Incompetence
Conscious to Unconscious Competence
Communication activity(for against)
-Mass media (print, electronic, public fora)- Exposure to situations (-ve/+ve)
- One to one-Linking to services- Talk shows,-Link to Life skills devt
-Community participatory approaches- Counseling-Skills dev’t & enhancement
Outcome Awareness,
(trigger need)
Confusion/
Uncertainty
Knowledge
Change & maintain Behaviour
Challenges to communication:Situational/behavioral
Stagnation to increasing prevalence rates Complacency
Fatigue, ‘cure’, competing priorities
Low risk/impact perception High Couple discordance rates
When & how does the partner get HIV? Limited service uptake e.g. for PMTCT
Message packaging, norms, beliefs, accessibility
Situational Challenges cont’d
Gender disparity High prevalence in females Poor male behaviour indicators
Rapidly changing environments information age -Internet, DSTV, video halls Exposure to new behaviours, practices Competing & conflicting messages Information goes stale very fast
Dynamics of the epidemic Changing body of knowledge Shifting epidemic – young pple to adults
Challenges to communication:Programmatic
Awareness rising Vs behaviour/ social change Targeting the individual not situations
Behaviour influenced by situations Blaming individuals
Stigmatizing messages & approaches
Information Inapplicability
Limited involvement of target audience in designing of messages & materials
Lack of local sources of information
Programmatic challenges cont’d
Lack of evidence-base What fuels epidemic, what works better Limited strategic focus
Limited linkages to services Failure to act on messages Unfulfilled demands
Balancing communication for prevention and care
Limited capacity Lack of standards
Impact on message quality
Programmatic challenges cont’d
Fragmentation, limited coordination Message inconsistency, duplication confusion
Competition, Conflict Background of communicator
Level of investment - sustainability No immediate results with communication Communication a Life long investment
Status Bliss in ignorance
Conscious Incompetence
Conscious to Unconscious Competence
Communication activity
IEC thru - mass media (print & electronic
- One to one-Linking to services- Talk shows-Link to life skills devt
-Community participatory approaches- Counseling-Skill dev’t
Outcome Awareness
Trigger need
Uncertainty /
Confusion
Knowledge
Change & maintain Behaviour
Obstacles -Lack of info
-Irrelevant messages
-Poor packaging
-Message conflict Peer pressure -Rapid changes- Myths, beliefs, norms-Stigma-Unmet demands
-Peer pressure-Lack of support services-Info conflict-Stigma
Opportunities for scaled action The success story – ever worked & still working
Reductions among young people, increased ART uptake
Community knowledge and commitment
Conducive policy environment Open dialogue at various levels – Think Tank
Input in Policy and strategy development
Comprehensive Communication Strategy
Prevention Policy Paper, ABC Policy guideline
Utilizing other services: health esp. reproductive health
Social, economic, religious, business etc
Opportunities for scaled action Build on existing knowledge base
Short and long term focus Utilize entry points for social change
Vulnerability analysis report Conceptual Framework for Communicating to
young people Risk behaviours, protective/harmful factors, domains
within which they interact, key duty bearers Participate in implementation of major
communication campaigns YEAH, PIASCY, ?
Young Empowered And Healthy
Bases on the agreed Conceptual Framework Campaign for all owned by none Promotes common thinking, common voices
Consistency, experience sharing, common priorities
Building partnerships in communication Compliment strengths, wider reach, optimal utilization of
resources/systems
From awareness to social change beyond individual, Under and beyond ABC
Experiences in involving young people
YEAH Cont’d Centered around Rock Point 259 drama
Over 4 million pple tuning in Community participatory approaches
Phase 1: “Something for Something Love” (engaging in sex in exchange for favors, money or material goods)
Phase 2: “Be a Man” Changing male Gender expectations (Boys & men)
Common funding approaches Wider coverage, social accountability
Join YEAH Now, Tune in to Rock Point
Proposals for way forward
Situations have changed – adopt approaches Make communication specific to situations
Shift focus from individual to social change Enhance information push with equal focus on
meeting information demands Harmonize communication for prevention and care Work in partnerships
Wider reach, learn from lessons etc
Utilize non-traditional partners Research, document, share
HIV/AIDS Communication is the backbone of our response
Reduce risk and vulnerability
Reduce impacts