Johns Hopkins Health and Education in South Africa

1. Johns Hopkins Health and Education in South Africa

2. JHHESA: Our Vision To improve the health and wellbeing of all South Africans through using a strategic communication approach.

3. JHHESA Our Mission • Designing and implementing strategic communication programmes. • Enchancing access to information and the exchange of knowledge. • Developing programming that is evidence informed through research. • Providing technical support to South African Partners

4. JHHESA: Our Approach

5. The P Process – Developing Evidence Informed Strategies

6. Key SAG Partners • SANAC • Men’s Sector • Women’s Sector • Youth Sector • Religious Sector • Department of Health – National, Provincial and District level. • South African Broadcasting Corporation • Provincial Departments of Health

7. Target Audiences • Primary Audiences: • Youth 15 – 24 • Women of a sexual and reproductive age • Men aged 25+ • Secondary Audiences • Policy and decision makers • Traditional leaders and structures • Government Departments

8. Objectives: Behavioural Prevention • Increase the age of sexual debut amongst young people • Increase people’s perception of risk to HIV infection in relation to their behaviours (Alcohol, transactional sex etc) and sexual partnerships and encouraging the development of risk reduction strategies. • Reduce the number of men who report having multiple and concurrent partners • Increase correct and consistent condom usage with all partners.

9. Objectives Biomedical Prevention • Promote early antenatal booking amongst pregnant women • Increase the knowledge benefits of exclusive breast feeding for PMTCT • Reduce the number of children born with HIV • Increase the levels of knowledge of the HIV benefits of Medical Male circumcision • Increase the number of men who are circumcised.

10. Objectives: C&T and C&S • Counseling and Testing • Increase the number of people who undergo VCT for HIV and who receive their test results • Increase the number of people who test for HIV on a regular basis • Care and Support • Increase awareness of the linkages between HIV/TB • Increase knowledge and awareness of the signs and symptoms of TB • Increase awareness of opportunistic infections and the need for early treatment

11. Objectives: Treatment and Strategic Information • Treatment • Increase the number of people who are treatment literate.

13. JHHESA is a Strategic Communication Partnership for Prevention, Care and Support and Treatment Strategic Partners: • SANAC • Department of Health • Provincial Governments • JHU-CCP Broadcast Partners • ABC Ulwazi (Radio) – Community Radio • SABC Education (TV and Radio) • E-TV (Television) • Mediology (Media Planning) • Mindset Health (Public Health Channel) Research Partners 5. Health and Development Africa 6. Centre for AIDS, Development and Research (CADRE) Media Advocacy Partners • Marcus Brewster Publicity (Media Advocacy) • Health-E (Media Advocacy) Creative Partners 9. Joe Public (Creative Agency) 10. Matchboxology (Creative Agency) Capacity building Partners • Community Media Trust (Siyayinqoba – Beat It – Training of Community Health Care Workers) • Sonke Gender Justice - Training for Men’s Sector on Brothers for Life • Wits HIV and the Media Project • UKZN – Centre for Cultural and Media Studies Community Outreach Partners working with youth, women, men , traditional structures 15. Footballers for Life - Working in Correctional services • LesediLechabile - Free State, Lejwelephutswa • Mothusimpilo, Gauteng – West • Turntable Trust, KZN, Sisonke • The Valley Trust (KZN, Ethekwini)

14. Programme Priorities for FY12 • Strategic Planning with Provinces and Districts for ACSM • 9 Provincial Reports • 7 local response activities • Adult Men - Brothers for Life – Sexual prevention and Demand creation for HIV prevention • Women and Girls – Developing a new programme that addresses maternal and child Health • Youth – focussed on tertiary institutions and in school and out of school populations using entertainment education programmes. • Building the capacity of community health care workers in support of the governments PHC • Building capacity of organisations in social mobilisation for prevention, HCT and

15. Accomplishments • 1st ever national communication survey • Planning to local needs using the local level studies and tracking progress at the local level • Able to expand on initial PEPFAR investment through public/private partnerships • Supporting MMC partners with materials to support outreach programmes. • Supporting the SANAC Men’s Sector and the Communications Technical Task Team • Developed tools and resources that work in supporting community mobilisation. • Community dialogues – building community cohesion and response to key issues. • Scrutinize – demonstrated impact on a number of key outcomes – Multiple partners, condom usage and HCT. • Intersexions – 2nd most popular drama series and over 23 000 people engaging through social media (Facebook). .

16. Accomplishment FY 09 • 2 661 000 people reached on Sexual Prevention. • 22 000 people trained on SP. • 3 085 million condoms distributed • 285 000 people reached through PMTCT. • 72 000 people reached on MMC • 858 000 people reached on HCT and 28 000 people counselled and tested. • 1.3 million people reached on promoting treatment adherence and literacy.

17. How do we know if we are having an impact • Monitoring system – electronic monitoring system that tracks partner data through monthly reporting • Monthly and quarterly reporting and Feedback • Baseline studies undertaken in 2008 will be repeated in 2012 • NCS measures the impact of communication interventions in South Africa includes provincial data. • Qualitative evaluations – Focus group discuss and individual indepth interviews. • Evaluating the training programmes what impact is this having?

18. Attitudes INDIVIDUAL Intention & Behavior COLLECTIVE Leadership Participation Goal Setting Action META-THEORY OF HEALTH COMMUNICATION SKILLS & KNOWLEDGE COMMUNICATION INSTRUCTION DIRECTIVE Dissemination Promotion Prescription NONDIRECTIVE Entertainment Counseling Dialogue Social Networks PUBLIC Advocacy Coalition Formation Regulation reinforcement IDEATIONAL FACTORS COGNITIVE Attitudes (Beliefs & Values) Subjective Norms Self-Efficacy Perceived Risk Self-Image EMOTIONAL Fear, Sadness, Affection, Happy, Trust, Empathy SOCIAL Mutual Understanding Cohesion & Reciprocity Collective Efficacy HEALTH PHYSICAL & MENTAL STATUS REDUCED MORBIDITY & MORTALITY from INFECTIOUS & CHRONIC DISEASES BEHAVIOR confirmation enabling ENVIRONMENTAL CONTEXT: SUPPORTS & CONSTRAINTS Burden of disease; level of toxic chemicals in air, water, & food; population density; technology; policy; access to food, safe water & sanitation; access to health care, socio-economic conditions

19. Challenges • Lack of common indicators means that one half of the response remains undocumented and unreported. • Lack of funding by provinces to support the implementation of provincial ACSM strategies. • Weak local structures – AIDS Councils, district and sub-district health structures. • Health care facilities for men are weak using B4L to advocate for improved health care services for men. • Getting biomedical people to pay attention to the social and biomedical and to respect the professional disciplines that contribute towards the epidemic. • Needing to keep track of the impact of training programmes – what are the knock on effects.

20. Looking beyond USAID/PEPFAR • Advocating with government to incorporate ACSM into annual planning process – have been some success with ACSM units established but need to be capacitated. • Encouraging greater linkages between community partners and local and district governments. • Need to advocate for provinces to budget for ACSM – beyond producing just posters and brochures. • Looking at additional SAG and other funding sources.