Developing Communication Strategies for PMTCT  UNICEF’s PMTCT Communication Initiatives in Africa & Asia: Lessons Learned February 5, 2002 Programme Communication, UNICEF New York February 2002 Shari Cohen

Communication for PMTCT 1998-2000: Most countries begin PMTCT pilot projects Communication components vary in quality - mostly ad hoc communication responses (IEC materials, etc.) March 2000: Global PMTCT meeting in Gaborone reveals progress, gaps, and need for communication assistance Programs in Africa & Asia request communication support PMTCT communication tools produced or under development: Generic communication framework for development of integrated PMTCT communication strategies Community dialogue tool for community-level mobilization Health worker sensitization training sessions Q&A guide on infant feeding for service providers Basic PMTCT info guide for service providers Video documentation of better practices Programme Communication, UNICEF New York February 2002 Shari Cohen

UN Three-Pronged Strategy for PMTCT I II III Prevention of transmission of HIV, from an HIV-positive woman to her infant Care & support for the mother and her family Prevention of HIV in young people Prevention of HIV infection in women of childbearing age Prevention of unintended pregnancies in HIV-positive women Programme Communication, UNICEF New York February 2002 Shari Cohen

Communication for PMTCT is more than simply increasing program uptake UNICEF’s PMTCT communication framework provides a strong foundation within which key PMTCT-related issues such as:  Primary prevention  Involvement of men, youth & PLWHAs  Community-based care & support  Gender imbalance  Stigma & discrimination  Income generation activities for HIV-affected families are addressed during the development of the integrated communication strategy, providing solutions that are realistic, feasible & based on input and guidance from community & civil society members. Programme Communication, UNICEF New York February 2002 Shari Cohen

Applying the ACADA approach to PMTCT Lessons learned from Africa & Asia: Using a wide variety of stakeholders in the planning stages ensures a more holistic strategy. Include: epidemiologists, communication specialists, nutritionists, HIV/STD/ANC/RH managers, counselors & service providers, men, youth, PLWHAs, CBOs, NGOs & International NGOs Community relevance is ensured when strategic communication planning begins with participatory, community-based research Capacity building & local ownership is key at all levels Clarifying accountability (roles & responsibilities) for implementation keeps communication strategies moving forward in a timely manner Lack of fulltime national PMTCT teams slows down progress in communication activities Programme Communication, UNICEF New York February 2002 Shari Cohen

Lessons learned continued... Involving men, youth, PLWHAs & local leaders is key to breaking the silence & stigma related to HIV/AIDS/MTCT HIV/AIDS/PMTCT information must be clear, realistic, relevant and simple, especially regarding infant feeding options PMTCT communication has wider reach & strength when integrated into existing HIV/AIDS/ANC/RH interventions Community dialogue tools can help communities to identify & address stigma, thus creating more caring & supportive environments for HIV-affected families Interpersonal communication remains the most effective & powerful tool in addressing issues related to PMTCT Programme Communication, UNICEF New York February 2002 Shari Cohen

Challenges Stigma & discrimination still not comprehensively addressed Inadequate use of research on community and audience perceptions of PMTCT-related issues Still a tendency to expect behavior change results based on ad hoc “IEC” communication interventions (e.g. posters, brochures, mass media, etc. that are not based on research or connected to a larger communication strategy) Communication interventions rarely address health workers, HIV-negative women & men in a comprehensive manner Continued confusion about infant feeding protocols - Due to lack of sufficient & authoritative research on infant feeding options for HIV-positive mothers, and health worker attitudes towards infant feeding options Programme Communication, UNICEF New York February 2002 Shari Cohen

Conclusions from the Africa & Asia experience Increase variety of participants in communication planning, making a more concentrated effort to look at HIV/AIDS holistically, as a societal issue, not only as a public health issue Begin communication with rapid social research, incorporating results in program design Use community dialogue to address stigma, care & support issues Increase participation of men, youth & PLWHAs Make couple counselling male-friendly Invest in interpersonal communication interventions Increase correct understanding of basic HIV/AIDS transmission & prevention facts, including MTCT Make more effort to research & understand community norms, values & practices related to PMTCT issues Programme Communication, UNICEF New York February 2002 Shari Cohen