The C-Change Community Conversation Toolkit on HIV Prevention: A Catalyst for Community Dialogue and Action Integrated Approaches, Local Answers Presenters: Sarah Meyanathan, Maclean Sosono July 22, 2012

C-Change is… C-Change is a five-year USAID funded initiative, with the mission to improve the effectiveness and sustainability of health and development communication for long term change by influencing underlying social norms = SBCC

Background and Development Response lacks interactive HIV prevention material for adults with lower literacy Materials developed through participatory process – using Action Media methodology in South Africa Adapted to local contexts in 7 countries in 10 languages Complements existing HIV prevention activities through triggering local actions with dialogue Community Conversation Toolkit

Example of Toolkit Implementation and Evaluation Phase I: Identified 4 CBO partners in Malawi and Zambia to facilitate dialogues w/ 23 existing community groups Orientation of CBO leadership on toolkit, community dialogues and monitoring Training of CBO staff and 49 existing peer educators Recorded toolkit use, individual & group action Phase II & III: Over 80+ discussions recorded with groups such as: – Community Leaders – PLHIV (various groups) – Middle class men – Women in small businesses – Youth in higher learning institutions (20+) Final analysis of actions and potential programmatic implications External evaluation ongoing

Example: Local Actions from Malawi CBO partner: Friends of AIDS Support Trust (FAST) – Covers population of 50,000 in 88 villages – 14% prevalence rate – Literacy rate 42% Dialogues held with: bicycle taxi operators, discordant couples, ex-sexual cleansers, tested couples, and local leaders

Community Leaders Before, meetings on prescribed topics & messages Now, deepened dialogue on harmful cultural practices & issues of GBV raised by community As a result of the dialogues: – Developed workplan, divided into small groups, traveled to other communities – Speaking out at funerals – Advocating for modification of practices while retaining tradition – FAST secured additional funds

Shapa Boys (Bike Taxi Operators) Before, campaign meetings & trainings Now, raised issues of their own risks--clients offering sex in exchange for payment; GBV in the wider community As a result of the dialogues: – Talk to their spouses about risk & being faithful – Carried out dialogues with church members, market goers, hairdressers, other Shapa Boys, welders – Counseled clients sitting behind them – Distributed condoms

Lessons Learned Toolkit elicits individual and community actions = promotes community ownership of local responses = sustainable actions Important to conduct dialogues with existing programs, community structures/ hierarchies and in local languages Peer educators are now facilitators instead of message presenters Outcomes of toolkit interventions are local, but process can be scaled to address HIV-related issues in other contexts