1. Communication for Behaviour and Social Change Making a difference through communication!

2. Presentation Objectives By the end of this presentation, you should be able to: describe the steps in developing a communication strategy; explain CSBC programme needs and challenges.

3. Communication for Social and Behaviour Change Communication for Social and Behaviour Change or CSBC is a wide range of activities and interventions targeted to specific individuals and groups that are intended to facilitate and promote selected changes in behaviour to mitigate HIV transmission and to strengthen care and support of those who are infected and/or affected by HIV and AIDS. The interventions should enable individuals and groups to sustain positive behaviours to mitigate the impact of HIV and AIDS. CSBC is developed within a framework and through the creation of communication strategies which focus on the lifestyle and social needs of individuals, their families, and the communities they live in.

4. The Purpose of CSBC The purpose of CSBC is to help people gain the awareness, knowledge, skills and attitudes as well as the ability to meet their developmental needs. CSBC is: –centered around people, that is based on an audiences' needs and perceptions; –interactive; –developed through partnership and collaboration with audiences; –integrated into existing and new social service programming and people's lives; –learning and action based, in other words, oriented to helping people understand issues and then be able to act in ways that improve their health, education or economic well being.

5. Role of CSBC in HIV and AIDS Increase knowledge Stimulate community dialogue Promote essential attitude change Advocate for policy changes Create a demand for information and services Reduce stigma and discrimination Promote services for prevention and care

6. Role of CSBC in a Comprehensive HIV and AIDS Programme Care and support Community mobilization Political support Prevention CSBC

7. Goals of Communication for Social and Behaviour Change for HIV and AIDS Safer sex practices (abstinence, delayed debut, less partners, condom use) Improved health care seeking behavior for STIs, TB Promote VCT and other services (MTCT) Create a demand for HIV/AIDS information Harm reduction of IDU (safer injecting) Stimulate community discussion on risk Reduce stigma and discrimination Blood safety -- better practices, recruitment Health worker attitudes and practices

8. Guiding Principles of CSBC Integrated comprehensive HIV and AIDS interventions and/or programmes Based on systematic formative assessment Developed with active participation of the stakeholders and the community Uses a variety of communication channels Monitoring and evaluation planned at the beginning and implemented throughout the life of the intervention Involvement of PLWA Positive and action oriented Messages and materials are pre-tested

9. Mass Media Community networks and traditional media Interpersonal/ group communication Unaware Aware Concerned Knowledgeable Motivated to change Trial behavior change Sustained behavior change Effective communication Enabling environment User friendly services, and accessible commodities Behavior Change Process Theory Stages of Change Continuum Enabling Factors Channels

10. Possible Channels of Communication Mass media: radio, TV, events Traditional media, puppet shows, music drama Print support materials Interpersonal communication Peer education Health workers NGOs/CBOs

11. Possible Partners and Channels Partners Local and state government Faith-based organizations Unions – teachers, transport workers Youth Non-governmental organizations Health care providers Women’s organizations Medical associations Channels TV/Radio/Newspaper Print materials Billboards Outreach Peer education Pulpit Community events Social networks (church, unions, military, women’s groups)

12. Mass Media Targeted to general community Increases acceptance of and empathy for community initiatives Helps to create positive image of condom use Increases personal risk assessment Tackles issue of stigma

13. Interpersonal Communication Outreach – with support tools Peer education – with support tools Local media – drama, puppets, etc. Targeted materials for specific groups Materials for health care workers

14. CSBC Strategy Development

15. 1. Programme Goals 3. Identify Target Audience 5. Segment Target Population 4. Conduct Formative Assessment 2. Stakeholder Involvement 7. Design BCC Strategy and M&E Plan 8. Develop Communications Materials 9. Pre-test Materials 10. Implement and Monitor 11. Monitoring and Evaluation 12. Feedback and Revision 6. Define Behavior Change Objectives Developing an Effective CSBC Strategy

16. 1. Programme Goals CSBC is based on the overall goals of the HIV and AIDS programme. A programme goal may be to decrease prevalence of HIV among a certain population group.

17. Avoids future backlash. Forges links for coordination and collaboration. 2. Stakeholder Involvement

18. Risk behavior Gender Age Location Ethnicity Language Primary and secondary target audiences 3. Identify Target Audience

19. Perceptions of risk Settings for risk Opinion leaders/Change Agents Services Barriers to behavior change Perceived key benefits Media habits and entertainment habits Health care seeking behaviors Hopes and fears for the future Communication resources and infrastructure 4. Conduct Formative Assessment

20. Primary populations –Those at high risk or vulnerability –Those providing services –Policy makers Secondary populations that influence the primary populations ability to adopt or maintain safe behaviors 5. Segment Target Population

21. Increase use of condoms Increase use of services Delay of sexual activity Reduction in number of partners Community’s ability to discuss risk and stigma Betterment of health provider attitude 6. Define Behavior Change Objectives

22. Examples of CSBC Objectives Programme Objective –Reduce prevalence of STIs among truck drivers Behavior Change Objective –Increase condom use –Reduction in number of partners –Increase appropriate STI seeking behavior Communication Objective –Increase self risk perception –Increase demand for information and STI services –Increase demand for condoms –Change in attitude about condom use and number of partners –Increase skill in condom use

23. Elements: –CSBC Objectives –Theme/Entry Point –Messages –Channels –M and E Plan –Partners –Resources 7. Design CSBC Strategy and M&E Plan

24. 8. Develop Communications Materials To disseminate messages Support print materials Mass media materials Spot development Advocacy materials

25. Test for: Comprehension Attraction Persuasion Acceptability Audience identification Promotes action 9. Pre-test Materials

26. Sequencing of activities Coordination Link to services Interactive Synergy of channels Flexible Target Interventions 10. Implementation and Monitoring

27. Monitoring Inputs and outputs Pulse on perceptions Evaluation BSS Findings Special Studies 11. Monitoring and Evaluation

28. Communication is not static Needs of community change over time CSBC is constantly changing 12. Feedback and Revision

29. Summary: CSBC Programme Needs 1.Understand and use CSBC processes and principles, management, and planning. 2.Develop a coordinated delivery plan. 3.Establish quality standards. 4.Build well trained staff to provide a quality service. 5.Ensure availability of supplies, updated to meet changing needs and situations of target audience.

30. Summary: CSBC Programme Needs 6.Provide monitoring and logistic support for the staff and their work. 7.Monitor and maintain relationships among implementing agencies, beneficiaries and stakeholders. 8.Hold periodical review and evaluation of both the system and the results.

31. Challenges Integrating CSBC into all programme elements Limited training resources Political and physical environments Sustainability and flexibility Expanding the response Linkages and coordination Developing sound CSBC objectives Developing capacity in CSBC

32. Conclusion CSBC is not a collection of different, isolated communication tactics, but rather, it is a framework of linked approaches that function as part of an on-going, interactive process.