1. Tanzania Capacity and Communication Project Promotion of Voluntary Medical Male Circumcision Robert Karam Ethiopia, February 2016

2. Lessons Learned 1.Need Close Collaboration 2.Communication Strategy is Important

3. Collaboration

4. Supply Demand

5. Supply Demand

6. Supply Demand

7. Supply Demand

8. Jhpiego CCP

9. Collaboration JhpiegoCCP Provided services; conducted formative research; pre-tested materials; provided mid-media and community outreach Developed age aware communication strategy, creative brief and branding; and designed, revised and produced materials Provided services; provided field staff’s feedback on materials; developed new materials; added adult priority static centers; provided mid- media and community outreach; and coordinated work plans Revised, refined and expanded materials including priority services for adults; improved referral cards; added use of loudspeaker vans; facilitated development of communication strategy; and coordinated work plans Added EIMC and Prepex Trial services and developed new materials Refined and produced materials for new activities and continued support

10. Communication Strategy

11. Based on Research

12. Socio-cultural Facilitators and Barriers FacilitatorsBarriers Positive perception of circumcised men by both men and women Strong preference for circumcision at pre-adolescence Community thinks of circumcision as “clean”, “hygienic” Stigma associated with being circumcised after marriage Many women express preference for circumcised men Fear of partners straying during the abstinence period Women starting to talk to/try to convince their partners to seek VMMC Lack of confidence in ability/desire to abstain for six weeks post- circumcision Perception that circumcised men are better/more pleasurable lovers Inability/lack of desire to take “off” the days needed to attend services and heal

13. Socio-cultural Facilitators and Barriers FacilitatorsBarriers Availability of VMMC services is widely known Loss of face associated with exposing genitals in public environment Services perceived as high quality and safe Loss of face in waiting with and being served along with younger people from the community Community knows providers have been specially trained to provide VMMC Service sites “overrun” with adolescents, particularly during campaign and outreach activities Services are free

14. Strategy

15. Promotion of VMMC Services Testimonials from older men and their spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

16. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

17. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

18. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

19. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

20. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

21. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

22. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

23. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

24. Promotion of VMMC Services Testimonials from older men and spouses Region specific Regional patriotism Specially trained providers Priority for older men Need guardian if under 18 Free quality medical service Benefits - Clean - Reduces disease - Better sex

25. Materials ComponentType Radio SpotsDemand Creation Radio ProgramsDemand Creation Brochures for Men, boys/guardians and women Demand Creation and Informational LeafletsDemand Creation Referral CardSystem PostersDemand Creation StickersDemand Creation

27. Source: Jhpiego Overall 22% Age Aware Communication Strategy Average Number Circumcised per Month Percent 20 Years and Over

28. An excellent model of collaboration between supply and demand

29. Increase Uptake by Older Males

30. Lessons Learned 1.Need Close Collaboration 2.Communication Strategy is Important