Sara Nieuwoudt - Soul City, South Africa
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Sara Nieuwoudt - Soul City, South Africa



An African-based Program Building Capacity in Social and Behaviour Change Communication (SBCC) for HIV Prevention

An African-based Program Building Capacity in Social and Behaviour Change Communication (SBCC) for HIV Prevention



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  • This presentation is a story about a partnership between a university and a NGO to provide postgraduate training to mid- to senior-level practitioners
  • Background:Though both institutions are based in Johannesburg, we shared a concern for the African sub-continent, which faces a complex and enormous burden of disease, including HIV.
  • The partnership also shared in interest in how communication can be harnessed to prevent diseases, such as HIV, from low-tech community theatre to ICT.
  • These communication approaches may target individuals, such as brochures, from low-cost community based drama to the use of mobile technology and will also explore the evidence for different levels of communication: from that targeting individuals, such as peer education or print media, to edutainment, social mobilization and advocacy, that seek to address social norms and alter legislation. Our hope is that graduates in this field will be equipped to design, implement, and critique communication strategies for the change they want to bring about. In the context of complexity, it becomes necessary to look at the underlying or social determinants of individual and population health. The starting premise of our programme is that that individual behaviours, including HIV risk behaviours, need to be understood within an ecological framework. This includes looking beyond the individual to interpersonal relations as well as the policies, cultural norms and values that shape the world in which they live. The field of SBCC looks not only at changing individuals, but also seeks to identify and promote social change through various means of communication.
  • Willjust flash and highlight that competency extends beyond knowledge to ability/skill as well as a set of values
  • In 2008-09, colleagues from Soul City and Wits University came together to discuss the idea of a partnership. A rapid needs assessment by Soul City with its regional partners identified that many practitioners perceived a need for further professional training for professional growth and to address existing challenges in field, e.g. donor discourse on evidence-based programming, attribution (evaluation), etc.. This was also happening in the context of a broader dialogue, voiced in meetings held in Bellagio and Ica, calling for competency-based programming to address skills gaps.
  • NOTE: I won’t go through the details of this slide. This is for reference if ther are questions. Course Development Process (if asked): Faculty of Health Sciences, Senate (central university), sent to other Faculties for review & comment, final revisions = 1 year
  • 22 African countries as well as other countries
  • Internally:All courses are evaluated and benchmarked to ensure quality standards and accountability
  • Note that there were shared values (justice, equity, multi-level approaches) and a history of collaboration to build
  • Only if asked
  • Health as experienced on the African continent is complex, with many countries experiencing a quadruple burden of disease  with limited resources

Sara Nieuwoudt - Soul City, South Africa Sara Nieuwoudt - Soul City, South Africa Presentation Transcript

  • Building Capacity in Social andBehaviour Change Communication (SBCC) for HIV Prevention An African-based Programme Sara Nieuwoudt (1), Nicola Christofides (1) & Shereen Usdin (2) 1.Division of SBCC, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand (Wits) 2.Soul City Institute for Health and Development Communication (SC:IHDC)
  • Partnership Vision To create a recognized and accredited African- led and based platform supporting the development of practitioners and academicswith the SBCC competencies required to address Africa’s public health priorities
  • Location: Johannesburg, South AfricaGeographic Focus: Sub-Saharan Africa Image Credit: Wikimedia Commons Estimated HIV prevalence among young adults (15-49) by country View slide
  • Communication as a tool for HIV prevention View slide
  • Social & Behaviour Change Communication as a Discipline Promotes: •Multi-level analysis of situation, including social determinants of health •Targeted and multi- level responses •Evidence-based programming Image credit: McKee, Manoncourt & Chin, 2000
  • Universities Training for the Market Competency-based Curricula Example: Research, Monitoring & Evaluation Competency FrameworkKnowledge of: Ability to: Values: key monitoring, evaluation, select relevant indicators do not “doctor data” and research concepts for measuring project learn from mistakes or tools and methodologies processes and results non-success in programs for monitoring, evaluation develop and implement use monitoring and and research monitoring plan with data evaluation data to improve qualitative and quantitative collection tools program activities research methods determine effectiveness of reliance of multiple participatory research communication strategy methods for monitoring methodologies identify problems in design and evaluation frameworks for project and/or implementation systematic use of evaluation maintain management monitoring and evaluation information system (MIS) at all levels of SBCC work use MIS to inform project direction conduct participatory monitoring, evaluation, and research document and communicate best practices
  • Problem AnalysisIn 2008, many SBCC Practitioners working on HIV prevention were:– In leadership positions, without public health or specific communication qualifications– Desiring professional development opportunities beyond non-accredited training– Not able to afford overseas study (SC:IHDC, 2008; 2010)
  • Establishing a platform for capacity building takes time Secured funding from DFID, CDC First cohort Pilot of first course & C-CHANGE in enrolled in in December 2009 2008/09 2010 Hired external Course staff to lead development Division program Launch in and development 2010 accreditation The entire process involved Study tour and a mix of adaptation of May 2009 stakeholders, including competency Consultative practitioners & academics framework Meeting from region & abroad
  • Result: Division of SBCC• 1-week blocks • Full and part-time offered for offered over 2-4 years Attendance or • 5 SBCC specific courses Competency• 7 accredited Short MPH Courses Program * Under review due to resource SBCC Community constraints Research of Practice* • Academic staff • Open to all course • MPH research participants, MPH students & program reports stakeholders (guest lecturers, board, etc.)
  • Division Participant Profile• Over 200 short course and 32 MPH students• Aged 28-54• Leaders in HIV responses: – National AIDS Committees, e.g. NERCHA – Government advisors – NGO leaders – Research institutions – Donor agencies, e.g. CDC
  • Division Reach: Africa and beyondMPH Short courseSouth Africa (same as MPH)Botswana NamibiaSwaziland MozambiqueLesotho NigeriaZimbabwe SudanEthiopia NigerMalawi EgyptUganda EritreaU.S.A. (in RSA) Ghana Uganda Tanzania + Institutional Kenya support to Zambia universities in: D.R.C. Nigeria Burundi Tanzania India Albania Switzerland Afghanistan
  • Individual capacity built“ Starting the MPH two years ago, I had lots ofpractical experience, but now, I have the addedbenefit of knowing the principles and theorybehind the practice. In my work in a large unitdealing with HIV prevention, and working closelywith the Department of Health, I have becomethe go-to person on social and behavior changecommunication. We no longer tolerate “sprayand pray” prevention efforts: it’s all a whole lotmore targeted and effective.” – MPH Student
  • Institutional capacity strengthening• Individuals contribute to their institutions• Institutions sending multiple individuals on short courses/MPH note shift in institutional culturePlans to systematically evaluate outcomes & impact• Tracer study – MPH student professional development/employment – Performance (self- and employer-assessed)• Comparison of short-courses vs. integrated degree learning
  • Lessons: Factors of Success Partnership between • Allows for professional development with accredited academic and practitioner certification/degree, while maintaining focus on developing the hard institutions skills required for practitioners Advisory board with local • Allows division to keep current on both academic & practitioners and international debates related to SBCC membership • Multidisciplinary (communication & public health)Hiring externally to lead and • Bringing on board someone with a core set of skills to guide process manage program • We add value to an already interdisciplinary field with a strong Housing program within a applied focus School of Public Health • Able to draw on a broad range of skills (epidemiology, policy, etc.) • More open to addressing social determinants of health through SBCC Framing intersectoral collaboration, at multiple levels
  • Implications for Capacity Strengthening in HIV• Understanding HIV with an ecological perspective and being able to use evidence to develop and evaluate our programmes is critical• Practitioners have an important role in defining what competencies (knowledge, skills & values) are needed, while universities are well placed to delivery competency-based training in a systematic way• Embedding training in an academic institution supports sustainability – Also, accreditation offers opportunities for career progression and quality assurance unlike non-accredited training courses• Basing the programme in Africa is more cost-effective than sending African practitioners to study overseas and supports instruction and content that is tailored to the African context
  • Thanks to our past donors!
  • Slide References• Labonte R, Mohindra K, and Schrecker T. 2011. The Growing Impact of Globalization for Health and Public Health Practice. Annual Review of Public Health, 32: 263–83.• McKee N, Manoncourt E, Chin SY, Carnegie R, eds. Involving People, Evolving Behavior. New York: UNICEF; Penang, Malaysia: Southbound; 2000.
  • SBCC Accredited courses• Applying Social & Behaviour Change Theory to Practice• Research, Monitoring & Evaluation for SBCC• SBCC Approaches• Planning and Implementing SBCC• Communication, Media & Society• Introduction to Health Promotion• Entertainment Education
  • Context: Complexity & Resource Constraints Image credit: Labonte, Mohindra & Shrecker, 2011