02 P Naidoo

Basic HIV Course and Mobilisation
Toolkit on HIV Prevention, Treatment,
Care and Support

Prevention is Better than Cure

Prathima Naidoo
Health Behaviour Intervention Manager
BroadReach Healthcare

2 December 2009
5th SAHARA Conference

Contents

• About BroadReach Healthcare (BRHC)
• Situation Analysis: Status of Health Education and
Community Dialogue
• The BRHC Basic HIV Course and Mobilisation Toolkit
• Roll-out Strategy
• Monitoring and Evaluation
• Results up to 30 November 2009
• Next Steps

© 2009 BroadReach Healthcare (Pty)Ltd
4

About BroadReach Healthcare

• Global healthcare solutions company
• PEPFAR Partner
• SA: 4 provinces
• 21 hospitals
• 10 CHCs
• 128 PHCs
• Key focus in SA:
– Health systems strengthening
– Capacity building
– Health behavioural interventions
• Staff compliment: just over 100

6

Situation Analysis
Status of HIV Health Education and Community Dialogue

Situation Analysis: HIV Education

• While much has been accomplished in terms of basic
education and information dissemination regarding HIV –
recent evidence suggests that there is a decrease in
knowledge and the quality of education
• Interviews with district health teams, healthcare
professionals and NGOs indicated a need for basic HIV
knowledge that is comprehensive and ‘integrated’ –
targeted towards volunteer community health workers
• There was a strong need for tools that did not ‘dilute’
messages and which facilitated community dialogue

8

Correct Knowledge about Prevention and
Rejection of Misconceptions

• South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008

9

The BRHC Basic HIV Course and
Mobilisation Toolkit

Overall Aim

• Capacitate and empower community mobilisers to
generate open and ‘de-stigmatising’ community dialogue
that supports preventative behaviour and promotes early
access to care
• Increase the efficacy of government, NGOs, CBOs and
other community volunteers to deliver ‘integrated’
messages on prevention, treatment, care and support
• Capacitate volunteers and community healthcare workers
to implement face-to-face education to scale, using
participatory and entertaining methods
• Encourage networking and collaboration between
volunteers

11

Development process
CO CLI REV
CO R PRE NI C I
N SUL ER
EFE -TE AL EW/
TAT REN STI AP
NG PRO
ION CES VA
L
• The BRHC technical • Workshop: Piet
team consulted • South African Retief technical
• Piet Retief
• Healthcare clinical guidelines team
• Heidelberg
professionals and and policies • 2nd review by BRHC
district health staff • The Centre for technical team
health educators, Disease Control • 3rd review by BRHC
social mobilisers and (CDC) clinical team and
home-based carers • The World Health Piet Retief team
• BRHC observation Organization (WHO) • External editing and
and need • UNAIDS proofing
assessment • Thebody.com • Sign-off on
documents • Avert.com translations (2
modules) per
district

SCB LINK
12

Target Audiences for the Course and Toolkit

Primary Audience
Mobilisers with little to
no comprehensive Secondary Audience
knowledge about HIV Mobilisers with some
and AIDS who comprehensive
conduct HIV knowledge about HIV End Recipients
education in the and AIDS – where the Families/household
community – and curriculum will act Men in work place
have no ‘tools’ as a refresher community at large
course and offer ‘tools’

13

Course and Toolkit Content

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What does the curriculum look like

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Structure of the Modules

• What is the ‘condition’
• How do you get it
• How to prevent getting it and infecting others
• What are the signs and symptoms
• What actions to take if you have it
• How to treat it
• Advantages of knowing if you have it
• Benefits of seeking healthcare intervention early
• How to benefit from treatment

16

Roll-out Strategy: TOT

2 or 4 Master of Masters
Trainers

Eastern
Mpumalanga: KZN: Gauteng:
Cape:
6 Master 6 Master 2 Master
6 Master
Trainers Trainers Trainers
Trainers

300 or more 300 or more 300 or more 100 or more
Mobilisers Mobilisers Mobilisers Mobilisers

All Communities in the 4 Districts

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Training Sessions

• TOT held in JHB for all provinces in September 09
– 7 Day in-house training
– Accommodation and meals provided
• Trainings held in various provinces in October and
November
– 5 day resident courses
– Accommodation and meals provided
– Transportation provided by District Health
– Allowance of R50 per day for incidentals

19

Innovations in Implementation

• Roll out at scale: ‘speed of lightening’
• Capacitate and utilise existing resources in the
community
• Full partnership with district health teams
• Method of implementation allows better understanding of
community mobilisation mechanisms to build more
‘involved programming that links the community to
healthcare services that is measurable’
• External company to manage logistics and toolkit
distribution

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Technology to Monitor and Evaluate

• External company to develop database, capture data and
produce reports
• External company to manage payments of all allowances
– 1000 bank accounts
• Paper based and WAP enabled cell technology to capture
education sessions
• Duplicate ‘paper based’ – posted to one destination with
self addressed envelopes
• Signatures of recipients of education
• Information captured and reported ‘real-time’ from cells
and district health has access to dashboard

22

Mobile Accessibility

• Mobilisers Trained on Project 999
• Number of Data Cards Distributed 970

23

Results: 12 October – 30 November
2009

Mobilization Toolkit projected reach
Total number of Community members reached after 6 months =
337,500
Projected reach in KZN, EC and Mpumalanga = 85,000 each

Oct Nov Dec Jan Feb Mar Apr
Master Trainers 4 4
Mobilisers 400 200
(Total) 400 600 600 600 600 600 600
Community 10000 15000 15000 15000 15000 15000
(Total) 10000 25000 40000 55000 70000 85000
Projected reach in Gauteng = 82,500
Oct Nov Dec Jan Feb Mar Apr
Master Trainers 3 3
Mobilisers 300 300
(Total) 300 600 600 600 600 600 600
Community 7500 15000 15000 15000 15000 15000
(Total) 7500 22500 37500 52500 67500 82500

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Cadres of Mobilisers trained

Traditional Healers and ward counselors form part of the ‘Other’ category – 3

26

Total Education Sessions in Community
(12 Oct to 30 Nov)

• Total number of sessions to date: 5,316

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Where do Education Sessions Take Place
(Summary 12 Oct to 20 Nov)

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Education Topics Covered

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People Reached per Region (Summary 12 Oct to 30 Nov)

• Total number of people reached to date: 44,362

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Gender Breakdown of People Educated

• Average time spent in a session is 42 minutes
• Number of condoms distributed 124,235

31

Next Steps: Beyond Education
• Extend training of mobilisers and toolkits to include more
ward counsellors, spiritual leaders, facility based health
promoters and traditional healers
• Implement verbal screening tools for primary prevention
for TB, PMTCT, VCT and high risk negatives
• Referral system between community and healthcare
facility for those screening ‘positive’ to seek early
healthcare intervention – secondary prevention

33

Next Steps: Prevention is Better than Cure

Encouraging early health seeking behaviours
and primary prevention

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Reaching families with integrated education

Back to Basics
35

Acknowledgements

• BRHC HBI team, clinical, PM and management

• PEPFAR

• Piet Retief and Heidelberg hospital staff , HBCs and
support groups

• Fleishman-Hillard SA

• Ngikwazi and Avo Vision

• All Master Trainers (they worked tirelessly)

• District Health Teams

36

THANK YOU

• WWW.BRHC.COM

Prathima Naidoo
011 482 7596
Prathima.naidoo@brhc.com

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02 P Naidoo

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