Attachment_9_CSH_Campaigns_One_Pagers_-_SafeLove.MothersAlive.StopMalaria.1000Days_(1).pdf

High rates of multiple and concurrent partners (MCP)

• Increase number of adults 15‐49 who report regular partner communication around sexual relations

• Increased number of adults 15‐49 who test for HIV, know own HIV status, and of sexual partners

• Increased number of adults 15‐49 who reduce the practice of MCP, and have one sexual partner at a time, whose HIV status is known

• Increase number of women demand protection from all partners

• Limited understanding of HIV risk linked to MCP

• Sexual exploration

• Social and cultural norms supporting the practice of MCP in all age groups, particularly for men

• Economic dependence

• Lack of skills to make the main relationship mutually satisfying

Low Condom Use with regular and casual partners

Low utilization of PMTCT

Services

SAFE LOVE CAMPAIGN

GOAL: To contribute reduction of new HIV infection in Zambia by changing key behaviours underlying the epidemic.

• Increase number of adults 15‐ 49 who use condoms correctly and consistently with all sexual partners including regular/long term/ trusted partners

• Increase number of women who get condoms (or tell partners where to get them) and demand condom use with partners

• Increase number of young people who get condoms (or tell partners where to get them)

• Increase number of young people, specifically girls, who can effectively negotiate condom use

• Increase number of couples who freely discuss condom use

• Societal perceptions that discourage women from purchasing condoms

• Limited skills to bargain for condom use among women

• Perception that condoms spoil the fun in sex

• Poor communication skills among couples about sexual desires and protection from

HIV

• Perceptions that condoms are a sign of mistrust

• Pregnant women and their male partners demand HIV counseling and testing, and get their results, and take up PMTCT services

• Pregnant women go for antenatal care early

• HIV positive women and men to refrain from having children in the event that they test positive

• Women, and specifically HIV positive women take up family planning use after a good, informed decision

• Male partners will encourage their partners to take up family planning

• Lack of knowledge of PMTCT, how to access it and how it works

• Health worker challenges in counselling on PMTCT

• Traditional desire for children may encourage HIV positive women to have children

• Lack of support from husbands/ partners to use family planning methods.

• To increase the personal risk perception for HIV infection through the understanding of sexual networks

• To increase understanding of how to stay faithful

• To increase dialogue and discourse around sexuality, MCP, condom use, and HIV testing

• To convince target audience to not accept a partner who has other sexual To increase understanding among young women of the risks of having sexual partners who are 10 years or older

• To increase community knowledge on how to use condoms and the benefits of condom use.

• To increase personal risk perception of contracting HIV from unprotected sex

• To build competence and confidence in the correct and consistent use of condoms for every sexual act.

• To build confidence in women to purchase (get) condoms

• To increase communication skills to discuss condom use

• Increase knowledge about PMTCT services, including FP, testing, treatment and feeding guidelines

• Increase demand for HIV counselling and testing for pregnant women and their partners

• Increase knowledge on the Increase knowledge on importance of using contraceptives among young women

• Increase demand and uptake of family planning services by HIV positive women

• Increased male participation in PMTCT activities

KEY DRIVERS of HIV epidemic in Zambia

BEHAVIOURAL

OBJECTIVES

BARRIERS TO

BEHAVIOUR

CHANGE

COMMUNICATION

OBJECTIVES

Mass Media Strategies:

•Radio: Journey to becoming a parent series

•Radio promotional/ reminder spots

•TV: Change Champion documentary/ Journey to Becoming a Parent

•Billboards

•SMS TBD

Clinic Strategies:

• Quick‐Counseling checklist

• Counseling materials for family planning post‐ partum

• Waiting area multi‐media (TV and/or radio) “Journey to becoming a parent”

• Posters

GOAL: TO INCREASE DEMAND FOR:

• Use of modern contraception

• Early initiation of ANC

• Completion of at least 4 ANC visits

• Completion of birth plan

• Facility‐based delivery

• Post‐partum follow up care

BARRIERS TO DEMAND CREATION

• Fear of family planning side‐effects

• Lack of knowledge on diversity of family planning options

• Fear of HIV test as part of ANC

• Disbelief in benefit of early ANC

• Fear of process/experience of facility delivery

• Disbelief that facility delivery is necessarily safer

• Weak social support/involvement of families, leaders, etc… (and a corresponding lack of willingness to allocate financial and emotional resources to care‐seeking)

• Transportation/access issues

• Perception of lack of quality in clinics

• Pregnant women perceive quality of care and treatment by health personnel to be inadequate

• Lack of preparation/birth planning

COMMUNICATION OBJECTIVES

• Empower women of all ages to feel that getting pregnant is a decision they can make rather than something that just happens

• Convince providers of family planning products that women of any age should be able to access family planning without judgment

• Address concerns and fear of side effects of family planning

• Convince women of importance /reasoning for practicing all key behaviors

• Demystify what happens in ANC, during facility delivery and postpartum

• Address concerns around HIV test

• Increase awareness of steps to birth planning

• Increase involvement of men in supporting women to practice family planning, seek necessary care and deliver in a facility

• Motivate “community change champions” to support women in seeking family planning, care during pregnancy and facility delivery

• Improve attitudes and quality of interpersonal communication by providers

Community Strategies:

•Communication tools for SMAGs and other community volunteers including flipcharts

•Picture‐based Birthplans •Change Champions program •Outreach to men with communication tools on “becoming a parent/father”

•Family planning counseling materials

Mothers Alive National Communications Campaign

IMPACT: REDUCE MATERNAL MORTALITY

KEY DRIVERS of high incidence of and morbidity/mortality due to Malaria

BEHAVIOURAL

OBJECTIVES/ KEY

OUTCOMES

BARRIERS TO

BEHAVIOR

CHANGE

COMMUNICATION

OBJECTIVES

Cross-cutting:

The perception that malaria is not a serious disease that requires prompt attention and vigilant prevention all year round especially for the most vulnerable

Testing & Treatment

Increase # of pregnant women who seek early malaria testing and treatment from the health center.

Increase # of mothers/ fathers/ guardians of children < 5 who seek early malaria testing and treatment for their child from the health center.

Increase # of pregnant women and children < 5 who complete their malaria treatment.

Increase # of mothers who feed their children with small, frequent meals during illness.

Increase # of health workers who use RDT’s to diagnose malaria.

Fear that a malaria test will be perceived as an HIV test/subsequent stigmatization

Worry that going for a test will be expensive/take too much time

Lack of easy access to a facility for testing

Widespread availability of malaria medication in communities and lack of awareness on dangers of self-diagnosis

IPTp ITN usage

STOP MALARIA CAMPAIGN

GOAL: To contribute to reduction in morbidity and mortality of Malaria by promoting key behaviours that prevent new infections and enable effective treatment of infections when they do occur.

Increase the number of pregnant women who attend ANC before month 4 and demand IPTp

Increase the number of pregnant women who complete at least three courses of IPTp

The lack of knowledge about when to initiate ANC

Lack of support for early initiation of ANC by family members

A belief that IPT is harmful to the baby

A fear of IPT side-effects (nausea, bad-taste)

Increase the number of pregnant women who sleep under ITNs consistently.

Increase the number of children less than five years who consistently sleep under ITNs.

A lack of self-efficacy around hanging a bednet

A perception that treated bednets are not safe

Use of bednets by heads of households instead of most vulnerable members

Cross-cutting:

Increase perception by community members that malaria is a very serious, potentially fatal illness especially for young children and pregnant women.

Increase number of community members who feel that they have the power to stop malaria.

Delayed initiation of IPTp (delayed ANC visit)

Refusal of IPTp

Lack of consistent use of ITNs by most vulnerable (pregnant women and children under 5)

Lack of diagnostic testing for malaria

Delayed care-seeking

Self-treatment

Poor feeding practices for sick children

Reinforce knowledge of pregnant women/care takers of children <5 on the signs & symptoms of malaria.

Increase knowledge of pregnant women/care takers of children < 5 on the dangers of self-treatment and the need to seek early testing & treatment.

Increase knowledge of mothers and caregivers on how to feed children when they are sick

Reduce perception that a malaria test might be an HIV test

Increase positive perception of the experience one will have at health center

Increase knowledge among families that a woman must go to an

ANC visit and get IPTp right when she finds out she’s pregnant

Persuade pregnant mothers that IPTp is safe and offer tips on how to deal with the side effects

Increase number of heads of household who feel capable of hanging a bednet in their home.

Increase number of family members who believe that treated nets are safe to use

Increase intention of families to ensure ALL young children and pregnant women sleep under a treated bednet every night of the year

• To improve amount and variety of food consumed by pregnant and breastfeeding women, particularly animal source foods and nutrient-dense vegetables and fruit

• To improve quality of exclusive breastfeeding, including increasing average duration of feeds and positioning

• To improve the quality of complementary feeding, including age- appropriate variety/diversity, frequency, food consistency and amount

• To improve feeding during illness and recuperation period

• To reduce diarrhea frequency and environmental enteropathy through increased handwashing with soap, and actions to keep babies from contacting feces (e.g. safe play areas)

• Local foods not seen as high-value; perception that “good” nutrition means buying food, especially packaged foods

• Difficulty in understanding/managing many recommendations for optimum health during pregnancy, breastfeeding and different age stages

• Fear of not having sufficient quantity of breastmilk to satisfy/nourish baby

• Lack of time to breastfeed for sufficient duration each feed

• Belief that young children should are not eat foods like vegetables/meat (even mashed) because they don’t have teeth

• Belief that watery porridge/soup has sufficient nutrients for a young child

• Illness, including diarrhea, is seen as a normal part of childhood and not necessarily connected to hygiene practices

• No concept/awareness of a recuperation period for children following an illness

• Lack of resources (time and money) for treating water

• Create a belief that the best start in life for a child begins with support of the pregnant woman and continues with through the child’s first 2 years of life

• Improve women’s sense of self-efficacy in following complex set of recommendations for health of her children

• Improve inter-family dialogue and in particular role of husband/partner in preparing and serving food and household hygiene

• Create attitude shift in health workers on supporting families to achieve maximum child growth and health, not just weight gain

• Create a sense of responsibility within communities for their women and children

• Reposition locally available foods and traditional ways of growing and preserving foods as the healthiest, best option for families.

• Build the link between poor hygiene and sanitation and poor child growth and health and empower families with the confidence that it is possible to reduce the incidence of child illness (including how to create a healthier environment for children with “safe play spaces”)

• Introduce and develop the concept and recognition of the “recuperative feeding window” for children following an illness.

The First 1000 Most Critical Days

IMPACT: REDUCE STUNTING

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• Good support from families for trying new foods/prioritizing children’s food

• Minimal existing food taboos for pregnant and breastfeeding women

• Overwhelming acceptance/belief that breastfeeding is best for babies

• Strong willingness to try new practices in interest of children’s health

• Frequency of feeding for young children generally high/appropriate

• Trust in health workers/information from health centers

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S • Mass media: Radio series

• Clinic level: Support to GRZ/NFNC in scaling up effective counseling and information given via clinics

• Interpersonal/community: 8 districts; 131 communities ; group meetings and one-on-one sessions using child growth reminder card, menu planning game and placemat, feeding bowl with age-appropriate amounts; creation of safe play-spaces; and cooking and food preservation demonstrations