|HIV/AIDS and Communication for Behavioural and Social Change: Programme Experiences, Examples, and the Way Forward (UNAIDS, 2001, 68 p.)|
Based on the three-days of intense workshop discussions on the role of communication for behaviour and social change, including the operationalizing of the UNAIDS communication framework, workshop participants made the following seven recommendations:
Recommendation #1.: Communication for behaviour and social change should address the full HIV/AIDS continuum of prevention, care, and support.
In the past, communication programmes have tended to treat these aspects of HIV/AIDS as separate. Thus, the role of communication for: a) those who are HIV negative is to keep them HIV free (i.e. prevention through safe sex practices, usage of clean needles, and safe blood supply); b) those who are HIV positive is to promote the provision and use of HIV testing, counselling, antiretroviral drug therapy, and others, and c) those who have full-blown AIDS is to promote an environment free of stigma, and the provision and use of care and support services.
In essence, workshop participants felt that communication programming can be immensely more powerful by promoting:
· diagnosis and treatment of STDs;
· condom availability, accessibility, and use;
· HIV counselling and testing;
· care and support for those with HIV/AIDS;
· information, education, and training for those that provide care and support;
· communication between health care providers and those living with HIV/AIDS (for instance, about adhering to drug treatment regimen);
· communication with the public about the strengths and limitations of antiretroviral treatments, status of vaccines, and others.
Recommendation #2: Communication for behaviour and social change is most effective when integrated with a cross-disciplinary approach, drawing upon knowledge of epidemiology, anthropology, sociology, information science, psychology, and community development.
Communication programmes should involve multi-sectoral and multidisciplinary actors, including the government, civil society organisations, and the private sector.
Recommendation #3: Communication for behaviour and social change should promote provision, access, and use of various services and products.
For instance, voluntary counselling testing (VCT) sites can represent a strategic entry point for communicating about prevention, care, and support. They can facilitate adoption of safe sex practices, counselling on ways to prevent mother-to-child transmission, and provide access to care and support groups.
Recommendation #4: Communication for behaviour and social change should be planned and implemented on a sustained, coherent, and long-term basis, to suitably address the HIV/AIDS continuum of prevention, care, and support.
Sustainability is especially warranted given that HIV prevention calls for continuous and sustained action by individuals over a good deal of their adolescent and adult lives.
Programme sustainability has various components: technical, managerial, political, and financial. Sustainability of communication programmes is often a function of the funding cycles of donor and implementing agencies. Also limited funds tend to foster competition between NGOs rather than cooperation.
Communication practitioners should consider setting project priorities based on how conducive the political environment is to create a sustainable programme, rather than solely being driven by epidemiological data. For sustainability, intersectoral coordination within and across government institutions, civil society, and the private sector is key. Sustainability also can be achieved by working through existing institutional structures of the military, prisons, workplaces, brothels, and others.
Recommendation #5: Communication for behaviour and social change should address regional, country, and community specificity.
A cookie-cutter approach to HIV/AIDS communication programming is likely to be culturally insensitive and ineffective. Resources should be managed in ways to build institutional capacity at the local, regional, national, and international levels.
Recommendation #6: Communication for behaviour and social change should incorporate aspects of research, monitoring and evaluation.
Research should begin in the planning phase to gain contextual understanding of what shapes the behaviours of individuals in a target audience, to understand the emotional and seemingly irrational reasons why people find themselves at risk for HIV, to identify cultural and spiritual opinion leaders, the appropriate communication channels, and other critical variables. Monitoring and evaluation should be participatory, involving the local people in assessing their present conditions and establishing future goals. Evaluation should utilize multiple methods and be able to assess changes at multi-levels i.e. at the level of the individual, family, community, and society. Monitoring and evaluation allow for timely feedback, affording possibilities for mid-course correction for programme interventions. Evaluation also makes possible distillation of lessons learned and documentation of best practices to strengthen subsequent interventions.
Recommendation #7: There should be increased advocacy for, and visibility of, communication for behaviour and social change initiatives, including their contributions, among UNAIDS Co-sponsors and other implementing agencies.
Increase in interagency coordination and collaboration in the implementation of HIV/AIDS communication programmes is an important way of increasing support for communications role in social change and development initiatives.