Building Capacity in Social and Behaviour 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 academics with the SBCC competencies required to address

Africa’s public health priorities

Location: Johannesburg, South AfricaGeographic Focus: Sub-Saharan Africa

Estimated HIV prevalence among young adults (15-49) by country

Image Credit: Wikimedia Commons

Communication as a tool for HIV prevention

Social & Behaviour Change Communication as a Discipline

Image credit: McKee, Manoncourt & Chin, 2000

Promotes:

•Multi-level analysis of situation, including social determinants of health

•Targeted and multi-level responses

•Evidence-based programming

Universities Training for the MarketCompetency-based Curricula

Knowledge of: key monitoring,

evaluation, and research concepts

tools and methodologies for monitoring, evaluation and research

qualitative and quantitative research methods

participatory research methodologies

frameworks for project evaluation

Ability to: select relevant indicators

for measuring project processes and results

develop and implement monitoring plan with data collection tools

determine effectiveness of communication strategy

identify problems in design and/or implementation

maintain management information system (MIS)

use MIS to inform project direction

conduct participatory monitoring, evaluation, and research

document and communicate best practices

Values: do not “doctor data” learn from mistakes or

non-success in programs use monitoring and

evaluation data to improve program activities

reliance of multiple methods for monitoring and evaluation

systematic use of monitoring and evaluation at all levels of SBCC work

Example: Research, Monitoring & Evaluation Competency Framework

Problem Analysis

In 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 & C-CHANGE

in 2008/09

Hired external staff to lead program development

Study tour and adaptation of competency framework

May 2009 Consultative Meeting

Course development and accreditation

Pilot of first course in December 2009

First cohort enrolled in 2010

Division Launch in 2010

The entire process involved a mix of stakeholders, including practitioners & academics from region & abroad

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Result: Division of SBCC

• Open to all course participants, MPH students & program stakeholders (guest lecturers, board, etc.)

• Academic staff• MPH research

reports

• Full and part-time offered over 2-4 years

• 5 SBCC specific courses

• 1-week blocks offered for Attendance or Competency

• 7 accredited

Short Courses

MPH Program

Community of Practice*

SBCC Research

* Under review due to resource constraints

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 course

South AfricaBotswanaSwazilandLesothoZimbabweEthiopiaMalawiUgandaU.S.A. (in RSA)

(same as MPH) NamibiaMozambiqueNigeriaSudanNigerEgyptEritreaGhanaUgandaTanzaniaKenyaZambiaD.R.C.Burundi IndiaSwitzerlandAfghanistan

+ Institutional support to universities in:NigeriaTanzaniaAlbania

Individual capacity built

“ Starting the MPH two years ago, I had lots of practical experience, but now, I have the added benefit of knowing the principles and theory behind the practice. In my work in a large unit dealing with HIV prevention, and working closely with the Department of Health, I have become the go-to person on social and behavior change communication. We no longer tolerate “spray and pray” prevention efforts: it’s all a whole lot more 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 culture

Plans 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

•Allows for professional development with accredited certification/degree, while maintaining focus on developing the hard skills required for practitioners

Partnership between academic and practitioner

institutions

•Allows division to keep current on both academic & practitioners debates related to SBCC

•Multidisciplinary (communication & public health)

Advisory board with local and international

membership

•Bringing on board someone with a core set of skills to guide process

Hiring externally to lead and manage program

•We add value to an already interdisciplinary field with a strong applied focus

•Able to draw on a broad range of skills (epidemiology, policy, etc.)

Housing program within a School of Public Health

•More open to addressing social determinants of health through intersectoral collaboration, at multiple levels

SBCC Framing

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.

SUPPORTING SLIDE

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