HEALTH COMMUNICATION PARTNERSHIP - UGANDA - WORKPLAN

Transcription

1 HEALTH COMMUNICATION PARTNERSHIP - UGANDA - WORKPLAN October 1, 2008 September 30, 2009 Submitted September 22, 2008 Health Communication Partnership Plot 77 Luthuli Avenue P.O. Box 3495 Kampala, Uganda Tel: Fax:

2 TABLE OF CONTENTS LIST OF ABBREVIATIONS... 3 EXECUTIVE SUMMARY... 5 BACKGROUND WORK PLAN BY PROGRAMME AREA... 9 A. FAMILY PLANNING... 9 B. HIV/AIDS i. HIV Counselling and Testing (HCT) ii. Paediatric Antiretroviral Therapy (ART) Literacy and Adherence iii. TB/HIV iv. Male Circumcision for HIV Prevention v. HIV/AIDS Stigma Communication C. YOUNG EMPOWERED AND HEALTHY (Y.E.A.H) CROSS-CUTTING CAPACITY BUILDING RESEARCH, MONITORING AND EVALUATION (RM&E) MANAGEMENT IMPLEMENTATION, COORDINATION AND COLLABORATION MANAGEMENT STRUCTURE SHORT-TERM TECHNICAL ASSISTANCE PLAN ATTACHMENT 1: IMPLEMENTATION PLANS ATTACHMENT 2: BUDGET

3 List of Abbreviations 4Rs AA ABC ACSM ACP AfriComNet AIC AIDS AIM ART CBO CCP CDFU CHCT CLV COP DCOP DHE DOTS FBO FHI FPRWG GBV GEM HCP IEC IPC IR IRB JCRC JHU M&E MARCH MC MFD MMC MOH MOU MUSPH NHC NTLP NUMAT PEPFAR PLHA PMP POL RAO RCE RLO RM&E RTI SAO Runyoro, Runyankole, Rukiiga and Rutoro languages Associate Award Abstinence, Be faithful, Condom use HIV prevention strategy Advocacy Communication and Social Mobilisation AIDS Control Programme African Network for Strategic Communication in Health and Development AIDS Information Centre Acquired Immune Deficiency Syndrome AIDS Integrated Model Programme antiretroviral therapy community-based organisation Center for Communication Programs Communication for Development Foundation Uganda Couples HIV Counselling and Testing Community Liaison Volunteer Chief of Party Deputy Chief of Party District Health Educator Directly Observed Treatment, Short-course faith-based organisation Family Health International Family Planning Revitalisation Working Group Gender based violence Gender-Equitable Men Health Communication Partnership Information, Education and Communication Interpersonal Communication intermediate result International Research Board Joint Clinical Research Centre Johns Hopkins University monitoring and evaluation Modelling and Reinforcement to Combat HIV/AIDS male circumcision Media for Development International Medical Male Circumcision Ministry of Health Memorandum of Understanding Makerere University School of Public Health National HIV Counselling and Testing Committee National TB and Leprosy Control Programme Northern Uganda Malaria, AIDS and TB Project US President s Emergency Plan For AIDS Relief people living with HIV/AIDS Performance Monitoring Plan Popular Opinion Leader Regional Adherence Officer Regional Center of Excellence Regional Lead Organisation research, monitoring and evaluation Research Triangle International Site Adherence Officer 3

4 SBCC SMD STF STI TAT TB CAP UAC UHMG UPHOLD USAID VHT YAG YEAH YP social and behavioural communication change Safe Motherhood Day Straight Talk Foundation sexually transmitted infection Technical Advisory Team Tuberculosis Control Assistance Programme Uganda AIDS Commission Uganda Health Marketing Group Uganda Programme for Human and Holistic Development United States Agency for International Development Village Health Team Young People s Advisory Group Young Empowered and Healthy Young Professionals 4

5 Executive Summary To consolidate and strengthen strategic health communication activities in Uganda, on 1 July 2007, the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) entered into a three-year Associate Award with the United States Agency for International Development (USAID). This document describes the planned activities; capacity-building mechanisms; research, monitoring and evaluation measures; management; and technical assistance activities for the second fiscal year (1 October, September, 2009) of the award. Under the Associate Award, the Health Communication Partnership (HCP) will build upon its four years of experience in providing technical assistance, implementing communication strategies and approaches, and strengthening capacity for strategic communication. From 1 October 2008 through 30 September 2009, HCP will work to advance strategic communication in Uganda to achieve three Intermediate Results: IR 1: Improved ability and motivation to use services and practices that enhance health; IR 2: Supportive social environments fostered to enable positive health behaviour; and IR 3: Increased capacity for sustained health communication. Working in line with the Government of Uganda and USAID Uganda s shared goals of preventing and reducing mortality and morbidity and promoting health and improved quality of life, HCP will provide communication support in the areas of family planning, HIV/AIDS, and young people s sexual and reproductive health. In the area of family planning, HCP will continue to assist the Ministry of Health (MOH) and its family planning partners to implement, monitor and evaluate the family planning revitalisation campaign to promote smaller, healthier, more prosperous families in Uganda and to address Uganda s population crisis. In addition, a new focus will be placed on the relationship between family planning and gender based violence. HCP will also provide communication support to five HIV-related programme areas: HIV counselling and testing, treatment (ART), tuberculosis (TB) and HIV, medical male circumcision for HIV prevention, and HIV-related stigma. Specifically, HCP will work with a number of partners to design and implement a communication campaign promoting HIV counselling and testing for couples; scale up and expand the paediatric ART campaign to include HIV positive adolescents; continue the dissemination and operationalisation of the TB/HIV Communication Strategy and Message and Media Plan; provide accurate, easy-tounderstand information about male circumcision for HIV prevention; and finalise and obtain support for a national HIV-related stigma reduction strategy. HCP will continue to work with Young, Empowered and Healthy (Y.E.A.H.) to address gender inequities and other social issues that increase young people s vulnerability to HIV and AIDS, adolescent pregnancy and early school leaving. During this work plan period, HCP s priority is to assist Y.E.A.H to mobilise resources and strengthen its institutional capacity to independently design and manage strategic communication programmes. HCP will also support Y.E.A.H to launch phase 2 of the Be a Man campaign, which will focus on three new areas: alcohol use and abuse, violence against women, and something for something love from a man s perspective. HCP remains committed to strengthening the capacity of Ugandan institutions and individuals to design, implement, and evaluate strategic health communication interventions. In this work plan year, HCP will continue to build the capacity of HCP staff and partners, the 5

6 media, the Ministry of Health, and young Ugandan professionals. Activities will include a communication capacity assessment for HCP staff and implementing partners and subsequent skills building trainings; development of a database for all approved MOH IEC and BCC materials; updating the Village Health Team (VHT) training curriculum; producing a radio-based distance learning course for health providers; hosting a national meeting for District Health Educators to provide technical and strategic communication updates; establishing a hotline for men and women affected by gender based violence, transactional sex, alcohol abuse, HIV/AIDS, and who are in need of information about reproductive health; and expanding the Generating Opportunities for Leadership and professional Development (G.O.L.D.) programme. Now that HCP has established a Research, Monitoring and Evaluation (RM&E) system, this year s work plan focus will be to continue to report on the Performance Monitoring Plan; analyse and disseminate findings from the HCP and Y.E.A.H. Baseline and Evaluation surveys conducted in 2008; carry out programme-specific research; and improve the capacity of staff and partners to collect, analyse, report and utilise RM&E findings. 6

7 Background On 1 July 2007, the Johns Hopkins University Bloomberg School of Public Health Center for Communication Programs (CCP) entered into a three-year Associate Award (AA) with the United States Agency for International Development (USAID) Uganda to consolidate and strengthen strategic communication activities within USAID/Uganda s health programme area, under its Investing in People Objective. This award extends and expands communication activities initiated between 1 July 2004, and 30 June 2007, under the Health Communication Partnership (HCP) in the areas of youth sexual and reproductive health, antiretroviral therapy (ART), family planning, and malaria. Funding for the HCP II AA is provided by USAID, the U.S. President s Emergency Fund for AIDS Relief (PEPFAR) and the U.S. )President s Malaria Initiative (PMI). The Government of Uganda and USAID Uganda both seek to prevent and reduce mortality and morbidity, and promote health and improved quality of life. In support of these goals, the new HCP award project provides technical assistance, implements communication strategies and approaches, and strengthens capacity to achieve three intermediate results (IR). IR 1: Improved ability and motivation to use services and practices that enhance health Strategic approaches to meet this IR will focus both on ensuring services are responsive to clients needs and encouraging their use, leading to improvements in service uptake and method continuation and adherence as well as preventive behaviour. The outcome of these two approaches will be empowered clients working with responsive providers to effectively use available services, products, and preventive behaviours. IR 2: Supportive social environments fostered to enable positive health behaviour HCP will design approaches that encourage debate and dialogue around social and normative change and advocate for enforcement and awareness of policies and laws, with the ultimate goal of supporting adoption of new attitudes and practices that lead to improved health outcomes. As many social norms have an underlying gender dimension, HCP will integrate gender issues into its approaches and initiatives. To the extent possible, communication programming will operate at various levels, from the national to the community, reaching individuals and families. Strategic approaches to meet this IR will: (1) focus on underlying issues that influence health behaviour; (2) help community-based organisations (CBOs) and community-resource persons catalyse social change at the community level and support behaviour change at the individual level; and (3) work closely with media personalities and leaders both official and unofficial to model and advocate for gender-equitable and health-conscious attitudes and values. The primary outcome of these approaches will be coordinated, scaled-up activities that contribute to openness, discussion, and changing norms that negatively influence health behaviours. IR 3: Increased capacity for sustained health communication HCP will work to strengthen strategic communication capacity among Ugandan partners, host country agencies, and civil society including the faith based community, that are the main implementers of health programmes. HCP will also work with popular media to ensure high quality and professionally developed products. This includes strengthening and improving health news reporting, as well as scripting and performing drama. 7

8 HCP will utilise two strategic approaches to achieve this IR: 1) training partners in strategic communication, and being there as they implement their programmes; and 2) sharing innovations among partners, and improving their ability to coordinate and share information among themselves. Outcomes of these two strategic approaches will include better-quality outputs, standardised and better coordinated approaches and messages, more efficient use of resources, and maximum public exposure to health communication. This work plan presents the activities that HCP will support during the period between 1 October 2008 and 30 September It was developed through a decentralised, consultative process that involved many Ugandan government and non-government partners, USAID Cooperating Agencies, and USAID. USAID will provide funding to HCP in the total amount of US$ 4,723,614 (US$ 3,546,587 in newly obligated funds, and US$ 1,177,025 in funds carried over from the first 15 months of the project) for communication support in the following programmatic areas: Programmatic Area Budget Family Planning US$ 323,917 HIV counselling and testing US$ 687,379 ART literacy and stigma reduction US$ 789,724 Tuberculosis and HIV US$ 85,567 Male circumcision and HIV US$ 639,453 HIV prevention (Abstinence and Faithfulness) US$ 1,467,572 HIV prevention (Other prevention beyond abstinence and faithfulness) US$ 250,000 Gender Based Violence US$ 480,000 This document presents planned activities for each of three programme areas: family planning, HIV/AIDS, and HIV prevention for young people the Young Empowered and Healthy (Y.E.A.H.) initiative and Be a Man campaign as well as cross-cutting capacity building, and monitoring and evaluation activities. Each programme area describes activities by intermediate result. 8

9 1. Work Plan by Programme Area A. Family Planning Output Indicators and Targets Indicator Target Number of individuals reached with HCP-supported media 1,606,503 messages on family planning practices and services 1.2. Number of health facilities that receive HCP-promoted family 150 planning communication materials 2.1. Number of leaders, service providers, community health workers, 1000 and CORPs who receive HCP-supported IEC materials on family planning practices and services Background Uganda has one of the highest fertility rates in the world, with an average of 6.7 children per woman. 1 This has resulted in one of the fastest growing populations in the world, and a magnitude of resulting social and health problems. To address the population crisis, HCP provided technical assistance to the Ministry of Health and the Family Planning Revitalisation Working Group in the last work plan year to develop and implement a national communication campaign to promote smaller, healthier, more prosperous families in Uganda through the use of modern family planning methods. This year, HCP will continue to assist the Ministry of Health (MOH) and its family planning partners to implement an integrated family planning revitalisation communication campaign. Proposed Activities by Intermediate Result IR 1: Improved ability and motivation to use services and practices that enhance health HCP will assist the Ministry of Health and the Family Planning (FP) Revitalisation Working Group to produce and broadcast radio mini-dramas and spots, and produce and distribute booklets, signposts, posters, calendars, t shirts and FP grain sack sets for community volunteers. Community hall video shows will also be held. HCP will collaborate with Pulse, the new bilateral FP/RH project, Lowe Scanad, and Steadman Associates to implement these activities. Broadcast radio mini-dramas and spots produced during the previous year about the benefits of family planning and smaller family size Reproduce and distribute booklets with key messages for men on population, development and family planning Produce and distribute FP Grain Sack Sets 1,920 radio spots and 1,920 mini dramas broadcast on 14 radio stations representing all regions in Uganda 8,000 booklets printed and distributed 100 Grain Sack Sets Q2 Q3 Q2 Q4 Q Uganda Demographic and Health Survey (UDHS), Uganda Bureau of Statistics 9

10 as tools used to create awareness and encourage discussion about FP by CRHWs Produce and place signposts with rainbow over the yellow flower at or near family planning points of service in 10 districts Print and distribute family planning posters through FP Revitalization partners Produce and distribute calendars with key messages on population, development and family planning Produce and distribute T shirts with key messages on population, development and family planning Produce FP television adverts to be aired in community video halls in 10 districts Use Alternative Media (community video halls) to broadcast adverts and video dramas about the benefits of family planning and smaller family size produced and distributed 150 signposts with rainbow over the yellow flower produced and put up in 10 districts 2,000 posters printed and distributed 5,000 calendars printed and distributed 600 T shirts produced and distributed to CRHWs 3 television adverts produced in 6 languages 9,000 FP adverts aired in 100 community video halls Q2 Q2 Q4 Q2 Q2 Q2 Q2 Q3 IR 2: Supportive social environments fostered, to enable positive health seeking behaviours and result in healthier individuals, families, and communities HCP will collaborate with partners to train family planning champions, community health workers and Village Health Teams to advocate on behalf of responsible family planning and smaller family size. In collaboration with the Be a Man campaign, media representatives will be trained to ensure more positive media coverage of family planning issues. HCP will specifically collaborate with the Ministry of Health, Y.E.A.H. and the Linkages Project to implement these activities. Identify and train champions to advocate on behalf of responsible family planning and smaller family size Train media representatives to improve and increase reporting on family planning and population issues Train community based health workers to advocate on behalf of responsible family planning and smaller family size 40 champions trained to advocate for family planning 20 media representatives trained in reporting on family planning 200 community based health workers trained to educate communities about responsible family planning and smaller family Q2 Q4 Q3 Q4 10

11 size Train Village Health Teams to advocate on behalf of responsible family planning and smaller family size 400 Village Health Teams educating others regarding responsible family planning and smaller family size Q3 Q4 IR 3: Improved communication capability to effectively support social and behavioural goals HCP will facilitate various Ministry of Health and Family Planning Revitalisation Working Group (FPRWG) workshops and meetings, and celebration of important health days. HCP will also provide technical assistance to revise the National Reproductive Health Communication Strategy to bring it in line with the Health Sector Strategic Plan III, and map family planning partners in all districts in Uganda. Specifically, HCP will collaborate with Uganda Health Marketing Group, Family Health International, Minnesota International Health Volunteers, Population Secretariat, World Health Organisation, ENGAGE Project, UNFPA, and the new bilateral RH/FP Project to implement these activities. Support FPRWG Information, Education and Communication (IEC) Subgroup meetings Update and disseminate family planning services map among partners Conduct workshop for the orientation of MOH District Health Educators (DHEs) on the population crisis and the family planning communication campaign Produce radio distance learning sessions on family planning, population, and development. Assist the MOH to revise the National Reproductive Health Communication Strategy Contribute toward Safe Motherhood Day celebration on 17 th October 2008 Contribute toward World Population Day celebration on 11 th July IEC Subgroup meetings held Family planning map updated and distributed 83 DHEs oriented to family planning revitalisation campaign Radio distance learning course for health workers includes sessions on FP, population and development National RH Communication Strategy updated and distributed Safe Motherhood Day celebrated highlighting the importance of FP in national development World Population Day celebration highlighting men s role in family planning Q2 Q4 Q4 Q2-4 Q3 Q4 Q4 11

12 Monitoring and Evaluation HCP will monitor the implementation its support to family planning communication in Uganda through media monitoring reports for radio spot broadcasts, and reports from partners concerning use of FP materials. HCP will develop a system for monitoring video hall broadcasts of spots and full-length FP videos. Also, HCP will analyze data collected during the HCP evaluation survey in FY2007 to assess reach and effects of FP media and activities conducted during FY2007. Implementation Arrangements The HCP Deputy Chief of Party will assist the MOH Reproductive Health Division to manage the family planning communication work plan, working in close collaboration with the FPRWG. The HCP Chief of Party will supervise and provide technical assistance as required. Assistance of consultants from outside of Uganda is not anticipated for this programme area. However, HCP will draw on consultants from within Uganda to fulfil short-term technical assistance needs as follows: Training of Community Health Workers and Village Health Teams Media training Coordinating the DHE workshop HCP will engage the services of an advertising agency for creative design and media placement. All materials will be reviewed by the family planning communication sub-group of the FPRWG, and approved by the MOH before production and dissemination. 12

13 B. HIV/AIDS i. HIV Counselling and Testing (HCT) Output Indicators and Targets Indicator 1.1. Number of individuals reached with HCP-supported media messages on HCT 1.2. Number of health facilities that receive HCP-supported information materials on HCT 2.1. Number of leaders, service providers, community health workers, and CORPs who receive HCP-supported information materials on HCT 2.2. Number of leaders, media representatives, service providers, community health workers, and CORPs who participate in designing and implementing HCP-supported strategic health communication activities on HCT 3.1. Number of communities (LC1) in project areas implementing HC-supported strategic communication programmes on HCT 3.2. Number of organisations integrating HCP programmes on HCT in their work plans and budgets 3.3. Number of people who have participated in HCT communication capacity building activities (training programmes, internships, exchange visits) conducted by HCP and its partners N.B. Targets for HIV Counselling and Testing will be set once the communication strategy is complete. Background The 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey reveals a high incidence of HIV among married couples; HIV transmission is highest among this group (42%). Married persons account for an estimated 65% of new infections; discordant couples may comprise up to 50% of these transmissions. As part of the efforts to change the profile of HCT clients and impact more positively on related behavioural response, HCP provided technical support to the National AIDS Control Programme (ACP) of the Ministry of Health to design an HCT concept note that will guide the implementation of a coordinated communication campaign targeting married and cohabiting couples and linked to testing weeks. However, implementation was delayed due to the need for consultation with national HIV/AIDS partners to build consensus on campaign issues. In this work plan year HCP will focus on designing and launching the national campaign. Proposed Activities by Intermediate Result IR 1: Improved ability and motivation to use services and practices that enhance health HCP will assist the ACP, the National HCT Coordinating Committee (CT17) and AIDS Information Centre (AIC) to design and implement a multi channel campaign to encourage couples to assess their risk of HIV, test together and/or share their status with their partners. With coordination from MOH, HCP will support the design of community mobilisation tools and IEC materials, launch of the campaign, roll out of community mobilisation activities and testing events, press coverage, and monitoring and evaluation. 13

14 Develop couple counselling and testing communication strategy Develop and pre-test creative concepts for the campaign Adapt existing and develop new HCT provider and client materials as appropriate Design community mobilisation strategies and tools Orient partners on job aids, materials, community mobilisation strategies Organise launch of HCT communication campaign Implement HCT campaign Strategy developed and disseminated Creative concepts developed and pre tested by the agency Materials reviewed, adapted, and produced Community mobilisation strategies and tools designed Partners oriented on job aids, materials, community mobilisation strategies Communication campaign launched Materials distributed, media broadcast, community mobilisation activities conducted. Q2 Q2 Q3 Q3 Q4 Q4 IR 2: Supportive social environments fostered to enable positive health behaviour HCP will support AIC to conduct an assessment of selected HCT facilities in order to identify those which will be used to provide couple HIV counselling and testing (CHCT) services during testing months. The assessment report will identify and address gaps and needs of the facilities related to CHCT. In order to prepare communities for the HCT campaign, HCP will work with the MOH and AIC to prepare and implement a strategy to inform and orient service providers, district and community leaders, CBOs, FBOs, and other local and national partners about the campaign. HCP will also review, adapt, disseminate and orient service providers on training materials/job aids for CHCT, educational materials for clients, referral lists, and data collection tools. If agreeable to partners, the campaign may label HCT service providers and facilities for easy recognition. HCP will also support AIC to conduct tailored training for counsellor trainers in CHCT and HIV status disclosure. Service delivery guidelines for couple counselling and testing will be developed and disseminated to service partners. HCP will support regular meetings to review progress. Establish and orient District Coordination Teams in 6 districts Conduct facility assessment to determine establish inputs required to provide good quality CHCT services Prepare and finalise training curriculum and job aids for providers District Coordination Teams established and oriented in 6 districts Facility assessment report disseminated Curriculum and job aides for providers developed Q2 Q2 14

15 Prepare guidelines for service delivery during testing weeks Support AIC to train service providers in CHCT and service delivery guidelines, and orient on job aids and client materials Conduct testing weeks in selected facilities in 6 districts Organise regular planning meetings for District Coordination Teams Service delivery guidelines for testing weeks completed At least three service providers oriented in each selected facility in 6 districts selected for testing weeks Testing weeks at selected facilities in 6 districts Meetings held Q3 Q3 Q4 Q4 IR 3: Increased capacity for sustained health communication In this work plan year, HCP will support the CT17, help build the strategic communication capacity of AIC, increase the HCT capacity of service providers, and establish an electronic library and distribution centre for relevant HCT resources. Support working committee and national coordination committee (CT17) Enter into agreement with AIC to manage and implement CHCT campaign Conduct assessment of AIC staff capacity in strategic communication Sponsor AIC staff for relevant training in communication Provide technical support for interested partners to design similar communication campaign Integrate updated HCT information into the radio distance learning programme for health workers and VHT training manual Active and functional HCT working committee Sub-agreement with AIC in place Assessment conducted, report compiled and disseminated AIC capacity strengthened Technical support provided Updated HCT information included in radio distance learning programme for health workers; and incorporated into VHT training manual Q2 Q3 Q4 Q3 Q4 Q2 Q3 Monitoring and Evaluation During implementation, the HCP Research, Monitoring & Evaluation (RM&E) team will work with the HCT working committee to track monitoring and evaluation indicators. Through its RM&E department, HCP will continue to document process indicators on a monthly basis and report as part of its quarterly, semi-annual and annual reports. All media broadcasts will be monitored by commercial media monitoring services to ensure that broadcasts are made as scheduled. In collaboration with HCT service providers, HCP may conduct a time series analysis of HCT uptake among married and cohabiting couples at selected health facilities in the 6 campaign regions to identify trends associated with campaign activities. HCP will design and conduct qualitative assessments of particular media and/or activities to inform future phases of the campaign. 15

16 Implementation Arrangements A full time Programme Officer will continue to manage this activity, under the supervision of the Deputy Chief of Party responsible for HIV/AIDS communication. AIC will manage day to day implementation and coordination of campaign materials development, and capacity building in the area of service delivery and counseling. Media placement will be contracted to an advertising agency. HCP will provide periodic short-term technical assistance through local or regional staff and consultants. Specific areas for short term technical assistance will be determined based on the campaign implementation progress. HCP will draw on consultants from within Uganda for short-term technical assistance needs. 16

17 ii. Paediatric Antiretroviral Therapy (ART) Literacy and Adherence Output Indicators and Targets Indicator Target Number of individuals reached with HCP-supported media messages 145,114 about paediatric ART 1.2. Number of health facilities that receive HCP-supported information 500 materials about ART 2.1. Number of leaders, service providers, community health workers, and 300 CORPs who receive HCP-supported information materials about ART 2.2. Number of leaders, media representatives, service providers, 600 community health workers, and CORPs who participate in designing and implementing HCP-supported ART communication activities Background An estimated 110,000 children are currently living with HIV in Uganda. While 50,000 of these children require antiretroviral therapy, only 13,000 have started. Lack of awareness about availability of testing and treatment services for young children hinders care takers from starting children on ART. Children who start antiretroviral treatment grow into adolescents and face a number of challenges which include prevention of transmission and re-infection, stigma, disclosure of status and adherence to treatment. In 2007 / 2008, HCP provided technical assistance to the Joint Clinical Research Centre (JCRC) to develop and implement a communication campaign aimed at increasing uptake of services and adherence to treatment by children and adolescents. In 2008 / 2009 HCP will continue to support JCRC to scale up the paediatric campaign and expand it to include communication on prevention of HIV transmission and re-infection for HIV-positive adolescents. Proposed Activities by Intermediate Result IR 1: Improved ability and motivation to use services and practices that enhance health HCP will assist JCRC to finalise the care giver booklet and children s book (Lukia s Story); two communication materials developed under the paediatric campaign during the previous fiscal year. HCP s support will go towards translating, pretesting, printing and training counsellors and ART service providers to use these materials when counseling children on ARVs and their care-givers. HCP will also produce and launch the children s book to organisations working with HIV-positive children. HCP will also assist JCRC to roll out a multi-channel communication campaign promoting adherence to ART, prevention of transmission and re-infection among HIV-positive adolescents. Produce 2,000 copies of the Children s Book; Lukia s story and distribute to organisations working with HIV positive children 2,000 copies of the children s book produced and distributed Q 1 17

18 Launch the Children s book to organisations working with HIV positive children and the media and encourage further reproduction Train counsellors from JCRC, PIDC. Mild may, TASO in use of the Children s book and other adherence materials Translate and re-produce caregiver booklet developed in previous financial year into 4 additional languages Children s book launched Training Session conducted for counsellors from each of the organisations working with young positive people Caregiver booklet reproduced in 4 languages Q2 - Q 2 Disseminate YEAH / HCP HIV treatment survey results to HCP / JCRC Finalise and pretest adolescent creative concepts Customise GTZ Make a start game to adolescent communication issues and produce 500 copies Working with net works for HIV positive adolescents hold 6 interactive sessions with adolescents using the Make a Start Game Develop a discussion guide for existing radio diaries on prevention and adherence Finalise discussion guide for Grain sack chart sets for use in facilitating discussions in adolescent clubs Work with YEAH to develop Jessica and Mike s story into Volume 6 of Rock Point 256 Develop discussion guide for Jessica and Mike story audio for use by Adolescent groups Produce and Feature Prevention message Adverts into Rock Point comic book Develop a basic facts booklet for sexually active HIV positive adolescents Develop Adherence posters focused on adolescents for use in health centre settings Results disseminated Adolescent creative concepts finalised GTZ Make a start game customised, 500 copies produced 6 interactive sessions held with HIV positive adolescents years using the make a start game Discussion guide for existing radio diaries on prevention and adherence developed Discussion guide for Grain sacks developed 10,000 copies of Rock Point comic book produced and distributed to HIV-positive adolescent support groups Adolescent messages featured in comic book Guide developed and distributed to net works for HIV positive young people Prevention message press adverts featured in Comic book Volume 5, 6 Booklet for sexually active adolescents developed and distributed Adherence posters developed Q 2 Q 1 Q 1 Q 3 Q3 Q4 Q2 Q 2 Q3 Q 1 Q4 Q3 Q2 Q2 Q 4 18

19 Work with net works for young positives / YEAH to conduct training for adolescent peer educators and health care providers in use of various adolescent communication products; game, comic book, Jessica & Mike audio, Radio diaries Work with Y.E.A.H. trainers to develop a curriculum and train trainers of young positive peer educators in use of adolescent communication products Document all practices for sharing with HIV treatment providers following the end of TREAT 100 peer educators (5 from each RCE; plus 50 from other organizations working with HIVpositive adolescents) equipped with skills to communicate to adolescents Manual produced and distributed. Peer educators trained in its use Report of activities for the adolescent campaign and CD of materials for sharing with other HIV treatment providers Q2 Q4 Q2 Q 3 Q 4 IR 2: Supportive social environments fostered to enable positive health behaviour HCP will help to create an environment where HIV positive adolescents are supported to adhere to medication and to practice HIV prevention behaviours. Interactive seminars on the importance of support networks for adherence and prevention for adolescents will be held for teachers, religious leaders, PLHA clubs and traditional healers. Planned Activities Activity Targets / Milestones Timeline Conduct teacher s seminars on the importance of support networks for adherence / prevention for positives Conduct interactive sessions for religious leaders and traditional healers on adherence and prevention for adolescents Conduct seminars for PLHA clubs on adolescent and paediatric issues One teacher s seminar held 2 briefing sessions for traditional healers and religious leaders held Seminar for PLHA club representatives from 6 RCE and at least 4 other organizations conducted Q2 Q2 Q3 Q2 IR 3: Increased capacity for sustained health communication HCP will assist JCRC to sensitise its Community Liaison Volunteers (CLV) about adolescent and paediatric issues to enable them to better understand key issues for communication. CLVs will also be trained in the use of adherence support materials. In support of JCRC s strategy of decentralising communication, HCP will support JCRC to disseminate the adolescent communication strategy to Site Adherence Officers (SAO) and Regional Adherence Officers (RAO). The same sessions will be an opportunity to refresh the adherence team on how to use available communication materials. Focus will also be on finalising content for part one of JCRC s post graduate diploma course in Counselling for Treatment Adherence and Disease Management. Assist JCRC to disseminate the adolescent communication strategy to SAOs and RAOs Work with JCRC to conduct sensitisation Briefing session for SAOs/RAOs conducted 100 CLVs briefed about paediatric Q2 Q3 Q2 Q3 19

20 seminars for CLVs on paediatric and adolescent health issues, communication strategy for adolescents and use of adherence support materials (adherence calendar, flipchart, grain sack posters, handbook) Orient DHEs to the adolescent and paediatric campaign Update VHT manual with paediatric and adolescent HIV/AIDS information Finalise content for part one of post graduate diploma course in Counselling for Treatment Adherence and Disease Management Integrate pediatric ART issues into distance learning radio programme for health workers and adolescent health issues 81 DHES briefed about adolescent and paediatric HIV/AIDS issues Paediatric and adolescent HIV/AIDS issues integrated into VHT manual Content for diploma course in Counselling for Treatment Adherence and Disease Management finalised Paediatric ART information integrated into distance learning radio programme Q4 Q2 Provide ongoing support to JCRC to implement communication activities Develop work plan for the next financial year and identify partners to work with at the end of the TREAT transitional year Support to JCRC provided Work plan developed. Partners identified Q2 Q4 Q4 The HCP RM&E team will document process indicators on a quarterly basis as part of its quarterly, semi annual and annual reports. Media broadcasts will be monitored by a media monitoring agency to ensure that broadcasts occur as planned. Implementation Arrangements JCRC will continue to be the key implementer of planned activities with technical support from HCP. Efforts will be made to involve other treatment providers and organisations that work with HIV positive children and adolescents in the implementation of the strategy. The HCP Deputy Chief of Party will provide technical assistance and manage the implementation of this work plan in close collaboration with the JCRC Communication Coordinator. The HCP Chief of Party will provide supervision, input and assistance. Assistance of consultants from outside of Uganda is not anticipated for this programme area. HCP will draw upon local consultants for short term technical assistance needs. Dr. Sam Kalibala will continue providing technical assistance towards the development of the diploma course on Counselling for Treatment Adherence and Disease Management. A creative agency will handle development of creative concepts for support materials and media buying, placement and monitoring. Printing of materials will be shared between JCRC and HCP. 20

21 iii. TB/HIV Output Indicators and Targets Indicator Target Number of individuals reached with HCP-supported media messages 2,153,160 on practices and services that promote the health of people living with HIV and TB 1.2. Number of health facilities that receive HCP-supported information materials on practices and services that promote the health of people 800 living with HIV and TB 2.1. Number of leaders, service providers, community health workers, and 4,000 CORPs who receive HCP-supported information materials on practices and services that promote the health of people living with HIV and TB 2.2. Number of leaders, media representatives, service providers, 120 community health workers, and CORPs who participate in designing and implementing HCP-supported activities on TB-HIV 2.3. Number of leaders, media representatives, service providers, 4,500 community health workers, and CORPs who participate in HCPsupported activities to disseminate the TB/HIV policy 3.1. Number of organisations integrating HCP programmes on TB-HIV in 90 their work plans and budgets 3.2. Number of people who have participated in TB-HIV communication 80 capacity building activities (training programmes, internships, exchange visits) conducted by HCP and its partners Background Uganda is ranked 16 th among the 22 high burden Tuberculosis (TB) countries, with approximately 80,000 new TB cases detected in the country every year. Despite efforts towards improving the control of TB, Uganda is yet to attain the global case detection and treatment success targets of 70% and 85% respectively. Whereas TB presents a public health problem in itself, the interaction between TB and HIV/AIDS aggravates the situation % of TB patients are co-infected with HIV, while TB, though curable, is still the leading cause of death among people living with HIV and AIDS (PLHA). The National TB/HIV Policy Guidelines (2006) call for collaborative efforts in order to control the two diseases. TB clients need to know about HIV and its relationship to TB, and be motivated to get tested for HIV so they can prevent its spread and access AIDS treatment when they are eligible. Likewise, PLHA need to know about TB and its relationship to HIV and get screened for TB so they can begin treatment early, if they are affected. In the last work plan year, HCP developed a Message and Media Plan (MMP) that operationalises the already available TB/HIV Communication Strategy, and supported the Ministry of Health s National TB and Leprosy Control Programme (NTLP) and ACP, TB CAP and the NUMAT Project to disseminate the strategy and MMP to more than 23 districts in Uganda. This year HCP has received no new funds, but will finalize these activities. 21

22 Proposed Activities by Intermediate Result IR 1: Improved ability and motivation to use services and practices that enhance health In this work plan year, HCP will finalise, produce, and disseminate materials specified in the MMP, as well as the new TB logo and the referral directory for TB services. These materials were already under production during FY Finalise production of TB/HIV job aides and client education materials specified in the MMP; TB logo, posters, flipchart, grain sack chart set, and referral directory Finalize the TB logo and referral directory and hand over to partners Orient NTLP, TB CAP, NUMAT and other partners on the use and wider dissemination of developed materials TB/HIV materials produced and distributed to partners TB logo Referral directory Partner staff at NTLP, TB CAP and NUMAT able to use and disseminate TB/HIV materials IR 2: Supportive social environments fostered to enable positive health behaviour HCP will support NTLP and ACP zonal teams to disseminate policy guidelines in 60 districts that are not receiving TB CAP and NUMAT support. This dissemination will involve District Health Teams, health sub districts, and district and regional referral hospitals. HCP will also produce a distance learning radio series with sessions on TB and HIV targeting health workers, especially those working in out-patient departments of public health facilities. Finalise production of referral directory to improve referral, access and utilisation of TB services Support NTLP and ACP zonal officers to finalise dissemination of policy guidelines to 60 districts Produce distance learning radio series session on TB infection control Referral directory produced and submitted to partners Dissemination workshops held in 60 districts Distance Learning series produced and broadcast Q3 Implementation Arrangements The Programme Officer in charge of Capacity Building will work in partnership with NTLP, TB CAP, NUMAT and the Uganda Stop TB Partnership under supervision and guidance from the HCP Deputy Chief of Party (FP and Capacity Building) through the end of November, HCP will share costs with NTLP, TB CAP, NUMAT and new partners for the following activities: 22

23 Health Communication Partnership (HCP) Finalise design of a TB logo and signage for branding TB services nationwide Finalise production of relevant client education materials and job aides specified in the MMP Orient partners in the use of developed materials Partners (NTLP & ACP, TB CAP, NUMAT, USTP & New Partners) Re-print and place signage to facilities in their respective areas Re-print and disseminate these materials for use in their districts/areas Fund logistical support for their normal training activities 23

24 iv. Male Circumcision for HIV Prevention Output Indicators and Targets Indicator Target Number of individuals reached with HCP-supported media messages on 1,614,870 Medical Male Circumcision 1.2. Number of health facilities that receive HCP-supported information materials 90 on Medical Male Circumcision 2.1. Number of leaders, service providers, community health workers, and CORPs 30,000 who receive HCP-supported information materials on Medical Male Circumcision 2.2. Number of leaders, media representatives, service providers, community 75 health workers, and CORPs who participate in designing and implementing HCP-supported communication activities on Medical Male Circumcision 2.3. Number of leaders, media representatives, service providers, community 1,500 health workers, and CORPs who participate in HCP-supported activities to disseminate the policy on Medical Male Circumcision and HIV Background Evidence from studies conducted in Kenya, South Africa and Rakai in Uganda shows that Medical Male Circumcision (MMC) provides partial protection from HIV acquisition among men. The National Strategic Plan recognises MMC as a supplementary measure to the ABC HIV prevention strategy. In response to the need for correct information on MMC, HCP provided assistance to Makerere University School of Public Health (MUSPH) and the Ministry of Health (MOH) to develop a communication strategy on MMC for HIV prevention. In this work plan year, HCP will continue to work with MUSPH and other partners to disseminate correct and easy to understand information on MMC to enable those seeking services to do so from an informed point and to advocate for a national policy. Proposed Activities by Intermediate Result IR 1: Improved ability and motivation to use services and practices that enhance health HCP will partner with the Makerere University School of Public Health (MUSPH) to provide technical assistance to the MOH ACP and Uganda AIDS Commission (UAC) to disseminate correct and easy to understand information about medical male circumcision (MMC) for HIV prevention to the health workers and the public, and to correct commonly held misconceptions about circumcision and HIV/AIDS. HCP will assist MUSPH to develop and produce a basic facts booklet for health workers based on the leaflet prepared in the previous year; broadcast radio talk-shows in traditionally circumcising areas; conduct community discussions on safe male circumcision in Bugisu region; and develop and incorporate a module on MMC for HIV prevention in the Men and HIV/AIDS Facilitators Manual produced for the Be a Man campaign. Develop a Basic Facts Booklet on MMC for HIV prevention for health care workers Include a module on MMC for HIV prevention in the Men and HIV/AIDS Facilitators Manual Conduct radio talk shows about MMC for HIV prevention in Kasese district and Bugisu region Integrate MMC messages and/or materials in the 10,000 copies of booklets produced and disseminated to DHTs and health facilities Facilitators training module developed and included in the broader Be A Man facilitators manual 20 radio talk-shows conducted MMC messages integrated in Q2 Q3

25 Afford/UHMG 4 Tent Model Continue to support Signal FM to conduct safe circumcision campaigns in Bugisu region the Afford/UHMG 4 tent model 6 call-in radio programmes and 6 recorded programmes broadcast on Signal FM IR2: Supportive social environments fostered to enable positive health behaviour HCP will work with the Linkages project, MUSPH, and other partners to disseminate messages to the parliamentary committee and other leaders on MC and HIV/AIDS prevention so as to encourage and influence a national policy on MMC. HCP will identify reputable spokespeople for MC from the public and the media and train them to speak knowledgeably about MMC and HIV prevention. Work with Linkages Project to disseminate messages and materials to parliamentarians to advocate for a national policy on MMC for HIV prevention Identify, train and provide MMC facts to champions from the media Identify and brief reputable spokespersons from the public in order to place MMC issues on the parliamentary agenda Feature MMC issues in weekly columns in English and local language newspapers to respond to questions from circumcised and uncircumcised men Create linkages with programmes focused on HIV/AIDS prevention / HCT to provide facts on MMC for HIV prevention and expand information reach Conduct seminars for local leaders in Bugisu region on safe male circumcision Key information on MMC delivered to the Parliamentary Committee on HIV/AIDS, based on participatory sessions with key members of the committee 1-day trainings for 30 health editors from various media houses on MMC for HIV prevention Reputable spokespeople identified and briefed 12 weekly columns in English and local languages answering questions on MMC for HIV prevention Organisations focused on HIV prevention / HCT identified and briefed about MMC 10 seminars conducted for 1,000 local leaders in Bugisu on safe male circumcision Q3 Q2 Q3 Q2 Q3 IR 3: Increased capacity for sustained health communication HCP will draw capacity assessment plans and provide support for MUSPH and other health communicators to perform strategic communication functions and effectively disseminate accurate information about MMC for HIV prevention. HCP will support MUSPH to finalise the communication strategy for MMC for HIV prevention in Uganda and orient the MC Task Force, as well as District Health Educators (DHEs), and religious leaders to the communication strategy so that they can ably discuss MMC for HIV prevention. HCP will incorporate details of MMC for HIV prevention in the village health teams (VHT) training manual and in the distance learning radio series for health workers besides conducting media relations trainings for health workers, religious leaders, and communicators. In addition, HCP will support MUSPH to establish a resource centre and become a Page 25 of 59