HEALTH COMMUNICATION PARTNERSHIP - UGANDA - WORKPLAN. October 1, 2011 June 30, 2012

Transcription

1 HEALTH COMMUNICATION PARTNERSHIP - UGANDA - WORKPLAN October 1, 2011 June 30, 2012 USAID/JHU Associate Cooperative Agreement No. 617-A Health Communication Partnership Plot 15 Binayomba Avenue P.O. Box 3495 Kampala, Uganda Tel: Fax:

2 TABLE OF CONTENTS LIST OF ACRONYMS... 3 EXECUTIVE SUMMARY... 6 A. SUSTAINABILITY OF HCP INITIATIVES... 9 B. INTEGRATED COMMUNICATION C. FAMILY PLANNING COMMUNICATION D. HIV/AIDS PROGRAMS HIV Counseling and Testing (HCT) Adult Care, Treatment and Adherence Support Safe Male Circumcision (SMC) Young Empowered and Healthy (Y.E.A.H.) E. CAPACITY STRENGTHENING Staff and partners capacity building HCP media relations initiative Mentoring program for young professionals (GOLD) F. RESEARCH, MONITORING AND EVALUATION (RM&E) G. DOCUMENTATION AND DISSEMINATION

3 LIST OF ACRONYMS 4Rs Runyoro, Runyankole, Rukiiga and Rutoro languages AA Associate Award ABC Abstinence, Be faithful, Condom use HIV prevention strategy ACP AIDS Control Programme AfriComNet African Network for Strategic Communication in Health and Development AIC AIDS Information Centre AIDS Acquired Immune Deficiency Syndrome ART Antiretroviral Therapy ARV Antiretroviral BBB Bringing Being into Business BCC Behaviour Change Communication CB Capacity Building CBO Community-Based Organisation CCP Center for Communication Programs CD4 Cluster of Differentiation 4 CDC Centers for Disease Control CDFU Communication for Development Foundation Uganda CHCT Couples HIV Counselling and Testing CM Community Mobilisation COP Chief of Party CORPS Community owned resource persons CRS Catholic Relief Services CSA Community Support Agents CT17 National HCT Coordinating Committee DCC District Coordinating Committee DCOP Deputy Chief of Party DHE District Health Educator DHO District Health Officer DHT District Health Team DSW German Foundation for World Population FAQ Frequently Asked Question FBO Faith-Based Organisation FHI Family Health International FOCAGIFO Friends of Canon Gideon Foundation FP Family Planning FPRWG Family Planning Revitalisation Working Group FY Fiscal Year GBV Gender Based Violence GEM Gender-Equitable Men HASAC HIV AIDS Stigma Advisory Committee HCP Health Communication Partnership HCT HIV Counselling and Testing HIPS Health Initiative for the Private Sector HPED Health Promotion and Education ICW International Community of Women IEC Information, Education and Communication ILO International Labour Organisation IPC Interpersonal Communication 3

4 IPRS IR IRB IRCU ITN JCRC JHU K4H M&E MARCH MARPS MC MFD MIHV MMC MOH MOU MSU MRI MUSPH MUWRP NACWOLA NAFOPHANU NGO NHC NUMAT OI PACE PEPFAR PIASCY PLHA PLHIV PMP PO POL PS RDL RHU RLO RM&E RCQHC SBCC SMC SMD SMS SPEARS SPH STAR-E STAR-EC STF STI Implementing Partner Reporting System Intermediate Result International Research Board Inter Religious Council of Uganda Insecticide-treated bed net Joint Clinical Research Centre Johns Hopkins University Knowledge for Health Monitoring and Evaluation Modelling and Reinforcement to Combat HIV/AIDS Most-at-Risk Populations Male Circumcision Media for Development International Minnesota International Health Volunteers Medical Male Circumcision Ministry of Health Memorandum of Understanding Marie Stopes Uganda Media Relations Initiative Makerere University School of Public Health Makerere University Walter Reed Project National Community of Women Living with HIV/AIDS National Forum of People Living with HIV/AIDS Networks in Uganda Non-Government Organization National HIV Counselling and Testing Committee Northern Uganda Malaria, AIDS and TB Project Opportunistic Infection Programme for Accessible Health, Communication, and Education US President s Emergency Plan for AIDS Relief Presidential Initiative on AIDS Strategy for Communication to Youth People Living with HIV/AIDS People Living with HIV Performance Monitoring Plan Programme Officer Popular Opinion Leader Population Secretariat Radio Distance Learning Reproductive Health Uganda Regional Lead Organisation Research, Monitoring and Evaluation Regional Centre for Quality Health Care Social and Behavioural Communication Change Safe Male Circumcision Safe Motherhood Day Short Message Service Supporting Public Sector Workplaces to Expand Action and Responses against HIV/AIDS School of Public Health Strengthening AIDS and TB Response in Eastern Uganda Strengthening AIDS and TB Response in East-Central Uganda Straight Talk Foundation Sexually Transmitted Infection 4

5 TASO TAT TB TOT UAC UCA UDHS UGANET UHCA UHMG UNASO UNFPA UPHOLD URCS USAID VAW VHT WHO YAG Y.E.A.H. YP ZEHRP The AIDS Support Organisation Technical Advisory Team Tuberculosis Training of Trainers Uganda AIDS Commission Uganda Counselors Association Uganda Demographic Health Survey Uganda Network on Law, Ethics and HIV/AIDS Uganda Health Communication Alliance Uganda Health Marketing Group Uganda Network of AIDS Service Organisations United Nations Population Fund Uganda Programme for Human and Holistic Development Uganda Red Cross Society United States Agency for International Development Violence Against Women Village Health Team World Health Organization Young People s Advisory Group Young Empowered and Healthy Young Professionals Zambia-Emory HIV Research Project 5

6 EXECUTIVE SUMMARY 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 with the United States Agency for International Development (USAID) in order to consolidate and strengthen health communication activities in Uganda. In 2009, the award was extended for an additional two years until June 30, The following document details the planned activities; capacity-building mechanisms; research, monitoring and evaluation measures; management; and technical assistance activities for the final nine months of the award (1 October, June, 2012). Under the Associate Award, the Health Communication Partnership (HCP) will continue to provide technical assistance, implement communication strategies and approaches, and strengthen capacity for strategic communication. From 1 October 2011 through 30 June 2011, HCP will continue to contribute to 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. In order to work towards the shared goals of preventing and reducing mortality and morbidity and promoting health and improved quality of life, HCP will work hand-in-hand with the Government of Uganda and USAID Uganda to provide strategic and evidence based communication support in the areas of family planning, HIV/AIDS, and young people s sexual and reproductive health. Sustainability, Documentation and Dissemination As this is the last nine months of the HCP Project in Uganda, the project will focus on completing work in progress, documenting and disseminating effective and promising tools and strategies, and ensuring that effective initiatives continue beyond the end of HCP. There will be deliberate efforts to ensure that the following four key initiatives continue to be implemented by partners beyond 2012: Y.E.A.H (Rock point 256) The National Health Hotline The Radio Distance Learning Program The G.O.L.D program. The workplan outlines plans for this. The project will also develop a website that will be published on DVD, containing all materials developed over the five year project. This will be accompanied by a catalogue of outputs, and how to videos on selected initiatives. These materials will be disseminated to implementing partners and government bodies during a hand over event during the last quarter of the project. Monitoring and Evaluation 6

7 HCP will conduct a final evaluation household survey in December, 2011, which will be disseminated during an end of project meeting in June. This survey will be comparable with the 2010 survey, and a comparative analysis published. Integrated Communication The project will focus on integrating communication issues in common media. The Nurse Mildred radio drama series will integrate HIV issues, and rather than producing separate radio talk shows about different health issues, HCP will produce Everyday Health Matters, an integrated health call-in talk show, which will run for two quarters. In addition, Y.E.A.H. will continue to integrate SMC, PMTCT, FP, violence against women, and HIV prevention in its programming; and the positive living campaign for PLHIV will continue to integrate information about nutrition, malaria prevention, water and sanitation, Cotrimoxazole prophylaxis, family planning, PMTCT, and prevention of re-infection and transmission. Other integrated communication that will continue during this fiscal year are the VHT radio distance learning programme, and the national health hotline. Family Planning HCP will continue assisting the MOH to implement and expand the Nurse Mildred campaign, focusing on providing accurate family planning information for rural men and women with unmet need. Couple HIV Counseling and Testing HCP will also continue to support the MOH and USG implementing partners to expand the Go together, know together couple counseling and testing campaign to 70 districts. Positive Living HCP will continue supporting the national positive living campaign for PLHIV in collaboration with PACE, the MOH, and USG implementing partners. The campaign aims at encouraging PLHIV to adopt healthy practices to maintain their health and delay their need for ARVs. Safe Male Circumcision At the end of FY 2011, HCP had assisted the MOH to complete the development of a national demand creation campaign, which will be launched through USG implementing partners and through national media early during quarter one of FY Young Empowered and Healthy The main focus of Y.E.A.H. during FY 2012 will be to continue the True Manhood violence against women campaign launched in late September, 2011, and mobilizing resources to continue its work beyond the end of March, 2012, when HCP funding will end. 7

8 Capacity Strengthening HCP will continue training media representatives to improve the quality of reporting on health issues, and will hand over training modules to the Uganda Health Communication Alliance. HCP will also continue supporting the GOLD internship programme for new graduates from Ugandan universities and colleges. 8

9 BACKGROUND Health Communication Partnership (HCP) is a five-year Associate Award (AA) managed by the Johns Hopkins University Bloomberg School of Public Health Center for Communication Programs (CCP), with support from 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. 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, HCP 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 IR 2: Supportive social environments fostered to enable positive health behaviour IR 3: Increased capacity for sustained health communication This work plan presents the activities that HCP will support during the period between 1 October 2011 and 30 June It was developed through a consultative process that involved the Ugandan government and non-government partners, and US government Implementing Partners. The total amount of US$ 2,469,066 is proposed for communication support in the following programmatic areas: Programmatic Area Budget Family Planning 440,450 HIV counselling and testing 294,300 HIV/AIDS care and treatment for adults 413,905 Male circumcision and HIV 390,411 HIV prevention through abstinence and faithfulness 500,000 HIV prevention through other prevention beyond abstinence and faithfulness 430,000 This document presents planned activities for each of these programme areas as well as integrated communication, capacity strengthening, documentation and sustainability, and monitoring and evaluation activities. As HCP enters its final nine months of implementation, its focus will be on finishing the work it has begun, evaluating the effects of its efforts, documenting and disseminating lessons learned and communication tools, and ensuring the continuation of effective communication interventions. A. Sustainability of HCP initiatives Introduction Since funding for the Health Communication partnership (HCP) project ends in June 2012, HCP is keen to ensure that initiatives that have proved useful continue to be implemented so that Ugandans continue to enjoy the benefits of these programs past the life of the project. During this 9

10 workplan period, there will be deliberate efforts to ensure that the following four key initiatives continue to be implemented by partners beyond 2012: Y.E.A.H (Rock point 256) The National Health Hotline The Radio Distance Learning Program The G.O.L.D program The key strategies for ensuring sustainability of these initiatives include identifying lead partners and resource mobilization. Evidence of the impact of these initiatives will be documented and shared with potential donors/partners. Efforts to ensure sustainability of these initiatives already began during the previous workplan year. Strategies for the four key initiatives Y.E.A.H. The Young Empowered and Healthy (Y.E.A.H.) is an initiative by and for year olds aimed at reducing HIV, early pregnancy and school drops. YEAH produces a radio serial drama and comic books entitled Rock Point 256, the centrepiece of sequential multi channel campaigns focused on underlying factors that affect young people s risk of HIV. Y.E.A.H. has been implemented by Communication for Development Foundation with support from HCP since There has been documented evidence of the impact of Y.E.A.H., with Rock Point 256 having a listenership of approximately 7 million young people. The biggest challenge faced by this initiative is the single donor support. To ensure sustainability of Y.E.A.H., our main strategy is to mobilize resources through fundraising and partnerships. It will also be important to strengthen the Y.E.A.H. brand through partnerships in the private sector and collaborations with other youth-focused and HIV-prevention initiatives. For more details, see the Y.E.A.H. section of the workplan. The National Health Hotline The national health hotline is a service that provides counselling and information to the general public through a telephone service about male circumcision, alcohol use/abuse, violence against women, HIV prevention, family planning, malaria, and HIV treatment. The hotline uses modern technology to allow a large numbers of calls to be handled at the same time. The broad thematic areas ensure that callers can receive counselling and have their questions answered on a variety of issues. Currently the hotline offers both toll-free and paid for services. Limited hours of operation and visibility of the hotline especially among partners are some of the challenges currently faced by the hotline. Currently, the hotline has secured commitments from a number of partner organizations to support some of its operational costs, and the paid phone line has reduced on its costs. But, there is still a need to cover approximately US$ 50,000 of institutional costs, if the hotline is to continue for another year beyond the end of HCP support in March, In the last workplan period, the main focus will be on increasing partnerships and resource mobilisation. This will include positioning the hotline as an expert centre for telephone counselling in Uganda based on evidence of the impact of the hotline. Strategic partnerships with the private sector will contribute to reduction in operating costs and increase visibility of the hotline. The hotline will also invest in new technologies such as social networking and SMS platforms to increase its reach. 10

11 VHT Radio Distance Learning Program The Ministry of Health is implementing the Village Health Team (VHT) strategy to ensure that every village in Uganda has village health team members who work together to mobilize individuals and households for better health. VHT members are community volunteers who are selected by communities to provide accurate health information and proper linkage to health services. As part of the process of implementing this strategy, the Ministry worked with HCP and other partners to produce a distance learning radio program for VHTs. This program was launched in the districts of Lira and Mukono where over 4,000 enrolled into the program. The program works with and supplements current VHT training efforts by providing continuing education, refresher training and transfer of knowledge and skills to VHTs on a regular basis and in a cost effective way. During the last workplan year, HCP will continue to implement the RDL program in the districts of Mpigi, Wakiso, Masaka and Rakai where it is expected that over 7,000 VHTs will be enrolled into the program, and will conduct a final evaluation of its pilot program in Mukono. The biggest challenge to implementation of the radio distance learning program is the weak district coordination system for VHTs. While several partners have expressed interest in the program and are implementing it, and the MOH is involved in its development and roll out to districts, there is currently no local lead partner to assist the MOH in administering the programme and producing new material. Therefore, most efforts will concentrate on identifying a lead partner organisation and building the capacity of this player to keep the programme running beyond HCP. This will involve sharing of information of strategic plans and proposals and dissemination of the evidence based impact of the program. G.O.L.D Program HCP established an internship program for new graduates from universities and colleagues in Uganda, where interns are recruited and placed in companies and organisations for one year internships. GOLD offers monthly seminars for interns, and monitors supervisors and mentors for the interns. Eighty-two young professionals have graduated from the programme since it started. To increase the number of young professionals who can continue to benefit from this program, the biggest focus will be on resource mobilisation and identifying a lead partner to continue implementing the program. Consideration will also be given to charging a minimal fee for the young professionals to increase the pool of resources for the program. Sustainability of other HCP Initiatives In addition to these four initiatives, HCP will also focus on increasing partner buy into individual HIV/AIDs and reproductive health initiatives. This will ensure that these initiatives are integrated into partner activities and as a result have a home beyond Planned strategies include development of campaign tool kits, and a website with DVD and how to videos to guide partners interested in further roll out of these activities. (Details are under individual program sections and the documentation section). 11

12 B. Integrated Communication Introduction Over the years HCP has provided technical assistance to the Ministry of Health and partner organisations to design, implement and evaluate strategic health communication programs targeting couples and adults of reproductive health age, young people, PLHIV, VHTs, journalists, health workers, faith based and community leaders. During this workplan period, HCP will scale up integrated communication interventions across the above audiences by building synergies between programs that target the same audiences. For couples of reproductive age (25 49 years), HCP will develop and disseminate communication that focuses on HIV prevention through combination prevention (partner reduction, condom use, PMTCT, CHCT, SMC) as well as family planning and paediatric HIV. For young people years old, HCP will integrate messaging about combination prevention (abstinence, partner reduction, condom use, SMC, HCT, PMTCT), male gender norms, HIV/AIDS stigma reduction, violence against women and alcohol abuse. Description of proposed activities Couples and adults of reproductive health age HCP will work with implementing partners to develop an integrated message plan for couples and adults of reproductive age. This plan will focus on combination HIV prevention: partner reduction, condom use, CHCT, SMC, family planning, stigma reduction, paediatric HIV, and HIV care and treatment, gender based violence, and alcohol abuse. Based on the message plan, HCP will work with USAID implementing partners to produce and broadcast an interactive weekly radio and television health show, Everyday Health Matters, which will broadcast for one hour on 10 radio stations and one national television station over a six month period. The programme will include pre-recorded segments, live broadcasts and live call-in with a health expert. The show will be linked to the telephone hotline and SMS platform (See Hotline workplan). HCP will continue producing and broadcasting the radio drama and call-in Nurse Mildred Show, currently focusing on family planning but will integrate HIV prevention, treatment, care and support as well as family planning. The series will broadcast weekly half hour episodes in four languages from October through March, HCP will provide technical support to IRCU to develop the organisation s integrated HIV/AIDS communication strategy for couples and adults of reproductive health age and will include HIV combination prevention, treatment, care and support, family planning, gender based violence, and alcohol abuse as well as advocacy among faith based leaders in Uganda. Planned Activities Activity Target/milestones Timeline Develop an integrated message plan for couples and adults on drivers of the epidemic, care and treatment, and family planning. Design workshop for integrated message plan conducted. Integrated HIV/AIDS communication plan for couples and adults. 12

13 Planned Activities Activity Target/milestones Timeline Produce and broadcast 26 Everyday Health Matters radio programmes for couples and adults. 26 weekly broadcasts of Everyday Health Matters radio programme broadcast on 10 radio stations and -Q2 one national TV station Produce 13 new episodes of Nurse Mildred Show drama on FP, CHCT, SMC, and positive living. Provide technical support to IRCU to develop a couples and adult integrated communication strategy on HIV/AIDS. 13 new episodes of Nurse Mildred Show produced and broadcast Integrated communication strategy developed with IRCU. -Q2 Q2 Integrated communication for young people HCP will continue integrating communication about youth sexual reproductive health; HIV/AIDS prevention, PMTCT, male gender norms, SMC, HIV/AIDS stigma reduction, family planning, violence against women and alcohol abuse under the Y.E.A.H initiative. For a detailed description of planned activities, please see the Y.E.A.H section of the workplan. Communication for PLHIV HCP will continue working with implementing partners to communicate with PLHIV about positive living practices including nutrition, malaria prevention, control of diarrheal diseases, TB screening and treatment, disclosure of status and psycho-social support, prevention of HIV transmission and re-infection, PMTCT and paediatric HIV, family planning, reduction of alcohol intake and Septrin prophylaxis. HCP will continue to broadcast radio diaries for PLHIV and other positive living messages on 12 radio stations country-wide and will disseminate print and other audio materials on positive living to community leaders, VHTs, media representatives and religious leaders. For a detailed description of planned activities, please see the adult ART section of the workplan. Radio distance learning program for VHTs During the last fiscal year, HCP provided technical support to MOH to design and produce a radio distance learning program for VHTs in Uganda which was broadcast in selected districts of Mukono, Lira, Mpigi and Wakiso. During the 2012 workplan period, HCP will work with STAR-SW to translate the existing 13 sessions into Runyakitara, conduct sub-county launches and broadcast the program in Western and will work with STAR EC to introduce the program in Eastern Uganda. HCP will identify a lead partner who will provide technical assistance to MOH in producing additional episodes of the program after the HCP project ends, and will provide technical support to World Vision and UNICEF which are interested in producing the second set of the sessions on child health, maternal health, diarrhoea, nutrition, sanitation and malaria. HCP will complete its evaluation of the program in Mukono and will disseminate findings to partners through the VHT stakeholders forum. HCP will also finalize a short video on the implementation of the program to advocate among partners to support the program and to guide partners during implementation. 13

14 Activities Activity Target/milestones Timeline Work with STAR-SW to translate CDs of translated episodes in episodes 1-13 in Runyakitara. Conduct sub-county launches with STAR-SW & STAR-EC. Broadcast the program on Radio West. Identify lead partner to continue providing technical assistance to MOH after HCP. Provide technical support to World Vision and UNICEF to produce episodes Finalize evaluation of the RDL program in Mukono. Disseminate RDL evaluation findings. Finalize short video demonstrating the implementation of the RDL program. Runyakitara.5,000 VHTs enrolled on the program Program broadcast in western and southwestern Uganda. Lead partner organisation identified. World Vision & UNICEF start producing episodes of the program. Evaluation exercise finalised for RDL program. Dissemination meeting for RDL held. Video developed on RDL implementation. Q2 Q2-Q3 -Q2 Q2 Q2-Q3 Q2 Telephone counselling, information and referral through the hotline HCP will continue providing technical assistance to CDFU and partners to manage the national health hotline, which provides telephone counselling, information and referral on HIV prevention, SMC, CHCT, adult and paediatric ART, family planning, maternal health, gender based violence, alcohol abuse and malaria. HCP will support CDFU to implement the 5 year hotline strategic plan focusing on resource mobilization and quality of services; support quarterly hotline technical advisory team meetings under the auspices of the Ministry of Health; follow-up with partners interested in providing financial support to the hotline; and write proposals to fund the hotline after the HCP project closes. Through CDFU, HCP will provide regular training and mentoring to hotline counsellors, train counsellor supervisors in counsellor supervision, organise stress management and a retreat for counsellors, and conduct mapping for referral organisations to strengthen the hotline referral system. HCP will conduct an evaluation of hotline callers to determine the efficacy of hotline service on beneficiary s health, and will partner with CDFU, PACE, UHMG and STRIDES who are currently supporting the hotline, to introduce a SMS service that gives clients more options for accessing information and referrals for services while decongesting telephone traffic. 14

15 Planned Activities Activity Target/milestones Timeline Support quarterly hotline advisory 3 hotline advisory meetings held at MOH. -Q3 meetings with MOH. Follow-up with partners interested in providing financial support to the hotline. Write proposals to secure additional funding for the hotline. Provide regular training and mentoring to hotline counsellors. Train supervisors in counsellor supervision. Organise stress management activities & retreats for counsellors. Conduct mapping of hotline referral organisations. Evaluate health effects of hotline. Set up an SMS platform at the hotline. Meetings and MoUs signed with at least 3 partners. Two proposals submitted every quarter. Weekly mentoring and training sessions for counsellors. 4 supervisors trained in supervision. 2 counsellor retreats held. 3 organisations visited per quarter and included in referral data base. Hotline evaluation conducted among beneficiaries. SMS platform established at the hotline. -Q2 -Q2 -Q3 Q2 Q3 -Q3 Q2 Other integrated communication areas HCP will also build synergies across several areas such as pre-testing and production of integrated messages, materials dissemination, field support supervision as well as training and orientation of partners in key integrated messages and tools. In addition to the e-learning courses on FP, HCP will acquire CDs of e-learning modules from Knowledge for Health (K4H) on HIV/AIDS, SMC and reproductive health and will promote them among staff and implementing partners. Planned Activities Activity Target/milestones Timeline Conduct integrated materials distribution. Integrated materials distributed. Conduct integrated field support supervision. Orient partners in integrated tools/materials. 2 support supervision visits held. Partners oriented in integrated tools. Q2-Q3 Q2-Q3 15

16 C. Family Planning Communication Output Indicators and Targets Indicator Target Number of individuals reached with HCP-supported media messages 2,156,948 on family planning practices and services 1.2. Number of Institutions that receive HCP supported IEC materials Number of leaders, service providers, community health workers, and 500 CORP who receive HCP-supported IEC materials on family planning practices and services 2.2. Number of stake holder representatives oriented on new health 40 policies or strategies 3.1. Number of health facilities that receive HCP supported IEC materials 200 Background Uganda has the third fastest growing population in the world, with a population growth rate of 3.2% and total fertility rate of 6.7 children per woman. The rapid growth of the population has serious implications for Uganda s social and economic development and national aspiration to evolve as a middle income economy over the next 25 years. Yet, only 24% of married women currently use modern family planning methods 1. Consequently, 41 percent of married women in Uganda have an unmet need for family planning, and this percentage has been increasing since Almost one half of all births between 1995 and 2001 were unplanned; and a 2003 study estimated that one in five pregnancies in Uganda end in abortion. 2 Based on statistical models, modest declines in unmet need and increases in contraceptive prevalence in Uganda can substantially reduce the country s total fertility rate 3, and population growth rate. Between 1 October 2011 and 30 June 2012, HCP will continue to assist the MOH and its reproductive health partners to implement the Nurse Mildred family planning campaign, designed to address unmet need, with a particular emphasis on reaching rural women and their husbands/partners with correct information about modern family planning. The Nurse Mildred campaign combines radio, print, and interpersonal communication to convince couples to talk with health workers about family planning, and to speak with one another about their reproductive plans, and to ultimately adopt and maintain the use of modern family planning methods. Description of proposed activities Mass Media HCP will produce phase II of the Nurse Mildred radio drama series aimed at correcting misconceptions about modern FP methods, modelling favourable attitudes toward modern family planning, and directing men and women to health workers for family planning information and services. As described under the integrated communication section of the workplan, the second Uganda Demographic and Health Survey (UDHS), Uganda Bureau of Statistics 2 Further Analysis of the Uganda Demographic Health Surveys, (Khan et al.,2008) 3 Op cit. 16

17 phase of programming will include six episodes on family planning, as well as two on HIV care and treatment, two on CHCT, and three on SMC. Between October and December, HCP will continue broadcasting the first phase episodes on family planning while it scripts and produces 13 new episodes. The new episodes will begin broadcasts in January and will end at end of March, In addition, HCP will continue broadcasting the Nurse Mildred family planning radio spots. To implement these activities, HCP will work with Scanad Uganda, scriptwriters and audio studios. Illustrative Activities Activity Targets/Milestones Timeline Broadcast phase one Nurse Mildred 13 episode of Nurse Mildred radio drama episodes broadcast in 4 languages on 10 Design and produce phase II of the Nurse Mildred radio series focusing on FP and HIV Broadcast phase II Nurse Mildred radio drama episodes stations 6 phase II Nurse Mildred radio drama episodes on FP produced 6 new episodes on FP broadcast on Q2 10 radio stations. Broadcast Nurse Mildred radio spots FP radio spots broadcast - Q2 Materials Production and Distribution HCP will reproduce and distribute IEC materials to be used during community outreach sessions with men and women. HCP will also distribute Family Planning Global Handbooks for service providers produced by the Johns Hopkins University to health workers and health facilities through the MOH, STRIDES, PACE, Reproductive Health Uganda (RHU) and Marie Stopes Uganda (MSU). Illustrative Activities Activity Targets/Milestones Timeline Reproduce family planning booklets and Everday Health Matters and FP - Q2 Everyday Health Matters newsletters booklets reproduced Distribute IEC materials to be used during Materials distributed to 500 leaders - Q2 outreach sessions with men and women and community resources persons Distribute FP Global Handbooks and Wall Charts to health workers and health facilities Handbooks and wall charts distributed to 200 health facilities - Q2 Orientation and Training In order to improve and increase media reporting on family planning issues, HCP will orient and train media representatives, providing them with basic knowledge about population and development and family planning. Religious leaders and hotline counsellors will also be trained on family planning, population, and development. Specifically, HCP will work with the Uganda Health Communication Alliance (UHCA), the Interreligious Council of Uganda (IRCU), MOH, Marie Stopes Uganda (MSU), STRIDES and Reproductive Health Uganda (RHU) to orient leaders on the use of family planning materials developed by HCP. 17

18 Illustrative Activities Activity Targets/Milestones Timeline Orient and train media representatives & faith 500 media representatives and - Q2 based leaders on FP and population issues faith based leaders oriented and Orient and train hotline counsellors in FP and population issues trained 15 Hotline Counsellors oriented and trained - Q2 Partner Support HCP will support two meetings of the Ministry of Health and Family Planning Working Group (FPWG) IEC subgroup. HCP will also contribute to celebrations of Safe Motherhood day and use this as an opportunity to promote family planning. To implement these activities, HCP will collaborate with UNFPA, WHO and FHI 360. Illustrative Activities Activity Targets/Milestones Timeline Support the FPWG Information, Education and 2 FPWG IEC meetings held - Q2 Communication (IEC) Subgroup meetings Contribute to Safe Motherhood Day celebrations on 17 th October 2011 Family planning highlighted during Safe Motherhood Day Implementation Arrangements HCP Deputy Chief of Party for family planning and capacity building will directly oversee the family planning communication activities in this workplan. She will work closely with the MOH Reproductive Health Division, with technical input from the FPWG, and will be assisted in her work by a Program Officer based at the HCP office. Media for Development International (MFDI) will provide technical assistance in the development of phase II scripts for the Nurse Mildred radio drama series. 18

19 D. HIV/AIDS PROGRAMS HIV Counseling and Testing (HCT) Output Indicators and Targets Indicator Target 1.1 Number of individuals reached through radio with HCP supported 2,084,112 messages 1.2 Number of institutions that receive HCP supported IEC materials Number of leaders, media workers, and community resource 250 persons who receive HCP supported IEC materials. 3.1 Number of health facilities that receive HCP supported IEC 150 materials Background According to the 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey, most new HIV infections are among married and co-habiting couples. Married persons account for an estimated 65% of new infections; and discordant couples may comprise up to 50% of these transmissions. Overall, 6.3% of Ugandan men and women age who currently in union are HIV positive, compared to 1.6% of those never in union 4. Discordant couples constitute 5% of the total couples tested in Uganda, with 3% of male infected and 2% females. Less than 13% of currently married women and men have ever tested for HIV and received their results. Some 90% of married women and 89% of married men do not know the HIV status of any of their partners or spouses. In response to this situation, HCP assisted the MOH and its counseling and testing partners to design and implement the Go together, Know together couple HIV counseling and testing campaign, which has been ongoing since The December 2010 HCP Survey found that the campaign has reached a large proportion of couples in Uganda, and that those exposed to the campaign were more likely to test for HIV, disclose their status to their partners, and to know where couple testing and counseling is available. During the 2011/2012 fiscal year, HCP will continue to provide technical support to the Ministry of Health (ACP) to coordinate the Go together, Know together communication campaign targeting married and cohabiting couples and linked to testing weeks. The campaign will focus on addressing discordance and promoting men s participation in couple counseling and testing. Community mobilisation and interpersonal communication will continue to take centre stage. Description of proposed activities National Go Together, Know Together Couple HIV Counselling and Testing Campaign Campaign Expansion Uganda HIV/AIDS Sero-Behavioural Survey 19

20 HCP will continue to provide central level support to ACP, the National HCT Coordinating Committee (CT17), and AIDS Information Centre (AIC) to implement the multi-channel Go Together, Know Together campaign. HCP will support AIC to implement the campaign in the 8 original districts (Kampala, Mbarara, Kabale, Jinja, Mbale, Lira, Soroti, Arua). In addition, STAR EC and STAR E will roll out the campaign in Eastern Uganda; NUMAT and MJAP in the North, West Nile and part of central region; while STAR SW will roll out the campaign in Southwestern Uganda. To support partners to implement the campaign, HCP will finalize and distribute a Go Together, Know Together Implementation Toolkit. The toolkit will include electronic versions of billboards, posters, client education materials, service provider materials, signage for branding the service delivery points, radio spots, guidelines for establishing discordant couple clubs and the guidelines for community mobilization and interpersonal communication activities. Planned Activities Activity Targets/Milestones Timeline Continue Supporting STAR E, EC, SW, MJAP, NUMAT and AIC to implement the campaign in 70 districts. Six partners using campaign materials, training service providers in CHCT, conducting community -Q2 mobilization, and organizing ouples clubs Finalise and disseminate the guidelines for establishing discordant couple clubs Produce and disseminate the campaign implementation toolkit to partners Guidelines for setting up discordant couple clubs disseminated to partners Six partners oriented on the campaign implementation toolkit -Q2 Materials development HCP will develop a wall chart and frequently asked questions booklet for counsellors to enhance their capacity to address issues on discordance. HCP will also reproduce existing campaign materials to share with partners. To ensure continued visibility of services, HCP will reprint the couple HCT signage and encourage partners to brand health facilities and place road stars. All materials will bear the hotline number to enable the public access further information from qualified counselors. Frequently asked questions from the hotline will be incorporated in the FAQ booklets. Planned Activities Activity Targets/Milestones Timeline Reproduce existing campaign materials as requested by partners. (Counsellor flip chart, couple certificates, fact sheet for leaders, couple brochures, video testimonials, posters and CHCT signage). 2,000 counsellor flipcharts produced 120,000 couple certificates produced in 7 languages 200,000 brochures produced 2,000 video testimonials produced 70,000 posters produced -Q2 20

21 Planned Activities Activity Targets/Milestones Timeline 500 CHCT sign boards produced Materials use monitored during support supervision visits Design and produce an integrated wall chart on discordance Integrate FP, SMC, ART messages into the CHCT Flip chart Produce a frequently asked question and answer booklet on discordance 2,000 wall charts produced FP, SMC, ART messages integrated into the CHCT Flip Chart. 5,000 copies frequently asked question booklets produced -Q2 Q2 -Q2 Interpersonal/community mobilisation HCP will continue to support AIC to conduct community drama, couple dialogue sessions, video shows in video halls and using video testimonials to motivate couples to access services. HCP will support activities in the 8 original districts supported by AIC, but not in the 3 districts supported by UNFPA. Planned Activities Activity Targets/Milestones Timeline Continue Supporting AIC to conduct community drama, couple dialogue sessions, video shows in video halls, and using video testimonials 104 community drama and video shows conducted in 8 districts -Q2 Mass media We will continue to broadcast radio talk shows and spots on nine (9) FM stations and TV messages on two (2) national televisions (NTV & Bukedde TV) and support the production and broadcast of the Every Day Health Matters radio programs. Partners will take the lead and run these tasks in their respective districts. Two episodes of the Nurse Mildred drama series focused on CHCT will be produced an broadcast. Planned Activities Activity Targets/Milestones Timeline Continue broadcasting radio spot messages 3,909 radio spots aired on 9 radio -Q2 stations Support Everyday Health Matters radio programmes Everyday Health Matters radio programmes featuring CHCT, discordance, and male participation messages broadcast on 9 radio station Q2 21

22 Planned Activities Activity Targets/Milestones Timeline Continue broadcasting TV spots on NTV and Bukedde TV stations Support production of 2 episodes of the Nurse Mildred drama series on CHCT 132 TV spots aired on 2 national TV stations 2 episodes of the Nurse Mildred drama series on CHCT produced and broadcast Q2 Gaining national support for couple HCT HCP will support MOH to disseminate the national HCT policy to district based partners. HCP will continue to support the working committees and national coordination committee (CT17) to coordinate HCT activities in the country. HCP will further support MOH to convene a PEPFAR partners meeting to ensure that USG implementing partners expand the availability of CHCT services and promote its uptake in the districts where they work. Planned Activities Activity Targets/Milestones Timeline Continue supporting working committees and 2 national subcommittee meetings -Q2 National Coordination Committee (CT17) held Support MOH to convene a PEPFAR partners meeting PEPFAR partners oriented to CHCT and Go together, Know together campaign -Q2 Support MOH to disseminate the HCT policy to district based partners Support World AIDS Day cerebrations HCT policy disseminated to all district based partners World AIDS Day celebration promotes CHCT -Q2 Campaign monitoring and quality assurance HCP will continue to work with MOH and AIC to conduct regular support supervision in all the campaign implementing districts to monitor campaign activities and the uptake of services. Planned Activities Activity Targets/Milestones Timeline Conduct regular support supervision in the 2 Quarterly support supervision -Q3 campaign implementing districts visits conducted Implementation Arrangements One full time Program Officer will be responsible for coordinating HCP s input to the Go together, Know together CHCT Campaign in collaboration with USG implementing partners and the MOH. HCP does not anticipate the need for any STTA from Baltimore or the region. 22

23 Adult Care, Treatment and Adherence Support Output indicators and targets Indicator Target 1.1 Number of individuals reached through radio with HCP supported 1,423,829 messages 1.2 Number of institutions that receive HCP supported IEC materials on 50 HIV/AIDS care and treatment 2.1 Number of leaders, media workers, community resource persons who 200 receive adult HIV care and treatment IEC materials 2.2 Number of health facilities that receive HCP supported IEC materials 100 Background Currently in Uganda there are 1.2 million people infected with HIV. With 132,500 new HIV infections occurring in Uganda every year, the government is struggling to meet the demand for ARVs among those eligible to start treatment. Only 180,000 are currently on treatment that covers only 50% of those eligible. To address this issue, the Ministry of Health (MoH) is focusing on lowcost interventions that keep people living with HIV (PLHIVs) healthy longer, delaying their need for antiretroviral therapy (ART). Over the past year, HCP has been assisting MoH and its partners to design and conduct a positive living campaign that promotes adoption of healthy practices among PLHIVs that will reduce transmission and re-infection, opportunistic infections and the progression of HIV to AIDS. The positive living campaign, which was launched in August, 2011, promotes the following practices among PHIVs: Using condoms to avoid transmission and re-infection Appropriate nutrition Adopting family planning and preventing mother to child transmission Taking daily Cotrimoxazole prophylaxis Sleeping under LLINs to prevent malaria Using clean water and hand washing to prevent diarrhoeal diseases Screening and early treatment for TB Findings from the 2010 HCP Survey show that apart from awareness about maintaining a balanced diet (59%), respondents had limited knowledge about other positive living practices, including boiling water (6%), sleeping under an insecticide treated mosquito nets (7%) and taking Septrin (8%) to mention a few. By contrast, over 80% of respondents believed that people carrying the HIV virus should start ARVS as soon as they test HIV positive During its final workplan period, HCP will continue to support partners to implement a multichannel communication campaign with the aim of helping close these knowledge gaps. The radio diary programme which commenced in August, 2011, will continue broadcasts through March, 2012, 23

24 accompanied by a discussion guide and various positive living client education materials for PLHIV groups. During FY , the focus will be to: Scale up the positive living communication campaign to USAID funded partners to ensure sustainability. HCP will strengthen collaboration with STAR EC, STAR E and STAR South West, IRCU, SPEAR, NUMAT, HIPS, AFFORD and SUSTAIN Integrate the positive living campaign within HCP programmes and outside HCP Document the positive living campaign to ensure continuity when HCP funding ends in June Description of proposed activities Positive Living Campaign Coordination and Sustainability The Ministry of Health AIDS Control Programme will continue to coordinate the national communication campaign and provide overall leadership, and HCP will continue to support the communication core team comprised of representatives from MoH, PACE and 10 PEPFAR funded partners to ensure the campaign is implemented as per strategy. HCP worked closely with PACE and supported MoH to develop the national Positive Living Communication Strategy, which was launched together with the Home Based Care Strategy in Northen and Eastern Uganda. In order to ensure that the positive living campaign continues beyond the end of HCP, HCP will continue to engage the 10 PEPFAR funded partners who are members of the coordination committee to support the implementation of the campaign among PLHIV groups. HCP will finalise a positive living tool kit that includes ready-to-print art work for all materials and a print version that shows what is available for partners to replicate. HCP will orient partners in the use of this tool kit, which will be saved on the HIV Care and Treatment website of the MOH. Planned activities Activity Targets Timeline Support MOH to hold 2 Quarterly meetings of the positive living communication core working group Two quarterly meetings &Q2 Update partners to the positive living campaign Finalize development of positive living toolkit and disseminate to partners to ensure campaign sustainability 10 PEPFAR funded partners working in line with the campaign Tool kit distributed to 10 PEPFAR funded partners &Q2 -Q2 24