The C-Change Community Conversation Toolkit on HIV Prevention: A Catalyst for Community Dialogue and Action Integrated Approaches, Local Answers

Presenters: Sarah Meyanathan, Maclean SosonoJuly 22, 2012

C-Change is…

• C-Change is a five-year USAID funded initiative,

• with the mission to improve the effectiveness and sustainability of health and development communication for long term change

• by influencing underlying social norms = SBCC

Background and Development

• Response lacks interactive HIV prevention material for adults with lower literacy

• Materials developed through participatory process – using Action Media methodology in South Africa

• Adapted to local contexts in 7 countries in 10 languages

• Complements existing HIV prevention activities through triggering local actions with dialogue

Community Conversation Toolkit

Example of Toolkit Implementation and Evaluation

Phase I: • Identified 4 CBO partners in

Malawi and Zambia to facilitate dialogues w/ 23 existing community groups

• Orientation of CBO leadership on toolkit, community dialogues and monitoring

• Training of CBO staff and 49 existing peer educators

• Recorded toolkit use, individual & group action

Phase II & III: • Over 80+ discussions recorded

with groups such as: – Community Leaders– PLHIV (various groups)– Middle class men– Women in small businesses– Youth in higher learning

institutions (20+)• Final analysis of actions and

potential programmatic implications

• External evaluation ongoing

Example: Local Actions from Malawi

• CBO partner: Friends of AIDS Support Trust (FAST)– Covers population of 50,000

in 88 villages– 14% prevalence rate– Literacy rate 42%

• Dialogues held with: bicycle taxi operators, discordant couples, ex-sexual cleansers, tested couples, and local leaders

Community Leaders

• Before, meetings on prescribed topics & messages

• Now, deepened dialogue on harmful cultural practices & issues of GBV raised by community

• As a result of the dialogues:– Developed workplan, divided

into small groups, traveled to other communities

– Speaking out at funerals– Advocating for modification of

practices while retaining tradition

– FAST secured additional funds

Shapa Boys (Bike Taxi Operators)

• Before, campaign meetings & trainings

• Now, raised issues of their own risks--clients offering sex in exchange for payment; GBV in the wider community

• As a result of the dialogues: – Talk to their spouses about risk &

being faithful– Carried out dialogues with church

members, market goers, hairdressers, other Shapa Boys, welders

– Counseled clients sitting behind them– Distributed condoms

Lessons Learned

• Toolkit elicits individual and community actions = promotes community ownership of local responses = sustainable actions

• Important to conduct dialogues with existing programs, community structures/ hierarchies and in local languages

• Peer educators are now facilitators instead of message presenters

• Outcomes of toolkit interventions are local, but process can be scaled to address HIV-related issues in other contexts