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IR 1 - BUILDING CAPACITY WITH COLLECTIVE LEARNING AND ACTION HIGHLIGHTS
HCP's work in capacity building is designed to facilitate local institutions in developing countries to lead the development, implementation, and evaluation of strategic health communication programs that achieve improved health and contribute to the development of health competent societies. In collaboration with local partners, HCP primarily uses a participatory, results-oriented approach called "Collective Learning and Action" (CLA). CLA is rooted in the idea that the most effective learning is based on results-oriented participatory action, practice, or doing. When this learning is achieved through systematic use of tools and processes and goes beyond focusing on individuals to focusing on groups and institutions, then capacities developed are more meaningful and sustainable. CLA ensures that key participants in the process of designing, implementing, monitoring, and evaluating health communication programs participate collectively in both the creation and sharing of knowledge and skills. As HCP's primary approach to capacity building CLA is complemented by:
HCP's targeted training activities in Year 3 ranged from practical training in interpersonal communication and counseling skills in family planning, reproductive health and HIV/AIDS to training in developing communication strategies and designing the community participation and mobilization programs.
For example, in Bangladesh a series of Life Skills Training-of-Trainers workshops were held based on the Adolescent Reproductive Health program package. HCP also built networks and links in several countries, including Mozambique where HCP played a key role in helping stakeholders reach consensus on a national HIV/AIDS communication strategy. In Year 3, HCP helped Jordan, Egypt, and India develop and/or implement national and sub-national health communication strategies. Specific examples of capacity building in Year 3 follow, grouped by Strategic Objective (SO) and divided into each Intermediate Result (IR).
Multiple Strategic Objectives (SOs)
Through joint planning of the communication strategy it is now engaged in joint implementation with the Ministry of Health and Population (MOHP), for the first time expanding the inter-ministerial collaboration to include all MOHP health directorates (Family Planning/ Reproductive Health, Healthy Mother/Healthy Child, Focus on Family Health, Infectious Disease Surveillance and Response) and the State Information Service (SIS). This collaborative planning and implementation includes partners in the NGO, Community Development Associations (CDAs), and private sector implementing a program guided by the life stages approach. The early establishment of the CHL Executive Steering Committee (ESC) in the multi-agency coordinating body allowed rapid progress on coordinated planning of CHL activities. Workplans for the MOHP, State Information Service (SIS), NGO-CDA and private sector components show a high level of coordination in strategy and planned activities.
With the King's endorsement and with the Minister of Health hosting, the national health communication strategy and HCP's program activities were launched at a gala event. The Healthy Jordan program covers family planning reproductive health, safe motherhood, child survival and healthy lifestyles, including diabetes, smoking and exercise. SO1 - Reproductive Health/Family Planning Optimal Birth Spacing in Mozambique: The Family Planning/Optimal Birth Spacing Communication Strategy was developed, implemented, and evaluated by the MOH and partners. A document containing the communication strategy was released and distributed among partners and collaborating institutions. The new P-Process was instrumental in creating consensus among the various partners, conducting formative research, identifying key objectives, developing materials and activities, and conducting a qualitative evaluation. Led by the MOH and NGO partners, the Spacing campaign was the first of its kind and was released and launched in Zambezia Province. High-level authorities including the Vice Minister and USAID representatives attended the ceremony. SO1: POPULATION AND REPRODUCTIVE HEALTH
SIFPSA, HCP's implementing partner, utilized the strategic design approach to design and implement the radio program (a component of the UP strategy). The Adolescent Reproductive Health Strategy - Bangladesh: During Year 3, the Bangladesh Center for Communication Programs (BCCP) went far in implementing its comprehensive communication strategy for the ARH project. This included production of comic books, newsletters, the TV magazine, and the training of local participating NGOs by BCCP in conducting local campaigns and using the ARH package with their youth clients. SO4: HIV/AIDS Providing Assistance to Haiti 's Communication Plan and Youth Strategy: HCP provided assistance to the BCC Working Group of the Ministry of Health's HIV/AIDS national coordination unit to develop and implement a national BCC HIV/AIDS communication plan, which was finalized during Year 3. HCP conducted a message and materials development workshop to design appropriate ABC materials with local partners and in collaboration with the MOH. The output was a strategy document and draft ABC materials. Building capacity simultaneously in different domains/sectors in Maharashtra: In India , HCP's current focus is on the three main pillars that can have an impact on the HIV/AIDS pandemic in Maharashtra State- the NGO sector, the corporate sector (public and private), and the media. Building the capacity of these three pillars of society will allow them to serve as the foundation for sustainable HIV/AIDS prevention interventions and care and support programs. Building on the statewide Communication Strategy and Plan previously developed with assistance from HCP, capacity building focuses on:
Mozambique 's first PMTCT Communication Strategy: HCP supported the MOH to develop their first Communication Strategy for PMTCT efforts to orchestrate and guide more that 30 local and international partners nationwide. The team building approach paid off as the first phase of the strategy is already underway and is preparing health providers to establish caring and respectful client-provider interaction overcoming HIV AIDS stigma and discriminatory attitudes in the workplace. Launch of the Bangladesh HIV/AIDS Strategy: The HIV/AIDS prevention Campaign activities for the general public were developed in coordination with the finalization of the National HIV and AIDS Communication Strategy 2005-2010. The campaign benefited from the research and is planned in coordination with other TV Spots, TV dramas and other media for the general population. More than 7,000 people packed the convention center during the launch, which included performances from local artists. Square 4, a pharmaceutical group, together with other corporate sponsors, sponsored the launch, including subsequent district-level events in Bangladesh. BCCP had the launch in coordination with the Ministry of Health and Family Welfare and NGO stakeholders.
Multiple Strategic Objectives (SOs) Egypt reaches out to newlyweds: Over 19 CHL partners from the public, private, and NGO sectors are using evidence-based tools. These include strategic plans that provide a unifying framework for the cross-cutting health communication program and guide annual activities; constant use of communication strategy briefs to define specific activities, entertainment-education treatment briefs to guide dramatic productions; and the new P-Process to guide local planning and outreach activities. Examples of activities that resulted from these evidence-based practices include a series of 26 Family Health weeks in six governorates that proved a successful way to engage government officials, health professionals, community leaders, and citizens to support campaign messages and coordinate efforts; seminars and entertaining dramas produced by the State Information Service (SIS) that served as vehicles for communicating health messages; and 1,000 workshops, seminars, and public events conducted by outreach workers that reached a total of 70,342 participants in a three-month period. Entertainment-Education and Local Health Committees in Jordan: HCP worked with the Government of Jordan and counterpart agencies to develop communication materials using evidence-based practices like the new P-Process with special focus on pretesting of materials. In addition, HCP's private-sector partner (Prisma Advertising agency) sponsored a one-week workshop, on its own, for the design and script writing of an HCP entertainment-education serial drama. The workshop was a vital tool in helping Prisma, the organization responsible for producing the entertainment-education drama, use proven practices of introducing health messages into an entertainment production (How to Design and Produce Radio Serial Drama for Social Development: A Program Manager's Guide and How to Write a Radio Serial Drama for Social Development: A Script Writer's Manual). It was also an exciting example of a private sector partner engaging in health communication both for altruistic and business reasons. Local Health Committees (LHCs) were established in two pilot underserved villages (Baej-Za'try) in Mafraq Governorate in the North. These LHCs were intensively trained on Participatory Rapid Appraisal (PRA), leadership, communication, decision-making, negotiation, problem solving and action planning, monitoring and evaluation skills. LHCs identified their communities' health priorities through PRA and set plans of action and started implementation. The JHU/Rockefeller handbook on Communication for Social Change: An Integrated Model for Measuring the Process and Outcomes was used as a guide for the community-level interventions. The Jordan program covers family planning/reproductive health, child health, safe motherhood, and healthy lifestyles (anti-smoking, diabetes, exercise, nutrition). Southern Partner Uses CDC Model for Uganda Youth Project: HCP's Southern partner, Zimbabwe-based Media for Development Trust, adopted the CDC MARCH (Modeling and Reinforcement to Combat HIV/AIDS) Model when it provided technical assistance to Uganda 's Y.E.A.H. campaign. The Y.E.A.H. campaign's focus is on youth reproductive and sexual health, including the issue of "sugar daddies." SO1: FP/RH
Health E-Communication: Subscriptions for the Health E-Communication newsletter more than doubled over the four months since it began. While the numbers are modest, HealtheComm will be a substantial global health communication platform before the year is out if the present growth rate continues. The average Unique Visitor Sessions per month for the first six months of 2005 was 1,100. Ndukaku: Female Genital Cutting (Core): With technical assistance from HCP, the Women Action Research Organization (WARO) led the Community Action Cycle (CAC) process that allowed a core group of community members to identify and address their most pressing health issues. WARO helped them identify their health priorities, provided information on community mobilization, and conducted technical sessions where FGC and other maternal health issues were discussed and analyzed. Core group members then developed action plans for the elimination of FGC in their communities with activities that included meeting with traditional leaders and ruling councils to garner their support as well as organizing larger community meetings to discuss the dangers of FGC. The core group disseminated information learned during the WARO technical sessions through their community and traditional leader meetings and through health seminars and peer health education sessions. The National Association of Women Journalists (NAWOJ) focused on the use of advocacy and the media to influence behavior change. Activities included advocacy visits to traditional leaders, regular newspaper columns, radio call-in shows, and public forums on FGC. First Arabic language Media/Materials Clearinghouse established in Egypt: The M/MC staff provided ongoing assistance to the State Information Service/Information Education and Communication (SIS/IEC) Center in Egypt. SIS/IEC is setting up a resource center to share evidence-based models and tools in Arabic and English, and the M/MC provided TA in setting up, staffing, and running the resource center and an online database. Spotlighting and Strengthening Southern Country Partner Leadership (Core): Four individuals - representing Family Planning Association of Kenya, Africa Regional BCC Network, the Near East Foundation, and the University of Indonesia - were trained as fellows under the CCP Leadership in Strategic Health Communication Workshop. The aim was to train them in advanced concepts, practices, and use of evidence-based tools in strategic planning for health communication.
Another Case Study on the Bangladesh Center for Communication Programs (BCCP), co-written by BCCP Director and CEO Mohammad Shahjahan, described how BCCP flourished because of good leadership, strategic partnerships, and a clearly defined mission. BCCP also was able to establish a market niche in a country where few organizations offered evidence-based health communication programs. Strengthening In-Country Capacity to Involve Communities in Health Communication Programs (Core): Eighteen participants representing ten partner organizations from Asia and Africa participated in a September 2004 workshop. Participants learned the importance of engaging communities in health communication programs and ways of increasing this participation. A Frequently Asked Questions (FAQ) guide (the toolkit) was revised to incorporate areas participants identified as being difficult when engaging communities or getting donor buy-in for the program. Partners were sent the first draft of the toolkit and asked to comment. Additionally, partners were introduced to How to Mobilize Communities for Health and Social Change , the P-Process, and other tools to be used when working with communities. Partners participating included BCCP, Coalition for Healthy Indonesia, Rozan, DramAidE, The Valley Trust, CDFU, ZINGO, The Social Marketing Association ( Namibia ), Soul City, and Straight Talk Foundation. The following organizations were also represented: HCP Namibia, ZIHP, and Save US Ethiopia FO. Promoting South-South Technical Assistance (Core): This activity provided resources to engage country-based partners to provide technical assistance to one another in the use of evidence-based tools and methods for health communication. This year, Movimiento Manuela Ramos ( Peru ) provided technical assistance to the Africa Transformations (Core) activity by strengthening the local implementing partners' abilities to effectively use proven gender and communication tools. In addition, in Nicaragua the Centro para Programas de Comunicación provided technical assistance to the HCP program in Honduras in the design and development of radio drama programs Transforming the Ordinary into the Extraordinary (Core): As part of the Transforming activity, partners working with HCP adopted the Arab Women Speak Out (AWSO) model of producing video and written profiles of women who have faced and overcome challenges in their communities and environments and sharing these products within communities to generate dialogue and change. During this year, master trainers were trained in implementing the package of materials and went on to train others.
VIPP used in Bangladesh ARH: For the Adolescent Reproductive Health program, a series of Life Skills Training-of-Trainers were held for trainers from many participating organizations implementing the ARH package. These individuals were taught to train others using the Visualization in Participatory Planning (VIPP) methodology. Participants have become enthusiastic about the training cycle that they are seeking their own funding to push implementation of the ARH program forward. BCCP, on its own, is using the new P-Process as a tool for developing TV and print materials related to ARH. A New Model - Social Inclusion Approach in Nepal : HCP has helped to create a new model for social inclusion through strategic communication in Nepal. This model demonstrates how to extend access to services of the existing USAID bilateral, the "Nepal Family Health Program" to poor and marginalized groups, including dalit (low caste) and Muslims. The approach also focused on developing the capacity of communities themselves to address their own health concerns using different proven methodologies: the HCP community action cycle manual and the use of distance education technologies through organized radio listening groups. The model is a strategic combination of the following: 1) a local language radio program and materials, 2) integrated literacy classes with a radio listeners group component, 3) improved links between the community and peripheral health services through participatory approaches, 4) Female Community Health Volunteer mobilization, and 5) support to the government to extend FP services to remote communities. With this comprehensive, localized approach, the program is able to help address inequities in the system and reach groups with the most need for quality services and create demand for them. The Nepal experience demonstrates the crucial role of culturally appropriate adaptation of materials; the need to work with local NGO and public health system at the district and community level; the added value of integrating literacy classes with mass media interventions; and the importance of using existing quality media and materials before adaptation to the local context (i.e., adaptation at the local level is a better way to develop materials than generation at the local level). Despite the conflict raging in the country, this model has been successful primarily due to the high level of partnerships between NGOs and the district health system personnel, and the close involvement of the community and health facility staff.
SO 3: NUTRITION AND CHILD HEALTH Healthy Indonesia Coalition: Koalisi untuk Indonesia Sehat (KuIS) introduced the use of the evidence-based hygiene improvement framework to launch handwashing with soap campaigns in two provinces, Banten and North Sumatra. In Banten, KuIS partnered with Laz Harfa, an influential association of Muslim organizations from five districts within Banten that concentrates on community development and fundraising. KuIS focused its activities on community-based hand washing promotion supported by mass media, mainly radio. The community mobilization activities are the driving force behind the program aimed at reducing the incidence of diarrhea especially among children. KuIS implemented the activities in partnership with local coalitions, and other local organizations integrating its messages and materials into their ongoing programs, as well as working with a micro-credit network, religious organizations and local journalists. Since partner programs are ongoing, the hand-washing messages and materials will not be new "stand alone" programs but will be fully integrated into existing activities. Family Health Card in Ethiopia: The Family Health Card was developed by a working group of more than 20 partner organizations following the child survival message harmonization workshop conducted in March 2004. It was then tested by field workers affiliated with a variety of organizations. The card is currently being used by eight implementing partners. ESHE (JSI) is using the FHC with 200,000 of its health extension workers in the regions of Amhara, Oromia, and SNNPR. The MoH distributes the card to all of its health extension workers in SNNPR (about 1,800 total). Concern is using 4,000 cards with its extension workers. Other organizations using the card in some capacity include MOST, Linkages, and UNICEF. SO 4: HIV/AIDS BCC Network (Core) : The East and Southern Africa BCC Network was established with the support of HCP. The initiative will work with a working group to meet the following needs for the region using evidence-based tools and approaches: development of standards for BCC practice; indicators, and methodology for monitoring performance; establishment of a list of core competencies for BCC professionals; conducting of annual assessments of BCC competencies among network professionals; development of core competency training course that focuses on gaps identified during the assessment; establishment of an accreditation system for BCC professionals; establishment of an annual award for excellence in HIV/AIDS BCC in the region; and contribution to establishing a regional center for BCC training excellence. This year, the BCC Network worked with several southern partners across Eastern and Southern Africa, including SAFAIDS, PACT Ethiopia, Healthscope Tanzania, PATH Kenya, Makerere University, AMREF, RCQHC, CRHCS, Soul City, CDFU, FHI-Kenya, Horizons-Kenya, NAC-Malawi, and many ministries of health. The Network allows these groups to share lessons learned and to introduce and share useful tools and models for HIV prevention work. Working with Scouts in Madagascar: Over 300 youth groups, schools, and clubs in Madagascar are using the Ankoay model for HIV/AIDS activities with youth. The Ministry of Education and Ministry of Youth Sports and Culture are preparing to launch "Ankoay" activities. Over 100 scout troops were trained and are advancing towards "Ankoay" status. Namibia: More than 30 Regional AIDS Coordinating Committees, National AIDS Coordinating Committee, MOHSS, faith-based local groups are using the Community Action Cycle and participatory learning approaches. South Africa: The HCP Pathways Model is being used by six organizations ( University of Stellenbosch, The Valley Trust, DramAidE, MCDI, CADRE). Zambia: A needs assessment workshop involving various youth organizations and ZINGO (Zambia Interfaith Networking Group on HIV/AIDS) led to the development of the HEART Life Skills Toolkit. This toolkit was tested with a cross-section of youth development organizations. Twenty-one youth peer leaders were trained on the final product, one from each HCP district. Regional HIV/AIDS Project (RHAP): In both Swaziland and Lesotho, local partners adapted proven life skills tools developed by SADC, DFID, Grassroot Soccer, and HCP for use in other African countries. These tools include a standardized life skills curriculum for Swaziland, which draws heavily upon HCP's Youth Action Kit and DFID and SADC's life skills kits, and Sports for Life coach's guide for Lesotho, which is an adaptation of Grassroot Soccer and HCP's tool of the same name. Haiti: Community care and support curricula was developed and validated by national and sub-national organizations. Public and private sector organizations at the sub national level were involved in training community-based organization in the 10 departments. HCP supported the development of a training of trainers curricula that was used to train 30 trainers among local NGOs chosen among public and private sector institutions from the 10 departments. The trainers have started the training at the departmental level for community-based organizations. Honduras: Local NGO and interest groups working on entertainment-education products for garifunas, MSMs, and PLWAs used the new P-Process and other tools to produce these products. In addition, these tools were used to develop a strategy for the theater programs, to train staff, and to produce radio dramas. SO5 - INFECTIOUS DISEASES Communicating about Malaria in Uganda: In Uganda, HCP worked with the National Malaria Control Program, using evidence-based practices and tools, to produce a package of materials that would help communicate effective malaria control policies, strategies, and guidelines among government and non-governmental partners, as well as the public. Using Existing Tools to Create a New Package of Materials for Malaria Communication (Core): HCP worked with Roll Back Malaria to develop a prototype set of communication materials for national country malaria programs to adapt as needed. Existing country-level packages of malaria materials and tools were be used as a starting point. A few key materials were developed in prototype format for distribution to country programs with clear instructions for adaptation. Materials will be distributed through the sub-regional networks and the RBM secretariat.
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Egypt's Communication for Healthy Living: The multisectoral Communication for Healthy Living (CHL) project developed and is now implementing a health communication strategy with broad participation from the public, private, and NGO sectors addressing multiple health concerns: family planning, reproductive health, safe motherhood, child survival and nutrition, safe injections, and infectious disease such as TB. 
Healthy Jordan: National and regional workshops with representatives from more than 20 different stakeholder groups led to the development of a national health communication strategy. A strategy brief written for the Behavior Change Communication (BCC) initiative supports the national health communication strategy. The "Our Health, Our Responsibility" brand was adopted by the MOH, USAID/PFH, and, for the first time, all USAID Cooperating Agencies and private sector partners agreed to use the logo and message as a sign and endorsement of trusted, credible health information. 
India: HCP facilitated a design workshop to develop and finalize the communication strategy design documents for the distance learning radio program and the radio drama serial for the State of Uttar Pradesh in India. 
Capacity of the local partner, AVERT Society, and the NGOs supported by AVERT, to plan and implement strategic BCC interventions targeted at at-risk groups, youth, and the general public. Staff at the NGOs are trained in interpersonal communication and counseling through a series of communication skills-building workshops. HCP is preparing the ground for helping Avert and the NGOs develop quality materials for care and support initiatives in their communities. 
Motivating the corporate and business sector to develop workplace intervention policies regarding HIV/AIDS to actively contribute to HIV prevention among their workforce and to support HIV-positive employees. A workplace intervention (WPI) advocacy kit was developed to increase the capacity of corporations to effectively address HIV/AIDS prevention and create a workplace intervention policy for people living with HIV/AIDS (PLHA) in their organizations. Working with AVERT (established as a para-statal with support from USAID), HCP is engaging business and industry leaders and encouraging them to integrate HIV prevention messages into their existing universal health and wellness programs. HCP is also encouraging them to connect with NGOs and services available in their communities. A documentary film highlighting various workplace intervention practices is being developed to motivate others in the corporate sector to launch similar WPI programs in their companies. 
Entertainment-Education Conference for Social Change (Core): The September 2004 Enter-Educate Conference provided an ideal opportunity for hundreds of participants to explore and discuss new tools and models for developing, implementing, and evaluating entertainment-education program work. The conference, "EE4: Community and Context," set out to explore traditional forms of communication including storytelling, songs and drama, mass communication approaches, related theories, and research. Participants focused on recent developments in entertainment-education programs by sharing experiences, opportunities, and challenges. They also worked towards developing a consensus on further enhancing EE methodology and field practice. The conference was organized by South Africa 's Soul City, the Center for AIDS Development, Research and Evaluation (CADRE), DramAidE, and HCP. HCP supported representatives of four Southern Partners to attend the conference. 
South-South Capacity Building (Core): The Partners in Action Case Study on Moviemento Manuela Ramos was written by former director Ana Maria Yanez with contributions from several current staff members and others. This case study examined MMR's evolution over the past 26 years as it grew from a vocal critic for women's rights to a respected advocate for women at the highest levels of government. MMR succeeded in reaching hundreds of thousands of Peruvian women by mobilizing Peru 's rural communities, involving men in reproductive health issues, and promoting gender equity. 
Sports for Life (Core) : Sports for Life (SFL) is currently being implemented in 250 of the largest primary schools in Ethiopia. The Ministry of Youth, Sport, and Culture adopted the model for the national physical education curriculum. SFL targets in-school 7th and 8th grade boys and girls in urban and rural areas. Each SFL school has at least 2,000 students. Trainings for teachers and parents at an additional 350 schools affiliated with the Ministry of Youth, Sports, and Culture, and World Vision were scheduled for Fall 2005. In addition, Sports for Life's website, established this year, offers a wide variety of tools and models for use in SFL programs. 
Punam's face lights up with pride as she shows her Female Community Health Volunteer (FCHV) badge. "Growing up in a small village, I didn't know anything about health," Punam explains. "Everything I know I learned through my training as an FCHV." Punam receives her continuing education for her vital position from the HCP-supported Distance Education radio program Sewa Nai Dharma Ho (Service is our Duty). Sewa Nai Dharma Ho airs weekly on Radio Nepal. For Punam, Sewa Nai Dharma Ho is serving its purpose. "I am not literate and cannot write and I find that I forget a lot of information," she says. "But when I hear information on the radio, I am better able to remember it!" 
Sewa Nai Dharma Ho has helped Punam and the other FCHVs as it has provided up-to-date information on a range of family health issues. Punam explains, "My knowledge about family planning was very limited before the radio program but I have learned about condoms, pills, Depo, Norplant. Now when women talk to me about their Family Planning options, I can make better recommendations." 
"This project finally lets us do something for ourselves."