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NEWS 
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ACTIVITIES
Pillar 1 - Mobilizing Communities through Behavior Change Communication
Dates: 7/1/2005 - 3/31/2006
Pillar 2 - Service Delivery, IPC/C training for HC Delivery workers in Govt. and Mission hospitals
Dates: 7/1/2005 - 3/31/2006
Strategic Information
Dates: 7/1/2005 - 3/31/2006
Namibia Field Office
Dates: 7/1/2005 - 3/31/2006
HIGHLIGHTS
Namibia: ABCs of HIV Prevention (Core): Sixteen member churches helped disseminate messages. In addition, the program involved 30 partner organizations, including NACOP, RACOPs, MOHSS, Ministry of Information and Broadcasting, Take Control Partnership (20 orgs), and faith-based organizations.
SUCCESS STORIES
Making Heroes
JHU/HCP strengthens A,B and Testing messages within Namibia’s national HIV/AIDS prevention campaign.
"Look and listen to the messages in the media and take a decision to make a difference!" With these words, the Namibian Deputy Minister of Information and Broadcasting launched the winter intensification of the national Take Control HIV & AIDS media campaign on June 30 in Windhoek. And even though people commonly do not listen to politicians words, it seemed that for the next two months, Namibians heeded the Deputy Minister’s words.
While the National Broadcaster and private media were broadcasting the brand new materials on partner reduction, partner testing, delaying sex and parent/child communication on HIV, people on the ground took action: For instance, in the following two months, the country’s New Start VCT Centres recorded unprecedented numbers of people taking HIV tests. Also, for the first time in the history of the national campaign, the Catholic Church was taking campaign messages to its congregations.
By strengthening the A, B and HIV testing messages in the Take Control campaign, JHU/HCP – alongside campaign key partners UNICEF, UNFPA and SMA/New Start – helped to sustain the popular campaign drive that under the slogan "Be Your Own Hero" had gathered momentum ever since its kick off in December 2004. Its strength lies in its semi-documentary approach with Namibians of all walks of life sharing what they are doing about the HIV/AIDS pandemic. Thus, the campaigns main message that everyone can do something about HIV/AIDS is dramatized by very individual and real examples.
"For me, this is one of the most successful campaigns that we have done, because it features the real stories of real Namibians," says Rianne Selle, Chairperson of the Task Force for the national campaign. "We have managed to showcase a wide range of positive action taken by people as diverse as Kwaito musician The Dogg and Deputy Minister Pohamba Shifeta around HIV/AIDS." While the campaign had embraced the ABC approach from the very start, materials focusing on making relationships safer, delaying sexual activity and HIV testing still needed strengthening. “The AB messages have not been featured prominently in the past,” observes Selle. “But it is important that we show that there are people who have chosen to abstain or to live happily in a monogamous relationship as we normally don’t see this in the media.
Especially the testimony of Petunia Matjila and Magnaite Dias Francisco impacted on audiences. After dating for a year, the young couple decided to take their relationship to the next level and go for an HIV test together - in front of a rolling camera. For Petunia, the determination of her boyfriend - who had been a self-confessed womanizer in the past - to get tested with her made a world of difference. "It shows me how much he loves me and that he has really changed his ways," she shares her feeling in the TV spot. This message also hit home with the viewers as Elize Biermann, site manager of Namibia’s busiest VCT Center in Windhoek, can confirm: "We had quite a few couples in the centre that said that they had seen the spot, discussed it - and that’s why they came." Attendance of testing centres hit all time highs during the campaign period with 3650 and 3828 clients getting tested in July and August respectively. The number of people coming increased by 40% because they had seen messages on TV.
While media, ongoing promotions and the introduction of rapid testing helped facilitate this growth, the work of JHU/HCP supported Community Action Forums (CAF) also did its share. In the small northern town of Oshikuku, where access to TV is limited, it was in fact more the hard work of the local CAF that was felt in the New Start Centre. "The activities of the CAF here impact on the community. We see people talking and coming to the centre because of that," says Anna Tshoopara, the local site manager. In Oshikuku, as well as in Rundu, Rehoboth and Walvis Bay, CAF members had been out in force to put up posters and hold information meetings on campaign topics. At the same time, community members also identified their own local heroes and interviewed them. The brief interviews then were published as part of the campaign partnership with the main local daily The Namibian.
Overall, much of the campaign’s success can be credited to the increased collaboration among partners at national, regional and community levels. JHU/HCP supported this spirit of working together by throwing its weight behind the national campaign together with UNICEF and UNFPA and promoting the services of Emergency Plan partners like New Start and CAA. By cooperating through the national mechanisms instead of only following their own agendas, partners also enjoyed significant leveraging of their funds. TV and radio materials, for instance, were run at no cost by the national broadcaster. Equally, the Ministry of Health used campaign materials on the billboard placed on hospital premises around the country.
JHU/HCP, together with the Ministry of Information and Broadcasting, UNICEF and UNAIDS, has seized this spirit of cooperation to kick start a process of revitalizing the partnership for the national campaign to continue following the Deputy Minister’s advice to make a difference.
Interpersonal Communication Skills Help Namibian Nurses to render quality VCT, PMTCT and ART services.
The Health Communication Partnership’s Quality Assurance Program which began as a pilot in 2003 on Interpersonal Communication has experienced a number of highlights during the fiscal year 2004 to 2005. Some of these are delineated below
JHU/HCP has developed a comprehensive training package consisting of a trainer’s manual, participant, manual, 5 job aids in the form of check lists on ART, VCT and PMTCT for health care workers, and a CD Rom with presentations to guide the facilitator. This gives trainers adequate instructions on how to effectively engage participants during training.
The pilot program led to a collaborative initiative between MoHSS and JHU/HCP to roll out IPC training to 10 treatment hospitals in 6 regions of Namibia namely Khomas, Oshana, Ohangwena Oshikoto, Kavango and Karas regions Ten training sessions of approximately 25 participants each were conducted with assistance from a subcontracted training NGO !Nara which has a pool of highly skilled and experienced trainers. This initiative kicked off with a trainer of trainers officiated by the Deputy Minister of Health and Social Services The training was then conducted over a period of eight weeks and fifteen trainers rolled out training to selected treatment sites in which 211 health care workers were trained.
"I want to be kept abreast with the developments of this project. Having been a nurse myself I know how poor communication has been between nurses and patients. This is an aspect that pre- nursing services has not addressed. I hope that the negative attitudes of nurses will also be improved with the roll out of IPC training to selected treatment hospitals." said the Deputy Minister of Health and Social Services at the closing ceremony of the national IPC TOT training.
The IPC training was one mile stone in establishing an open dialogue between service providers and service users. The training has helped nurses explore their own fears about the HIV epidemic and how it affects them as individuals, their work environment, and their communities. Participants were able to brain storm on issues relating to qualities of a good nurse communicator, role play scenarios as they experience them at service delivery level and use these scenarios to practice learned communication skills.
"Now that I know my own fears about the epidemic, I am in a better position to assist my patients deal with theirs. I also feel confident to help patients reflect feelings and counsel them in an empathetic but confidential manner" said one participant. "We should have had this training a year before treatment was rolled out." said another.
This training has filled a gap in the Department of Nursing Service within MoHSS because something that targets nurses and that focuses on enhancing quality service delivery is now being implemented. "Everyone is asking when we are rolling out this training to all sites" said the Head of Nursing Services. "The program is practical, hands on, stimulating, and is thought provoking" said the assistant Head.
After conducting ten training sessions during the July and August months, a debriefing sessions was conducted with the Ministry of Health management to inform them on the outcome of training and to map out the way forward.
"You know what makes this training different, it allows moments for fun while learning," said one trainer during an energizer.
"Clearly, the reaction from nurses has demonstrated a need for this training to be extended to all nurses. We have barely touched the surface with this initial training given the fact that the nurse population in Namibia is about 7000 nurses. We need to come up with a 3 to 5 year strategic plan in which we can at least reach 50% of nurses" said the Under Secretary in the Ministry of Health, Social Services and Rehabilitation at the IPC training debriefing session.
Following these remarks, Nursing Services has agreed to lobby for institutionalization of IPC training into pre and post nursing training in FYO6. JHU/HCP will continue supporting this initiative to ensure a smooth handover of the training to the Ministry.
The training has been well received by emergency plan partners. Efforts to main stream it into their training schedules are beginning to be realized. A TOT for Lifeline Childline, RPM + and Department of defense will be conducted. Lifeline Childline will then continue training community counselors, RPM + will train pharmacist, and Department of deface will train defense nurses on Interpersonal Communication.
JHU/HCP will continue promoting and supporting Interpersonal communication up to community level because it is well received, enhances quality of service, can be integrated and is sustainable.
Rehoboth Community Action Forum tackles alcohol abuse and high risk behavior
Harold Swartz, the chairperson for the Community Action Forum in Rehoboth Block E (RECAF) was determined to do something about the number of illegal Shebeens (local bars) in his community. RECAF was established in 2004 as a result of JHU/HCP’s community participatory assessment. The key problem identified during the assessment that’s driving the Rehoboth HIV epidemic is the incredibly high level of alcohol abuse and subsequent high risk behavior and sexual abuse. Rehoboth has a prevalence rate of approximately 14%, and rising.
Harold, with the assistance of the other 7 RECAF members, set about tackling this problem in two ways. Firstly, with assistance from JHU/HCP, Harold visited the Walvis Bay District AIDS Committee (another JHU community site in a different part of the country) to gain an understanding of how this community has addressed the same problem. From this experience he developed an action plan for Rehoboth and set about partnering with the National Shebeen Association, which is responsible for regulating shebeen licenses, hours of sale and to whom alcohol is sold.
He also mobilized the RECAF members to start HIV/AIDS awareness and information sessions in Shebeens. To date12 awareness sessions have taken place, with demand growing for more. Examples of the kind of misunderstandings and very real issues that Rehoboth community members have are reflected in the following questions that arose during a recent HIV/AIDS awareness session: A man in his 40s asked, "Am I safe using two condoms for double protection?" Then a woman wanted to know, "How do I all of a sudden ask my husband to use a condom after 15 years of marriage, just because I think he is sleeping with other women?"
Although the RECAF members have received training from JHU/HCP on basic HIV/AIDS facts and the new treatment services available in the community, Harold still needs to assist them with some of the difficult and emotional issues that arise. When necessary, Harold invites experts from the service based organizations like New Start or the PMTCT nurse at the hospital to talk at these sessions on specific topics. He also negotiated free HIV testing vouchers with the local New Start center to encourage people who attend the awareness sessions to go for a test.
Harold Swartz was recently employed by JHU/HCP as a Regional Coordinator. His initiative, hard work and commitment to HIV/AIDS are a valuable asset to JHU/HCP, an organization which is constantly striving to build local capacity at every level.
Peace Corps Volunteer and Community Action Forum members reach out to villagers
Zach Stednick is a Peace Corps volunteer in Oniipa, a semi-urban center in the far North of Namibia. The Onandjokwe Hospital in Oniipa is one of the 35 treatment sites in the country and has the highest number of patients on ARVs. Oniipa is also one of JHU/HCP’s CMA sites.
Results from the participatory assessment revealed that Oniipa is one of the few communities in which JHU/HCP has done assessments that rates HIV/AIDS as one of the top three problems in the community. Despite a number of HIV/AIDS interventions in the area and the establishment of a New Start center and treatment services at the local hospital, the assessment also revealed the poor understanding and knowledge that most peer groups had with regard to VCT, PMTCT and ART. An excerpt from the assessment report for the men’s group 26 - 45 years reads:
VCT can be used for getting condoms, sticking to one partner, abstinence, and no alcohol. The sources of such information are the VCT centre, media, community, and church. From the explanation it is clear that they do not know what VCT is.
Zach, in partnership with the Oniipa CAF, set about addressing this information gap by raising funds from his church in the United States of America so that CAF members could perform HIV/AIDS IEC outreach activities in their immediate community and surrounding villages. Due to Zach’s enthusiasm, determination and transfer of skills, the CAF members have been holding HIV/AIDS information and awareness sessions for the past 6 months. JHU/HCP supported an initial HIV/AIDS training for all CAF members and provides them with Nawa Life T-shirts and HIV/AIDS support materials on a regular basis. In some instances, CAF members have walked 20 kilometers to reach people with their information and to promote the new VCT and treatment services at the Onandjokwe hospital.
Zach’s Peace Corps service will end in a year’s time; however he’s confident that by that time, he will have built sufficient capacity within the CAF members that they will continue with their work.
CONTACTS
Jane Brown, jbrown@jhuccp.org |
