Transcript COMMUNICATIONS - Stop TB Partnership

Presentation of ACS Country Level
Workplan, 20015 - 2015
1st Meeting of Advocacy, Communication
and Social Mobilisation sub group:
September 2005, Mexico City
James Deane
Communication for Social Change
Consortium
What is the country level workplan
and why has it been produced?
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Fulfil the request of the Geneva country level
workshop, February 2005
To support the TB 2 summary submission with a
more detailed workplan in line with other working
groups
Request from those tasked by the country level
subgroup with following up the Geneva meeting
To synthesise discussions and conclusions of TB
ACS debates over the last 4 years
To provide a framework for country level action on
advocacy, communication and social mobilisation
The process of producing this
workplan
Process strengths
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Detailed review of many hundred documents, discussions and
presentations over last four years;
Analysis rooted in needs assessments from within countries.
Call for contributions from the whole working group
For the first time a detailed synthesis of the analysis, methodologies
and tools available for country level action on ACS
Mexico meeting an opportunity for detailed discussion
Process weaknesses
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A deadline determined by the TB2 schedule
Inadequate time for sufficient consultation and discussion
Lack of clarity of over where country level advocacy (as opposed to
communication and social mobilisation) sits
 A desk study
Some Assumptions
This is not a roadmap – more accurately a
framework for action and implementation;
 Tools and methodologies rooted as much as
possible in demand and needs assessments
as expressed by country level TB
programmes and actors;
 Central assumption that strategies will be
country driven;
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The problem that ACS needs to help
address
 Improving
case detection and treatment
compliance
 Combating stigma and discrimination
 Empowering people affected by TB
 Political commitment and resources for
TB.
What our response consists of
 Advocacy
 Programme
communication
 Social Mobilisation
 Capacity Building in each of these
 INTEGRATED
STRATEGIC
COMMUNICATIONS
An evidence base, a foundation of
good practice
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Successful country based ACS programmes leading to impact
on TB (Mexico, Peru, Vietnam et al)
Extensive experience from other health communication
initiatives, much (not all) of which is relevant to TB
An expectation of 5-10% increase in desired changes based on
experience with other health challenges
Several years of debate, analysis and research, and substantial
needs analysis, of the necessity for a greater requirement of
ACS in TB control.
Substantial experience, practice and knowledge exists to
achieve real impact.
Workplan includes detailed list of resource materials illustrating
wealth of communication practice
Clear principles underpinning this
strategy
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Knowledge is critical: a huge effort is required to use communication to
educate people
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TB symptoms;
How TB is transmitted;
That TB is curable;
That TB treatment is free;
That TB cases should seek care;
That active TB cases should comply to TB treatment
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Lack of knowledge prevents people from seeking treatment or takes
them to other health providers;
 Knowledge is not enough: many people who know that they should
seek treatment are unable to do so:
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Stigma and marginalisation
Gender
Distance
Time
Poverty
Generate demand only for services that exist;
Country driven ACS strategies are those that work
Principle of subsidiarity
Capacity building central to this strategy
Goals of this process
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to provide guidance for GP2 goals and
targets as these translate to national ACS
initiatives;
 to foster participatory ACS planning,
management and evaluation capacity at
regional, national and sub-national levels;
and
 to support and develop strategies to achieve
key behavioural and social changes,
depending on local context, that will
contribute to sustainable increases in TB
case detection and cure rates.
Objectives
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By the end of 2008:
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By the end of 2012:
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At least 15 priority high burden countries will have both high level capacity
and be implementing ACS initiatives and generating qualitative and
quantitative data on the ACS contribution to TB control;
And will have developed comprehensive communication and social
mobilization strategies in support of the national TB control plan;
Have senior level communication managers coordinating these plans
All high burden countries will have reached this stage;
All priority countries will be implementing multi-sectoral, participatory-based
ACS initiatives and generating qualitative and quantitative evidence of ACS
contribution to TB control;
These plans should contribute to setting and affecting the political,
institutional and societal agenda and behavior against TB.
By the end of 2010 (NB change from submission to GP2 which state
2015)
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Multi-sectoral, participatory-based ACS methodology will be a fully
developed component of the internationally recommended strategy for
controlling TB
Process Targets
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By the beginning of 2006
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By the middle of 2006:
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a process will have started to form strategic agreements with
international technical support organizations able to offer technical
support to countries.
A detailed ACS capacity building implementation plan will have
been developed aimed at ensuring the appointment/recruitment of
senior level communication strategists in all high burden countries.
Such a plan will draw heavily on the experience, expertise and
insight of national TB programmes and partners.
At least 5 technical support agreements will have been agreed and
implementation will have begun.
By the end of 2006
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a strategy will have been developed with medium burden countries
detailing the communication support necessary (including technical
advice, resource materials and other mechanisms) to meet TB
targets in those countries (Particular discussion needed).
Building Capacity is central
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More dedicated, trained and senior level
communication staff at country level;
Technical support contracts aimed at:
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Improving country partner access to timely and quality
assured technical assiatance in agreed priority areas;
Encourage a collaborative approach to the delivery of
technical assistance in support of country partner-owned and
partner-led ACS plans;
Assist in the professional development of national institutions
as well as national and regional ACS consultants
Through:
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Training
Development and dissemination of support materials
Networking
Mentoring
Strategic addition of personnel, equipment and supplies
Distance consultation and support
Building Inclusion
 More
practical guidelines and
mechanisms needed to build inclusion
 Ideas suggested include:
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Positively Empowered Partnerships (tbtv.org)
Community/patient/affected representatives
appointed at national level to provide strategic
guidance and support to national ACS TB
programmes
Empowerment and participation hard wired
in to strategic planning
Knowledge Exchange
 Much
good practice, in fragmented
community and local experiences:
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No such thing as best practices
A wealth of good practice
Knowledge exchange programme on ACS
strategies
 e.g. Communication Initiative
Communication Approaches
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Communication for Behaviour Change
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Many models and tools available to country
programmes
COMBI Process already developed and tested for
TB (assessment in progress)
Communication for Social Change
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Individual change difficult to sustain without
broader social and community changes
CFSC a dialogue process adapted to modern
communication environments and adapted to
different cultural contexts
PIM Process (Participation, Interaction,
Mobilisation) in Bangladesh one example of many
community based approaches
Key tools available
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Handbook for communication programming
(AED/PATH and COMBI processes)
 Needs assessment tool developed by the
Stop TB Partnership
 JHU Outcome map
 AED Cough to Cure Pathway
Monitoring and Evaluation
Indicators proposed for:
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Assessing social mobilisation communication
capacity
Assessing delivery of ACS activities
Assessing sputum test outcomes (communication
related behavioural impact only)
Assessing treatment outcomes (communication
related behavioural impact only)
Assessing stigma and discrimination outcomes
Measuring most significant change
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Detailed analysis and list of indicators in workplan
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Role of the working group
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Providing strategic guidance and frameworks for national and
regional ACS strategies, and oversight of:
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international technical agreements;
progress of key elements of recommendations made in this
workplan;
the production of key documents (such as an ACS country level
handbook);
other elements of strategic support;
Helping to ensure that sufficient, and sufficiently senior, human
resources are available at all levels (international and national)
Providing an ongoing forum for discussion and lesson learning
on the most effective and appropriate communication strategies
and methodologies in supporting TB control efforts;
Commissioning regular technical reviews of ACS contribution, to
GP2 goals and targets based on country-level data and reports,
including cost-effectiveness research and tool development.
Role of the working group
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Making recommendations to the Stop TB Partnership’s
Coordinating Board and to STAG on the strategic direction and
resourcing of ACS activities.
Acting as a reference point for the whole TB community on ACS
strategies and initiatives;
Holding regular meetings to monitor progress and ensure
targets are met and ACS is demonstrating its value to meeting
the goals and targets set out in Global Plan 2.
Engaging, in combination with the secretariat, to monitor and
understand broader communication and media processes and
trends to ensure that ACS strategies keep pace with rapidly
changing media and communication environments.
Some outstanding issues
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Pinning down a country level advocacy strategy and
where responsibility rests for this;
TB prevention (TB aware communities)?:
communication is traditionally focused on prevention
– is there no role for this in relation to TB?
Structured relationships/joined up strategies with
other working groups – what are the mechanisms
which can guarantee this?
Some outstanding issues
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Implementation/strategic engagement mechanisms at
country level - workplan weak on:
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what are the precise mechanisms/loci of responsibility at
country level to take forward ACS programming?;
Staffing and human resources: how can country level ACS
staff be better qualified, more senior and more influential in
design and implementation of national TB strategies?;
Can we ensure that ACS is a comprehensive strategy doing
what is easy (posters, TB events) rather than what is
necessary?
A patient/affected inclusion/empowerment strategy:
further development of practical steps/mechanisms
needed;
 Good practice and knowledge exchange: how
important? what mechanism?
Conclusion
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Near universal agreement throughout the TB
community that increased emphasis on ACS
needs to be urgent and substantial at the
country level – substantial expectations of the
work of this group;
 Universal agreement from throughout the
communication community that many of the
methodologies, tools and learnings exist to
make a substantial impact on TB;
 The challenge is one of organisation and
resources.