Engaging People to Test For HIV through More Effective Messaging
|The only trained doctor in the entire district, Dr. Fred not only sees patients in the clinic, but also helps manage the Matibabu Foundation.|
“When we started we took it one day at a time and often felt overwhelmed because of the sheer magnitude of HIV cases," says Dr. Fred Okango, technical director at the Matibabu Clinic in Ukwala, Western Kenya. "We saw HIV patients two days a week, and we'd see about 120 to 180 patients a day. I didn't have time to think; I'd just shuttle from one patient to the next…we all would.
"At the time we didn't have nearly enough supplies or
drugs, let alone ARVs to treat AIDS. The PEPFAR
New Partners Initiative grant has helped us buy
commodities, pay staff, and get lab tests done. But just
as important, the technical assistance that came with
the NPI grant has strengthened us and enabled us to
prepare for the future."
In 2008, the Matibabu Foundation was awarded a
PEPFAR New Partners Initiative (NPI) grant that
provided resources to offer expanded HIV services in
In conjunction with the PEPFAR award for HIV
services, which comes through the U.S. Centers for
Disease Control and Prevention, Matibabu also
received technical support from John Snow, Inc. and its partner Initiatives Inc. to strengthen its management
and technical capabilities, through TA-NPI.
TA-NPI began its work with Matibabu by conducting
thorough management and technical capacity assessments.
These assessments helped the clinic both
organize its services and improve how those services
The technical capacity assessment looks at critical
approaches to HIV care, including comprehensive
prevention, HIV counseling and testing, prevention of
mother-to-child transmission of HIV, home-based
care, and care for orphans and other vulnerable children.
Matibabu's technical assessment led to several
recommendations to strengthen staff skills in crosscutting
approaches to care.
"One of the issues that came out of the assessment
was how we approached giving HIV prevention
messages," says Dr. Fred. "We realized that raising
awareness was not enough—in fact, 90% of people
knew something about HIV already, but they weren't
changing their behavior. We've learned from the literature
that you typically need five encounters with someone
before they change their behavior. In the first year, we would essentially gather a large group of people around, talk about HIV, and then count the number of people in attendance and report that we had delivered health information to however many people had been there. We never looked at whether people actually changed their behavior.
"When TA-NPI helped us examine our approach, we
also realized that we were providing information from
many different sources that were not necessarily all
up-to-date. We recognized the need for more standardized
prevention messages that would work with our
target populations—and we needed a curriculum to
help us make sure that everyone was conveying the
same messages effectively so that people not only had appropriate information but also knew where to go to get tested.
"Once we realized all this, we began using the
Government of Kenya-approved curriculum. We
increased the number of information sessions we held
in communities and decreased the number of people
attending each session. We found that in some of the
smaller groups, 100% of the people then went for
HIV testing—we could see the impact immediately
and it was a great success!
"We are now working with TA-NPI to adapt a
community-based curriculum based on everything we
know about our target populations as well as what we
know about how people learn and what is effective
around HIV counseling. We'll use the curriculum
when we train trainers, who will then go out and use
the curriculum with in-and-out of school youth and
women in peer education groups.
"We believe this approach will help in sustaining the messages because the trained peer educators will continue even after the New Partners Initiative program ends."
Technical Assistance to the New Partners Initiative (TA-NPI) is funded by the Centers for Disease Control and Prevention (CDC) and implemented by John Snow, Inc. (JSI). The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the CDC or the U.S. Government. The contents are the sole responsibility of John Snow, Inc. For more information, please contact: firstname.lastname@example.org.