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TOP R seau: Results and Lessons from a Youth-Focused Social Marketing Program in Madagascar

Background. Concentrated HIV/AIDS epidemic, high STIs, and unmet need for family planning (FP)Toamasina province34% of all STI cases nationwide3rd most populated provinceLack of youth-focused programmingSocial marketing of 6 products including oral and injectable contraceptives and condoms. You

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TOP R seau: Results and Lessons from a Youth-Focused Social Marketing Program in Madagascar

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    1. TOP Réseau: Results and Lessons from a Youth-Focused Social Marketing Program in Madagascar

    2. Background Concentrated HIV/AIDS epidemic, high STIs, and unmet need for family planning (FP) Toamasina province 34% of all STI cases nationwide 3rd most populated province Lack of youth-focused programming Social marketing of 6 products including oral and injectable contraceptives and condoms

    3. Youth in Toamasina 73,000 unmarried 15-24 year olds 37% rural, 75% not attending school 76% sexually experienced 11% STI prevalence among males 46% of females ever pregnant 74% of all pregnancies either mistimed or unwanted Multiple partners and sex for money [Based on 2000 data]

    4. Goal Prevent STIs and unplanned pregnancies among sexually active 15-24 year olds in Toamasina Purpose Motivate consistent condom use or abstinence Increase correct STI treatment

    5. Program Components Social franchise of youth-friendly clinics to improve access to: Affordable, confidential and quality reproductive health (RH) services including modern contraceptives, STI diagnosis and counseling Behavior change communication to: Promote dual protection attributes of condoms Encourage prompt and correct STI treatment Promote TOP Réseau clinics as youth-friendly Build skills and confidence to negotiate and practice consistent condom use or abstinence

    6. Clinic Network Consists of 30 providers at 17 pre-existing private and NGO clinics in Toamasina town PSI inputs: Assessment of youth-friendly criteria Training in STI diagnosis, modern contraceptives and RH counseling Monitoring and supervision Branded promotion Franchisee inputs: Sign contractual commitment to quality standards Franchise fee Successfully complete training

    7. Behavior Change Communication Use research & behavior change theories to identify behavioral determinants: Internalization of RH risks Skills and confidence to discuss, buy and use contraceptives Perceived support from parents and other gatekeepers Confidence in condom efficacy for FP Mixture of mass media, interpersonal communication and community outreach to address key barriers Peer education, Mobile Video Unit (MVU) shows, televised debates, community outreach Develop brand to link communications and promote consistent image Use drama, entertainment and humor to attract and hold youth attention

    8. Monitoring & Evaluation Program MIS: clinic visits, peer education contacts, etc. Household surveys conducted in 2000 and 2002 Logistic regression analysis to assess the impact of high program exposure on behavior and determinants (comparison group = youth with low exposure)

    9. Results (MIS) Increased client flow at TOP Réseau Clinics

    10. 2002 Results: Program Reach 7% of youth visited a TOP Réseau clinic No difference by gender 64% exposed to TV spots, 41% to radio 31% reached through peer education 37% attended MVU show

    11. 2002 Results: Behavior Change TOP Réseau contributed to significant increases in reported safe behaviors: Consistent condom use with regular and casual partners (males) Current use of a modern FP method (females) Purchased condoms in past year (both males and females) [p<.05]

    12. 2002 Results

    13. 2002 Results

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