The Role of Behavior Change Communication in the context of Comprehensive care

1. The Role of Behavior Change Communication in the context of Comprehensive care Stephen Mucheke Senior Technical Adviser for BCC Family Health International

2. Behavior Change CommunicationBCC Coined in the early 1990 by communication experts working in HIV and AIDS in order to give emphasis in the roles of sexual behavior in the PREVENTION of HIV infection. During this time, there were probably no ARV - VCT might have been available in limited places - The HIV epidemic was still in its infancy BCC program involved the design and implementation of a package of communication interventions targeting individuals families and communities to reduce the risk contracting/spreading HIV.

3. 15 Years later What is the role of BCC in HIV prevention and mitigation of Impact in the context of comprehensive care?.

4. Change of Concept The programs of early 1990 were focused on BCC for prevention. Over the years, the program has expanded to cover other components of comprehensive care. Therefore the need to change from BCC to Strategic Behavioral Communication (SBC) There is a behavioral component within the prevention, Care and treatment continuum

5. Elements of Comprehensive Care Primary Prevention Counseling and Testing Prevention of Mother to child Transmission Antiretroviral Therapy Management and treatment of opportunistic infections Care and support for the terminally ill Support to orphans and other Vulnerable children

6. Objectives of SBC in Prevention  Provide complete, accurate relevant information on HIV and AIDS Stimulate Community Dialogue Increase Community Ownership of information Provide Feedback on questions Demonstrate conversion positive behavior through magnification

7. SBC counseling and Testing Promote and raise awareness of CT within the community Work with the communities in creating additional services and/or strengthening existing services. Provide a supportive environment to community members to motivate them to get tested, stay and/or return for their results, and make healthier decisions in the future.

8. Prevention of mother to child Transmission (PMTCT) Primary prevention of HIV infection Promote community understanding and acceptance of PMTCT services Promote HIV/AIDS prevention and access to prevention services, particularly among girls and women. Include emphasis on abstinence and being faithful approaches among girls/young women Promote HIV counseling and testing Prevention of unintended pregnancies among women infected with HIV Promote awareness, knowledge and use of Family Planning services as a sure way to prevent such unintended pregnancy

9. Prevention of mother to child Transmission Prevention of HIV transmission from women infected with HIV to their infants Promote informed decision making for all pregnant women, especially HIV+ pregnant women Increase knowledge and skills among PMTCT clients about PMTCT services, anti-retroviral therapies, infant feeding options, disclosure (where appropriate), family planning Promote involvement of partners and families to support disclosure support testing and infant feeding and family planning choices Support improved policy environment for improved PMTCT services, PMTCT protocols for providers, infant feeding, drug therapies, family planning and HIV/AIDS prevention

10. Prevention of mother to child Transmission Provision of treatment, care, and support to women infected with HIV, their infants, and their families. Promote involvement of partners and families to support disclosure support testing and infant feeding and family planning choices Promote access and referrals to related services, including ANC, L&D, post-partum, family planning and PLHA support services

11. Strengthen STI services Increase STI Prevention and Treatment-Seeking Behavior Identify the barriers and motivating factors driving risky behaviors such as unprotected sex with someone infected with an STI, such as sex workers who routinely have unprotected sex with clients. Educate audiences at risk of STI infection about the major symptoms of STIs to enable them to spot these in a potential sex partner (to encourage protection) or themselves (to encourage immediate seeking of treatment); Identify motivating factors that may compel members of beneficiary populations to adopt preventive behaviors to avoid contracting an STI.

12. Improvement of ART Services Improving adherence to treatment regimens so that clients receive the full benefits of treatment and avoid development of ARV-resistant strains of HIV. Promoting clients as full participants in care who play an important role in making choices about their lives Creating an enabling environment for ART clients at family and community levels to ensure adherence, promoting reduction of stigma and discrimination against PLHA, dispelling myths, fears, and misconceptions about ART and HIV/AIDS

13. Tuberculosis and other OIs Promote and raise awareness of tuberculosis and opportunistic infection prevention, symptoms and treatment within the community in a sensitive manner Work with the communities to mobilize them in creating additional services and/or strengthening existing services. Provide a supportive environment to community members to motivate them to seek and adhere to OI and TB treatment

14. Home-based care Increase support for and promote sustainability of HBC programs among policy makers and stakeholders Reduce stigma and discrimination of PLHA and PABA Empower PLHA to demand and access essential services including HBC Strengthen families and care-givers capacity to care for PLHA 

15. Orphans and vulnerable children Promote support for children and their families before they are orphaned. Promote children�s basic rights.

16. In conclusion SBC interventions must be planned and implemented in an integrated way. For instance, the program can incorporate several different but interrelated versions of the same key messages in such diverse interventions (within the same program)