Behavior change programme , condom promotion & distribution & VMMC

1. Behavior change programme, condom promotion & distribution & VMMC Dr Martin MIGOMBANO mmigombano@ippfaro.org

2. fromtheonset to whenthesituation allows Emergency Post-emergency Destabilizing event Durable solutions -Blood Transfusions -Standard Precautions -Condoms -ARVs (cont. use) -PMTCT -Meet STI needs Comprehensive HIV & STI services MISP Implementing & integrating comprehensive HIV services Loss of essentialservices Restoration ofessential services Relative stability Returnto normality

3. Prevention programme • Behavioural interventions • Condoms, Promotion and distribution • VCT • Prevention of mother-to-child transmission (PMTCT), • Management of sexually transmitted infections (STIs), • Strengthen health service delivery (Safe blood transfusion programme, Standard precaution programme (use of PEP) • Voluntary medical male circumcision (VMMC) for HIV

4. Behavior Change

5. Process of behavior Change

6. BCC Steps 1 Establish program goals 2 Involve stakeholders 3 Identify t arget population 4 Conduct Formative assessment 5 Segment target audience 6 Define desired behaviour 12. Analyze, feedback and revise 7 Design BCC Strategy and M&E plan 11. Evaluate 8. Develop a communication product 10. Implement and Monitor 9. Pre test

7. Conducting a formative assessment • Questions • Risk situations including what influences the decisions and settings for risk • Which target groups are most vulnerable; • What persons or groups constitute their social networks and key influencers? • What factors influences their behavior? • What are the insights of opinion leaders • …..

8. Conducting a formative assessment • Methodology • Focus groups discussion (cote d’Ivoire crisis) • Key Informant interview • In Depth interview • Discussion with PLWA/Key population • Observation • Inventory health facility and community based programme already in place (services, quality • Check your Logistic, conduct the assessment then analyze result than proceed the next BC step

9. Condom Promotion and distribution

10. Condom Promotion and distribution • Condoms male and female should be made available and free of charge during a crisis situation • Programme should include supply chain management including lubricant • Programme should targeted any person regardless of sex, age or marital status • Programme can be effective when it includes community and with tailored messages • Promotion messages should include dual protection approach (HIV-unplanned pregancy) • Condom needs to be visible

11. Steps for condom integration • Coordination and strategies • Information materials (involve leaders …) • Train staff and community (especially for Female condom) • Supply system in place (at the beginning you can use IAWG RH Kit (Kit 1 A & B), IPPF MAs, UNAIDS… • Provision (through health system or none health system) • Awareness campaign especially for female condoms)

12. Voluntary Medical Male Circumcision

13. VMMC • Effective intervention which can be perform during a crisis • Require trained staff and medical supplies • Require a task shifting approach • Require an improved infrastructure • Use of BCC strategy to create demand • It has to be integrated with other services such condom distribution, STI, BCC… • There is project implemented by UNHCR in Ethiopia and Uganda Needs to be done in protracted setting

14. Guidelines and other tools • IASC : Guideline for addressing HIV in Humanitarian setting • SPRINT Facilitator manual for MISP (IPPF-UNFPA) • Field experience from UNHCR • Reproductive health in emergency, Field manual www.aiwg.net, www.ippf.org ,www.unhcr.org, www.unfpa.org

15. Thanks, Merci beaucoup, Obrigado