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The Beeg Bang for MMC. Circumcision in South Africa Supporting the Scale Up plan. Richard Delate Johns Hopkins Health and Education in SA. Men Ever Counselled and Tested NCS - 2006/2009. Men Counselled and Tested in last 12 Months – 2006/2009.
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The Beeg Bang for MMC Circumcision in South Africa Supporting the Scale Up plan Richard Delate Johns Hopkins Health and Education in SA
Knowledge Levels of the benefits of MC for HIV risk reduction – NCS 2009
Acceptability Levels of MC amongst Men and Women* * Data from four community studies in Ethekwini Metro Municipality (KZN), Matjhabeng and Masilonyana Local Municipalities (Lejwelephutswa, FS); Merafong (Gauteng); Madibeng Muncipality (Bojanala, North West)
WHY IS A BEEG BANG REQUIRED • TO REACH 16 600 per month until March in the priority to make target of 100 000 • To reach 41 600 circumcisions per month to achieve 500 000 over the next five years. Without Social and Behavioural communication we will NOT have the beeg bang
Have laid the foundation for the Beeg Bang • SANAC Comms Strategy in place • Provincial ACSM strategies being developed • Men’s sector sensitised and provincial strategies developed • Radio Talk Shows undertaken • Radio Producers Trained • 8 community radio stations • 1 National Station (Ukhozi FM – Zulu)
Foundations have been laid • Television – integrated into Mindset in public health centres and on Siyayinqoba-Beat-it. • Posters Developed in 2 languages • Brochure developed in 2 languages • Integrated into toolkits and Peer Educators trained • Siyayinqoba – Beat It – 2 300 peer educators trained • Brothers for Life – 500 peer educators trained • Men’s sector and community partners mobilised and ready– but absence of services for referral is on hold.
Community Dialogues Face to face Communication Media Advocacy /PR THE BEEG BANG Social Mobilisation Mass Media Small Media Posters Brochures Outdoor SERVICES Soc. & Beh Change New Media Web/ email/ mobile Radio Talk Shows – Advert. Television Drama / Advert. Telephone Helpline
Attitudes INDIVIDUAL Intention & Behavior COLLECTIVE Leadership Participation Goal Setting Action META-THEORY OF HEALTH COMMUNICATION SKILLS & KNOWLEDGE COMMUNICATION INSTRUCTION DIRECTIVE Dissemination Promotion Prescription NONDIRECTIVE Entertainment Counseling Dialogue Social Networks PUBLIC Advocacy Coalition Formation Regulation reinforcement IDEATIONAL FACTORS COGNITIVE Attitudes (Beliefs & Values) Subjective Norms Self-Efficacy Perceived Risk Self-Image EMOTIONAL Fear, Sadness, Affection, Happy, Trust, Empathy SOCIAL Mutual Understanding Cohesion & Reciprocity Collective Efficacy HEALTH PHYSICAL & MENTAL STATUS REDUCED MORBIDITY & MORTALITY from INFECTIOUS & CHRONIC DISEASES BEHAVIOR confirmation enabling ENVIRONMENTAL CONTEXT: SUPPORTS & CONSTRAINTS Burden of disease; level of toxic chemicals in air, water, & food; population density; technology; policy; access to food, safe water & sanitation; access to health care, socio-economic conditions
What do we need to make the beeg bang happen NEED INVESTMENT AND COMMITMENT • Current disconnect between what Government and Donors want and resources! • National and provinces have cut back on ACSM budgets – but still want drive people to services. • Donors have cut back on ACSM budgets – but still want to drive people to service? • Private media owners have given GREAT benefits in the past – matching investments by donors and government – but in the absence of resources its not possible to fund these efforts.