Building Capacity in Social and
Behaviour Change Communication
(SBCC) for HIV Prevention
An African-based Programme
Sara Nieuwoudt (1), Nicola Christofides (1) & Shereen Usdin (2)
1.Division of SBCC, School of Public Health, Faculty of Health
Sciences, University of the Witwatersrand (Wits)
2.Soul City Institute for Health and Development Communication
(SC:IHDC)
Partnership Vision
To create a recognized and accredited Africanled and based platform supporting the
development of practitioners and academics
with the SBCC competencies required to address
Africa’s public health priorities
Location: Johannesburg, South Africa
Geographic Focus: Sub-Saharan Africa
Image Credit:
Wikimedia Commons
Estimated HIV prevalence among young adults (15-49) by country
Communication as a tool for
HIV prevention
Social & Behaviour Change Communication
as a Discipline
Promotes:
•Multi-level analysis
of situation, including
social determinants of
health
•Targeted and multilevel responses
•Evidence-based
programming
Image credit: McKee, Manoncourt & Chin, 2000
Universities Training for the Market
Competency-based Curricula
Example: Research, Monitoring & Evaluation Competency Framework
Knowledge of:
 key monitoring, evaluation,
and research concepts
 tools and methodologies
for monitoring, evaluation
and research
 qualitative and quantitative
research methods
 participatory research
methodologies
 frameworks for project
evaluation
Ability to:
 select relevant indicators
for measuring project
processes and results
 develop and implement
monitoring plan with data
collection tools
 determine effectiveness of
communication strategy
 identify problems in design
and/or implementation
 maintain management
information system (MIS)
 use MIS to inform project
direction
 conduct participatory
monitoring, evaluation,
and research
 document and
communicate best
practices
Values:
 do not “doctor data”
 learn from mistakes or
non-success in programs
 use monitoring and
evaluation data to improve
program activities
 reliance of multiple
methods for monitoring
and evaluation
 systematic use of
monitoring and evaluation
at all levels of SBCC work
Problem Analysis
In 2008, many SBCC Practitioners working on HIV
prevention were:
– In leadership positions, without public health or
specific communication qualifications
– Desiring professional development opportunities
beyond non-accredited training
– Not able to afford overseas study
(SC:IHDC, 2008; 2010)
Establishing a platform for capacity
building takes time
Secured funding
from DFID, CDC
& C-CHANGE in
2008/09
Pilot of first course
in December 2009
First cohort
enrolled in
2010
Hired external
staff to lead
program
development
Course
development
and
accreditation
Division
Launch in
2010
Study tour and
adaptation of
competency
framework
May 2009
Consultative
Meeting
The entire process involved
a mix of stakeholders,
including practitioners &
academics from region &
abroad
Result: Division of SBCC
• Full and part-time
offered over 2-4 years
• 5 SBCC specific courses
• 1-week blocks
offered for
Attendance or
Competency
• 7 accredited
Short
Courses
SBCC
Research
• Academic staff
• MPH research
reports
MPH
Program
Community
of Practice*
•
* Under review
due to resource
constraints
Open to all course
participants, MPH
students & program
stakeholders (guest
lecturers, board, etc.)
Division Participant Profile
• Over 200 short course and
32 MPH students
• Aged 28-54
• Leaders in HIV responses:
– National AIDS Committees,
e.g. NERCHA
– Government advisors
– NGO leaders
– Research institutions
– Donor agencies, e.g. CDC
Division Reach: Africa and beyond
MPH
Short course
South Africa
Botswana
Swaziland
Lesotho
Zimbabwe
Ethiopia
Malawi
Uganda
U.S.A. (in RSA)
(same as MPH)
Namibia
Mozambique
Nigeria
Sudan
Niger
Egypt
Eritrea
Ghana
Uganda
Tanzania
Kenya
Zambia
D.R.C.
Burundi
India
Switzerland
Afghanistan
+ Institutional
support to
universities in:
Nigeria
Tanzania
Albania
Individual capacity built
“ Starting the MPH two years ago, I had lots of
practical experience, but now, I have the added
benefit of knowing the principles and theory
behind the practice. In my work in a large unit
dealing with HIV prevention, and working closely
with the Department of Health, I have become
the go-to person on social and behavior change
communication. We no longer tolerate “spray
and pray” prevention efforts: it’s all a whole lot
more targeted and effective.”
– MPH Student
Institutional capacity strengthening
• Individuals contribute to their institutions
• Institutions sending multiple individuals on short
courses/MPH note shift in institutional culture
Plans to systematically evaluate outcomes & impact
• Tracer study
– MPH student professional development/employment
– Performance (self- and employer-assessed)
• Comparison of short-courses vs. integrated
degree learning
Lessons: Factors of Success
Partnership between
academic and practitioner
institutions
• Allows for professional development with accredited
certification/degree, while maintaining focus on developing the hard
skills required for practitioners
Advisory board with local
and international
membership
• Allows division to keep current on both academic & practitioners
debates related to SBCC
• Multidisciplinary (communication & public health)
Hiring externally to lead and
manage program
Housing program within a
School of Public Health
SBCC Framing
• Bringing on board someone with a core set of skills to guide process
• We add value to an already interdisciplinary field with a strong
applied focus
• Able to draw on a broad range of skills (epidemiology, policy, etc.)
• More open to addressing social determinants of health through
intersectoral collaboration, at multiple levels
Implications for Capacity
Strengthening in HIV
• Understanding HIV with an ecological perspective and being able to
use evidence to develop and evaluate our programmes is critical
• Practitioners have an important role in defining what competencies
(knowledge, skills & values) are needed, while universities are well
placed to delivery competency-based training in a systematic way
• Embedding training in an academic institution supports sustainability
– Also, accreditation offers opportunities for career progression and
quality assurance unlike non-accredited training courses
• Basing the programme in Africa is more cost-effective than sending
African practitioners to study overseas and supports instruction and
content that is tailored to the African context
Thanks to our past donors!
Slide References
• Labonte R, Mohindra K, and Schrecker T. 2011. The Growing Impact of
Globalization for Health and Public Health Practice. Annual Review of
Public Health, 32: 263–83.
• McKee N, Manoncourt E, Chin SY, Carnegie R, eds. Involving People,
Evolving Behavior. New York: UNICEF; Penang, Malaysia: Southbound;
2000.
SUPPORTING SLIDE
SBCC Accredited courses
• Applying Social & Behaviour Change Theory to
Practice
• Research, Monitoring & Evaluation for SBCC
• SBCC Approaches
• Planning and Implementing SBCC
• Communication, Media & Society
• Introduction to Health Promotion
• Entertainment Education
Context: Complexity & Resource
Constraints
Image credit: Labonte, Mohindra & Shrecker, 2011