Advocacy,
Communication and
Social Mobilization
Using ACSM to maximize civil
society engagement in GFATM
projects
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Objectives
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
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To promote and facilitate engagement of civil society
Examine the role of civil society in policy discussions
and programme design
Examine the role that different civil society
actors/audiences can play in implementing ACSM
activities and integration of TB control into
governance and societal structures
Expand the effectiveness of ACSM approaches to
increase TB case detection, service usage and
engagement of civil society
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What is civil society?

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'A civil society is a public space between
the state, the market and the ordinary
household, in which people can debate
and take action'.
any voluntary collective activity in which
people combine forces to achieve change on
a particular issue
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Importance


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Health interventions are social interventions
Broad-based support needed to maximise
impact of health interventions
Strong political and social support are critical
to program success
Civil Society is a force multiplier that can
increase impact—ACSM is the means to an
end.
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More Effective
Advocacy
Gov’t makes TB
control high
priority
Gov’t
ensures
adequate
drug supply
Gov’t
provides
quality DOTS
services
STOP
TB
Monitoring
More Effective
Communication
Households
learn about
TB
symptoms,
transmission
and treatment
Gov’t,
community,
households
team up to
eliminate TB
stigma
People with
symptoms
seek health
care
Social
Mobilization
Civil society works with
Gov’t ,and households to
eliminate TB in the
community
Providers,
community
and people
team up to
detect
potential
cases and
diagnose
correctly
Civil society allocates
resources and nurtures
appropriate environment
to eliminate TB in
community
Providers,
community and
people team up
to encourage
correct
treatment
regimen
Gov’t,
community, civil
society and
households
integrate into
culture
appropriate
health values
and practices
# Cases
drop long
term
# of TB free
communities
increase
Possible Contributions of Social Mobilization
To Desired Outcomes to STOP
TB
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Philippines
Social Mobilization Project
Micro level engagement of civil society
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Question: How to increase case detection through
community engagement?
CCM turned to community-based NGOs.
Partner Profile: World Vision—faith-based NGO
with strong community level visibility.
Project: Formation of community based TB "task
forces".

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Active TB case referral
House to House communication and education for TB
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Increase in detection of TB suspects as a
result of civil society engagement
Barangay Pangobilian, Brooke’s Point, Palawan
Case Finding Activities
2001
2002
2003
2004
2005
160
140
120
100
80
60
40
20
0
no. of symptomatics
no. of TF referrals
no. of new smear
positive
no. of new smear
positive from TF
referrals
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Unforeseen benefit!
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Community members lobby local government
to increase TB services
Community members involved in active case
detection (based on clinical presentation)
Engagement of businesses, schools,
churches, civic organizations
Beginning of a political health movement for
wider health issues
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Mobilizing civil society to
implement ACSM
activities in Kenya
A national approach
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Journalists can advocate for equitable access
Problem
NLTP's
access to
to TB/HIV
detection1:
and
treatment
people living in urban slums
TB/HIV
povertybecause
often go hand
in hand
isand
limited
of resource
constraints
A peri-urban area in Southern Africa.
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Local NGOs have access slum dwellers, but need
training to deliver TB information to patients and
need to become more involved in the planning and
policy process
Cured TB patients on World TB Day in Kinshasa.
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There's no problem in mobilizing civil society
in Kenya
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9,000 registered NGOs and CBOs in Kenya out of which 6,000 are
operationally active.

About 500 are members of the Kenya Consortium to Fight AIDS, TB
and Malaria (KECOFATMA).

KECOFATUMA has used a GIS system to map and analyze its
members countrywide.
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The NLTP and its implementing partners work with KECOFATUMA and
therefore more than 500 organizations that are members of this
umbrella body.
…but civil society activities for ACSM are uncoordinated
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The NLTP had already established an ACSM
Task Force to manage the COMBI project
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There was past history of good relations in the Task Force
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Good management structures had been established
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Members knew each other and communicated effectively
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New members were simply included in the existing ACSM Task Force:
World Health Organization (WHO), African Medical and Research
Foundation (AMREF), Centers for Disease Control (CDC), Family
Health International (FHI), Global and National Stop TB Partnership;
International Medical Corps (IMC), Kenya Medical Research Institution
(KEMRI), KNCV, National AIDS, STI Control Programme (NASCOP);
National Empowerment Network of People Living with HIV/AIDs in
Kenya (NEPHAK); PATH; Population Services International (PSI);
United States Agency for International Development (USAID); in
coordination with the Ministry of Health's Division of Health Promotion
and the National Leprosy and Tuberculosis Control Programme (NLTP).
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Lines of communication were already established
NLTP
PATH – lead
agency on ACSM
Other agencies
NGOs
…Flow of funds
Were discussed openly in the Task force at the outset
Given to the lead agency for each component of the strategic plan
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The Task Force gained
consensus on the target
audiences based on the
problem
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NEPHAK and IMC : train 100 first line health providers include
religious, civic and cultural organizations
PATH, FHI and PSI: evaluation of communications needs
PATH, FHI, and IMC: use peer education etc in communities, schools and with health workers
PATH: develop community-linked mass media campaigns
PATH and NLTP: mobilize the media
PSI and AMREF: plan the mass media campaign
Kenya Medical Research Institute and NLTP: take out quarterly TB ads in national papers
FHI: review, upgrade and develop new IEC materials for mass pamphleteering
FHI, Min of Lab and Manufacturers Association etc: train on peer-to-peer education in
workplace.
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Conclusion
Mapping of:
 The problem
 Target audience
 Stakeholder expertise
 Policy, judiciary and legal barriers to TB
control
…leads to improved coordination of activities
and greater access to the urban poor
…but local NGOs still need support to build
capacity to deliver services and to lead some
aspects of the programme design and policy
process
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Exercise
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Instructions: Take a sheet of paper and map
an overview of all the different players and
actors involved in your TB program
Draw lines and arrows indicating the
connects of authority, influence and support.
Are there other actors and players that can
be accessed?
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Report out
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Conclusions and discussions
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