1 Advocacy, Communication and Social Mobilization Using ACSM to maximize civil society engagement in GFATM projects.

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Advocacy, Communication and

Social Mobilization

Using ACSM to maximize civil society engagement in GFATM

projects

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Objectives 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?

'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

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

More Effective Communication

Gov’t makes TB control high priority

Civil society works with Gov’t ,and households to eliminate TB in the community

People with symptoms seek health care

Gov’t provides quality DOTS services

Gov’t, community, households team up to eliminate TB stigma

Gov’t ensures adequate drug supply

Providers, community and people team up to encourage correct treatment regimen

# Cases drop long term

Gov’t, community, civil society and households integrate into culture appropriate health values and practices

Social Mobilization

Households learn about TB symptoms, transmission and treatment

# of TB free communities increase

Possible Contributions of Social Mobilization To Desired Outcomes to

Civil society allocates resources and nurtures appropriate environment to eliminate TB in community

Providers, community and people team up to detect potential cases and diagnose correctly

STOP TB

STOP TB

Monitoring

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Philippines Social Mobilization ProjectMicro level engagement of civil society

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". 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

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20

40

60

80

100

120

140

160

no. of symptomatics no. of TF referrals no. of new smearpositive

no. of new smearpositive from TF

referrals

2001 2002 2003 2004 2005

Barangay Pangobilian, Brooke’s Point, PalawanCase Finding Activities

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Unforeseen benefit!

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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A national approach

Mobilizing civil society to implement ACSM

activities in Kenya

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Journalists can advocate for equitable access to TB/HIV detection and treatment

TB/HIV and poverty often go hand in hand

A peri-urban area in Southern Africa.

Problem 1: NLTP's access to people living in urban slums

is limited because of resource constraints

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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

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.

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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There was past history of good relations in the Task Force

Good management structures had been established

Members knew each other and communicated effectively

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).

The NLTP had already established an ACSM Task Force to manage the COMBI project

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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 outsetGiven 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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ConclusionMapping 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

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

Conclusions and discussions