Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 9189
Country/Region: India
Year: 2010
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health
Organizational Type: University
Funding Agency: USAID
Total Funding: $798,105

With the growing complexity of the HIV epidemic, the National AIDS Control Program (NACP III) focus has shifted from raising awareness to behavior change, from a national response, to a decentralized response and an increasing engagement of NGOs and networks of people living with HIV/AIDS (PLHIV). The major emphasis of NACP III is on prevention, since more than 99% of the people in India are uninfected. The focus is on saturating high-risk groups such as commercial sex workers (CSWs), men who have sex with men (MSM) and injecting drug users (IDUs), vulnerable groups, namely migrants and truckers, with prevention messages. NACPIII also seeks to implement the principle of a continuum of care that includes management of opportunistic infections and antiretroviral therapy (ART). The Government of India (GoI) has dedicated substantial resources to accomplish its goal of halting and reversing the epidemic.

The Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (JHUCCP) with its global experience in the area of communication has provided technical assistance (TA) to GoI with USG funding. In India, the first phase of JHU CCP communication assistance was a field support activity (Oct 2004- July 2007) under the Global Health Communication Partnership (HCP) program. It was marked by development of campaigns focused on youth, workplace, care and support.

In phase two (July 2007-June 2011), JHUCCP through an Associate Award (AA) under HCP provided TA to the National AIDS Control Organization (NACO), Maharashtra and Goa State AIDS Control Societies (SACS) as well as other SACS in the design, development and operationalization of strategic communication programs for different thematic areas. The target audiences for prevention include most-at-risk-populations (MARPs), vulnerable populations and young women and men in high prevalence districts. Programs also included messages for the general public in an attempt to reduce stigma and discrimination. JHUCCP will continue to work closely with the government to create proto-type creatives that will be mass produced and distributed by GoI. The mass media and other audio visual materials will also be rolled out with GoI funds. An amount of $4.76 million has been leveraged from GoI for all the campaigns developed for NACO in FY 07-08.

The communication program will build on lessons learned, replicate and consolidate current communication activities and build capacity for successful and sustained implementation of communication activities at state and national levels. In keeping with the PEPFAR vision, JHUCCP's goal is to identify and build the capacity of local organizations to sustain strategic communication in the country.

JHUCCP has developed and scaled-up campaigns for Youth, Workplace Interventions, Care and Support for NACO at the national level. In FY08, JHUCCP developed a national campaign for generating demand for Integrated Counseling and Testing Centre (ICTC) services with focus on increasing awareness among pregnant women about the benefits of prevention of mother-to-child transmission (PMTCT) program. The launch of the campaign was preceded by a baseline study in all 35 districts of Maharashtra and findings shared with NACO, Maharashtra State AIDS Control Society (MSACS), Mumbai District AIDS Control Society (MDACS) specifically established for Mumbai being a large city and an epicenter of HIV. JHUCCP also developed a national campaign to address stigma and discrimination faced by children infected and affected by HIV/AIDS. The innovative 'Dabbawalas' (Daba+walla Dabba refers to lunch box and Walla to persons paid to carry the lunch boxes from home to workplaces) communication campaign reached 100,000 people at workplaces over a period from 2005-2007. A music video for young people was produced to promote protective behavior. JHUCCP also provided TA to NACO for developing materials for increasing adherence to ART.

JHUCCP is providing TA at state/national level for an integrated communications program in prevention, counseling and testing and care and treatment services for Most-at-Risk Populations (MARPs) and other vulnerable populations. JHUCCP developed a range of innovative materials addressing safe behavior for use by NGOs during interpersonal communication (IPC). JHUCCP will train NGO staff in the effective use of these materials and in IPC. Media advocacy workshops were conducted across the state for media professionals and news coverage tracked before and after workshops to assess the effects of the workshops. In collaboration with the Indian Express group an award for "Excellence in HIV/AIDS Reporting" was given for the print media in Marathi and English.

JHUCCP is providing TA in various aspects of behavior change communication (BCC) to NACO. Some of the examples of this TA include: capacity building of radio program producers to develop radio programs addressing vulnerable youth and rural women; development of a communication strategy for interstate migrants; evaluation of activities implemented under the District Communication Action Plan (DAP) in the district of Aurangabad; and scaling up of DAP in other districts of Maharashtra.

A workshop on Leadership in Strategic Health Communication was conducted by JHUCCP for SACS, NACO and other partner staff. Simulated software 'SCOPE' (Strategic Communication Planning and Evaluation), adopted for evidence-based planning was used at the workshop. Efforts are in place to institutionalize the workshop.

Capacity-building of NGO partners including refresher trainings in communications skills and use of various media and materials was also carried out. JHUCCP is a member of the IEC /Youth Technical Resource Group at NACO, and its core committee to evaluate and provide technical inputs on content of materials for MARPs.

Funding for Care: Orphans and Vulnerable Children (HKID): $90,000

Summary:

There are very few materials that focus on the information needs of HIV affected and infected children and provide children basic information on psychosocial issues, nutrition, possible side effects of ART and importance of adherence. These types of materials are needed to bring out the main issues that OVC face in their day-to-day lives and may be used by parents and care givers as discussion starters on the issue of HIV/AIDS.

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1: Technical Support to Develop Communication Materials for OVC programs

In FY08 and FY09, two sets of story books on themes of HIV/AIDS are being developed for children affected and infected with HIV. These books are being developed for children of two age groups (6-11years) and (12-16 years). Each book will have a set of 5 stories along with illustrations and interactive activities for children at the end of each story.

In FY10, JHU CCP will step up efforts in providing need based technical support to the Avert project for their OVC projects. Depending on the requirements of the OVC projects technical support could be in the form of developing specific communication materials for OVC activities conducted by health care providers, parents, guardians and caregivers on the provision of basic health care and nutritional support for OVC at home and in institutional settings. Building on the communication materials that JHU CCP has already developed, additional materials may be developed to address stigma and discrimination against OVC at the community level and at schools.

In FY10, a monitoring and evaluation plan will be designed and implemented to understand the reach of the "Story Books." The research will include qualitative feedback from children and their caregivers as well as from NGO/CBO staff. Service statistics of NGOs/CBOs will also be tracked to measure the reach of the set of story books developed by JHU CCP. Qualitative measures will be used to understand the way these books are being used and their effect on children. Efforts will also be made to translate the stories in other languages and intensify the dissemination of the books to other states through the different SACS and NACO.

Funding for Treatment: Adult Treatment (HTXS): $95,000

Summary:

The advent of antiretroviral therapy (ART) has made possible better quality of life and dramatic decrease in mortality among HIV-infected people. But very high levels of adherence are required for ART to be effective. At least 95% adherence to medications is required for a sustained response. Unfortunately, non-adherence remains a formidable barrier in the management of HIV, resulting in development of resistance and drug failure. Although the Indian National ART Program was launched in April 2004, adherence remains a public health concern and there is limited information regarding levels of adherence.

There is need for adequate preparation of patients prior to initiating ART and incorporating adherence support measures for all patients receiving ART. Despite some attention to adherence in recent years, much more remains to be done to better understand and promote adherence to ART through effective communication materials. For addressing the issue of adherence, there is need for a comprehensive range of materials which includes information counseling, reminders, reinforcement and self monitoring.

ACTIVITIES AND EXPECTED RESULTS

Activity 1: Technical Support for developing materials on ART adherence

In FY09, NACO replicated and adapted a care and support kit developed by JHU CCP for PLHIV which contained materials on ART adherence. Further in FY09, NACO rolled out a poster on registration at ART centers and importance of ART adherence developed by JHU CCP. In FY10, JHUCCP will provide technical assistance to NACO to develop communication materials to improve adherence to ART regimens among adults. This could be in the form of job aids for counselors to counsel on ART or take-away materials for clients on the importance of adhering to the ART regimen.

The key monitoring and evaluation objective will be to understand the reach and effectiveness of various communication materials and reminder tools on ART adherence. Research will include feedback from both client (PLHIV) and service providers such as NGO/CBO staff and care givers, on ART adherence, and this will be captured with the help of qualitative research tools. Service statistics of PLHIV groups, NGOs/CBOs will be tracked to measure reach of the materials.

Funding for Prevention: HIV Testing and Counseling (HVCT): $93,105

Summary:

It is important that an individual who is HIV-infected is aware of his/her status as otherwise he/she could unknowingly transmit the virus to others. As of today, only 2530% of the people who are HIV positive in the country are aware of their HIV status. According to NACO, the challenge faced today is to make all HIV-infected people aware of their status so that they adopt safe behaviors and a healthy lifestyle to prevent transmission of HIV to others, and also access life-enhancing care and treatment services. Hence, HIV counseling and testing services are a key entry point to prevention of HIV infection, treatment and care of people living with HIV/AIDS (PLHIV) and to control the spread of HIV/AIDS in the country. In FY 08, based on a request from NACO, JHU CCP started developing a national campaign targeted to increase awareness about the availability of a range of services at the Integrated Counseling and Testing Centers (ICTC) and generate demand for ICTC services. Based on the main sources of knowledge for HIV/AIDS, the campaign utilizes multiple and appropriate channels of communication and includes mass, outdoor and print media to generate demand for the ICTC services. NACO has identified that less than 10% of the MARPs are accessing the public sector ICTC services. The national counseling and testing (CT) plan has articulated a comprehensive strategy to increase of the coverage CT services for MARPs and has outlined the need to develop innovative demand generation campaigns addressing the needs of the MARPs.

ACTIVITIES AND EXPECTED RESULTS

Activity 1 Provide Technical Support for Implementation of the Ongoing ICTC Campaign to Create Demand for ICTC Services

JHU CCP has developed a campaign for NACO in FY08 for generating demand for ICTC services which has been implemented by NACO nationally and in Maharashtra by the MSACS, MDACS and Avert project for the last two years.

In FY09, JHU CCP integrated messages about counseling and testing in all the materials developed and disseminated to the MARPs. In FY09, JHU CCP also developed an interactive training toolkit with a video accompanied by a facilitator's guide for training of trainers (TOT) who will conduct training for counselors at ICTCs. This interactive training toolkit, with a stop and start video component demonstrating ideal counseling sessions, was developed per NACO's request and used during the ICTC counselors' trainings in the country. In FY10, JHU CCP will provide technical assistance to NACO in replicating the training toolkit in other languages and in conducting refresher trainings for the master trainers.

During FY10, JHU CCP will continue to provide technical assistance to NACO, MSACS, MDACS and the Avert project to create demand for ICTC services, specifically targeting MARPs and vulnerable populations. JHU CCP will assist in the development of materials for the ongoing ICTC campaign, will assist in the technical review of materials, media planning and support the implementation, monitoring, and evaluation of the campaign.

Additionally, in FY10, JHU CCP will disseminate the evaluation report of the end-line survey and develop/modify the ICTC demand generation campaign and communication materials to meet the needs in Maharashtra state, to increase the uptake of services.

Funding for Strategic Information (HVSI): $100,000

Summary:

The Center for Communication Programs/Johns Hopkins Bloomberg School of Public Health (JHU/CCP) will provide technical assistance (TA) to the Maharashtra State AIDS Control Society (MSACS), Mumbai District AIDS Control Society (MDACS), Goa State AIDS Control Society (GoaSACS), Uttar Pradesh State AIDS Control Society (UPSACS), Avert project, the National AIDS Control Organization (NACO) and other USG partners for developing formative research, and monitoring and impact evaluation as needed to cut across all stages of design and implementation of the communication program. JHU/CCP will provide expertise in evidence-based programming, ensuring the application of state-of-the-art individual behavior change and social change perspectives as well as robust methodological analyses.

ACTIVITES AND EXPECTED RESULTS

In continuation of FY08 and FY09 activities, in FY10, JHU CCP will provide TA at the national and state level to monitor and evaluate effectiveness of various communication programs.

ACTIVITY 1: Designing an Evaluation Methodology and Monitoring Tools to Assess the Effectiveness of Communication Activities

In FY10, JHU CCP will assist NACO, MSACS, Goa SACS, Uttar Pradesh SACS, and Avert project to evaluate the communication campaigns/activities. JHU CCP will assist the agencies in designing an evaluation methodology, including sampling and interview tools, to assess the effectiveness of the materials, messages and media-mix in terms of behavioral objectives and project-wide indicators. JHU CCP will also provide TA for developing the evaluation protocol, selecting the agencies, implementing the evaluation and using evaluation data for program planning.

In FY10, JHU CCP will provide TA in evaluating the impact of the District Communication Action Plan roll out in the State of Maharashtra, the use of IPC materials with MARPs and the impact of the migrant communication strategy implementation on migrants and their families in the source and destination sites. In addition, TA will also be provided to NACO to assess the impact of the campaigns to increase the uptake of services among pregnant women in the focus States where NACO has rolled out the PMTCT campaign, the impact of the IPC skills building training on the quality of counseling among the ICTC counselors, the effect of the children's books on OVC and their caregivers, the usefulness of the ART adherence materials for PLHIV and the overall capacity built for strategic communication at SACS and the NGOs they support. Through the process of working with SACS and NACO to measure the impact of their programs, their capacity in monitoring and evaluation will also be strengthened.

Funding for Health Systems Strengthening (OHSS): $160,000

Summary:

JHU/CCP implements a targeted HIV/AIDS communication program in Maharashtra State under the Avert project. In the first phase (ended in July 2007), JHU/CCP provided TA to the state in the design, implementation, monitoring and evaluation of behavior change communication (BCC) activities in HIV/AIDS across a range of issues including advocacy, work place interventions, NGO capacity building, youth, care and treatment and high-risk behavior interventions. Several of these activities and approaches have been adopted by NACO for national level use. In FY08 and continuing in FY09 JHU/CCP will provide technical support to MSACS, MDACS, GoaSACS, Uttar Pradesh SACS and Avert project in the design, development and operationalization of communication programs. The aim of the communication program in Phase two of the JHU/CCP project (July 2007-June 2011) is to support the TA needs of the National AIDS Control Program and also to support the state of Maharashtra in developing a unified communication response including uniform communication messaging, product development and implementation. As the second phase of the program comes to an end in FY10, constant and strategic efforts will be made to build the capacity of the partner organizations, both government as well as NGOs, in continuing to engage in strategic communication program planning and evaluation. In order to accomplish this sustained effort, capacity building of government partners, stakeholders and the NGOs becomes essential as well as identifying and training other local resources that can carry the agenda forward.

ACTIVITIES AND EXPECTED RESULTS

In continuation to FY08 and FY09, in FY10, JHUCCP will continue scaling up of following activities at national and state level:

ACTIVITY 1: Institutionalization of Follow-up Workshop on Leadership in Strategic Health Communication Workshop

In FY08 the Leadership in Strategic Health Communication workshop was organized for NACO, DAPCUs and Technical Support Units (TSUs) of Maharashtra, Karnataka, Goa, Uttar Pradesh, Tamil Nadu, Andhra Pradesh and other partners. This intensive training program was designed in a manner that would best serve the needs of the SACS, TSUs and other partners to effectively design and implement evidence-based communication strategies.

The framework of the Workshop was the P-Process, developed by JHU/CCP as a conceptual planning model. NACO's IEC Operational Guidelines follows the same P-Process framework developed by JHU CCP as the conceptual model for developing effective communication programs. The workshop first introduced participants to key concepts of strategy development (i.e., hierarchy of effects, the multi-stage approach to planning, and the concept of strategic leverage) and then delved into the five steps of the P-Process: Analysis, Design, Development, Implementation & Evaluation, and Review.

The workshop used SCOPE (Strategic Communication Planning and Evaluation), an interactive computer software simulation planning tool, that assists users in designing and implementing effective health communication projects. Developed by JHU CCP, SCOPE integrates communication theory and strategies with actual data from India and specific information from Maharashtra. The process trained participants to make decisions based on qualitative and quantitative data.

During FY09 another workshop will be conducted for the senior officials from NACO and SACS. It is envisaged that this training workshop will be institutionalized during the FY10 within a growing, learning organization in India so that the process of capacity building of health professionals in strategic communication is sustained.

ACTIVITY 2: Implementing and Monitoring District Communication Action Plans

Under the National AIDS Control Program Phase III, HIV programs will eventually be integrated into the National Rural Health Mission (NRHM) framework for optimization of resources and to ensure sustainability of interventions. At the district level, DAPCU will ensure implementation and monitoring of the communication plan.

In FY 09, JHU CCP assisted the Avert project in developing and implementing a district-level communication plan for the district of Aurangabad in Maharashtra State. The HIV/AIDS communication activities were integrated with the existing district level plan of MSACS for implementation of prevention, care and treatment services along with the National Health Rural Health Mission (NRHM) machinery. Aurangabad DAPCU was responsible for monitoring the communication activities. JHU CCP in collaboration with SACS and Avert project will develop communication plans for the remaining 34 districts in Maharashtra and two districts in Goa.

In FY10, JHU CCP will continue to assist MSACS, MDACS, GoaSACS and Avert project in reviewing, developing and implementing the plans for the year, based on the communication needs identified. JHU CCP will also provide technical support for capacity building of the existing NRHM workforce other health service personnel such as link workers, NGO peer educators and outreach workers, to strengthen the implementation and for evaluating the communication plan.

Operational guidelines will be finalized in FY10 on how District Communication Action Plans can be designed and rolled out in a collaborative and synergistic way, how capacity can be built for sustaining the plans in the future, how the impact of such a synergistic plan can be assessed and how this can assist in influencing policy frameworks. In FY10, the evaluation data on impact of the district communication action plans in Maharashtra will be disseminated.

ACTIVITY 3: Refresher training for National level Master Trainers for Training of ICTC Counselors on Interpersonal Communication and Counseling (IPC/C) Skills.

The 12 day training that ICTC counselors across the country receive does not adequately cover interpersonal communication and counseling skills and neither does it include training on the effective use of materials. In FY08, an interactive interpersonal communication skills building module had been developed for training counselors to help them understand the basic principles that they needed to follow while communicating with their clients in order to make the client-provider interaction more effective. The module along with orienting them on the basic principles of interpersonal communication was meant to build their skills around other issues which directly or indirectly affected their interaction with clients. The training module consisted of participatory techniques for transacting the contents with the participants. The sessions were supported by a specially designed stop and start video to demonstrate both effective as well as ineffective styles of communicating with clients.

Along with developing the module, JHU CCP had also been involved in training Master trainers deputed by NACO to roll out the training in states across the country. During FY10, refresher trainings will be carried out for the Master trainers to help address issues that they would have faced while carrying out the trainings and also refresh their learning.

The overall Monitoring and Evaluation objectives are to understand the knowledge and attitude of the workshop participants and communication skills including use of IPC tools. Pre and post workshop interviews will be conducted to examine changes in knowledge, skills and attitudes among the Counselors who attend the training workshops.

Visualization in Participatory Planning (VIPP) methodology will be used during the workshop to understand the awareness of participants and the obstacles in dealing with clients. Communication skills including effective use of IPC tools by the counselors will be tracked using the Observational and Client feedback approach. Observation using a checklist will be conducted among a sample of counselors who participated in the training to understand how efficiently and effectively they are using their skills in practice. Client feedback will also be collected using exit interviews to understand the quality of counseling. Also an attempt will be made to understand how clients attribute their behavioral changes to the interaction with Counselors.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $165,000

The key communication approach to working with most-at-risk populations (MARPs) is through interpersonal communication and counseling (IPC/C). It thus becomes important that these IPC sessions are effective and are adequately supported by messages and materials that are acceptable, appropriate, relevant, understandable, attention-getting, memorable, attractive, and credible to and have an impact on the intended audience. There was also a need expressed by NACO, the Avert project, Mumbai District AIDS Control Society (MDACS) and Maharashtra State AIDS Control Society (MSACS) for specific communication materials for the NGOs working with different target groups among the MARPs.

People move from one place to another-temporarily, seasonally or permanently. Migration and mobility increases vulnerability to HIV, both for those who are mobile and for their partners back home. Back at their place of origin or home, female spouses/partners of migrants are vulnerable to HIV if their husbands/male partners are infected with HIV. Some wives/female partners also have their own sexual networks in the absence of their husbands/male partners. Female migrants are also at risk of HIV through transactional sex. For women, lack of knowledge, poor negotiation skills and decision-making power, traditional gender roles in Indian society together with poor health seeking behavior, poor adoption of safer sexual practices with both their husbands and other sexual partners facilitates the spread of HIV. An ideal response with migrants should address HIV prevention, care and support before they leave (source), as they travel (transit), in communities and areas where they stay and work (destination), and after they return home (source /place of origin).

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1: Designing Communication Campaigns for Most-at-Risk-Populations (MARPs)

In FY08 & FY09 JHU CCP conducted a series of workshops with NGOs working with MARPs and developed a set of innovative materials for outreach workers (ORWs) and peer educators (PEs) to work with their target populations of female sex workers (FSWs), men who have sex with men (MSM), injecting drug users (IDUs) and transgendered. A compilation of street play scripts with accompanying card puppets and other games and activities were also developed and disseminated. In FY09, monitoring tools are being developed with the help of the Avert project, MSACS and MDACS. These tools will monitor distribution/flow and utilization of various communication materials.

In FY09, JHU CCP will finalize a second set of communication materials for MARPs. JHU CCP will disseminate the MARPs communication materials at the national level and provide support to NACO, SACS and District AIDS Prevention Control Unit (DAPCU) to replicate the material in local languages. NACO, MSACS, MDACS, GoaSACS and Avert project will replicate MARPs communication materials as needed by their NGOs /CBOs.

JHU CCP will provide TA to the training of trainers (TOT) that will be conducted for MSACS, MDACS and the Avert project on effective interpersonal communication, effective use of communication materials and use of the monitoring tool developed by JHU CCP to track the use of the materials. These trainers will further conduct a series of trainings for NGOs/CBOs working with the SACS and DAPCUs to train their ORWs and PEs.

In FY10, JHU CCP will gather feedback about the utility and effectiveness of the materials developed and used by outreach workers (ORWs) and peer educators (PEs) of NGOs supported by MSACS, MDACS, Goa SACS and Avert project. In FY10, an impact evaluation will be conducted to asses use and effectiveness of these materials by the ORWs and PEs through a mix of qualitative and quantitative research techniques. The impact of the NGO outreach work on the target audience, supported by these inter-personal communication materials, will also be evaluated.

The process regarding the MARPs communication material development and the curriculum of the training workshops will be documented in detail in order to institutionalize the process at SACS and DAPCUs.

ACTIVITY 2: Communication Strategy and Campaign Development for Migrant Population:

In spite of the fact that migration is a continuum with different stages source, transit and destination point the bulk of HIV related migration programming has been directed towards migrants in their urban destinations. As a result, where migrants came from, how they travelled and the situation of their families left behind were largely left unaddressed by stand-alone destination based interventions. Current interventions do not adequately address the migrants' emotional, social and other service-related needs before departure, during travel and in the destination districts/states. Therefore, there was a need and rationale for establishing effective linkages between source and destination programs.

NACO, in consultation with partners at the national level has been working on a more comprehensive migrant intervention strategy. In FY 08, JHU CCP, in partnership with NACO, CARE India, the Avert project, MDACS and Uttar Pradesh SACS developed a 'source-transit-destination' migrant intervention plan with a communication strategy. JHU CCP will support the Avert project, MDACS and MSACS in the development of a Needs Assessment tool and communication strategy for migrant destination interventions. A baseline will be conducted at source in Uttar Pradesh and at destination in Mumbai/Thane which has the largest concentration of single migrants.

In FY09, as part of this communication strategy, a short film and other BCC materials and activities will be developed for migrants by JHU CCP. The materials will be rolled out by MSACS, MDACS and the Avert project in Maharashtra and by NACO through SACS in other States.

Further, in FY09, JHU CCP will provide technical assistance in the roll out of the pilot project linking source sites in Uttar Pradesh and destination projects in Maharashtra. JHU CCP will also conduct TOTs for NGOs involved in these interventions for effective IPC and effective use of communication materials and activities.

In FY10, an impact evaluation will be conducted at source, transit point and destination to understand the use and effectiveness of materials developed for migrant interventions in Maharashtra and Uttar Pradesh. This impact evaluation will also include case studies and qualitative research at source, destination and at transit points, depending on the kind of intervention.

In FY10, in consultation with NACO, JHU CCP will provide technical assistance to NACO for the scale up of these interventions to other states, linking the high prevalence in-migrant districts/sites to out-migrant source districts/sites.

ACTIVITY 3: Developing a Feature Film on HIV/AIDS

The influence that mainstream Hindi cinema has on the attitudes, lifestyles and larger social norms and values in India are well known. Mainstream Hindi films, popularly known as 'Bollywood Films' reach out to all sections of society and along with entertaining the public they mould their thinking in a subtle but effective manner in favor of what is depicted through them. They also often reflect the social realities of the times. There have been several 'cult films' that have sparked debate and also formed public opinion around important social issues such as child marriage, patriotism, religious tolerance, etc.

The biggest challenge towards effective implementation of prevention, care and support programs in the context of HIV/AIDS is the stigma associated with it. The stigma often stems from fear, ignorance, misconceptions and sometimes a culture of intolerance. Mainstream Hindi cinema with its all encompassing reach and power to influence public thinking provides a great opportunity to reach out to every nook and corner of the country in order to address stigma and discrimination and also bolster prevention efforts and public opinion.

JHU CCP would work with like-minded film makers and production companies to create a feature film addressing the various social dimensions associated with HIV/AIDS. The film would aim to create awareness, dispel commonly held myths and misconceptions, address issues around stigma and discrimination and most importantly make people realize that HIV/AIDS is something that they cannot turn a blind eye towards and that it is closer to their lives than they ever thought before. In the making of the film, JHU CCP will provide TA while the film company will fund the production costs.

The film that would be commercially released all over the country, would aspire to mobilize the country into a movement against HIV/AIDS and also create a supportive and enabling environment for PLHIV by destigmatizing them in particular and the epidemic in general.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $95,000

Summary:

Peri-natal transmission accounts for 2.72% of HIV transmission in India. The Prevention of Mother To Child Transmission (PMTCT) program aims to prevent the perinatal transmission of HIV from an HIV-infected pregnant mother to her newborn baby. PMTCT is an important prevention strategy of the third phase of the National AIDS Control Program targeted at vulnerable populations in the high-prevalence districts. Given NACO's national mandate to increase the utilization of PMTCT services, an ongoing national level demand generation campaign on Integrated Counseling and Testing Centers (ICTC) has a special focus on pregnant women, with the aim of increasing awareness about the availability of PMTCT services and the utilization of PMTCT services. As part of this campaign, specific materials for both mass media (TV and radio spots) as well as outdoor media (posters, bus panels, hoardings, bus shelters) have been developed addressing the issue of PMTCT.

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1: Provide Technical Support for Implementation of Campaign to Create Demand for PMTCT Services

In FY08 and FY09, as part of the national PMTCT campaign JHU CCP developed a new TV spot and outdoor media promoting PMTCT services. This was implemented by NACO nationally. Flashcards on PMTCT were developed as job aids for auxiliary nurse midwives (ANMs) to help them to refer pregnant women to PMTCT and ART centers. In FY09, the content and messages of the flashcards will be finalized and illustrations and design of the flashcards will be completed.

During FY10, JHU CCP will continue to provide technical assistance (TA) to NACO, MSACS, MDACS and the Avert project to create demand for PMTCT services. NACO's FY10 needs in the area of PMTCT will be better understood in FY09 and JHU CCP will be responsive to those needs.

JHU CCP will assist in the development of materials, technical review of materials, media planning and support the implementation, monitoring, and evaluation of the ongoing PMTCT campaign. Special emphasis will also be given to the needs of female sex workers and the wives of migrants and truckers while designing the PMTCT campaign.

Subpartners Total: $0
To Be Determined: NA
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Mobile Populations