The Community Mobilization Activities (CMA) program was created in 2004 to provide expertise to

communities interested in addressing problems relating to HIV/AIDS and to link them to specific services.

Through dynamic communication and outreach, the program aims to transform communities into active

agents for changing behavior and addressing crucial social factors relating to HIV/AIDS. NawaLife Trust

(NLT) selected each CMA site in consultation with the MOHSS and USAID, based on location of treatment

programs in these areas.

The minimum package of prevention services provided through this program includes strategies to

overcome stigma and discrimination, understanding, empowerment and enhanced efficacy to address

gender equity, increased efficacy for abstinence and faithfulness, heightened awareness for responsible

drinking and increased self-risk perception that lead to safer behaviors and more caring relationships (see

Prevention OP and HBHC).

The behavior change objectives for these outreach programs include building skills for safe behaviors such

as abstinence and faithfulness, increasing perceptions of risk regarding multiple concurrent partners,

increasing risk perceptions of cross-generational and transactional sex, increasing positive attitudes and

behaviors for gender equity and empowerment, and reducing negative attitudes and behaviors leading to

stigma and discrimination.

NLT will have support from these areas: alcohol counseling and screening (activity 17061.08); Men and

HIV/AIDS mainstreaming gender into clinical and community programs (activity 12342.08); and capacity

building in behavior change communications (activity 16501.08).

NLT established 14 Community Action Forums (CAFs) in 11 of Namibia's 13 regions by the start of FY 07.

CAFs consist of 15 elected community members aged 15-60, who mobilize their communities to identify and

address HIV/AIDS-related problems. Specifically, the CAFs conduct Community Participatory Assessments

(CPAs). The CPA process assists communities in identifying and addressing their own HIV/AIDS-related

problems such as alcohol abuse, gender inequity and stigma and discrimination. Thus, CAFs also address

HIV/AIDS-related services such as PMTCT, VCT and, ART. CAFs also promote and advocate for support

services offered by other PEPFAR partners, including the MOHSS. By the end of 2007, a total of 16 CAFs

will be established and operating in: Keetmanshoop Urban, Rehoboth Urban East, Tobias Heinyenko,

Opuwo, Khorixas, Oshikuku, Gobabis, Oshakati East, Rundu Rural West (two sites), Ndiyona, Oniipa,

Grootfontein, Walvis Bay Urban, Omaruru, and Otjiwarongo (see Prevention-OP and system strengthening).

NLT will use the Communications Pathways Conceptual Framework developed by Johns Hopkins

University/Health Communications Partnership to incorporate this model via CAFs and mass media

campaigns, targeting three distinct levels of communication intervention (social political environment,

service delivery system and community & individual).

In FY 2008, CAFs will reach 24,576 community members ages 15 and above through outreaches, or about

17% of target audiences in these sites. Outreaches will focus on such AB areas as HIV/AIDS awareness,

life skills, relationships, gender equity, and stigma and discrimination. Each CAF will use an average of five

sites to conduct these outreaches continuously throughout an 11 month period. All of the people reached

through AB outreaches (24,576) will receive at least one IEC material (see Systems Strengthening).

A total of 208 CAF members will receive outreach training in such areas as HIV/AIDS awareness, life skills,

relationships, gender equity, and stigma and discrimination.

NLT will incorporate gender themes within CMA projects, implementing program materials from the Acquire

project implemented by Engender Health and Promundo to address health and development vulnerabilities

of men and women. These themes address violence and coercion within relationships, and encourage male

participation in HIV/AIDS programs. This will have a beneficial cross-cutting effect especially on CAF

outreaches focusing on relationships and HIV/AIDS (activities 5690.08, 7464.08).

NLT will provide technical assistance to help facilitators from other organizations such as Catholic AIDS

Action and Development Aid from People to People utilize its training guides more effectively.

NLT will continue partnering with the MOHSS and such regional partners as NASOMA, creating a link for

distribution of condoms through CAFs, which act as service outlets. CAFs will partner with Catholic AIDS

Action and Project Hope at the community and regional levels to strengthen referrals and share information

between their volunteer bases and program activities. As a result, CAF members will be knowledgeable of

and able to refer community members to volunteer services in different HIV/AIDS-related fields.

NLT will assess its outreach training package through analysis of successes and challenges noted in CAF

monthly feedback forms and activity field reports, and via direct observation through field visits and ongoing

supportive supervision. NLT will incorporate findings from this information into future trainings and technical

assistance efforts to ensure improved intervention quality and relevance.

CAF outreaches will continue reinforcing mass media messages at the community level, reaching

underrepresented areas such as informal settlements. CAF members will specifically reinforce Take

Control's "Be there to Care" mass media campaign messages, focusing on relationships. Take Control is a

government-led initiative, comprised of international and local organizations, including line ministries and

development partners. All activities under the "Be There to Care" campaign aim at encouraging Namibians

to re-evaluate the way they conduct relationships and will involve extensive discussion on gender relations

and the role of men in HIV prevention. Specifically, NLT works with Take Control's national mass media

campaign to promote partner reduction, partner testing, condom use and the development of healthy

behaviors in sexual relationships. NLT leadership has resulted in sourcing increased campaign funding and

partner support.

By 2008, Take Control will conclude the "Care and Support" and "Respect" phases of "Be There to Care",

focusing on family support to PLWHA and male involvement in PMTCT and partner reduction respectively.

In 2008, NLT will conduct the "Trust & Honesty" phase of its campaign, focusing on couples testing and may

link with counseling and testing demand creation activities for a period of three months. Other issues that

may be addressed include cross-generational and transactional sex. NLT may support one additional phase

Activity Narrative: in the campaign (e.g. Communication) with partners. NLT will produce two televised messages on partner

reduction/partner testing and related radio, print and outreach materials. Messages will also be adapted to

positive audiences where applicable.

Under Take Control, NLT will strengthen interpersonal communication and campaign regionalization efforts,

providing message toolkits to at least 500 outreach workers attached to CAFs and other organizations

partnering with the campaign. Two production workshops will be held to strengthen local ownership in

priority areas.

NLT will extend campaign activities to non-traditional marketing channels such as consumer promotions,

sponsorships, public relations to strengthen material distribution.

Short films promoting campaign values as respect, trust & honesty will be produced and nationally

broadcasted to foment discussion on social norms. Such discussions will then be replicated using films

during outreach sessions and through programs like NawaCinema.

NLT will reach 800,000 Namibians ages 15 years and above with mass media messages under the "Be

There to Care" campaign. Key target groups for the 2008 campaign will include steady couples (married

and unmarried) of reproductive ages (15-49 years) with a focus on men.

NLT will train CAF members in its relationships campaign (see system strengthening). CAF members will

implement this training through community outreaches. NLT will analyze the quality of these outreaches

through a review of successes and challenges noted in CAF monthly feedback forms and activity field

reports, and via direct observation through field visits and ongoing supportive supervision. NLT will

incorporate findings from this information into future trainings and technical assistance efforts to ensure

improved intervention quality and relevance.

These activities build and expand existing community mobilization and mass media activities from COP07.

The Community Mobilization Activities (CMA) program, created in 2005, uses dynamic communication and

outreach, the program transforms communities into active agents for changing behavior and addressing

crucial social factors relating to HIV/AIDS. NawaLife Trust (NLT) selected each CMA site in consultation

with the MOHSS and USAID, based on location of treatment programs in these areas.

NLT will have support in: mainstreaming alcohol awareness and sensitization messages into mass media

and interpersonal communications (activity 17061.08); Men and HIV/AIDS mainstreaming gender equity into

clinical and community programs (activity 12342.08); and capacity building in behavior change

communications (activity 16501.08).

NLT has established 14 Community Action Forums (CAFs) in 11 of Namibia's 13 regions. CAFs consist of

15 elected community members aged 15-60, who mobilize their communities to identify and address

HIV/AIDS-related problems (see Nawa AB 4048.08).

Overall, the behavior change objectives for community mobilization OP outreaches are consistent with this

minimum package of prevention services: enhancing understanding and self-efficacy towards responsible

drinking with awareness of sexual risk behaviors associated with alcohol abuse and towards risks of

multiple concurrent partners, increasing efficacy of correct and consistent condom use within steady

relationships, increasing risk perceptions for youth and older audiences of cross-generational and

transactional sexual practices, promoting efficacious behaviors towards counseling and testing (see CT

12334.08), especially male and couple testing, and creating an enabling environment in which needed

referrals to HIV/AIDS-related services are correctly advocated.

CAF Outreaches: In FY 2008, CAFs will reach 24,576 community members aged 15+ years in 16 sites,

reaching about 17% of the target audiences in these sites. Outreaches will focus on such OP areas as

alcohol awareness, prevention with positives and possibly reproductive health. Each CAF will use an

average of five sites to conduct these outreaches continuously throughout an 11 month period.

Approximately 19,660 people will receive IEC materials on VCT, treatment literacy and alcohol awareness

through these outreaches. A total of 208 CAF members will receive outreach training (see Systems

Strengthening 7464.08).

NawaSport: NawaSport is a behavior change intervention created to engage young men 15 - 35 years, who

have been underrepresented in prevention & care activities. The program uses soccer playing to create a

comfortable environment for men to discuss basic life skills and HIV/AIDS-related issues, including alcohol

abuse, stigma and discrimination and gender inequity through a 12 session curriculum. NLT will train a total

of 106 CAF members and partners to be program coaches. The NawaSport Coaches Guide will be updated

in 2007, providing advanced HIV/AIDS-related information on treatment literacy, stigma and discrimination,

gender equity and possibly circumcision. NLT will work with partner organizations such as Catholic Aids

Action and other community-based groups to bring this program to new sites and audiences.

The NawaSport program will expand to five additional communities by the end of 2008, for a total of 16

sites. The program will reach 2,160 men between the aged 15-35 years, representing approximately 5% of

this target group in the 16 CAF sites.

"Street Squad Soccer" enables NawaSport men completing the formal program to continue their

involvement. In COP 08, Street Squad Soccer will increase to 1,440 members, engaging more communities

and increasing attendance at its events. The program will host a tournament series including a national

competition on World AIDS Day. IT will also begin forging partnerships with popular sponsors such as One

Africa Television. Approximately 6,400 individuals will receive IEC leaflets on alcohol, gender, VCT and

ART through the NawaSport program and Street Squad activities by the end of COP 08.

NLT will assess NawaSport through its program activity forms, pre- and post test quizzes, Training of

Trainer course evaluations, and via direct observation on field visits and ongoing supportive supervision.

NLT will incorporate findings into future trainings and technical assistance (TA) to improve intervention

quality and relevance.

NawaCinema: NawaCinema is designed to generate participatory discussions through thought-provoking

films on issues relating to HIV/AIDS prevention, care and treatment in a socially comfortable and

entertaining way. NawaCinema targets older audiences, using videos from the Steps for the Future series

within its program format. A total of 240 CAF members will be trained as facilitators in this program.

By the end of 2008, NawaCinema will be active in all 16 CAF sites, reaching 30,720 community members

ages 15+ years, reaching about 17% of target audiences. Approximately 24,576 individuals will receive IEC

leaflets through these outreaches. NawaCinema will expand to 8 institutions offering VCT, PMTCT and ART

services, enabling the program to reach patients and clients. This will also improve collaboration between

CAFs and other HIV service providers. Each CAF will screen approximately 20 videos at three different

local venues over an 11 month period. The videos will cover 10 OP topics, including alcohol awareness,

gender themes, condom use and PMTCT (see System Strengthening 7464.08).

In FY 2008, NLT will continue to build partnerships with film distributors to strengthen the entertainment

component of the program by including more "blockbuster" movies in the program, which will be screened

after the educational videos.

NLT will assess NawaCinema through analysis of its facilitator and audience feedback forms, the program

pilot evaluation, and via direct observation through field visits and ongoing supportive supervision. NLT will

incorporate findings from this information into future trainings and TA to improve intervention quality and

relevance.

Mass Media: NLT is actively working through the Take Control national HIV & AIDS media campaign to

promote behavior change (see System Strengthening). Take Control is a government-led initiative of NGOs,

faith-based organizations, UN Agencies, line ministries and development partners. NLT is working to

strengthen this forum and contribute to coordinated efforts. NLT provides technical support to the Take

Control secretariat (at the Ministry of Information and Broadcasting) to develop a strategy document for the

national campaign and strengthen partnerships with other organizations.

Activity Narrative:

Mass media messages will be reinforced at the community level through CAF outreaches. NLT developed

alcohol facilitation guides in FY 2007, which will continue to be used in community mobilization activities in

FY 2008, and additional guides will be distributed to PEPFAR-supported partners. This guide includes a

description of the physiological and emotional impacts of alcohol abuse and detailed directives for

responsible drinking.

"Alcohol aids HIV" campaign: NLT will continue serving in a leading role with Take Control and its partners,

UNICEF and CAA, to support the Coalition for Responsible Drinking (CORD) to highlight the link between

alcohol abuse and vulnerability to HIV infections and to publicize responsible drinking guidelines.

By 2008, the "Alcohol aids HIV" campaign will be evaluated, updated and improved. Print and radio

materials for the campaign will also be developed. The focus of the campaign will be on moderate drinkers.

The campaign will also target persons of reproductive age (15-49 years). NLT aims to reach a minimum of

70% of social drinkers (350,000 persons) with mass media messages in this campaign (ref: 17057.08)

In 2008, NLT will assist Take Control/CORD in sustaining this initiative. NLT will expand the campaign by

adapting radio messages to three more languages and by adding a television component. NLT will support

placement of materials and will plan to run messages during two holiday intensification periods. NLT will

seek to leverage additional funds for placement through Take Control and CORD partnerships. Based on

the program's potential success, NLT will support CAFs to expand its work with Shebeen and bar owners to

encourage them to operate in a manner that reduces negative impacts on communities.

NLT will train CAF members in alcohol awareness and responsible drinking during community outreaches.

NLT will analyze the quality of these outreaches through a review of successes and challenges noted in

CAF monthly feedback forms and activity field reports, and via direct observation on field visits and ongoing

supportive supervision. NLT will incorporate findings into future trainings and TA to improve intervention

quality and relevance.

Over the next two years, NLT will evaluate the initial impact of this campaign and develop a follow-up phase

in collaboration with other partners. This will include developing mechanisms allowing greater involvement

of alcohol retailers. This may include a "responsible retailer" program conducted through CAFs to recognize

Shebeens operating responsibly and in accordance with the National Liquor Act.

NawaLife Trust will serve on the national circumcision task force with such stakeholders as the Ministry of

Health and Social Services and Catholic Health Services, and will be able to work with partners and

stakeholders in establishing communication initiatives as identified and needed (ref: MC 16762.08).NLT will

cultivate responsible drinking habits within Namibia through support to the national campaign and other

alcohol treatment initiatives, material development for partner organizations, and supportive supervision to

CAF outreaches (activity 17057.08).

This activity continues from COP 2007 and includes technical support for four elements:

Development of messages on HIV-related basic care and prevention with positive elements which are

adapted to the Namibian context and local languages; 2. Formulation of a communications campaign and

strategy to promote basic care and prevention with positives in Namibia; 3. Partnership and technical

support with MoHSS and USG partners, including PACT care subgrantees and DAPP, to develop a

communications brand and integrate appropriate messaging and communications tools on basic care and

prevention with positives into community-based care programming; and 4. Integration of HIV-related care

and prevention with positives messages and materials into a treatment literacy radio program.

In COP07, the Johns Hopkins University/Health Communication Partnership's (JHU/HCP) local office

transitioned to direct funding as a local NGO under Namibian law, known as Nawa Life Trust (NLT). Nawa

Life Trust began sensitizing key stakeholders in COP2007, such as Community Action Forums, MoHSS,

USG and USG partners on the need for basic care and prevention with positives interventions, and

collecting existing materials and messages which exist on these elements in Namibia. There is

overwhelming evidence attesting to the effectiveness of basic HIV care and prevention strategies which

improve the quality of life of PLWHA, including chemoprophylaxis, use of bednets (where malaria is

prevalent), counseling and testing, safe water/hygiene strategies in delaying HIV progression, improved

nutrition, and promotion of safe sex practices including abstinence, fidelity with condom use; family

planning; support for disclosure of HIV status; screening and support for STI care; reduction in alcohol

abuse and the prevention of mother-to child transmission of HIV. However, awareness of these

interventions and access and demand by PLWHA, their families and health providers remain low in

Namibia. This activity is aimed at expanding awareness, messaging and referral for basic care

components, including prevention strategies for HIV-infected individuals.

1. NLT proposes that all reference to its organization developing a national PwP campaign be removed from

the narrative. This matter is addressed in the Activity Change Justification section.

2. NLT proposes that it be responsible for adapting rather than developing PwP materials. NLT proposes

that the CDC, MoHSS and Department of Defense, who have the needed expertise, be responsible for

developing PwP communication messages.

3. NLT would like to clarify that all references to signage in the narrative to refers to its hospital display

stands, which are being placed in health facilities.

During COP08, Nawa Life Trust (NLT) will develop messages and launch a national branded

communications campaign that will support Namibia's prevention, care & treatment with HIV positive

Namibians. The campaign will be positive, interactive and empowering, and driven by PLWHA themselves

during the design and implementation phases. NLT will determine the strategy and communications mix,

but branded campaign elements will likely include the following:

a). The message: Nawa Life Trust will develop messages on basic care and prevention with positives

which are focused on providing information for PLWHA and their families on how to improve their quality of

life, how to live longer and healthier and how to prevention the transmission of HIV to others. Translation

into local languages will also be provided. Messages will also be developed to improve awareness of both

facility and community level providers on the need for basic care and prevention strategies for PLWHA and

their families. Emphasis will be placed on benefits and accessibility of cotrimoxizole prophylaxis to prevent

OIs, use of bednets (where malaria is prevalent), counseling and testing, safe water/hygiene strategies,

improved nutrition, and promotion of safe sex practices including abstinence, fidelity with condom use;

family planning; support for disclosure of HIV status; screening and support for STI care; reduction in

alcohol abuse and the prevention of mother-to child transmission of HIV. The goal will be to develop a

message which will effectively promote awareness of these interventions and demand by PLWHA, their

families and health providers

b). The brand or logo: NLT will develop a common brand name or logo that will appear on all program

elements, materials and sites and will become a symbol for reliable, relevant and client-centered

communication and their families. HIV positive Namibians and their friends and families will associate the

brand with high quality, trusted products and services. NLT will develop this brand in COP07 via PLWHA

participation.

c). Signage: NLT developed branded signage for all facilities and community sites to identify PwP services.

This will be a powerful visual link between PwP services and clients. Similar VCT and TB service signage in

Kenya helped destigmatize HIV services, and increased service accessibility.

d). Partnership with Existing Community-Based USG Partners: Nawa will develop communications on

quality of basic care and PwP services at facility and community levels of care. They will collaborate with

MoHSS and USG partners to develop the brand, market the brand at facility and community levels, thereby

moving towards certification of sites in basic care and prevention with positives messaging and service

delivery in following years. In COP2008, Nawa in conjunction with selected PACT subgrantees and DAPP

will create community-driven demand for quality basic care and prevention with positives services through

prevention strategies. Nawa will also produce a directory of clinical and community resources available in

Namibia for PLWHA for referral purposes. NLT will distribute the care guide to all Community Action Forums

and USG-supported partners and working in prevention, care and treatment of PLWHA.

e). Integration of Care into the Treatment Literacy Radio Program: in COP 2008, NLT will further develop

the Treatment Literacy radio program in collaboration with IBIS, a local leader in PLWHA-led

communication. The program's goal is to give PLWHA a voice. The Treatment Literacy Radio program has

been led by PLWHA trained in public speaking and basic radio production skills. The program is supervised

by an editorial board of project partners that links with service providers and technical experts at the

MOHSS, the USG and partners to ensure that messaging is relevant, accurate and in line with the Positive

Living campaign behavior change objectives. The treatment literacy program is based on methodologies

used by South African media production company, Community Health Media Trust (who are providing

technical assistance to the project), to produce its television/magazine program for PLHWA entitled, Beat It.

This program has been recognized by UNAIDS as a best practice in the field of HIV/AIDS related mass

Activity Narrative: media activities. Nawa will use this existing program to integrate basic care to reach the target population

with additional care and prevention messages. An expected impact of this program will be to reach more

men with PLWHA messages as research findings in Namibia indicate that men are much more likely to use

mass media channels than to access health information through other sources. By the end of COP 2007,

the Treatment Radio program will be broadcast in two community radio sites (Oshakati and Windhoek) on

local language and radio stations; the program will also link with two additional sites (Katima Mulilo and

Rundu) with a similar project conducted by SMA, Tusano.

f). Materials: NLT will review in consultation with the MoHSS and update its six treatment literacy materials

with basic care and prevention with positives messages. Nawa Life Trust will provide translation services

and integrate the final set of materials with the communication activities listed above. Posters will also be

developed and distributed.

The outputs of this program include: 1. Increased informed demand for basic care and prevention with

positive program components among PLWHA; 2. Increased awareness among facility and community level

providers on basic care and prevention with positive program components; and 3. Increased social and

governmental support for basic care and prevention with positive products for PLWHA in Namibia.

This activity is a continuation of COP 2007 CT activities and links with the support to the national Take

Control campaign and community mobilization and outreach activities (see Prevention OP and Prevention

AB).

According to the Report of the 2006 National HIV Sentinel Survey, nearly 20% of Namibians are living with

HIV. According to the 2005 Follow-Up Survey conducted by the Social Marketing Association (SMA) of

Voluntary Counseling and Testing Services, approximately 70% of people infected with HIV do not know

their status (see HBHC). Men are less likely to ever have been tested than women.

The goals of all Counseling and Testing (CT) activities are to use communication interventions to increase

the overall uptake of HIV testing services in Voluntary Counseling and Testing (VCT) Centers as well as

within public health facility settings (including the reduction of clients opting out of recommended HIV testing

in PMTCT/TB programs). The key behavioral objective is to mobilize people that have not been tested

before to go for HIV testing. Based on current research results, this will require increasing a sense of risk

perception and decreasing fear of positive results among the target population as well as helping create

convenient opportunities for testing. Additionally, activities aim at reinforcing HIV prevention behaviors

(ABC) for those who test negative and positive prevention behaviors (dietary changes, prevention of

opportunistic infections, safer sex practices, promotion of partner testing) among those who test positive

(see also HBHC).

Key target groups are sexually active Namibians between 15 and 49 with an emphasis on men and those in

steady relationships (couple testing).

NLT has taken over the portfolio of demand creation for CT services in COP 2007 from SMA. By the end of

COP 2007, NLT will have completed a basic qualitative evaluation of existing CT communication (including

the generic testing campaign launched by MOHSS). Based on this evaluation and in close consultation with

Intrahealth/PACT and the MOHSS Directorate of Special Programmes, NLT will have adapted existing or

created new mass media communication materials that promote CT.

This highly visible media campaign that promotes VCT and testing in government health facilities will link

with community mobilization activities and activities in and around testing centers as well as with the

regular New Start radio broadcasts that provide in-depth information around HIV testing and other HIV/AIDS

related issues.

In COP 2008, NLT will sustain and expand mass media activities promoting VCT through its campaign as

well as through the New Start radio project .While the campaign will continue to be geared at general

population, sub-components will be developed that target at least two specific priority audiences in COP 08,

most likely couples and men. Final identification of priority audiences will depend on research outcomes as

well as on feedback from testing centres and from Intrahealth. In addition, NLT will advocate for partner

testing to become a focus topic in the Take Control campaign, linking this national mass media initiative with

the VCT service campaign. Both these initiatives will then be linked to create a national HIV-testing drive,

reaching a minimum of 400,000 Namibians in a three-month period, covering World AIDS Day. NLT will,

through Take Control, also use this opportunity to step-up the mobilization of social capital by creating

synergies with Take Control partners and strengthen leadership support for testing.

Throughout COP 2008, NLT will reinforce mass media campaign messages with interpersonal

communication activities. This involves strengthening the delivery of information in and around testing

centers by intensifying outreach, especially but not exclusively during the partner testing campaign, through

CAFs and New Start Mobilizers. This will include the distribution of a minimum of 400 outreach toolkits that

help promote messages around couple testing. NLT will also forge partnerships with other organizations in

the field to reach at least 10,000 community members through interpersonal communication in the course of

COP 08. NLT will also assist IntraHealth with possible communication needs around mobile testing services

that are anticipated to be introduced by 2008.

NLT will also sustain the New Start radio project which has been broadcasting on 8 NBC language radio

stations since 2006. By the end of COP 2007, these program's will have undergone a full revamp to

increase attractiveness to audiences and increase reach with target groups. This will include the

development of a more entertaining format, increased training of presenters and, potentially, repackaging

content in various timeslots and promoting programme slots through other media. This reformatting will also

aim at reducing media placement costs and may include the downscaling of some language broadcasts that

do not prove to have a larger following.

In COP 2008, NLT will complete this process and step-up the promotion of the remaining radio slots to

increase their audience reach. Messages in the radio programmes will closely link with the activities of the

CT and national campaigns to create synergies. Quality assurance will be provided through refresher and

follow-up trainings to radio presenters on media skills and updated HIV/AIDS information. Also, NLT will

introduce interactive elements (e.g. SMS feedback, competitions) to gauge audience involvement. Selected

broadcasts will be included in CT post-testing focus group discussions.

In the course of COP 08, NLT aims to raise recall values of its targeted testing campaigns to at least 50% of

the target populations. NLT is aiming to also reach 40% of the target populations (listened over last 6

months) through the New Start radio program by the end of COP 2008. NLT aims to contribute to

significantly higher numbers of people having gone for a test among those exposed over those not exposed

to the above programs. Program exposure and KAP data will have to be generated through the

collaborative surveys.

NLT will, for all of the above activities, receive and utilize the support of a BCC capacity building

organization that will strengthen program design and monitoring.

During COP 2007, NLT will have developed a new set of print IEC materials for use in testing centers,

including information on testing procedures as well as prevention/care pack to give to support post-test

counseling for negative and positive clients after the test. Post-test care materials will promote the minimum

care package and link with HBHC activities (see that section). Sites will be equipped with information points

that will help display key information and IEC materials more prominently to clients.

Activity Narrative: In COP 2008, NLT will expand on on-site communication activities by installing audiovisual equipment in

waiting areas of VCT sites. This will allow NLT, under the guidance of IntraHealth to produce and screen TV

"info-mercials" on topics such as the testing process and prevention for negatives and positives. Also, these

TV/DVD sets can be used to screen campaign messages and relevant materials from community outreach

programmes such as "NawaCinema". In project sites, "NawaCinema" teams can also assist IntraHealth's

community mobilisers in screening these "info-mercials" during community outreach or mobile testing

sessions.

Print Information, Education and Communication (IEC) materials developed in COP 07 will be reprinted and

according to need but not exceeding 12 materials (language versions included). Post-testing activities will

determine whether updates are necessary. Using care funds, this will include the mainstreaming of

additional care messages into on-site communication materials for use in VCT as well as government

testing facilities in line with the stepping-up of activities under the "Positive Living" campaign.

This activity represents a continuation of FY 2007, and links with Prevention AB/OP activities conducted

with partner organizations that are proposed for FY 2008.

NawaLife Trust (NLT) conducts qualitative research activities to assist in program planning and

implementation efforts and to guide message design and implementation of mass media campaigns.

NLT will conduct or assist in the following types of research:

(1) Formative research for program design and evaluation purposes;

(2) Support to a PLWHA survey and

(3) Literature Reviews

(4) Media Monitoring/Impact Assessments

(5) Community Participatory Assessment Analysis

Formative Research

In FY 2008, NLT will conduct the following formative research, using focus group discussions to guide in the

development, production and evaluation of mass media messages and subsequent campaign materials:

(1) Eight focus group discussions involving mixed sex age clusters of individuals 20-30 years and 31-40

years to assist in the design of messages for Take Control's partner testing campaign

(2) Four focus group discussions involving mixed sex age clusters of individuals 20-30 years and 31-40

years to assist in pre- and post-testing materials for Take Control's partner testing campaign

(3) Four focus group discussions involving mixed sex age clusters of individuals 20-30 years and 31-40

years to assist in pre- and post-testing television adverts for the "Alcohol aids HIV" campaign

(4) One focus group discussion involving male groups between the ages of 15-35 years in the design of

NawaSport program materials such as ExtraTime magazine and other promotional materials

(5) Eight focus group discussions involving primarily males in age clusters of 20-30 and 31-40 years to pre-

and post test campaign materials focusing on male testing

(6) Two focus groups discussions involving mixed sex age clusters of individuals 20-30 years and 31-40

years to assist in the pre-testing prevention for positives (e.g. opportunistic infections and TB) materials

Since community members will be instrumental in providing feedback, the research process will also

generate community ownership for campaign messages and materials.

People Living with HIV/AIDS (PLWHA) Survey

NLT partner IBIS has developed a survey methodology that focuses on support group members and utilizes

interviewers living with HIV/AIDS to minimize social desirability reporting. The consultation combines

quantitative (survey) and qualitative (focus group discussions) methods. Through this unique approach,

these consultations have yielded crucial, first structured data on challenges that PLWHA are confronting in

living positively and adhering to treatment.

NLT will support IBIS in strengthening and expanding its "treatment consultations" in 2008. This support

may include increasing survey size from its current sampling of 350 respondents. This may also include

adjusting the survey tools to capture exposure to interventions. This tool will then be used to measure the

exposure of NLT projects targeting PLWHA (e.g. campaigns, treatment literacy radio and IEC) and their

attitudes towards these interventions to assess program reach and impacts with this audience. It will also

allow for comparison of knowledge, attitude and behavior indicators between individuals that were exposed

to interventions and those that were not.

Literature Review

In FY 2008, NLT will identify an area of critical concern in HIV/AIDS research, and hire a consultant to

publish a literature review in that particular field. The goal of this review is to qualitative analyze social

attitudes and behaviors in Namibia identified as pandemic drivers.

Media Monitoring/Impact Assessments

In FY 2008, NLT will hire a consultant to conduct additional analysis of National Knowledge, Attitudes and

Practices Survey results to examine media reach in program implementation. The goal of this analysis is to

provide NLT and stakeholders with greater understanding of the overall reach of mass media messages

and community outreaches.

Community Participatory Assessment Analysis

NLT will hire a consultant to summarize its 16 community participatory assessments in FY 2008. These

assessments address community perceptions towards social attitudes and behaviors that render people

vulnerable to HIV/AIDS. The goal of this analysis is to provide NLT, CAF members and interested

stakeholders with more accessible, consolidated findings on these assessments.

Monitoring and Evaluation

In 2006, NLT hired a Monitoring and Reporting Officer, who is responsible for coordinating monitoring,

reporting and research activities. In COP 08, this individual will continue work closely the Community

Mobilization Activities (CMA) and Media Departments of NLT in tracking progress of program activities, and

proposing recommendations for improving CAF outreaches and mass media campaign messages.

To measure the success and impact of NLT programs, two external contractors (to be determined) will be

hired to conduct a targeted evaluation of one of NLT's interventions, most likely NawaSport since this is a

new and large program, with various PEPFAR partners involved.

Activity Narrative:

This activity links with local, national and international organizations and stakeholders, and represents a

continuation of 2007 System Strengthening activities conducted by NawaLife Trust (NLT). The goals of this

activity are to raise organizational, local and national-level capacities through workshops, meetings and

regular technical assistance to foment autonomy, expertise and ownership of programs within Namibia. This

activity will be achieved through three main areas:

1. Organizational Development:

During 2006/07, NLT staff transitioned from a Johns Hopkins University/Health Communication Partnership-

(JHU/HCP) managed field office into an independently operated and Namibian staffed Non-Governmental

Organization (NGO). Therefore, 2008/09 will be a period of adjustment and organizational development.

However, NLT will ensure the same high quality interventions and programs by providing its managerial,

administration and programmatic staff with training in the following areas: Advanced HIV/AIDS training

Strategic planning; Program Planning and Implementation; Management principles; Financial and Cost

management; Human Resources Skills; Report writing; Behavior change communication; Monitoring and

Evaluation.

This training will be conducted on basic, intermediate and advanced levels, according to each individual's

needs and requirements. In addition, an organization to be determined will provided NLT with technical

assistance in strengthening the overall quality of behavior change community programming, including

design, implementation, quality assurance and monitoring and evaluation.

NLT's Regional Coordinators will be taking greater responsibility for Community Action Forum (CAF)

supervision and reporting during 2007. As a result, NLT will strongly focus on upgrading capacities of these

individuals to ensure more effective CAF outreaches and more accurate and detailed reporting for

monitoring and evaluation purposes.

As a result of its organizational development efforts, NLT will aspire to become a leading communication

centre in Namibia, assisting communities and stakeholders in developing and implementing quality behavior

change interventions, ,raising the standards of excellence in outreaches.

2. Community Level Capacity Building

CAFs are established and supported by NLT to address community-identified HIV/AIDS-related issues,

including stigma and discrimination, alcohol abuse, male engagement and support/participation for services

(PMTCT, VCT, ART). CAFs promote HIV/AIDS support services offered by other PEPFAR partners

including the Ministry of Health and Social Services (MOHSS), and advocate for additional and/or improved

services. CAFs consist of 15 elected community members, men and women, between the ages of 15-60.

CAF members create their own action plans with technical assistance from NLT, choosing specific problems

to address through outreaches (see prevention OP & AB).

NLT will also develop and implement a CAF development plan to ensure the longer term viability and

growth of all CAFs from inception to maturity (three-year plan) in their respective communities. The Johns

Hopkins University/Center for Communications Program (JHU/CCP) will work with NawaLife Trust to

develop this initiative. The development plan, which is based on the Stages of Change model byJames

Prochaska and Carlo Diclemente, will help lead CAF members through four distinct phases beginning with

contemplation of perceived HIV/AIDS risks and culminating in high levels of sustained efficacious behaviors

towards HIV/AIDS prevention.

NLT strengthens CAF capacities through training, supportive supervision and additional resources. CAF

trainings will focus on partner reduction, male responsibility, care and support, relationships, stigma

reduction, tuberculosis (TB), PMTCT of HIV, ART, VCT, gender, reproductive health rights, alcohol

awareness and positive living (see Prevention). NLT will train 240 members in stigma and discrimination,

using the stigma toolkit developed by the CHANGE Project; this toolkit contains a collection of participatory

educational exercises to raise awareness and promote action to challenge HIV stigma. NLT will train an

additional 300 individuals in HIV-related community mobilization for prevention care and/or treatment.

NLT will assist CAFs in integrating gender-based themes within community outreaches, NawaCinema- and

NawaSport projects (see prevention). NLT will obtain technical assistance from the Acquire project

(implemented by Engender Health and Promundo) to incorporate gender themes within trainings and

outreaches. The Acquire project assists Namibian PEPFAR partners in establishing themes to address

health and development vulnerabilities of men and women. NLT will also provide refresher training to

members from seven support groups in media skills as part of the Treatment Literacy Radio program (See

HBHC).

NLT offers supportive supervision to CAFs through intermittent field visits, regular telephonic conferences,

CAF exchange visits, and annual conferences. Exchange visits enable CAF members to visit other sites,

providing them with experiential learning and sharing opportunities to hone outreach planning and

implementation approaches. CAF annual conferences provide participating members with information on

best practices for outreaches, CAF management, and monitoring & reporting. These events also enable

CAF members to share outreach experiences, allowing for a cross-pollination of ideas and strategies.

NLT provides CAF members with resources, including IEC materials (e.g. NawaInfo! newsletter, treatment

literacy and Take Control campaign materials) and promotional (e.g. campaign-branded bags, t-shirts and

key-holders) to bolster campaign identity and awareness throughout communities.

As part of its prevention programs, NLT will develop materials focusing on reproductive health issues such

as STDs, opportunistic infections, gender equity and relationships, assisting CAFs and other organizations

in utilizing these materials in outreaches. The gender-based materials will address violence and coercion

within relationships, and encourage male participation in HIV/AIDS programs. NLT will also publish

NawaInfo! newsletters on a quarterly basis.

NLT will provide 25 local organizations with technical assistance for HIV-related institutional capacity

building at the community and national levels. At the community level, NLT will provide supportive

Activity Narrative: supervision to Community Action Forums to improve outreach efforts, bolster collaboration with local service

providers and strengthen reporting systems. NLT will also train as many as 30 individuals from other

community-based organizations in HIV-related institutional capacity building. This will include trainings in

such HIV/AIDS-related fields as gender equity, relationships, NawaSport and possibly stigma and

discrimination. This may also include focus group discussion and monitoring and evaluation trainings.

3. National level capacity building

NLT will continue providing technical assistance to Take Control through its involvement in the "Be There to

Care" campaign which aims to promote quality relationships, in which risk reduction behaviors are

addressed. NLT staff will assist the Ministry of Information and Broadcasting (MIB), MOHSS and other

collaborating partners in developing the 2007 strategic communication plan for the national campaign. It will

also provide technical assistance in message development, pre-testing and production of television and

radio spots and print materials (see Prevention).