Tanzania Capacity and Communication Project (TCCP) provides mutually reinforcing quality interventions at individual, community, services, and policy levels. TCCPs mandate encompasses key elements of the HIV continuum of care such as sexual prevention, HTC, PMTCT, ART, including adherence and retention in care, as well as OVC. In addition, TCCP is working in family planning, safe motherhood, and child survival. Aligned with the GHI strategy of increasing impact through strategic coordination and integration, this allows for a holistic approach to promoting adoption of healthy behaviors and services, with numerous opportunities for synergy and economies of scale for cost savings and maximum impact.

TCCP works at the national level as well as in eight priority regions of Dar es Salaam, Iringa, Mara, Mbeya, Mwanza, Pwani, Shinyanga ,and Tabora. A heightened focus will be on Iringa, the region with the highest HIV prevalence in the country. TCCP target populations vary according to specific behavioral objectives. For example, the radio distance-learning program focuses on community volunteers while the TV serial drama focuses on adults of reproductive age, specifically families.

TCCP also has a mandate to build capacity for sustainable BCC systems. TCCP is working with MOHSW, local NGOs, and institutions of higher education to ensure that systems are in place for message harmonization, coordination, and sustainability.

A baseline of key indicators has already been established through a national household survey in the first year. An external midterm and endline surveys will be conducted. With a strong internal research team, TCCP conducts numerous pre-tests and other formative research to inform campaign development and execution.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Specific BCC interventions on OVC include integrated messaging in support of the National Costed Plan of Action (NCPA), the strategy developed by the Department of Social Welfare, and the communication strategy developed by the four USG OVC partners. This funding will be a continuation of the support provided by STRADCOM. This will include continuation of a radio campaign developed for OVC for the NCPA. The main objective will be to continue to foster a conducive environment for the care of vulnerable children.

Communication activities for OVC include the use of radio, video, print, community outreach activities, mobile phone SMS, and the internet.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Campaign activities for VMMC include integrating messages in the on-going television serial drama; directing radio distance learning programs at village health volunteers; and broadcast the radio magazine programs on regional and national stations.

The specific VMMC messages include continuing the consistent and correct use of condoms, required abstinence period after surgery, importance of testing, and promoting the service to older men in collaboration with USG/T VMMC service providers. TCCP will work in close coordination with the USG/T service providers, Jhpiego and IntraHealth. The focus for these activities is in Iringa.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Campaign activities utilizing AB messaging include continuing with multiple and concurrent partnerships (CP) campaign on the dangers of CP and safe means of avoiding CP; continue modeling appropriate behavior change on CP in the on-going television serial drama; continue with community outreach activities in the priority regions; community outreach CP activities in radio distance learning programs directed at village health volunteers (avoiding expensive workshops); CP in radio magazine programs on regional and national stations; continuing at maintenance level Fataki campaign on cross generational sex and Chonde Chonde campaign on alcohol and GBV.

Communication activities for AB include the use of radio, video, print, community outreach activities, mobile phone SMS, and the internet.

The CP campaign, in collaboration with PSI, illustrates the commitment on harmonization of behavior change communication messages and jointly adhere to the national and USG/T priority objectives. Cost sharing of $1 million from KfW has been allocated.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Specific behavior change communication interventions on HTC include the importance of testing, PITC, and couples HTC. These are integrated into the ongoing television serial drama, radio distance learning program, radio magazine programs on regional and national stations, and on independently produced videos and TV programs. The TV serial drama allows the modeling of appropriate behavior with testing in a realistic and powerful manner. The weekly radio diaries of PLHIV will continue to help reduce stigma and promote testing.

Communication activities for VCT include the use of radio, video, print, community outreach activities, mobile phone SMS, and the internet. TCCP will closely collaborate with USG/T VCT service providers to promote couple's HTC.

Target Population / Coverage / Activity: Target populations for these activities include young men and women (aged 15-24) and older men and women (25+). According to mass media results as measured by Synovate Omnibus Survey August 2011, TCCP's Chonde Chonde alcohol campaign has the ability to reach 14+ million people. IPC activities are expected to reach 60,000 people in four regions. The activity incorporates mass media as well as interpersonal communication activities to address current drinking norms and risky behaviors associted with alcohol abuse. These funds will be used to expand and continue this campaign.

TCCPs underlying theoretical framework is the Integrated Change Model. Central to this model is the belief that creating the desire for change across all levels of society is at the heart of real progress. As any intervention with the aim of long-term, generational change requires attention to individual, social, and structural factors. Thus, TCCPs interventions will catalyze the desire for change by shifting perceptions of risk and efficacy at the individual behavioral level and norms and priorities at the socio-political and cultural level. When people want change, they will allocate resources, enforce policies, demand better services, participate in community processes, and choose healthier practices.

Campaign activities include integrating the correct and consistent use of condoms into ongoing and expanded concurrent partnerships (CP) and alcohol campaigns; the television serial drama; radio distance learning program; radio magazine programs on regional and national stations; and independently produced videos and TV programs.

Communication activities for behavior change include the use of radio, video, print, community outreach activities, mobile phone SMS, and the internet.

As part of key USG/T and GHI strategies, the integration of condom messaging in various TCCP platforms allows for mutually reinforcing quality interventions to be implemented and scaled in a cost effective mode. Synergy and increased impact is expected to be achieved by integration of key behavior change messages with other key interventions of HTC, VMMC, PMTCT, and ART.

TCCP is also addressing another key USG/T objective of capacity building of individuals and organizations. Through the ACE mentoring program, TCCP is supporting a cadre of entry level and mid-career professionals in BCC along with providing targeted long-term on the job training supplemented with seminars and course work. They are placed in key organizations including ministries, parastatal organizations, USG partners, NGOs, and private companies.

TCCP innovative radio distance learning program directed at community volunteers provides an alternative to expensive workshops. This approach will be evaluated to learn more about the effectiveness of using radio to train community volunteers.

Through AfriComNet and faculty from the John Hopkins University Bloomberg School of Public Health, TCCP is working with educational institutions, such as the Iringa Primary Health Care Institute and Muhimbili University, to transfer and institutionalize state of the art behavior change communication. In addition, TCCP is working with the private production houses to improve production value in order to increase their audience, while at the same time demonstrating how health messages and behaviors can be integrated into popular entertainment programs and films.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Specific PMTCT interventions include an integrated campaign on safe motherhood, including ANC, malaria prevention, and safe delivery; PMTCT being integrated into a FP campaign; PMTCT literacy is integrated into the ongoing television serial drama; a radio distance learning program; national and regional radio magazine programs; and an independently produced videos and TV programs. The safe motherhood and FP campaigns are also supported by the President's Malaria Initiative (PMI) and USAID's Health Office.

Communication activities for PMTCT include the use of radio, video, print, community outreach activities, mobile phone SMS, and the Internet.

(For background, see TCCPs HVOP budget code narrative as well as TCCPs implementing mechanism narrative)

Specific behavior change interventions on treatment include integrated messaging on treatment literacy on the TV serial drama, weekly diaries by people undergoing treatment on regional and national radio stations, and production of CTC support materials. Treatment literacy will include living positively, adherence, retention, continuity of care, pediatric treatment, couples testing, use of condoms, and avoidance of alcohol.

The mass media objectives are to mainly reduce stigma and encourage people to get tested by explaining how treatment works. In light of treatment scale up, TCCP will enhance focus on messaging around adherence and retention in care, acknowledging that the full impact of USG/Ts treatment efforts depends on maintaining people on treatment in order to see a reduction in HVI incidence. CTC support materials will be targeted for people on treatment as well as their relatives and friends.