07-P0201: Makgabaneng.

This activity links to the following: C0907 & P0203 & P0205 & P0209 & P0211.

This activity also links to the Other Prevention (OP) entry for Makgabaneng, PO501, which provides additional funding for this activity. This entry represents the AB part of the project. The project's funding is split between the two program areas (AB and OP), at approximately 60% and 40%, respectively. This will allow the program to address the needs of a wider range of beneficiaries than they would with funding from only one of the prevention program areas. The project's effort will reflect the funding proportions noted here.

Gaps in the areas of uptake of interventions, adherence to treatment regimens, and, most important for this program, in the sexual behaviors that place many Batswana at risk of HIV infection, still remain. To help bridge these gaps, the GOB in collaboration with the USG through their Botswana CDC office (HHS/CDC/BOTUSA), piloted HHS/CDC/HQ's MARCH (Modeling And Reinforcement to Combat HIV/AIDS) strategy using a serial radio drama and reinforcement activities for HIV prevention.

The two governments initiated a behavior change program called Makgabaneng. It includes Setswana-language entertainment-education radio serial drama designed to support the nation's HIV prevention and mitigation goals. It targets 10-49 year old Batswana. Complementing the radio drama are a series community-based reinforcement activities to encourage safer HIV related behaviors (such as delaying initiation of sex, partner reduction, accessing services, and providing support to people living with HIV/AIDS). The drama has been airing nationally twice weekly on Radio Botswana's two radio channels since August 2001. As of end of September 2006, nearly 500 different episodes were aired. Reinforcement activities to date have included, for example, listening and discussion groups, mass media epilogues, school and community rallies, and a fan magazine for students.

Overall, Makgabaneng has proved to be an important component of an effective national strategy to fight HIV/AIDS. For example, from a population-based survey in 2003, nearly half of the respondents in the survey reported that they listened to the program one or more times every week. Weekly listening was associated with greater knowledge about key HIV issues, less stigmatizing attitude toward people living with HIV/AIDS (PLWHAs), and some testing behaviors. For example, weekly listeners were more likely: (82.8%) to recognize that PMTCT is possible than other respondents (66%), (70.8%) to say they would allow their children to play with HIV infected peers than other respondents (58.9%), (96%) to say they would allow an HIV infected relative to live in their household than other respondents (87.4%). Building on the initial success of the radio drama and community initiatives, Makgabaneng will continue to produce high quality radio dramas that focus on modeling appropriate behavior change focused on prevention, treatment, and stigma reducing themes. To supplement the radio drama, Makgabaneng will implement a coordinated plan to scale up effective outreach strategies that will increase the impact of the on air themes. Modeling through a radio serial drama The radio serial drama (RSD) is meant to provide listeners with role models for behavior change, based on the MARCH model. Two new 15-minute episodes are broadcast a total of three times every week (104 programs per year) on Radio Botswana 1 and 2 and an "omnibus" repeat is broadcast at the weekends. The radio HIV/AIDS storylines will contain 60% AB themes targeting 10 - 29 year olds. For the 10-14 year olds, the storylines will target A messages and for the 15-29 year olds, AB messages. The remaining 40% will contain ABC and other themes targeting 15 - 49 year olds (reproductive age group).

Reinforcement activities (RAs) These activities are implemented in select communities meant to intensify the impact of Makgabaneng by clarifying and supporting themes from the drama. Activities will cover four rural and semi-urban districts with a total population of 541,000 people (out of a total Botswana population of approx 1.7 million). They will aim to reach 76,000 people in the first year, with FY07 funds. The Botswana National Youth Council (BNYC) and Humana's People to People's (HPP) Total Community Mobilization (TCM) program will implement RAs

under Makgabaneng supervision. The activities include: Makgabaneng Teen Mag, which is produced and distributed by Makgabaneng to in-school youth, aged 10-16, each school term. Makgabaneng will produce and distribute 50,000 copies to 100 schools in the 4 target districts per school term, (3 per year), reaching a total of up to 50,000 students. School Rallies are events held in primary, junior and secondary schools, which reinforce themes of abstinence, self-efficacy to negotiate relationship issues and peer- pressure, and other healthy outcomes. Rallies will cover 100 schools in 4 districts, reaching 50,000 children three times per school year who have also been reached by the magazine. In Listening and Discussion Groups (LDGs), trained facilitators lead groups of 5 to 20 people, who listen to selected scenes from the drama and discuss issues arising from those scenes. Skills-building activities, such as debates and role-plays that encourage interactive discussion among participants, are part of each session. The LDGs will target 10,000 adults aged 30 to 49 in the target districts. Materials will be written and recorded, and a series of training of trainer courses will be provided for around 164 field workers comprising 32 TCM field officers, 16 BNYC peer educators, plus 16 BNYC volunteers and 100 teachers. Community events will include: Health fairs conducted by the BNYC, which will reach an estimated 16,000 out of school youth. Youth Health Fares (approximately 32) will be held at BYNC centers across the country, with support and involvement of Makgabaneng. Separate road shows allow Makgabaneng to take the drama to the public in person. Road shows draw large numbers of people, who gather to meet Makgabaneng actors and to learn about HIV/AIDS-related issues and the drama itself. Four road shows will be conducted in a year targeting 4,000 people.

Other behavior change mass media activities would include: Epilogues and Trailers, which are brief messages aired immediately after the drama, invite listeners to utilize various HIV-related services. Epilogues (10 per annum) and Trailers (180 airings) will be broadcast approximately monthly and will draw attention to a behavior change objectives related to service uptake (e.g., being tested for HIV status, taking advantage of PMTCT services).

A new late-night once weekly (36 in year one) interactive chat show called "Makgabaneng Extra" will also be initiated. This is a proposed phone-in program which will use scenes from the RSD plus pre recorded ‘vox pops' (interview extracts) to stimulate discussion and debate among callers. The value will be to promote an ongoing dialogue between listeners and broadcasters that is not possible with the drama format alone. The RSD and other mass media activities will reach 800,000 people nationally.

Monitoring and Evaluation Activities A Monitoring and Evaluation (M&E) plan will be developed with realistic, measurable process and outcome/impact indicators. Standard items used in population-based surveys will be reproduced in program-specific questionnaires to be conducted in small-scale listener surveys, and the option to add exposure questions to existing surveys (e.g. PSI TraC, BAIS) will be investigated. A Makgabaneng evaluation survey will be conducted 18 months after implementation of the new, expanded program in order to correlate the relationship between listenership/participation in Makgabaneng and related RAs, and changes in behavior and service uptake.

07-P0501: Makgabaneng.

Activity links to the following: P0201 & P0203 & P0207 & P0502 & P0512. P0201 is the AB Prevention entry for Makgabaneng.

This entry represents the other prevention (OP) part of the program. The program's funding is split between the two program areas (AB and OP), at approximately 60% and 40%, respectively. The reason for dividing the funding is to allow the program to address the HIV prevention needs of a wider range of beneficiaries than they would with funding from only one of the prevention program areas. The program's effort will reflect the funding proportions noted here.

Gaps in the areas of uptake of interventions, adherence to treatment regimens, and, most important for this program, in the sexual behaviors that place many Batswana at risk of HIV infection, still remain. To help bridge these gaps, the Botswana Government in collaboration with the US Government through their (HHS/CDC/BOTUSA office, piloted HHS/CDC/HQ's MARCH (Modeling And Reinforcement to Combat HIV/AIDS) strategy using a serial radio drama and reinforcement activities for HIV prevention.

The two governments initiated a behavior change program: Makgabaneng. It includes, on the one hand, a Setswana-language entertainment-education radio serial drama designed to support the nation's HIV prevention and mitigation goals. It targets 10-49 year old Batswana. Complementing the radio drama series are community-based reinforcement activities to encourage safer HIV related behaviors (such as delaying initiation of sex, partner reduction, accessing services and providing support to PLWHA). The drama has been airing nationally twice weekly on Radio Botswana's two radio channels since August 2001. Nearly 500 new episodes have been aired since then. Reinforcement activities to date have included, for example, listening and discussion groups, mass media epilogues, school and community rallies, and a fan magazine for students.

Overall Makgabaneng has proved to be an important component of an effective national strategy to fight HIV/AIDS. For example, from a population-based survey in 2003, nearly half of the respondents in the survey reported that they listened to the program one or more times every week. Weekly listening was associated with greater knowledge about key HIV issues, with less stigmatizing attitude toward PLWHAs, and some testing behaviors. For example, weekly listeners were more likely: (82.8%) to recognize that prevention of mother to child transmission (PMTCT) is possible than other respondents (66%), ( 70.8%) to say they would allow their children to play with HIV infected peers than other respondents (58.9%), (96%) to say they would allow a positive relative to live in their household than other respondents (87.4%). Building on the initial success of the radio drama and community initiatives, Makgabaneng will continue to produce high quality radio dramas that focus on modelling appropriate behavior change focused on prevention, treatment, and stigma reducing themes. To supplement the radio drama, Makgabaneng will implement a coordinated plan to scale up effective outreach strategies that will increase the impact of the on air themes. Modeling through a radio serial drama The radio serial drama (RSD) is meant to provide listeners with role models for behavior change, based on the MARCH model. Two new 15-minute episodes are broadcast a total of three times every week (104 programs per year) on Radio Botswana 1 and 2 and an "omnibus" repeat is broadcast at the weekends. The radio HIV/AIDS storylines will contain 60% AB themes targeting 10 - 29 year olds. For the 10-14 year olds, the storylines will target A messages and for the 15-29 year olds, AB messages. The remaining 40% will contain ABC and other themes targeting 15 - 49 year olds (reproductive age group). Reinforcement activities (RAs) These activities are implemented in select communities meant to intensify the impact of Makgabaneng by clarifying and supporting themes from the drama. Activities will cover four rural and semi-urban districts with a total population of 541,000 people (out of a total Botswana population of approx 1.7 million). They will aim to reach 76,000 people in the first year, with FY07 funds. The Botswana National Youth Council (BNYC) and Humana People to People's (HPP) Total Community Mobilization (TCM) will implement RAs under Makgabaneng supervision. The activities include: Makgabaneng Teen Mag, which is produced and distributed by Makgabaneng to in-school

youth, aged 10-16 each school term. Makgabaneng will produce and distribute 50 000 copies to 100 schools in the 4 target districts per school term, (3 per year), reaching a total of up to 50 000 students. School Rallies are events held in primary, junior and secondary schools, which reinforce themes of abstinence, self-efficacy to negotiate relationship issues and peer- pressure, and other healthy outcomes. Rallies will cover 100 schools in 4 districts, reaching 50,000 children three times per school year who have also been reached by the magazine. In Listening and Discussion Groups (LDGs), trained facilitators lead groups of 5 to 20 people, who listen to selected scenes from the drama and discuss issues arising from those scenes. Skills-building activities, such as debates and role-plays, which encourage interactive discussion among participants, are part of each session. The LGDs will target 10,000 adults aged 30 to 49 in the target districts. Materials will be written and recorded, and a series of training of trainer courses provided for around 164 field workers comprising 32 TCM field officers, 16 BNYC peer educators plus 16 BNYC volunteers and 100 teachers. Community events will include: Health fairs conducted by the BNYC, which will reach an estimated 16,000 out of school youth. Youth Health Fares (approximately 32) will be held at BYNC centers across the countries, with support and involvement of Makgabaneng. Separate road shows allow Makgabaneng to take the drama to the public in person. Road shows draw large numbers of people, who gather to meet Makgabaneng actors and to learn about HIV/AIDS-related issues and the drama itself. Four road shows will be conducted in a year targeting 4,000 people.

Other behavior change mass media activities will include: Epilogues and Trailers, which are brief messages, aired immediately after the drama and invite listeners to utilize various HIV-related services. Epilogues (10 per annum) and Trailers (180 airings) will be broadcast approximately monthly and will draw attention to a behavior change objectives related to service uptake (e.g., being tested for HIV status, taking advantage of PMTCT services).

A new late-night once weekly (36 in year one) interactive chat show called "Makgabaneng Extra" will also be initiated. This is a proposed phone-in program which will use scenes from the Radio Serial Drama (RSD) plus pre recorded ‘vox pops' (interview extracts) to stimulate discussion and debate amongst callers. The value will be to promote an ongoing dialogue between listeners and broadcasters that is not possible with the drama format alone.

The RSD and other mass media activities will reach 800,000 people nationally.

Monitoring and Evaluation (M&E) Activities A M&E plan will be developed with realistic, measurable process and outcome/impact indicators. Standard items used in population-based surveys will be reproduced in program-specific questionnaires to be conducted in small-scale listener surveys, and the options for adding exposure questions to existing surveys (e.g. Population Services International's [PSI] Tracking Results Continuously Study [TRaC], BAIS). A MaKkgabaneng evaluation survey will be conducted 18 months after implementation of the new, expanded program in order to correlate the relationship between listenership/participation in Makgabaneng, and changes in behavior and service uptake.