Summary

With Emergency Plan (EP) funds, BRIDGE will support activities that contribute to an effective PMTCT

program including pre-testing counseling with relevant audiences, consensus-building, and raising

awareness for support of PMTCT with community leaders and other local stakeholders, with particular

emphasis on male involvement. This ensures that the link in health facilities between implemented

activities, and outreach to counseling and testing services related to MTCT, will be strong. These funds will

be used to further develop and disseminate a Hope Kit PMTCT supplement for use at the community level

to encourage increased uptake of PMTCT.

Background

Previous EP funding was used by BRIDGE to develop and disseminate a "Hope Kit" that is a package of

interactive and participatory HIV/AIDS tools and materials that have been used successfully and widely to

guide individuals and community groups to develop personal and appropriate HIV prevention strategies.

Hope Kits have been adapted by several groups including Peace Corps Volunteers (PCVs) who routinely

use them in educational and training sessions in their catchment areas. With this package, partners have at

their disposal, a variety of proven and participatory approaches to operationalize their HIV prevention plans.

The Hope Kit PMTCT Supplement provides additional material which focuses on community support for

prevention of maternal to child transmission of HIV. These activities are also designed to be implemented at

the community level. The material and outreach sessions are designed to increase community and

household acceptance of, and support for, PMTCT services, to reduce sigma surrounding PMTCT services,

promote greater male involvement in PMTCT, and ultimately to increase the uptake of PMTCT services in

the 8 BRIDGE districts (Balaka, Chikwawa, Kasungu, Mangochi, Mulanje, Mzimba, Ntcheu, and Salima).

During the past 12 months, with FY 2006 USG funds, the BRIDGE project was successful in developing the

new Hope Kit PMTCT package of supplemental materials, including identifying new content, conducting

pretest training and facilitation activities, and producing 1600 copies. The BRIDGE project also adapted the

regional Africa transformation tool and filmed 3 new profiles to supplement the package in Malawi. Both

tools are ready for full scale distribution and use during FY 2008.

BRIDGE expects these interventions to result in increased uptake of PMTCT services and improved

practice of basic PMTCT behaviors, including improved nutrition, the use of nevirapine during labor delivery,

and breastfeeding practices appropriate to the circumstances of mother and child.

Activity 1: Increase Use of PMTCT Services in Ante-natal Care Settings

The first activity is to use the Hope Kit PMTCT material in ante-natal care settings at district hospitals and

health care centers (a minimum of 4 per district) in the 8 BRIDGE districts, to support counseling and testing

services for pregnant women and their families through highly interactive sessions held at the ANC waiting

rooms.

This activity will primarily target pregnant women aged 15-49 but also will reach out to the families of

pregnant women particularly their husbands. The activity is an expansion of the PMTCT Hope Kit

developed with FY 2006 USG funding, and the initial Hope Kit outreach sessions that have taken place at

the ANC clinic at Mulanje district hospital since 2006.

Save the Children and district NGOs will assist with activity implementation. Counseling will be conducted

by trained community facilitators with support from ANC nursing staff. Targeted sites will also receive

copies of the "Mwana Wanga" (My Baby) PMTCT video produced in Zambia. The Mulanje experience was

shown to have a profound effect on the uptake of HTC services by pregnant women, more than doubling

the number of women who "opt" for testing as part of their ANC package.

The model of cooperation between local NGOs and the district hospital will support the sustainability of this

initiative beyond the life of the BRIDGE project. Also BRIDGE will work with local teams to explore

expansion of the activity to health centers that offer HTC services, on a district by district basis.

Activity 2: Strengthening Community Awareness of PMTCT

The second activity involves strengthening community awareness and knowledge about PMTCT (including

knowing your status, preventing unwanted pregnancies, safe delivery, and infant feeding options) through

facilitated participatory Hope Kit PMTCT activities in community settings. Eight hundred organizations from

select CBO's, NGO's, District Aids Coordinating Committees (DACC's) will receive training in the usage of

the PMTCT supplement to conduct activities in their areas. Activities will address men and women of

reproductive age as well as those who influence them, in the surrounding communities. Activities

emphasize men's involvement in PMTCT decision making (including the importance for couples to both

know their status, and produce an opportunity to address the issue of discordance). Community PMTCT

activities also address stigma for infant feeding decisions and the importance of facility-based delivery for

the health of mother and child. The activity will include referral to health centers and VCT sites for additional

counseling and information.

Activity 3: Assessment of the Impact of the Hope Kit on PMTCT

BRIDGE will evaluate the PMTCT component of the Hope Kit in FY 2008 to learn more about the impact of

this participatory methodology on community and family acceptance and uptake of PMTCT services. This

understanding will be of great value to partners in Malawi and USG Malawi to inform decisions of whether to

scale up Hope Kit style approaches. It will also assist BRIDGE and partners to understand better how the

Hope Kit is used, what features are the most popular, and which elements are most influential to reinforce

new norms and behaviors.

Summary

Since FY 2005, BRIDGE has supported a radio diary project featuring the personal testimonies of male and

female PLWAs on six local radio stations. An evaluation shows that the Radio Diaries project which began

FY 2005 reached up to 75% of the listening audience in Malawi and indicated that listening to the radio

diaries is strongly associated with reduced stigma towards people living with HIV/AIDS and more agreement

with attitudes that "people with HIV are just like me." All radio stations report good listener feedback to

these innovative programs and there is widespread recognition of the programs in all eight emphasis

districts as well as in Lilongwe and Blantyre.

Background

In FY 2007, BRIDGE made progress in AB programming through a variety of initiatives targeting youth: the

Nditha! Sports Initiative implemented in four BRIDGE districts; the second season of an HIV radio program

called "Tisankhenji" finalized; and Youth Alert! listening clubs and related activities reaching over 5,400

young people on a weekly basis. Also, BRIDGE is active in the interfaith mobilization of religious

communities via collaboration with the sub-partner Public Affairs Committee (an umbrella group for faith

based organizations) as well as joint youth outreach and seminars for faith leaders.

JHU Bridge's FY 2008 activities to reach youth will continue to focus on youth participation: developing

youth leadership, promoting the delay of sexual debut, increasing youth knowledge of HIV and risky

behavior, and teaching youth skills to adopt and maintain healthy behaviors. Strengthening access to

resources, delivering practical user-friendly tools and interventions targeting youth remain important areas

for BRIDGE.

Activity 1: Youth Alert! Mix

Youth Alert! uses mass media to reach hundreds of thousands of youth across Malawi. Youth Alert! Mix

(YAM!), funded by the USG, was recently named the most popular youth radio program in Malawi drawing

parents as well as youth. It stimulates improved communication within Malawian families on HIV and the

value of delayed sexual debut ("A") and mutual faithfulness ("B") among couples. The BRIDGE Project

supports YAM! through funding for the Listeners' Club program which works to translate and leverage the

popularity of the mass media communication intervention into a powerful interpersonal behavior change

activity by facilitating a weekly guided discussion on YAM's content.

In FY 2008, the YAM! Listener's club activity will include refresher trainings for listening groups, training in

community-based approaches for Youth Alert (YA) staff, and facilitating meetings with NGOs, CBOs and

Youth and Prevention technical sub-committees. The Listener's Clubs provide opportunity for discussion

and reinforcement of social norms around issues of primary and secondary abstinence, HIV counseling and

testing, mutual faithfulness, resisting harmful peer pressure, and building self-esteem and self-worth. The

Youth Alert! team will also participate in other activities sponsored by the BRIDGE project and its partners,

such as district level youth festivals and outreach to faith-based organizations.

Activity 2: Empowering Young Girls through Tisankhenji

In FY 2008, BRIDGE will continue the partnership with Business Eye and Nanzikambe to use entertainment

-education approaches to highlight the stories of dynamic role models as inspirations to young women in

Malawi. This collaboration will use a multi-media approach and activities will include community based

events (that also link to the Nditha! campaign, particularly community theater), radio, and print materials.

The current Tisankhenji radio program features Alinafe - a plucky girl who loves her family, sports, and is

true to her friends. She learns from her mistakes and has confidence in her own decisions regarding

themes such as personal achievement in and out of school, dignity and self-worth, modeling parent-child

communication, delaying sexual debut, resisting sexual pressures and discussing these pressures with a

trusted adult. In addition, Tisankhenji includes radio magazine-style elements that invite listener "talkback",

ideas on the challenges for girls "growing-up" in Malawi, real youth groups profiles, and suggestions for

young women and men to get involved with HIV prevention in their communities (and have some fun!).

Community-based radio listening clubs (currently 10 supported clubs per district) provide a link between the

radio program and community action.

Activity 3: Nditha! Sports

The Nditha! Sports package encourages positive mentoring of young adults by the community (which links

to the Men's Involvement campaign), youth leadership skills, decision making skills, youth involvement in

community activities (especially for girls), goal setting, and placing value on their lives. Through Nditha!

Sports, mentors and coaches assist young people to articulate strategies to delay sexual debut, address

gender challenges, seek advice from trusted adults, build skills to tackle coercion, and develop a positive

and proactive outlook on life. The accessibility of the model has made it popular with teachers, sports

coaches and youth alike. The methodology links sporting skills to life skills, focusing on prevention through

AB as ways to achieve your goals and future aspirations.

In FY 2008, BRIDGE will scale-up this activity.

Activity 4: Young Women's Congress

BRIDGE has supported four successful and popular Young Women's Congresses (YWC) over the past four

years. Last year, BRIDGE developed a partnership with the Malawi Girl Guides Association (MAGGA) and

UNFPA to deliver the YWC. This partnership will continue in FY 2008 with additional congresses and

activities offered to young women leaders in all 8 emphasis districts as well as select NGOs and youth

groups outside of the BRIDGE districts.

In FY 2008 there will continue to be a strong emphasis on building leadership skills and engaging the

community while supporting girls' education and promoting female role models to support economic

empowerment and achievement. The content of the congresses also includes HIV prevention basics,

support for delayed sexual debut and mutual faithfulness to one life-partner, the importance of HIV

Activity Narrative: counseling and testing, and stigma reduction towards PLWA.

In addition, the congress will offer youth leaders a place to explore the social, economic, political, religious

and cultural realities and customs that, joined with biology, make women especially vulnerable to HIV/AIDS.

In sessions, young women will not only focus on the factors that place them at risk, but most importantly

they will identify actions that they can take to reduce these risks, especially those related to gender-based

issues such as sexual coercion and gender-based violence, and cross-generational and transactional

sexual activity.

Activity 5: Mobilizing Faith Communities

Relationships between younger women and older men not only put the young woman at increased risk, but

can have detrimental effects on the man and his family as well. Faith groups play a critical role in

establishing and reinforcing social norms - especially norms of faithfulness and compassion related to

HIV/AIDS. The BRIDGE project will continue to support the Public Affairs Committee (PAC), an interfaith

umbrella organization of faith based institutions, to mobilize FBOs that play an active role in reaching men.

HIV behavior change messages include those related to gender inequities and intergenerational sex, mutual

faithfulness, male involvement in families and communities, risk reduction, and communication to foster

committed relationships.

The Caravan for Life feature of the collaboration between BRIDGE and PAC will continue during FY 2008.

PAC will provide on-going support to a high-visibility traveling "Caravan" of religious leaders demonstrating

their commitment to HIV prevention by providing activities from the Hope Kit and BCC manual as well as an

outlet to discuss themes and tie in teachings from the Bible or Qu'ran. Themes include fighting stigma,

male involvement in HIV prevention (particularly risks posed by alcohol and extra), marital relationships,

mutual faithfulness, raising healthy families, supporting abstinence in children, and alternatives to risky

behaviors.

Activity 6: PLWHA Radio Diaries

In FY 2008, BRIDGE will continue to support the radio diaries project by emphasizing community

mobilization and scale up proven approaches with an emphasis to customize the diary programs to the

unique audience characteristics of each radio station partner and place more emphasis on outreach

activities at the community level by the diarists and PLWA listening groups. In preparation for the next

phase of the diaries, radio partners have already developed proposals for diary programs based off of an

assessment completed by the management partner Galaxy Media that developed an index of topics

covered in all diary programs from inception to date on all partner radio stations.

Activities related to the radio diary project with FY 2008 funds include emphasis on identifying private sector

sponsorship for the programs for sustainability, on-going psycho-social support for the diarists involved

through linkages to positive living support groups, Malawi Network of People Living with HIV/AIDS

(MANET+) and National Association of People Living with HIV/AIDS in Malawi (NAPHAM), meetings with

counselors during program planning retreats, and capacity building for the producers and radio stations.

The radio stations are also being encouraged to develop alternate sponsorship arrangements for longer

term program sustainability. With FY 2008 funds, BRIDGE anticipates stronger involvement of NAPHAM

and MANET+ in project management. Currently, MANET+ has requested additional funding from NAC to

support the diary initiative.

Summary

The project will build on the success of earlier activities to emphasize risk and effective "small do-able

actions" to minimize risk, while still supporting self and communal efficacy to act. In particular, BRIDGE will

concentrate on three areas that have wide reaching relevance to the Malawian context:

i. Risk of mother to child transmission of HIV (MTCT)

ii. Risks from alcohol misuse

iii. Particular vulnerabilities of young women to HIV infection through inter-generational relationships

Background

BRIDGE has created a well-integrated list of activities to respond to needs in the "other prevention

category" which includes mass media supported not only by community drama, but also popular road

shows. Experience has shown that this emphasis on outreach personalizes the campaign messages. With

FY 2008 funds, BRIDGE will introduce the innovative African Transformation initiative which lends fresh

perspective on existing gender norms and encourages discussion about how they contribute to the spread

of HIV.

The national media campaign will link with activities already addressing PMTCT and AB at the district and

community level in the eight emphasis districts. The "Young Women's Congress", the Hope Kit updates,

and the PAC "Faith Caravan" activities, among others, will provide further linkages and reinforcement for the

national media messages. BRIDGE collaboration with the National AIDS Commission (NAC), and USG

Partners MACRO, PSI, and other service providers, will also provide audiences with concrete outlets for

HIV Counseling and Testing (HCT), condom services and HCT post-test clubs as recommended based on

risk self-assessment in mass media and community interventions.

Activity 1: Nditha! Mass media

With FY 2008 Emergency Plan (EP) funds, BRIDGE will build on the success of Nditha! to emphasize the

urgency for action by focusing on specific do-able actions, while still supporting self- and communal-efficacy

to act. In particular, BRIDGE will concentrate on the risk of MTCT; risks from alcohol use; and the particular

vulnerability of young women to HIV infection.

Strategic information collected in 2005 indicated an increase in self-efficacy and behavioral intentions to

prevent HIV significantly correlated with campaign exposure. With efficacy strengthened, the time is right to

shift focus to realistic risk self-assessment in order to optimize preventive behaviors. Similar to earlier

phases of the Nditha! national media activities, the risk awareness phase will include radio spots, print

materials and community outreach events. The emphasis on risk (Could it be me?... I can prepare...) will be

linked to Nditha! small do-able actions that people can take to reduce or eliminate the risk.

Special Nditha! risk materials will address issues of prevention with positives, including materials designed

for use in counseling sessions on prevention of transmission and materials to support prevention behavior

in discordant couples. BRIDGE will collaborate closely with NAC, MACRO, Lighthouse and other

counseling providers on the development of these materials. BRIDGE anticipates that NAC will assist with

continued production of these materials after the initial print run.

Activity 2: Experience Momentum (EXP) Outreach

Mass media is further supported by community outreach events which provide a framework for local

activities and decision making. EXP conducted road shows in each of the BRIDGE emphasis districts

during both phases I and II of the Nditha! Campaign, and will continue to do so during this project year. The

road shows have served to personalize the mass media ideas, and get people involved in the places where

they live through a variety of participatory activities. It is these events that have often spurred real

discussion within a community, and have galvanized small-town residents to take action within their area.

Activity 3: Community Drama

Using participatory "theatre for life" techniques, BRIDGE supports Nanzikambe Theatre Company to work in

emphasis communities to develop narratives of risk and accompanying strategic solutions for young

women, as well as to model healthy, equitable relationships with young men. The dramas are performed at

community festivals and typically draw large crowds. Previously BRIDGE has supported actors from

Nanzikambe to train in the "theater for life" methodology, already proven effective in the development of

Tisankhenji itself and also in their work with school drama groups during the Mzimba launch of the

Tisankhenji Radio Program. Nanzikambe's methodology is very participatory and probing and stimulates

dialogue and an immediate modeling of consequences in line with Social Learning Theory elements of

behavior change programming. Drama provides a shelter to give voice to concerns, to raise problems. and

to offer solutions from the safe distance of a character's point of view. The use of drama is also an

opportunity to showcase the skills and talents of young women in the community.

In 2007, Nanzikambe began this initiative by collaborating with community drama activators in four BRIDGE

emphasis districts. With FY 2008 funds this collaboration will be extended to the remaining BRIDGE

emphasis districts allowing a full year for all activators to conduct activities.

Activity 4: African Transformation

African Transformation, (AT) enables men and women to explore how traditional and gender norms have

impacted their lives including any resulting barriers to practicing HIV prevention behaviors. It also engages

men and women to work together to overcome those barriers individually, within their families and in the

wider community. Developed with input from throughout Africa, including Malawi, AT is a package of real life

role model profiles and a guide to facilitate community workshops. The Malawi AT package includes a

thought-provoking profile showcasing the consequences of intergenerational sex. The profile encourages

young women, older men, and family members to be aware of the health risks that can result from

intergenerational relationships and to develop strategies to avoid these harmful consequences.

Activity Narrative:

The BRIDGE team already has drafted and pre-tested materials for the mass media materials that will be a

part of the "risk" campaign; it is currently working with EXP to finalize road show content. Nanzikambe's

work in "theater for life" to date puts them in a ready position to expand on this technique with the new

material reflected in the ongoing Tisankhenji series. AT modules have been reviewed by stakeholders and

Malawi-specific additions, particularly reflecting intergenerational sex, are nearly completed.

With the success in building efficacy of the previous phases of the BRIDGE mass media campaign, Nditha!,

the time is right to reinforce the complementary need of realistic risk perception in order for Malawians to be

prepared and able to protect themselves. The Other Prevention activities listed here will contribute to

Malawians' ability to understand access and act on their potential risk of contracting HIV through

participatory methods that include a fresh look at gender roles, traditional norms, and potentially unsafe

behaviors.

Summary

At the beginning of the project in July 2003, BRIDGE conducted both qualitative and quantitative research

that identified several underlying factors of individual and collective behavior that could enhance HIV

prevention practices - as well highlighted factors that may currently impede the widespread adoption of

healthier behaviors. During early FY05, BRIDGE shared this research with partners at the national and

district level. BRIDGE conducted two additional rounds of quantitative research during FY 2005 and FY

2006 to track change in project related outcomes. During FY 2008, BRIDGE will produce simplified

overviews of the second round midterm research (conducted during FY 2007) and monitoring findings (in

very easy vernacular) for use at the community level to build understanding about behavior change

approaches and to inform local actions.

Background

With USG funding, BRIDGE has conducted periodic (approx. 1-1/2 year intervals), targeted evaluations of

prevention activities using Knowledge, Attitude and Practice surveys and risk perception assessment

frameworks to inform project progress and monitoring shifts in target population norms with respect to HIV

prevention indicators beginning in July 2003.

The BRIDGE survey tool facilitates documenting an association between changes in attitudes and

behaviors with exposure to BRIDGE HIV preventions interventions at the national and community levels.

With FY 2007 funds, an end of project assessment will be supported to determine changes in knowledge,

attitudes and most crucially behaviors related to HIV prevention. This strategic information obtained will be

shared with a wide cross section of stakeholders for use in on-going programs and the development of

future strategies and approaches.

BRIDGE will continue to collaborate with local research partner organizations to track the evolution of

behavioral indicators in Malawi - especially prevention behaviors. In addition to conducting surveys,

BRIDGE will provide training to our partner in data quality assurance, sample design, interviewing skills,

data coding and other related areas.

Activity 1: End of Project Evaluation and Dissemination

Towards the end of FY 2008, BRIDGE will conduct a quantitative, representative sample survey in our

districts to assess change in indicators pertaining to (among others):

-Percent of young people that can correctly identify methods of HIV transmission and reject misconceptions;

-Percent of respondents expressing a willingness to express their HIV status to close friends or family

members if found to be HIV positive;

-Percent of respondents utilizing HTC services;

-Percent of young people (15 to 24) who have never had sex;

-Percent of respondents (15 to 49) who had sex with more than one partner in last 12 months;

-Percent respondents 15 to 49 years old who report using a condom while having sex with a non-marital,

non-cohabitating partner in the last year.

Activity 2: Program Partner Mentoring

BRIDGE will mentor and oversee its 19 program implementing sub-partners on reporting activities at both

the district and central levels to ensure that data is gathered and reported in an accurate and timely manner.

To this end, BRIDGE project officers will train project implementing partners and district coordinators on the

use of the BRIDGE M and Etools to document achievement of training, outreach and capacity building

targets; ensure understanding about the correct use of the tools; and ensure compliance with reporting

requirements. The BRIDGE M and E assistant will review all monthly and quarterly submissions from

partners to check incoming M and E data for reliability & validity; ensure all source documents are properly

coded for easy access and identification; and tabulate data across districts and activities in a secure

database to create summary tables. On a semi-annual basis the BRIDGE staff will conduct training

activities for program officers and counterparts at its 19 implementing partners on data tracking, storage and

management issues. BRIDGE will also conduct site visits to districts to ensure accuracy of M and E data

reported to the office and proper record keeping by the program partner to meet data quality and

performance standards. BRIDGE will supplement its internal trainings through collaborations with Pact's

training initiative. As necessary, based on feedback from USG and other program partners, BRIDGE will

update its M and E tools to support ease and maximum reporting accuracy.

BRIDGE has worked with a local research partner, Salephera, Inc., to gather strategic information since the

beginning of the project. During that time, BRIDGE has built the capacity of the Salephera team, and they,

in turn, continue to show their enthusiasm and abilities with new lessons and techniques. Since working

with BRIDGE in FY04, Salphera has won research and evaluation tasks through competitive procurements

from international NGOs and donor organizations. BRIDGE and Salephera have assembled a baseline

study and two complete mid-term evaluations together.

BRIDGE's on-going data use for decision making is based upon the Risk Perception Attitude (RPA)

framework that posits a behavioral relationship between perceived risk (susceptibility and severity) and

efficacy (including self efficacy and response efficacy). This theoretical construct has guided the

development of program interventions to date, and the new data collected will also contribute to the

successful implementation of project activities, as well as informing partners and stakeholders of new

information that will inform and be relevant to their efforts as we work together to harmonize national

strategy.

Summary

With FY 2008 Emergency Plan (EP) funds, BRIDGE will provide technical assistance (TA), capacity

building, and social mobilization among district and community HIV/AIDS coordinating committees and

other local organizations to design, implement and evaluate comprehensive HIV prevention initiatives.

BRIDGE will strengthen the capacity of 40 new community level partners while providing on-going guidance

and support to current partners, including community-oriented radio stations, to design, coordinate,

implement and evaluate the impact of HIV prevention initiatives. The work with communities supports and

emphasizes the importance of delay of sexual debut among the youth, mutual faithfulness and the risks

associated with multiple concurrent partners, correct and consistent condom use, and accessing PMTCT

services for HIV-positive pregnant women, and the importance of knowing one's HIV status. BRIDGE

assistance also builds the technical and organizational capacity of local entities to become more self-reliant

in terms of activity planning and monitoring.

Background

Community mobilization is a capacity-building process through which communities, individuals, groups, or

organizations plan, carry out, and evaluate activities on a participatory and sustained basis to improve their

health and other needs, either on their own initiative or stimulated by others. Building capacity and social

mobilization at the community level has been a key component of the BRIDGE project in Malawi since its

inception in 2003.

At the district level, BRIDGE works closely with the District AIDS Coordinating Committees (DACCs) and

their subsidiaries at the community (CAC) and village (VAC) levels. DACCs, CACs and VACs are the front

line of the national HIV and AIDS response, tasked through the National AIDS Commission with

mainstreaming, implementing and supervising HIV and AIDS activities in each district. These structures

provide guidance to NGOs and emergent CBOs at the district level and are often the only response

mechanism in rural and remote areas of Malawi.

During the past three years, BRIDGE supported skills building trainings for a broad-based cross-section of

its district-level partners, including DACCs, CACs, VACs, their Youth and Prevention technical sub-

committees, NGOs, individuals who have influence in the community ("community influentials") and change

agents - such as traditional leaders, healers, and Chief's Councils. To date the BRIDGE project has

facilitated skills-building in over 300 community based groups in eight districts. These groups are able to

independently identify, plan for, and implement HIV prevention activities using nationally available tools and

materials along with initiatives of their own creation. Just a few examples of district activities in the last year

to combat HIV locally, include:

• Community dialogues with traditional and religious leaders on HIV/AIDS and cultural practices

• Youths and women's guild members, including agogo ("grandmothers"), actively conducting outreach and

guidance on HIV prevention

• Local advocacy campaigns combating stigma and discrimination, promoting testing for couples, and

encouraging engagement of local PLWA groups

• Collaboration with the District Assemblies and other partners to implement district level HIV/AIDS

campaigns and strengthen and fund prevention activities in District Implementation Plans (DIPs)

Since FY 2005, the BRIDGE project has supported a radio diary project featuring the personal testimonies

of male and female PLWHAs on six local radio stations. The Malawi Health Sector mid-term evaluation

showed that the Radio Diaries reached up to 75% of the listening audience in Malawi and indicated that

listening to the radio diaries is strongly associated with reduced stigma towards people living with HIV/AIDS

and more agreement with attitudes that "people with HIV are just like me." All radio stations report good

listener feedback to these innovative programs and there is widespread recognition of the programs in all

eight emphasis districts as well as in Lilongwe and Blantyre. The activity is also characterized by strong

partnerships not just with the radio stations, but also with PLWA organizations, specifically Malawi Network

of People Living with HIV/AIDS (MANET+) and National Association of People Living with HIV/AIDS in

Malawi (NAPHAM).

Activity 1: Skills Building at the Community Level

The BRIDGE project partners with DACCs, CACs, and VACs to strengthen their ability to plan, coordinate

and implement HIV prevention activities. Adequately skilled DACCs will oversee and coordinate broad-

based responses to HIV/AIDS district-wide and, through CACs and VACs, reach community change agents.

With FY 2008 EP funds BRIDGE will support the continuation of these capacity building plans in its districts

in partnership with the NAC umbrella grants program, and continue to encourage and support a more

engaged and supervisory relationship between DACC technical subcommittees and district based CACs.

Support includes trainings on components of the community mobilization process, behaviour change skills

building workshops and specific technical assistance to community groups including youth groups, faith

based organization and PLWHA support groups on planning and activity monitoring. BRIDGE support

includes linkages to activities in other area of the EP, such as PMTCT, abstinence/be faithful programs, and

VCT among others.

In FY 2008, this process will be expanded to include additional traditional authority areas in all eight focus

districts. To monitor progress, the BRIDGE project will continue to encourage meetings of the BCI technical

subcommittees in the DACCs and CACs. The project will facilitate DACC and CAC review meetings to

provide critical assessments of the activities conducted by these structures. Working with partners in the

DACCs, CACs, and other NGOs, the BRIDGE project will continue to mobilize communities to respond to

the HIV epidemic through the formation of VACs; the strengthening of CBO's; and advocating for the

inclusion of prevention programs to work alongside home-based care and orphan support activities. FY

2008 funds will be used to strengthen 40 VACS to assist DACCs support District Assemblies to ensure

widespread reach of the NAC umbrella grants and district-based forms of financial support.