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Challenges of Health Behavior Change in the Democratic Republic of Congo (DRC)

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Democratic Republic of Congo (DRC) is both one of the poorest nations in the world (with the second lowest GDP) and one of the richest (with mineral deposits worth $24 trillion). Its population of 70 million live in an area about four times the size of France. DRC has the world's second largest rainforest, second longest river, savannas, glaciated mountains, and few good roads. DRC is also remembered for "Africa's World War," which involved nine countries and killed 5.4 million people. Yaya Drabo is Chief of Party for the C-CHANGE project in the DRC. He invites you to learn why this country is so challenging to a social and behavior change program, and why it is so exciting.

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C-CHANGE DRC Yaya Drabo Washington DC, 3rd , JANUARY 2012
Speakers ? Neil McKee (Introduction) ? Yaya Drabo (Presenter)
Here is the DRC Located in in Central Africa
? Size: 2,345,410 sq km C 80 times Belgium C 4 times France C 10 times my native country: BF ? 11 Provinces including Kinshasa the capitol that is the 1/3 of the country: equivalent of Mali or BF population! ? Shares borders with 9 countries Angola, Congo, Central African Republic, Uganda, Rwanda, Buru ndi, Tanzania, Zambia and Sudan)
A DIFFICULT COUNTRY´ ? Mainly because of its size DRC is a very difficult country to work in ? Transportation is frustrating ? Terrible roads: flying is the best way to reach any town; no safety regulations ? Everything is expensive: e.g., housing as well as air plane tickets
´But a Fascinating One! ? DRC is like a God¨s gift. ?The second largest rainforest in the world ?The second largest river in the world ?Each of the 10 Provinces has an unique richness (cobalt, diamond, copper) ?Creatures found nowhere else in the world ?DRC is Africa¨s most biologically rich country
C-Change assigment in DRC GOAL : Increase positive behaviors and norms related to family planning (FP), HIV and AIDS, malaria, maternal and child health(MCH) tuberculosis(TB) and water and sanitation (WATSAN) through evidence-based SBCC programs.
C-Change assigment in DRC (2) ? OBJECTIF 1: Support National Level Coordination: increase coordination, participation, and ownership by the MOH, NGOs, and other stakeholders in national health programs ? OBJECTIF 2: Build SBCC Skills: Develop SBCC skills and competencies of the MOH, NGOs and partners to design, implement and evaluate SBCC programs with the aim of changing a range of health behaviors that will improve health status.
C-Change assigment in DRC (3) ? OBJECTIF 3: Develop Evidence-Based Interventions and Materials: Improve the quality and effectiveness of SBCC programs and materials by employing evidence-based process that addresses individual factors, community and gender norms , environmental influences in their design, and implementation.
EXISTING PROGRAMS Family planning Malaria HIV/AIDS
EXISTING PROGRAMS Water and Sanitation Maternal and Child Health GBV/School Tubercolis ( TB)
NEW PROGRAMS Sexual and Gender-based violence/HIV/AIDS Nutrition/HIV/AIDS Prevention Mother-To-Child Transmission
C-CHANGE PARTNERS National Partners ( MOH) Sub-Contractors USAID¨s Project Partners PNSR (Reproductive CARE/DRC PROVIC health) PNLP ( Malaria) SFCG (Search for Common PROSANI (USAID Bilateral Ground) project in the country) Direction de l¨Hygiene IDI ( Initiatives pour le publique ( Villages et Developpement Integral) Assainis)[WATSAN] PNLS (HIV/AIDS) Kinshasa¨ School of Public Health No formal agreement Contract Memorandum of signed Understanding
BUDGET [Field support] 2009-2011 Malaria HIV MCH WATSAN GBV TB TOTAL Fiscal FP/RH AIDS HIV years FY 09 250,000 250,000 - 250,000 450,000 100,000 1,300,00 FY 10 600,000 1,847,000 500,000 250,000 500,000 - 3,697,000 FY 11 600,000 135,000 500,000 150,000 - 250,000 1,664,320 Total (1) 1,450,000 2,232,00 1,000,00 650,000 950,000 350,000 6,632,000 FY 12 340,900 314,650 113,400 130,900 46.970 717,500 - Funding Total (2) 8,296,320
OBJECTIVE 1: SUPPORT NATIONAL LEVEL COORDINATION ? We work mainly at the national level in supporting 3 national programs: C PNLP ( National Malaria Control Program) C PNSR( National Reproductive Health Program ) C PNLS ( National HIV/AIDS Program) ? Advocacy (PNSR and PNLP) ? Coordination (support national and provincial working group PNLP) ? Support the development and implementation of SBCC programs supported by USAID related to FP, Malaria, HIV and AIDS, MCH and Water and Sanitation
OBJECTIVE 2 : BUILD SBCC SKILLS ? National Programs' staff ? USAID¨s project¨s staff ? NGO C SBCC Training ( 70 people trained from the 4 main national supported, NGO and USAID partners ) C SBCC Strategy development ? National Malaria SBCC Strategy developed ? National FP SBCC Strategy ? 2 Provincial SBCC Strategy developed
What is SBCC? Social and Behavior Change Communication (SBCC)´ ? Systematic and evidenced-based
What is SBCC? ? Addresses social context, not just individual behavior - Use in analysis and design
What is SBCC? ? Employs various strategies for levels of intervention
PNLP staff SBCC Training in Katanga
Pretest training in Kinshasa
Pretest Briefing in the fields Mbuji-Mayi
PNLP staff SBCC training in South Kivu
PNLP STAFF SBCC training in Katanga
Some Products Katanga Province¨s SBCC Strategy
Some Products South Kivu Province¨s SBCC Strategy
OBJECTIVE 3: DEVELOP EVIDENCE-BASED INTERVENTIONS AND MATERIALS ? The 2nd year we focused on developing new materials related to each key programs we are working on ? Here are the materials we developed during the second year of the project ( See Table) ? Each of the materials were pretested through our subcontractor, CARE
PRINT MATERIALS DEVELOPED BY C-CHANGE DRC Programs Flipcharts Counse Job aids Brochures Leaflets Comic Message Posters ling books guide cards FP x Malaria X X ( 8) Watsan X X X X (10) (3) MCH X HIV X (10) GBV X School (2)
AUDIOVISUAL MATERIALS DEVELOPPED BY C-CHANGE DRC AUDIO TV Radio spots Interactive Radio drama TV show TV series programs X X X X X* HIV/AIDS (8) (8) ( 4 episodes) (2) (1) 5 languages French GBV/School X (3) Swahili Total 43 8 4 2 1*
Pretesting is key before producing the materials
PRETESTS OF MATERIALS GBV/School Malaria Lubumbashi ( Katanga) comics books in school Radio spots in Mbuji-Mayi (Eastern Kasai)
SPECIAL EVENTS ? Given our responsiveness USAID/DRC asked us to organize 3 big events. We did it successfully. ? PEPFAR technical meeting and stakeholder meeting ? PMI launch in DRC in a province far from Kinshasa where we have no presence ? C-Change presence at the Kinshasa International Fair (USAID 50th Anniversary)
PMI Launch in Mbuji-Mayi Amiral Zimmer, US Ambassador in DRC and the DRC MOH Secretary general
PMI LAUNCH Amiral Zimmer after giving a bednet to a household member
Amiral Zimmer, US Ambassador in DRC and the DRC MOH Secretary general distributing bednet at a Health Center
OTHER SPECIAL ACTIVITIES FOR USAID ? Facilitation of the communication component of the Malaria course held by the University of Kinshasa (Medical Faculty) ? Facilitation of the communication component of the MPH program of Kinshasa School of Public Health
HOW DID WE MAKE ALL THIS HAPPEN? ? Focus on quality SBCC ? More technical staff recruited in a competitive environment (6 new staff) ? Personal factors based on confidence and professionalism (I was fortunate to know the country and to have trained MOH staff in DRC and outside) ? Responsiveness to USAID requests ? Committed staff
WHERE DID WE COME FROM? ? C-Change has started in March 2009 with only ? Two technical persons ( one permanent and one consultant) ? The former COP resigned after one year ? 2 days after my arrival he left ? C-Change visibility as a SBCC project was low ? Staff were not as much motivated ( no technical feed back no staff meeting ) ? Difficult relationships with the Mission
CHALLENGING THE CHALLENGES! ? Working in DRC is a matter of challenging the challenges! ? In fact, our program is growing and we will need: C More space (Our Office that was seen as to big at the beginning of the project is now too small!) C More staff C Effective ways to scale up. That is the next ＾episode￣ with the upcoming Associated Award: 10 programs to run!
Discussion
THANK YOU!!!

More Related Content

Challenges of Health Behavior Change in the Democratic Republic of Congo (DRC)

  • 1. C-CHANGE DRC Yaya Drabo Washington DC, 3rd , JANUARY 2012
  • 2. Speakers ? Neil McKee (Introduction) ? Yaya Drabo (Presenter)
  • 3. Here is the DRC Located in in Central Africa
  • 4. ? Size: 2,345,410 sq km C 80 times Belgium C 4 times France C 10 times my native country: BF ? 11 Provinces including Kinshasa the capitol that is the 1/3 of the country: equivalent of Mali or BF population! ? Shares borders with 9 countries Angola, Congo, Central African Republic, Uganda, Rwanda, Buru ndi, Tanzania, Zambia and Sudan)
  • 5. A DIFFICULT COUNTRY´ ? Mainly because of its size DRC is a very difficult country to work in ? Transportation is frustrating ? Terrible roads: flying is the best way to reach any town; no safety regulations ? Everything is expensive: e.g., housing as well as air plane tickets
  • 6. ´But a Fascinating One! ? DRC is like a God¨s gift. ?The second largest rainforest in the world ?The second largest river in the world ?Each of the 10 Provinces has an unique richness (cobalt, diamond, copper) ?Creatures found nowhere else in the world ?DRC is Africa¨s most biologically rich country
  • 7. C-Change assigment in DRC GOAL : Increase positive behaviors and norms related to family planning (FP), HIV and AIDS, malaria, maternal and child health(MCH) tuberculosis(TB) and water and sanitation (WATSAN) through evidence-based SBCC programs.
  • 8. C-Change assigment in DRC (2) ? OBJECTIF 1: Support National Level Coordination: increase coordination, participation, and ownership by the MOH, NGOs, and other stakeholders in national health programs ? OBJECTIF 2: Build SBCC Skills: Develop SBCC skills and competencies of the MOH, NGOs and partners to design, implement and evaluate SBCC programs with the aim of changing a range of health behaviors that will improve health status.
  • 9. C-Change assigment in DRC (3) ? OBJECTIF 3: Develop Evidence-Based Interventions and Materials: Improve the quality and effectiveness of SBCC programs and materials by employing evidence-based process that addresses individual factors, community and gender norms , environmental influences in their design, and implementation.
  • 11. EXISTING PROGRAMS Water and Sanitation Maternal and Child Health GBV/School Tubercolis ( TB)
  • 12. NEW PROGRAMS Sexual and Gender-based violence/HIV/AIDS Nutrition/HIV/AIDS Prevention Mother-To-Child Transmission
  • 13. C-CHANGE PARTNERS National Partners ( MOH) Sub-Contractors USAID¨s Project Partners PNSR (Reproductive CARE/DRC PROVIC health) PNLP ( Malaria) SFCG (Search for Common PROSANI (USAID Bilateral Ground) project in the country) Direction de l¨Hygiene IDI ( Initiatives pour le publique ( Villages et Developpement Integral) Assainis)[WATSAN] PNLS (HIV/AIDS) Kinshasa¨ School of Public Health No formal agreement Contract Memorandum of signed Understanding
  • 14. BUDGET [Field support] 2009-2011 Malaria HIV MCH WATSAN GBV TB TOTAL Fiscal FP/RH AIDS HIV years FY 09 250,000 250,000 - 250,000 450,000 100,000 1,300,00 FY 10 600,000 1,847,000 500,000 250,000 500,000 - 3,697,000 FY 11 600,000 135,000 500,000 150,000 - 250,000 1,664,320 Total (1) 1,450,000 2,232,00 1,000,00 650,000 950,000 350,000 6,632,000 FY 12 340,900 314,650 113,400 130,900 46.970 717,500 - Funding Total (2) 8,296,320
  • 15. OBJECTIVE 1: SUPPORT NATIONAL LEVEL COORDINATION ? We work mainly at the national level in supporting 3 national programs: C PNLP ( National Malaria Control Program) C PNSR( National Reproductive Health Program ) C PNLS ( National HIV/AIDS Program) ? Advocacy (PNSR and PNLP) ? Coordination (support national and provincial working group PNLP) ? Support the development and implementation of SBCC programs supported by USAID related to FP, Malaria, HIV and AIDS, MCH and Water and Sanitation
  • 16. OBJECTIVE 2 : BUILD SBCC SKILLS ? National Programs' staff ? USAID¨s project¨s staff ? NGO C SBCC Training ( 70 people trained from the 4 main national supported, NGO and USAID partners ) C SBCC Strategy development ? National Malaria SBCC Strategy developed ? National FP SBCC Strategy ? 2 Provincial SBCC Strategy developed
  • 17. What is SBCC? Social and Behavior Change Communication (SBCC)´ ? Systematic and evidenced-based
  • 18. What is SBCC? ? Addresses social context, not just individual behavior - Use in analysis and design
  • 19. What is SBCC? ? Employs various strategies for levels of intervention
  • 22. Pretest Briefing in the fields Mbuji-Mayi
  • 27. OBJECTIVE 3: DEVELOP EVIDENCE-BASED INTERVENTIONS AND MATERIALS ? The 2nd year we focused on developing new materials related to each key programs we are working on ? Here are the materials we developed during the second year of the project ( See Table) ? Each of the materials were pretested through our subcontractor, CARE
  • 28. PRINT MATERIALS DEVELOPED BY C-CHANGE DRC Programs Flipcharts Counse Job aids Brochures Leaflets Comic Message Posters ling books guide cards FP x Malaria X X ( 8) Watsan X X X X (10) (3) MCH X HIV X (10) GBV X School (2)
  • 29. AUDIOVISUAL MATERIALS DEVELOPPED BY C-CHANGE DRC AUDIO TV Radio spots Interactive Radio drama TV show TV series programs X X X X X* HIV/AIDS (8) (8) ( 4 episodes) (2) (1) 5 languages French GBV/School X (3) Swahili Total 43 8 4 2 1*
  • 30. Pretesting is key before producing the materials
  • 31. PRETESTS OF MATERIALS GBV/School Malaria Lubumbashi ( Katanga) comics books in school Radio spots in Mbuji-Mayi (Eastern Kasai)
  • 32. SPECIAL EVENTS ? Given our responsiveness USAID/DRC asked us to organize 3 big events. We did it successfully. ? PEPFAR technical meeting and stakeholder meeting ? PMI launch in DRC in a province far from Kinshasa where we have no presence ? C-Change presence at the Kinshasa International Fair (USAID 50th Anniversary)
  • 33. PMI Launch in Mbuji-Mayi Amiral Zimmer, US Ambassador in DRC and the DRC MOH Secretary general
  • 34. PMI LAUNCH Amiral Zimmer after giving a bednet to a household member
  • 35. Amiral Zimmer, US Ambassador in DRC and the DRC MOH Secretary general distributing bednet at a Health Center
  • 36. OTHER SPECIAL ACTIVITIES FOR USAID ? Facilitation of the communication component of the Malaria course held by the University of Kinshasa (Medical Faculty) ? Facilitation of the communication component of the MPH program of Kinshasa School of Public Health
  • 37. HOW DID WE MAKE ALL THIS HAPPEN? ? Focus on quality SBCC ? More technical staff recruited in a competitive environment (6 new staff) ? Personal factors based on confidence and professionalism (I was fortunate to know the country and to have trained MOH staff in DRC and outside) ? Responsiveness to USAID requests ? Committed staff
  • 38. WHERE DID WE COME FROM? ? C-Change has started in March 2009 with only ? Two technical persons ( one permanent and one consultant) ? The former COP resigned after one year ? 2 days after my arrival he left ? C-Change visibility as a SBCC project was low ? Staff were not as much motivated ( no technical feed back no staff meeting ) ? Difficult relationships with the Mission
  • 39. CHALLENGING THE CHALLENGES! ? Working in DRC is a matter of challenging the challenges! ? In fact, our program is growing and we will need: C More space (Our Office that was seen as to big at the beginning of the project is now too small!) C More staff C Effective ways to scale up. That is the next ＾episode￣ with the upcoming Associated Award: 10 programs to run!