Using human centered design approach to develop a comprehensive HIV communications strategy in Zimbabwe
Summary:
Zimbabwe has one of the highest burden of HIV in Africa, with a prevalence rate of 14.1%. Key populations are most affected, including men who have sex with men, female sex workers and adolescent girls. To achieve epidemic control, Zimbabwes first ever comprehensive HIV communications strategy was developed using the human centred design (HCD) approach, allowing for an empathetic analysis of the complex nature of peoples lives. The strategy development process included review of global frameworks and Zimbabwes operational and communications strategies in HIV prevention, care and treatment. The HCD approach was used to generate insights from 85 key stakeholders, 250 community members as well as 70 target audience members. The multi-level engagement resulted in the formulation of this new strategy. The strategy provides a major shift in focus, where now HIV communications is client-centered and not program-centered. This strategy unpacks the complex and intricate communication needs of 11 distinct audiences. Key insights in the strategy include: adolescent girls fear an HIV-positive result because they believe the boyfriend will hurt her, leave her or stop the financial rewards she gets for sex; young girls are not accessing PrEP as they fear being judged as promiscuous in the community; health care providers are an important target group that should be targeted separately as an audience in HIV programming. The new integrated approach places full emphasis on meeting the needs of 11 priority audiences with tailormade messages and interventions that meet them at their individual HIV risk journeys.
Background/Objectives:
With an HIV prevalence of 14.1%, Zimbabwe has one of the highest burden of HIV in the world. Women are most affected compared to their male counterparts. Further, key populations are most affected than the general population; prevalence among female sex workers (FSW) is as high as 57.1%, and about 23.5% of men who have sex with men (MSM) have HIV. Some of these populations including adolescent girls and young women have remained hard to reach using the traditional communication approaches. Against this backdrop, Zimbabwe sought to develop a comprehensive HIV communications strategy addressing all these population needs.
Description of Intervention and/or Methods/Design:
A multi-disciplinary team that included experts in journalism, human centered design, public health, monitoring and evaluation and costing was assembled to lead development of the strategy. The strategy development process included the review of global frameworks and peer-reviewed articles as well as review of Zimbabwes HIV operational and communications strategies across all levels of HIV prevention, care, and treatment. The human centered design (HCD) approach was used to generate insights from 85 key stakeholders involved in developing audience archetypes and journey maps; 30 technical working group members; 250 community members who gave insights on barriers and motivators as well as 70 target audience members who validated the illustrative messages and proposed interventions. Key findings were validated with data collected through key informant interviews with funders, implementing partners, Ministry of Health officials and non-governmental entities, as well as dialogues with target audiences in their environments.
Results/Lessons Learned:
The consultations resulted in the formulation of Zimbabwes first ever comprehensive HIV prevention, care and treatment communications strategy. The strategy provides a shift in focus, where HIV communications is client-centered and not program-centered. It provides visibility to the individual persons experiences with the motivators and barriers of accessing services. This strategy unpacks the complex and intricate needs of 11 audiences namely: FSW; MSM, people with disabilities, adolescent girls, young women, adult women, adolescent boys, young man, adult men, health care providers, and influencers. Key insights in the strategy include: adolescent girls fear an HIV-positive result because they believe the boyfriend will hurt her, leave her or stop the financial rewards; young girls are not accessing PrEP as they fear being judged as promiscuous in the community; health care providers are an important target group that should be targeted separately as an audience in HIV programming.
Discussion/Implications for the Field:
Implementing this strategy will move the Zimbabwe HIV program from the silo approach that sought to satisfy the needs of the HIV prevention, treatment and care programs. The new integrated approach places full emphasis on meeting the needs of these 11 priority audiences with tailormade messages and interventions that meet them at their individual HIV risk, prevention, treatment and care journeys. It is envisaged that this new approach will enable the program to reach these key audiences who were being missed or not fully served by the current HIV services and move the country towards epidemic control.
Abstract submitted by:
Brian Nachipo
Getrude Ncube
Kumbirai Chatora - PSI
Jim Rhyne - Boxcar Communications
Nicole Grable
Joseph Murungu
Zimbabwe has one of the highest burden of HIV in Africa, with a prevalence rate of 14.1%. Key populations are most affected, including men who have sex with men, female sex workers and adolescent girls. To achieve epidemic control, Zimbabwes first ever comprehensive HIV communications strategy was developed using the human centred design (HCD) approach, allowing for an empathetic analysis of the complex nature of peoples lives. The strategy development process included review of global frameworks and Zimbabwes operational and communications strategies in HIV prevention, care and treatment. The HCD approach was used to generate insights from 85 key stakeholders, 250 community members as well as 70 target audience members. The multi-level engagement resulted in the formulation of this new strategy. The strategy provides a major shift in focus, where now HIV communications is client-centered and not program-centered. This strategy unpacks the complex and intricate communication needs of 11 distinct audiences. Key insights in the strategy include: adolescent girls fear an HIV-positive result because they believe the boyfriend will hurt her, leave her or stop the financial rewards she gets for sex; young girls are not accessing PrEP as they fear being judged as promiscuous in the community; health care providers are an important target group that should be targeted separately as an audience in HIV programming. The new integrated approach places full emphasis on meeting the needs of 11 priority audiences with tailormade messages and interventions that meet them at their individual HIV risk journeys.
Background/Objectives:
With an HIV prevalence of 14.1%, Zimbabwe has one of the highest burden of HIV in the world. Women are most affected compared to their male counterparts. Further, key populations are most affected than the general population; prevalence among female sex workers (FSW) is as high as 57.1%, and about 23.5% of men who have sex with men (MSM) have HIV. Some of these populations including adolescent girls and young women have remained hard to reach using the traditional communication approaches. Against this backdrop, Zimbabwe sought to develop a comprehensive HIV communications strategy addressing all these population needs.
Description of Intervention and/or Methods/Design:
A multi-disciplinary team that included experts in journalism, human centered design, public health, monitoring and evaluation and costing was assembled to lead development of the strategy. The strategy development process included the review of global frameworks and peer-reviewed articles as well as review of Zimbabwes HIV operational and communications strategies across all levels of HIV prevention, care, and treatment. The human centered design (HCD) approach was used to generate insights from 85 key stakeholders involved in developing audience archetypes and journey maps; 30 technical working group members; 250 community members who gave insights on barriers and motivators as well as 70 target audience members who validated the illustrative messages and proposed interventions. Key findings were validated with data collected through key informant interviews with funders, implementing partners, Ministry of Health officials and non-governmental entities, as well as dialogues with target audiences in their environments.
Results/Lessons Learned:
The consultations resulted in the formulation of Zimbabwes first ever comprehensive HIV prevention, care and treatment communications strategy. The strategy provides a shift in focus, where HIV communications is client-centered and not program-centered. It provides visibility to the individual persons experiences with the motivators and barriers of accessing services. This strategy unpacks the complex and intricate needs of 11 audiences namely: FSW; MSM, people with disabilities, adolescent girls, young women, adult women, adolescent boys, young man, adult men, health care providers, and influencers. Key insights in the strategy include: adolescent girls fear an HIV-positive result because they believe the boyfriend will hurt her, leave her or stop the financial rewards; young girls are not accessing PrEP as they fear being judged as promiscuous in the community; health care providers are an important target group that should be targeted separately as an audience in HIV programming.
Discussion/Implications for the Field:
Implementing this strategy will move the Zimbabwe HIV program from the silo approach that sought to satisfy the needs of the HIV prevention, treatment and care programs. The new integrated approach places full emphasis on meeting the needs of these 11 priority audiences with tailormade messages and interventions that meet them at their individual HIV risk, prevention, treatment and care journeys. It is envisaged that this new approach will enable the program to reach these key audiences who were being missed or not fully served by the current HIV services and move the country towards epidemic control.
Abstract submitted by:
Brian Nachipo
Getrude Ncube
Kumbirai Chatora - PSI
Jim Rhyne - Boxcar Communications
Nicole Grable
Joseph Murungu
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: PSI