 |
|
Global Reproductive Health:
Modeling and Reinforcement to Combat HIV/AIDS (MARCH) |
|
Back to HIV Prevention
What is the need?
Ultimately, the success or failure of global efforts to prevent HIV/AIDS
depends on people’s willingness and ability to behave in certain ways—to
avoid risk, to seek counseling and HIV testing, to take appropriate
preventive measures, and to adhere to recommended treatment regimens. To
ensure that people are both motivated and able to do these things, country
programs must focus not only on establishing services, but on individual,
social and environmental factors that influence people’s willingness and
ability to: 1) avoid risk, 2) seek and obtain appropriate services, and 3)
adhere to recommended treatment regimens. In many countries, encouraging
behavior change is complicated by issues such as widespread poverty, stigma
surrounding HIV, as well as cultural norms that may constrain certain
choices, especially for women and youth. What programs are available?
Behavior change is an important part of the technical assistance
activities CDC offers. Behavioral scientists from CDC’s Division of
Reproductive Health have developed a strategy called MARCH:
Modeling and Reinforcement to Combat HIV/AIDS (Galavotti et al. Am J Public
Health. 2001;91:1602–1807). Through the
Global AIDS Program (GAP),
CDC is supporting implementation in four countries (Botswana, Ethiopia,
Zambia and Guyana).
The goals of MARCH are to promote behavioral changes that
reduce the risk of HIV infection and transmission and to create normative
environments in which behavioral changes can be sustained. Behavior change
goals appropriate to the target population in each country are identified
and include: abstinence, delay initiation of sex, mutual monogamy, condom
and contraceptive use, use of HIV counseling and testing, use of prevention of
mother to child transmission and treatment services, adherence to
recommended treatments, and care and support for infected and affected
families.
The MARCH strategy is built on two fundamental principles
of behavior change–modeling by showing people how to change and
reinforcement—supporting them in their efforts to change. Building on
theory and past research, the MARCH strategy combines key
aspects of individual behavior change with efforts to change social norms
using two main program components: 1) entertainment (e.g., serial drama) as
a vehicle for education using broadcast media, and 2) interpersonal
reinforcement and mobilization at the community level.
What are MARCH programs doing?
This is a sample of ongoing MARCH activities in various GAP countries.
Botswana
- Supported the institutionalization of Makgabaneng as a local entity
that continues to develop and implement MARCH and other HIV prevention
entertainment-education programs.
- Support program evaluation efforts, including monitoring
implementation and outcomes.
Ethiopia
- Provides technical assistance on the design and implementation of
evaluation of activities for partners implementing MARCH behavior change
programs.
Guyana
- Provides technical assistance for serial drama, reinforcement
activities and evaluation. Reinforcement activities include
integration of MARCH materials into Guyana’s Health and Family Life
Education (i.e., Life Skills curriculum taught in schools).
Zambia
- Provides technical assistance for serial drama and reinforcement
activity development and implementation, and for outcome evaluation.
- Works with local partners to analyze baseline and mid-term data.
Appendix of Selected Resources
- Resource Manual for MARCH Coordinators
(draft): A comprehensive resource on the design, implementation and
evaluation of MARCH for use by project coordinators in country. Includes a
narrative description of MARCH and appendices of materials designed and
used in various MARCH projects to date.
- Training and facilitator’s manual for conducting
listening groups; group discussion guides, and small group activities.
- Pathways to Change game and behavior
change adherence tools: Pathways to Change game is a board game that
introduces scriptwriters to behavior change theory and helps them
integrate data from the formative assessment into program design.
Additional tools help monitor appropriate integration of behavior change
principles and data into communication products.
- Radio and HIV: Making a Difference, by
Gordon Adam and Nicola Harford (UNAIDS, 2000; 118 pages). This resource
manual explains the importance of understanding the issues, the context,
the target population, and the media environment when developing a
communication strategy for health and social development. It describes how
to conduct audience research, pilot and pre-testing, as a part of planning
and development of communication strategies using radio; monitoring and
evaluation; scheduling and effective formats; building partnerships with
other organizations; sustainability, training and capacity building. This
manual can be used effectively for the design of local trainings for
broadcast personnel and other stakeholders.
- Institutional Review of Educational Radio
Dramas, prepared for CDC by Mary Myers (January 2002; 121 pages).
This report is divided into 2 major components: 1) an overall summary and
analysis of the key features contributing to the success of the projects
reviewed and 2) 14 individual case studies of entertainment-education
radio drama programs from around the world
Back to HIV Prevention Page
last reviewed: 7/29/08
Page last modified: 7/29/08
Content source: Division
of Reproductive Health,
National Center for Chronic
Disease Prevention and Health Promotion |
|
|
