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TCDC regional manager Anthony Nacasenga training a group of community volunteers to facilitate with the Safari ya Mafanikio kit.The Journey of Success: An Integrated Community Approach for an AIDS-Free Tanzania

Thousands of communities throughout Tanzania have a new tool for the sustainable control of the HIV epidemic, thanks to a new community health resource kit from the Johns Hopkins Center for Communication Programs (CCP) and the Tanzania Communication and Development Center (TCDC).

The Safari ya Mafanikio (which means “Journey of Success” in Swahili) is a comprehensive behavior change toolkit which addresses the most important health topics facing Tanzanians today. The kit contains interactive modules that tackle HIV, malaria, tuberculosis, family planning, and maternal and child health, and was designed from the outset to empower Tanzanians at the community level with the tools to take charge of their own health.

The kit’s emphasis on participatory learning is unique, engaging participants through interactive story-telling, drama, games, metaphors, personal risk assessments and other innovative activities that inspire solution-seeking behaviors and shift mental models around deeply held cultural values.

 “The twelve modules and activities in the Safari ya Mafanikio involve participants in a way that goes far beyond just discussing and understanding the issues,” says Peter Labouchere, a behavior change expert who was instrumental in developing the kit.  “The kit creates learning experienceswhich ‘touch the heart, not just the head,’ and which participants can apply in a practical way to their own health and wellness issues.

These learning experiences are designed to complement each other in a coherent manner throughout the course of each module. A lesson on how the immune system works, for example, demonstrates how white blood cells protect against infection by asking participants to act out the roles. One participant plays the role of the white blood cell, while another acts as a pathogen attacking the immune system. Later in the module, this example is revisited with additional participants to demonstrate the role that anti-retroviral treatment plays in protecting white blood cells from HIV.

Over half of the lessons in the Safari ya Mafanikio are dedicated to HIV-related topics. These include HIV prevention; testing and counselling; voluntary medical male circumcision; treatment, adherence and support; the prevention of mother-to-child transmission of HIV; and reaching out to most vulnerable children.

The kit also puts considerable emphasis on the reduction of HIV-related stigma, a topic addressed in multiple activities across various modules. Anthony Nacasenga, TCDC’s manager for Coast region, notes that stigma reduction will play a significant role in getting those living with HIV on treatment.

“As stigma decreases, more people will be willing to disclose their status,” he says. “This creates a safer environment for everyone.”

Like the rest of TCDC’s regional managers, Mr. Nacasenga has been training members of the council health management teams (CHMTs) in each district in his region. Those CHMT members are, in turn, working with local community-based organizations (CBOs) to train community volunteers (called community change agents, or CCAs) to facilitate the Safari ya Mafanikio at the community level. Working with established counterparts at each level of implementation helps to ensure local buy-in and contributes to the kit’s sustainability.

Through the district CHMTs and CBOs, TCDC has trained over 2000 CCAs, covering more than 7000 villages in sixteen regions. This massive, locally-driven network can reach out to Tanzanians at every level with positive behavior change programming through the Safari ya Mafanikio.TCDC trainers demonstrating one of the Safari ya Mafanikio's many interactive components.

The kit has been designed to rely primarily on cost-effective, locally-available resources, such as string, maize seeds and matches. This ensures that CCAs will be able to take advantage of each module with materials easily obtained at the village level.

The comprehensive and modular nature of the Safari ya Mafanikio allows the CHMTs to identify their own health priorities and implement the relevant modules, all in one resource. A district with a high rate of HIV and low malaria prevalence, for example, might develop a campaign around the kit’s HIV modules. This ability to implement in a decentralized manner allows those nearest to the problem to maximize their impact by meeting specific needs.

In addition, the Safari ya Mafanikio links to existing health infrastructure by enabling CCAs to write referrals for community members who believe they may be experiencing a health-related issue. This creates continuity between demand creation and the uptake of services, encouraging community members to act positively on their concerns and visit their local health facility.

The potential impact of the kit is not lost on local health officials, says Mr. Nacasenga. “The CHMTs are already saying that this kit is important and will be helpful in their communities. It gets right to the heart of the community.”

Altogether, the Safari ya Mafanikio is the complete resource for community health behavior change in Tanzania. Designed to cover a comprehensive range of health topics in an engaging, participatory manner, and implemented with established counterparts at every level to ensure sustainability and local buy-in, the Safari ya Mafanikio is well on its way to living up to its name.

The Safari ya Mafanikio was developed by CCP’s Tanzania Capacity and Communication Project (TCCP) and TCDC, in collaboration with the Tanzania Ministry of Health and Social Welfare, with support from the United States Agency for International Development (USAID), the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI).

Last modified on Friday, 19 February 2016 09:05

Mtwara Rural invested millions of shillings to support its CCA programs.Communities throughout rural Mtwara district have a new reason to be optimistic about the future of their health, thanks to the Mtwara Rural District Council’s recent commitment of financial support for the Community Change Agent (CCA) health outreach program.

CCAs are community volunteers who have been trained in malaria, HIV and family planning outreach education. The council’s decision, which followed meetings between TCDC implementing partner MUKEMBA, the council health management team (CHMT), and the district medical office, provides TShs 6,720,000 to the program. This will double the monthly allowance for the district’s 28 ward-level CCAs for one year.

According to Mtwara Rural’s malaria focal person and CHMT member Lilian Wina, the CCA program warranted investment due to its ongoing success at the community level.

“The council decided to invest in the program because of its performance in community sensitization, advocacy and health education. It’s a bridge between the community and government.”

The impact of the program in regions where CCAs are active has been tremendous; in the first quarter of fiscal year 2015, CCAs reached hundreds of thousands of Tanzanians with small-scale interventions.

As trained behavior change facilitators who are also active members of the communities in which they serve, CCAs are uniquely qualified to tailor interactive, community-specific interventions that empower those most affected by today’s health issues. Ms. Wina believes this element is critical for success.

“CCAs have a close relationship with their communities. I hope those communities continue to recognize the importance of their CCAs, and that the program is their own - the CCAs come from among them.”

Steven Tibaigana, TCDC’s Mtwara manager, believes Mtwara Rural District’s commitment is a promising step for program sustainability.

“To get to this stage is a major achievement [for the CCA program]. Investment from the district council increases project oversight and helps cement local ownership. We hope our system of cooperation serves as a model for organizations in other districts.”

The CCA program is a key component of the USAID-funded Tanzania Capacity and Communication Project, led by Johns Hopkins Center for Communication Programs in collaboration with TCDC.

There are currently more than 800 ward-level CCAs serving in six regions throughout Tanzania, a number expected to double once TCDC completes training new CCAs in nine new regions by the end of October. These trainings will also coincide with an expansion of the program’s scope of work, introducing materials to allow CCAs to focus on other health priorities such as tuberculosis and safe motherhood.

Last modified on Tuesday, 16 February 2016 17:38

Bodaboda riders proudly sport their new shirts in support of the Lishe Ruvuma campaign!Nutrition campaign to end stunting reaches thousands in Tunduru district. Topics covered included proper breastfeeding and nutritional variety in young children, among other things.

Thousands of mothers and young children in Tunduru district have a better understanding of proper nutrition and hygiene practices, thanks to the recent ‘Lishe Ruvuma’ campaign.

The campaign, which was implemented by TCDC in collaboration with the Center for Counseling, Nutrition and Health Care (COUNSENUTH) through the Ministry of Health and Social Welfare, sought to reduce incidence of stunting in children under 24 months of age. This was achieved with interventions that targeted mothers with young children, local healthcare providers and local officials, as well as other caregivers.

The campaign was launched with a rally at Tunduru’s Baraza la Idd grounds on April 27th that saw over 4000 Tunduru residents attend. Highlights from the launch event included performances by nationally-acclaimed pop stars Izzo Bizness and Belle 9, who took time between some of their most popular songs to tell personal stories about why providing proper nutrition and hygiene for young children was important for them.

“Can’t you see that I’m in great health?” Izzo Bizness asked the crowd during his performance. “This is because my parents provided me with good nutrition when I was a child. Children who are given proper nutrition grow better and have improved abilities.”

Belle 9 echoed these sentiments with a message specifically for new mothers. “Remember: it is very important to breastfeed your newborns exclusively for the first six months of life, without mixing in any other foods. After [introducing solid foods], it is important to feed children well so they can grow healthy!”

In the weeks following the launch event, road shows traveled through Tunduru’s eight wards to conduct interventions with mothers with young children, midwives, community health workers, ward and village officials and other important community figures. Interventions included question and answer sessions, culture and theater performances, and singing and dancing activities.

Volunteers with TCDC’s Community Change Agent (CCA) program distributed thousands of print materials during the campaign, and 25 wall murals were also painted throughout the district to create lasting and sustainable visibility for the campaign’s key message.

The local response to the campaign has been tremendous, with residents commending the “historic” scale of the launch event and praising the campaign’s message and delivery. Regional stake-holders are now asking that the campaign be expanded to other areas to increase the scale of its impact.

Last modified on Tuesday, 16 February 2016 17:38

Hundreds Take Part in the Malaria Safe 5k Walk on World Malaria Day 2015Representatives from some of Tanzania’s biggest public and private players in the fight against malaria came together to mark World Malaria Day in Dar es Salaam last month.

Residents of Dar es Salaam’s Msasani Peninsula woke up to quite a sight on April 25th, as hundreds of participants from the public and private sectors took to the streets to commemorate World Malaria Day in this year’s Malaria Safe 5k Walk.

The walk, sponsored by BG East Africa, began at Oysterbay’s Farasi Grounds and circled the lower half of Msasani along some of Dar es Salaam’s busiest roads. Over 300 participants took part, seeking to raise awareness and improve advocacy efforts relating to malaria while strengthening the Malaria Safe partnership and demonstrating some of Tanzania’s biggest companies’ commitment to investing in the fight against malaria. 21 companies, government organs, donors and civil society groups took part in the walk, and contributed 620 insecticide-treated mosquito nets to five hospitals in Dar es Salaam.

After the walk was completed, Mr. Michael John, Acting Permanent Secretary for the Ministry of Health and Social Welfare, served as the Guest of Honor and addressed the crowd. He was joined by representatives from the United States Agency for International Development (USAID), Malaria Safe and HSSE BG East Africa.

“The walk was a huge success,” says Malaria Safe coordinator Nicholas Nderungo. “The turnout really brought it to life, and we hope it serves to demonstrate the significant impact that the private sector can play in the fight against malaria through the Malaria Safe Initiative.”

Malaria Safe is an initiative of the National Malaria Control Program, funded by USAID and coordinated by Johns Hopkins Center for Communication Programs and TCDC. It brings private sector companies together to collaborate with the Ministry of Health and Social Welfare on issues relating to malaria, and to provide trainings for employees of member companies. The initiative launched in 2012 with 8 companies in Dar es Salaam, and has since expanded to 57 companies in multiple regions.

“Our goal is to reach out to communities throughout Tanzania,” explains Mr. Nderungo. “Malaria Safe companies have much to offer, and I think we are well on our way.”

 

For more information, check out our interactive PDF(726k)!

Last modified on Tuesday, 16 February 2016 17:39
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