From choice, a world of possibilities Behavior change programme, condom promotion & distribution & VMMC Dr Martin MIGOMBAN O mmigomban rg

from the onset to when the situation allows EmergencyPost-emergency Loss of essential services Restoration of essential services Relative stability Return to normality Destabilizing event Comprehensive HIV & STI services Durable solutions MISP -Blood Transfusions -Standard Precautions -Condoms -ARVs (cont. use) -PMTCT -Meet STI needs Implementing & integrating comprehensive HIV services

Prevention programme Behavioural interventions Condoms, Promotion and distribution VCT Prevention of mother-to-child transmission (PMTCT), Management of sexually transmitted infections (STIs), Strengthen health service delivery (Safe blood transfusion programme, Standard precaution programme (use of PEP) Voluntary medical male circumcision (VMMC) for HIV

Behavior Change

Process of behavior Change UnawareKnownledgeable Sustained behavour change

BCC Steps 1 Establish program goals 2 Involve stakehold ers 3 Identify t arget population 4 Conduct Formative assessment 5 Segment target audience 6 Define desired behaviour 7 Design BCC Strategy and M&E plan 8. Develop a communication product 9. Pre test 10. Implement and Monitor 11. Evaluate 12. Analyze, feedback and revise

Conducting a formative assessment Questions Risk situations including what influences the decisions and settings for risk Which target groups are most vulnerable; What persons or groups constitute their social networks and key influencers? What factors influences their behavior? What are the insights of opinion leaders …..

Conducting a formative assessment Methodology Focus groups discussion (cote d’Ivoire crisis) Key Informant interview In Depth interview Discussion with PLWA/Key population Observation Inventory health facility and community based programme already in place (services, quality Check your Logistic, conduct the assessment then analyze result than proceed the next BC step

Condom Promotion and distribution

Condoms male and female should be made available and free of charge during a crisis situation Programme should include supply chain management including lubricant Programme should targeted any person regardless of sex, age or marital status Programme can be effective when it includes community and with tailored messages Promotion messages should include dual protection approach (HIV-unplanned pregancy) Condom needs to be visible

Steps for condom integration Coordination and strategies Information materials (involve leaders …) Train staff and community (especially for Female condom) Supply system in place (at the beginning you can use IAWG RH Kit (Kit 1 A & B), IPPF MAs, UNAIDS… Provision (through health system or none health system) Awareness campaign especially for female condoms)

Voluntary Medical Male Circumcision

VMMC Effective intervention which can be perform during a crisis Require trained staff and medical supplies Require a task shifting approach Require an improved infrastructure Use of BCC strategy to create demand It has to be integrated with other services such condom distribution, STI, BCC… There is project implemented by UNHCR in Ethiopia and Uganda Needs to be done in protracted setting

Guidelines and other tools IASC : Guideline for addressing HIV in Humanitarian setting SPRINT Facilitator manual for MISP (IPPF-UNFPA) Field experience from UNHCR Reproductive health in emergency, Field manual

Thanks, Merci beaucoup, Obrigado