Implementing a Multi-media Pilot Programme to Promote Reproductive Health in Central Uganda

From the introduction

With support from UNFPA-Uganda, Africa Health and Development International (AHADI) executed a multi- media entertainment education pilot programme on sexual and reproductive health between June and December 2005 in Central Uganda, with greater concentration in Masaka, Luwero, Wakiso and Mukono. Through the entertainment education strategy, AHADI aimed to contribute to developing positive attitudes, values and beliefs that would increase adoption of desired sexual and reproductive health practices and support access to reproductive health.

For this multi-media edutainment pilot project AHADI partnered with Population Secretariat (POPSEC), the Central Broadcasting Corporation (CBS), Bukedde Newspaper, Education Through Culture and Sports and Afri-Talent Theatre Group.

The multimedia programme aimed to deal with key sexual and reproductive issues identified by the Government of Uganda and development partners. The programme aimed to provided information to mobilise individuals, families, and communities so that they can engage in dialogue on sensitive health issues and make informed choices about their sexual and reproductive health. It discussed family planning services, prevention and treatment of STIs, prevention of HIV, and adolescent reproductive health. Issues of gender violence and equality, early marriages and maternal health were also addressed. To achieve these objectives the project used radio soap opera, talk shows, comic strips, a comic book, posters and street theatre.

Following 6 months of implementation AHADI came up with the following lessons learnt, conclusions and recommendations:

Lessons learnt from the project include:

• Giving accurate information to target groups promotes the acceptability of the project. Through weekly discussion programmes, the project was able to interact directly with audience members and to clarify issues raised. The availability and sharing of concrete information ensured that myths and misconceptions about sexual and reproductive health were addressed.
• The use of a multi-media strategy in an integrated and synergized way works. The project used the radio soap opera as the organising and central component. For reinforcement, street performances, promotional materials (T-shirts, caps, posters, stickers), radio spots, comic strips, a comic book, discussion programme and listener clubs were developed and facilitated. The synergy enhanced each component.
• Community centers are important social spaces for adolescents. Because community centers are used for music and dramatic performances, they can be vital spaces for the distribution of materials and dissemination of SRH information.
• Behavior change is slow in coming because practices solidify over time. It is important to be patient when dealing with sensitive socio cultural issues. Engaging community members in dialogue in a respectful and optimistic manner is key in reassessing and readjusting cultural and social practices. Community dialogue when concretised can contribute to change in behavior. It is difficult to claim that a pilot program has brought about behavior change: it can only start the process of reflection.
• Poverty is a factor in early pregnancy and child bearing. Many adolescent girls get pregnant and drop out of school because of family poverty and limited life choices. Wealth creation and increased access to education for girls will slow the incidence of adolescent child bearing and lower the total fertility rates.
• It is possible to influence the behaviour of adolescents positively. The pilot project has shown that with innovative and consistent programming, the behaviour of adolescents towards sexual and reproductive health could be positively influenced. This requires the use of youth friendly intervention strategies.
• Multi media projects can have long term effects by contributing towards improved sexual and reproductive health of young people in Uganda. They can provide appropriate information on reproductive health, including family planning, STIs/HIV/AIDS, sexual and gender violence, treatment and support services. By encouraging safer sex, multi media projects can contribute in reduced incidences of STIs/HIV/AIDS. This will have the effect of reducing levels of poverty because resources will be directed to income generation for communities and by addressing gender inequality, girls will be availed with more life choices and career opportunities.
• The mobilisation of leaders at all levels is key to the success of SRH efforts. The multi media project will contribute in mobilising leaders to address adolescent reproductive health issues deliberately and consistently .
  
  

  AHADI reached the following conclusions::

  • " The entertainment-education strategy used in the pilot is suitable for relaying the messages identified because it is subtle and information is presented in a non-threatening manner.
  • Learning takes place within the intersection of stories and experiences of characters employed in the programme. By bringing the experiences of characters in homes and in public spaces, audience members are affected emotionally. The characters become their ‘neighbours and friends.’
  • Saturation of message delivery through a multi media approach is important in attracting and bonding with audience members. Application of different strategies provides reinforcement of the messages.
  • Audience members identify with characters in the drama and this is further amplified in the talk shows and stage performances. Audience identification is essential to the learning process in entertainment education strategy. The closer the lives of the characters are to that of the target audience the better.
  • The choice of a language that clearly brings out people’s views and interpretation of their health surroundings is appropriate. Use the discourse of the target audience as much as possible.
  • The media used appeals to audience sentiments, cultural aspirations and practices.
  • EE programmes have potential for behavior change, if presented consistently for a longer period. Change takes time to be realized but with repetition of credible messages, it is bound to occur.
  • There is a strong need to continue to integrate and synergize the components: radio soap opera, comic strips, comic book, stage performances, promotional materials and monitoring. Each component feeds into the other giving it renewed energy and vitality."

The following recommendations are considered by AHADI to be critical for continued success of the programme:

1. "The implementation of the project be considered for a longer period of time to build on the audience members captured during the pilot and to strengthen partnerships;
2. Strengthening of the street theatre component will improve project effectiveness;
3. There is need to link the programme to service delivery at clinics and hospitals to allow the actual exercise of behaviour and attitude change among the target population;
4. The approach could benefit key regions in Uganda through a process of translation and trans-creation;
5. The comic book, posters, and T-shirts were developed in English. Mass production of these items could be very useful;
6. Future programs should discuss sexual and reproductive health issues alongside the pursuit of gender equality;
7. Effective multi-media programming should be culturally appropriate in order not to alienate audience members;
8. Future programmes ought to address issues of fertility, as well as HIV prevention amongst the youth."