Circumcision in South Africa Supporting the Scale Up plan

1
Circumcision in South Africa Supporting the
Scale Up plan
The Beeg Bang for MMC

• Richard Delate
• Johns Hopkins Health and
• Education in SA

2
Men Ever Counselled and Tested NCS - 2006/2009
3
Men Counselled and Tested in last 12 Months
2006/2009
4
Knowledge Levels of the benefits of MC for HIV
risk reduction NCS 2009
5
Acceptability Levels of MC amongst Men and
Women
Data from four community studies in Ethekwini
Metro Municipality (KZN), Matjhabeng and
Masilonyana Local Municipalities (Lejwelephutswa,
FS) Merafong (Gauteng) Madibeng Muncipality
(Bojanala, North West)
6
of men self reporting to be circumcised NCS
2009
7
A BEEG BANG IS REQUIRED!
8
WHY IS A BEEG BANG REQUIRED

• TO REACH 16 600 per month until March in the
  priority to make target of 100 000
• To reach 41 600 circumcisions per month to
  achieve 500 000 over the next five years.

Without Social and Behavioural communication we
will NOT have the beeg bang
9
Have laid the foundation for the Beeg Bang

• SANAC Comms Strategy in place
• Provincial ACSM strategies being developed
• Mens sector sensitised and provincial strategies
  developed
• Radio Talk Shows undertaken
• Radio Producers Trained
• 8 community radio stations
• 1 National Station (Ukhozi FM Zulu)

10
Foundations have been laid

• Television integrated into Mindset in public
  health centres and on Siyayinqoba-Beat-it.
• Posters Developed in 2 languages
• Brochure developed in 2 languages
• Integrated into toolkits and Peer Educators
  trained
• Siyayinqoba Beat It 2 300 peer educators
  trained
• Brothers for Life 500 peer educators trained
• Mens sector and community partners mobilised and
  ready but absence of services for referral is on
  hold.

11
Community Dialogues
Face to face Communication
Media Advocacy /PR
THE BEEG BANG
Social Mobilisation
Mass Media
Small Media Posters Brochures
Outdoor
SERVICES Soc. Beh Change
New Media
Web/ email/ mobile
Radio Talk Shows Advert.
Television Drama / Advert.
Telephone Helpline
12
META-THEORY OF HEALTH COMMUNICATION
SKILLS KNOWLEDGE
COMMUNICATION INSTRUCTION DIRECTIVE
Dissemination Promotion
Prescription NONDIRECTIVE
Entertainment Counseling Dialogue
Social Networks PUBLIC
Advocacy Coalition Formation
Regulation
reinforcement
IDEATIONAL FACTORS COGNITIVE Attitudes
(Beliefs Values) Subjective Norms
Self-Efficacy Perceived Risk
Self-Image EMOTIONAL Fear, Sadness, Affection,
Happy, Trust, Empathy SOCIAL Mutual
Understanding Cohesion Reciprocity
Collective Efficacy
HEALTH PHYSICAL MENTAL STATUS REDUCED
MORBIDITY MORTALITY from INFECTIOUS
CHRONIC DISEASES
BEHAVIOR
confirmation
enabling
ENVIRONMENTAL CONTEXT SUPPORTS
CONSTRAINTS Burden of disease level of toxic
chemicals in air, water, food population
density technology policy access to food, safe
water sanitation access to health care,
socio-economic conditions
13
What do we need to make the beeg bang happen

• NEED INVESTMENT AND COMMITMENT
• Current disconnect between what Government and
  Donors want and resources!
• National and provinces have cut back on ACSM
  budgets but still want drive people to
  services.
• Donors have cut back on ACSM budgets but still
  want to drive people to service?
• Private media owners have given GREAT benefits in
  the past matching investments by donors and
  government but in the absence of resources its
  not possible to fund these efforts.