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Program at a Glance
Health focus: HIV/AIDS prevention and palliative care, Malaria prevention and treatment, Family Planning, Child Health, Healthy Pregnancy
Intended audiences: PLHAs, caretakers of children under 5, pregnant women, and couples of reproductive age
Timeframe: 5 years, beginning in 2005
Funding source: USAID
Partners:
Constella Futures, Malaria Consortium, Communication for Development Foundation of Uganda (CDFU), Pulse Communication Ltd., Aclaim Africa Ltd.
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AFFORD Health Marketing Initiative
PROJECT OVERVIEW
AFFORD is an innovative five-year health marketing initiative led by the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs and funded by the U.S. Agency for International Development. AFFORD integrates health communication and social marketing techniques to encourage private sector participation in health issues, increase access to and affordability of products and services such as counseling and testing for HIV, malaria drugs, long-lasting insecticide-treated nets, multivitamins with zinc, and condoms, and produce sustainable positive behavior change.
CCP is working with Constella Futures (formerly Futures Group), the Malaria Consortium, CDFU, Pulse Communication Ltd., and Aclaim Africa Ltd. to create an autonomously functioning Uganda Health Marketing Group (UHMG).
OBJECTIVES/STRATEGIES
Vision: A Uganda where families and communities are empowered to protect and improve their health; markets for health products and services are vibrant and expanding, and consumer access to affordable products and services steadily improves and is increasingly sustainable.
In order to achieve this vision, AFFORD has developed the following objectives:
- Increase accessibility and affordability of HIV/AIDS, reproductive health, child survival and malaria products and services through innovative marketing approaches.
- Enhance knowledge and correct use of HIV/RH/CS/Malaria products and services to encourage healthy lifestyles.
- Strengthen/establish indigenous organization(s) and distribution systems for sustainable delivery of health marketing functions.
ACTIVITIES AND HIGHLIGHTS
Communication Interventions
The Good Life Campaign: AFFORD and its partners designed a common communication platform for health practices, products, and services that cuts across audience segments. This platform, known as The Good Life Campaign, defines the practices, products and services that produce wellness for each of AFFORD’s priority audiences, and positions "a good life" as desirable, attainable, a basic right, and an individual and societal responsibility. The campaign also aims to stimulate dialogue and change attitudes around social issues that influence wellness, including family size norms, HIV/AIDS stigma and discrimination, and male involvement in family health. The crux of the campaign is The Good Life Gameshow, an entertainment education quiz show that uses an integrated multimedia approach, including community activations, radio shows, and television shows.
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The entertaining and educative gameshow - the first of its kind in Uganda - features different health topics each week, and shows how simple health practices and lifestyle choices can protect the family’s health and lead to socio-economic fulfillment. Winners take home prizes such as generators, water tanks, and mobile phones. The winning couple of each show also has the opportunity to spin the ‘Wheel of Life' and gamble for a chance to win a mystery prize. At the end of the game show’s 24 episodes, a lucky audience member or contestant will take home the grand prize - a brand new Toyota Hilux, donated by Toyota Uganda and IAA Health Care.
Popular Opinion Leaders (POL): The objective of the POL intervention is to bring about significant and sustainable positive change in behaviors and practices specifically through the efforts of popular opinion leaders interacting with and talking to their peers. The POL intervention will be closely tied to the Everyday Health strategy, so that messages across communication interventions are integrated and consistent. AFFORD will work with local partners to identify, train and supervise popular opinion leaders in areas where AFFORD works. A training curriculum and information cards were developed and will undergo pretesting prior to commencement of pilot activities.
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Testimonies from the Field
A mother in Ihandiro - Kasese District who had never delivered in a hospital agreed to go to the hospital after talking to a POL. She had complications, and the health workers told her that if she had delivered at home it would have been very dangerous for her life. Mom and baby are both doing well.
A woman in Ihandiro - Kasese District who had an STI would not seek proper medical treatment because she feared her husband’s reaction. She shared her situation with the POL and asked the POL to talk to her husband, too. The POL did, and as a result, the husband asked his wife to go with him for a medical check up. The couple was encouraged to treat the STI together, and now are well and happy.
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Working with At Risk Groups: AFFORD is contracting the Uganda People’s Defense Force (UPDF) and Women at Work International (WAWI) to work with UPDF soldiers and commercial sex workers (CSW), respectively. AFFORD is also assessing the feasibility and desirability of expanding UPDF and WAWI activities to integrate other health issues such as family planning, malaria control, and child health.
Community Outreach: Pulse provides direct brand/service communication to diverse target audiences. Pulse conducts experiential marketing activities for various audiences through clinics, ladies clubs, "Under The Mango Tree" village meetings (see below), and men’s clubs; activities include road shows, bar promotions, films, and video shows. Pulse is conducting experiential marketing outreach in pre-selected areas of the country.
Under the Mango Tree: While live broadcasts are best at creating dialogue on AFFORD’s health issues, Uganda has no unified language or radio station that reaches the entire country. The radio landscape is highly segmented with over 40 spoken languages, making it hard to reach the nation with live radio shows in local languages. Severe message fatigue also exists, due to the plethora of NGOs trying to reach Ugandans on similar topics. Given these complexities, it was vital to introduce a communication vehicle that could not only reach the nation, but also give communities' concerns a voice.
AFFORD worked with Fenon, a Kampala based audio production house, to create Under the Mango Tree (UMT), an innovative community outreach program and reality radio show. Community members gather under a mango tree to discuss real issues they face on one of AFFORD’s supported topics, with a moderator and health professional. These live sessions are recorded and edited into entertaining 30 minute radio segments. Listeners provide feedback by calling a toll free hotline with questions and comments about the show, and frequently asked questions are selected and answered in 45 second radio spots, which helps bring out the communities’ real questions. Health workers selected by the Ministry of Health serve as health professionals and review episodes for medical correctness.
 In the second year of AFFORD, 13 family planning and 13 malaria episodes of UMT were produced and recorded in 5 languages. These were broadcast on 11 stations nationwide, along with 22 45-second radio spots. One thousand three hundred and sixty Ugandans were involved in the live discussions that reached an estimated 5.7 million listeners. The hotline received an average of 900 weekly calls, indicative of the appeal and relevance of UMT for listeners. “I thank the organizers of this mango tree program for their good work because malaria rates have now decreased,” said one male listener from Soroti.
AFFORD is now developing HIV prevention and palliative care episodes.
Everyday Health Matters: Produced quarterly in English and local languages, each issue of this four-page newsletter focuses on a specific health issue. Written for a low literacy audience, the newsletter targets AFFORD's consumers with updated information on products, services, and health policies. View the family planning edition of Everyday Health Matters.
Products, Marketing and Distribution
Local Distribution Structure: In order to help strengthen the local commercial sector, AFFORD is gradually putting in place a distribution structure which relies on local distributors rather than on its own distribution force. One key element in the distribution strategy is the incorporation of Small Scale Entrepreneurs (SSE), based on the model of community distribution successfully used in other countries but with a special emphasis on financial sustainability. This model is currently being piloted in parts of the Western and Northern regions.
Long-Lasting Insecticide Treated Nets (LLINs): AFFORD is working with the Malaria Consortium to distribute LLINs where they are needed most. To date more than 28,000 LLINs have been distributed to 3 war torn Northern Uganda districts.
MoonBeads: MoonBeads, the AFFORD-branded Standard Days Method of natural family planning, was launched by the First Lady of Uganda, Janet Museveni, on October 6, 2006. View the MoonBeads guide.
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First Lady Janet Museveni launches MoonBeads at a ceremony
on October 6 2006
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Lauch attendees show excitement over MoonBeads
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RECENT NEWS
FUTURE DIRECTIONS
Establishment of the Uganda Health Marketing Group (UHMG): AFFORD is in the process of establish an independent organization that can lead health marketing activities. UHMG is an indigenous organization that will lead the implementation of all AFFORD activities, and eventually become self-sustaining.
AFFORD and partners are also working on new products:
Water Purification Tablets: Constella Futures and CCP are jointly developing product marketing plans for water purification tablets.
Low Osmolarity Formula for Oral Rehydration Salts (LoORS): AFFORD is planning to produce this WHO endorsed product with the support of local manufacturers.
Communication Package for PLHA: AFFORD is planning to introduce a package of preventive care products and services to PLHA.
CONTACT INFORMATION
Baltimore: Jennifer Orkis, jorkis@jhuccp.org
Kampala: Kojo Lokko, klokko@uhmg.org
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© 2005 The Johns Hopkins University. All rights reserved.