Madagascar
The Red Card: A low cost, easily scalable AIDS prevention tool
Activity Dates
2005-2007
Activity Summary
The concept behind the Red Card in AIDS prevention programs is similar to that in soccer--a player who commits a violation of the rules is "carded" by the referee and must leave the game. Field tests in Ethiopia and Madagascar indicated that the Red Card is most effective when used by young women.
Background: In 2004, the Red Card concept was briefly introduced into HCP youth programs in Ethiopia. A rapid field test with 30 young girls and guys was informative. Young men quickly found ways to make fun of the concept. However, several young women reported using the card in creative, unexpected ways. For example, one high school student placed the card on a table in front of her older sister who was "going out a lot at night and coming back late." The Red Card effectively catalyzed the first discussion between the sisters around this issue.
 Madagascar: Due to pressure on the Ethiopian team to meet PEPFAR goals, HCP program staff decided to conduct further tests with the Red Card in Madagascar. In 2005 the card was given to girls in 20 scout troops that were already actively engaged in the Ankoay AIDS Prevention Program. Again feedback from the girls and troop leaders was promising. USAID health staff and the Executive Director of CNLS, the National Anti-AIDS Committee, actively supported an extension of the field test to approximately 5,000 young women.
Additional considerations: Lessons learned from the Ankoay and other youth prevention programs around Africa contributed to HCP's understanding of the Red Card's potential.
- Difficulties in scaling up AIDS prevention programs: from the outset, the fundamental operating principle of HCP and Madagascar has been "no scale, no public health impact." HCP youth programs in Madagascar have demonstrated that a three-day training workshop for 6 leaders suffices to launch 8 - 12 months of sustained AIDS prevention activities for a group of approximately 30 youth. However, budget, logistical, political and administrative constraints work against scaling programs up in a significant way. Although the Red Card was first conceived as a component of more comprehensive youth programs its minimal cost (literally 2 cents) makes reaching hundreds of thousands of youth feasible.
- Reluctance to deal with sensitive issues: In traditional societies, indeed in most every society, there is a natural reluctance to deal head on with the toughest issues--coercive or exploitative behaviors which "drive" the AIDS epidemic. Repeatedly HCP staff has observed young Malagasy who "talk-the-talk" about values, negotiation and A, B, C fundamentals, but shy away from subjects that cut closer to the bone, such as the real role sugar daddies and multiple "steady" partners play in their lives. Field results indicate that the Red Card has the potential to go to the heart of the dynamics of exploitation which underlie the epidemic.
- Creating a buzz: The gender empowering aspect for women who use the Red Card together with its easily understood central message (time out, I feel uncomfortable, back off, HELP!) give this communication tool high "buzz" potential among youth.
 Primary Concern: To date, when health professionals discuss the Red Card, one concern repeatedly surfaces: is the card too confrontational? HCP has monitored the Red Card's use and studied how it is employed in social situations. Evidently, it is clear that a thin piece of Red Cardboard can be a match for the money of sugar daddies, the power of a high school teacher or the abuse that frequently follows excessive drinking.
Using the Red Card: To date most women have not used the card in confrontational ways but more as a conversation starter. The following are a few examples of how the Red Card has been used:
- A 15-year-old high school girl was being pressured by her boyfriend to have sex. After repeatedly trying to dissuade him, she finally gave him the Red Card. The guy was completely surprised. The couple broke up. The young girl, however, was pleased--she said it was for the better.
 A 16-year-old girl, Tina, brought the card home and showed her mother. Tina's mother approved of the card and for the first time had a discussion with Tina about sex and high-risk situations. - Young girls performed a skit for the community about a guy who has too much to drink at a wedding and tries to get a girl to "go to a quiet place." In the skit, the girl red-cards the guy. Afterward the skit, during a discussion with community members, the girls spoke of other situations in which the Red Card can be used.
- Girls in the tenth grade were bantering in the school yard. One girl explained that although she was going out with Ben, she wanted to date Rivo too. Her friend replied "that's a Red Card."
Situation as of July 2007: In October 2006, the Red Card campaign was launched through a mass-media effort: 4 Red Card Spots were broadcast several times each night on two Malagasy TV stations. Since then, the CNLS has rebroadcast the TV spots and has funded the development and broadcast of a series of 15 situational Red Card radio spots. As of July 2007, over 200,000 Red Cards had been distributed following short 2-hour workshops. A dozen faith-based organizations and NGOs, UNFPA,CARE, CRS, WWF and the Peace Corps are all engaged in the training young women and distributing the Red Card. Grant requests have been written for funding the production and distribution of one million additional cards.
Future TV and radio spots will explore themes such as:
- "Heroes in AIDS prevention"
- "Good kids in bad situations"
- "Don't leave home without it"
- "I feel more confident"
 Research Needs: HCP's understanding is that if the Red Card continues to be actively supported by mass media it will create a significant "buzz" that will, over time, be linked to a shift in gender norms. Other issues that require exploration include
- The 5% issue: It is possible that the Red Card will only be used by 3% - 5% of young women, but still be completely cost effective. Only by taking the initiative to a relatively large scale can HCP understand if and when the card is used in the most serious situations.
- Who, when, why? HCP will need to know more about the situations in which the card are most commonly used. This information will help inform the creation of each round of mass-media spots.
- Deterrent potential: Research can also illumine if the card encourages a certain percentage of men to act more responsibly simple due to a heightened sense of responsibility or potential for embarrassment.
Materials and Tools
Audience
Adolescents
Back to Madagascar
Note about materials: Some of the materials and resources listed on each page are available in their full form, others are represented by image or citation only. For more information and resources, go to www.jhuccp.org
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