COUNTRY OVERVIEW AND PROJECT BACKGROUND
Though Namibia has a small population of 1.8 million in an area of over 800,000km, it is a culturally diverse and complex country with at least 11 major ethnic groups. The HIV/AIDS pandemic has hit the country very hard. By the end of the 2006, the antenatal clinics reported an overall prevalence rate amongst pregnant women as being 19.9%, making Namibia one of the top five countries most affected by HIV/AIDS in the world. A complex array of socioeconomic and cultural factors is spreading this disease throughout Namibia, including poverty, internal labor migration, sexual norms and attitudes, high alcohol use, geographic inequities in access to services and information, major transportation corridors that connect Namibia to other high-prevalence countries, and unequal power dynamics between men and women.
The Government of Namibia (GRN) has developed a series of policies and plans (Government's National Strategic Plan on HIV/AIDS and the Third Medium Term Plan, MTPIII, 2004-2009) to form the basis for all sectors of Namibia to work together in fighting the health, economic and social challenges presented by HIV/AIDS.
In support of the GRN's efforts, the US President's Emergency Plan for AIDS Relief (Emergency Plan) is helping to establish voluntary counseling and testing (VCT) services, prevention of mother-to-child transmission of HIV (PMTCT) services, and antiretroviral therapy (ART), as well as supporting a wide variety of behavior change communication (BCC) initiatives and other HIV/AIDS-related programming initiatives. The United States Agency for International Development (USAID), under the Emergency Plan in Namibia, works with more than 30 different organizations from civil, religious and private sectors and six national government ministries.
Through its strategic approach to communication, HCP and its Namibian partners have worked to create an environment that supports individuals, families and communities to act positively for their own health, to promote for and have access to quality services and advocate for changing social norms. This integrated communication approach to improving health is based on a growing body of evidence that strategic health communication can change individuals' behavior and influence social norms.
Through its grassroots approach, HCP recognizes that behaviors and practices in relation to HIV/AIDS are not framed by individual choices alone, but are influenced strongly by access to resources and services, economic factors, gender and the prevalence of sexual violence, which require a community-driven response. Therefore, community initiatives are the engine and central thrust of the program, supported by mass media to achieve broad reach and scale, and interpersonal counseling to achieve in-depth and individualized interaction.
The diagram below illustrates five core programs that HCP has implemented to achieve the overall goal. The three pillars form the communication strategies: mass media, community mobilization and quality assurance of counseling at service delivery sites. Although the diagram illustrates these as separate pillars, they are inextricably linked in achieving the overall goal. The two support blocks--research and capacity building--are crosscutting, ongoing activities, which will ensure that programs are effectively and efficiently implemented.
Goal: Establishing AIDS Competent Communities that provide an enabling environment to:
- reduce the rate of new HIV infections
- encourage testing
- promote and support the treatment and care of those who have contracted the virus.
HCP established a Field Office to coordinate and drive the Namibian program in early 2003 to achieve the following objectives:
- Decrease HIV transmission by motivating audiences to use the full spectrum of prevention tactics: Abstinence, Faithfulness, and Condom use
- Increase the up-take of VCT, ART and PMTCT services
- Increase the care, support and treatment of PLHA
- Increase the caring responses towards orphans and vulnerable children
- Reduce stigma and discrimination
- Increase involvement at the individual and community levels in HIV prevention, care, and treatment
Working closely with HCP/Baltimore, the Namibian field office added staff and expertise in program development and management including fiscal responsibilities as the health communication component of the Emergency Plan grew. In 2006 the Field Office registered itself as a Namibian non-governmental organization, Nawa Life Trust (NLT) with the vision of improving the quality of life for all people in Namibia.
USAID endorses HCP’s capacity-building efforts and recognizes NLT as an emerging Namibian social and behavior change communication organization. NLT adds value as a key partner to the USG/USAID Emergency Plan programs and interventions in Namibia.
STORIES FROM THE FIELD
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