Eish! Thandi Breaks Her Silence: An Evaluation of the Power of the Comic as an Element of an HIV/AIDS Communication Strategy

This 33-slide Powerpoint presentation summarises an evaluation of the South African series, eKasi comics. A 24-comic series covers the various topics, including HIV/AIDS, disclosure, opportunistic infections, reactions of people to HIV/AIDS, sexually transmitted infections, knowing your partner’s past, condom usage, sexual violence and secrecy surrounding it, pregnancy, peer pressure, family violence, social relationships, gender issues, living with HIV and having a relationship, responsible sexual behaviour, coping with school, multiple partners, alcoholism, and antiretroviral treatment (ART) rollout. Comics are suitable in language and format, as they provide access for both first language and second language speakers of English. The comics also enable a merging of the fictional world with the real world, in that comics are based on real stories of readers.

Research was carried out on 89 respondents, using focus group discussions with both educators and learners. There was a thematic analysis of the comics, a review of letters sent to eKasi offices and an analysis of data. The researcher commented on potential limitations of the research: that there may be simplistic leaps of cause and effect, that extrapolation of local findings may be reported as ‘verifiable truths’, that there are difficulties in measuring real behaviour change, that attitudes and perceptions are recorded in the absence of preintervention data. Additionally, there are limitations in the communication/marketing theories and models.

The objectives of the evaluation were to ascertain how eKasi is a component of a wider communication strategy (sponsored by the Gauteng Department of Health, for the province of Gauteng), to assess the outcomes of the eKasi intervention, and determine the national/regional relevance of comics.

Research findings include, that readers actively engage with comics, identify strongly with characters and say that the social context in the comics mirrors their world. The participants‘ attitudes and perceptions recorded included:

• There is stigma attached to being HIV positive within learner communities.
• Responsibility for high risk behaviour must be shared.
• The balance of male/female role models in eKasi is perceived as positive as it challenges stereotypical notions of roles.
• There is insufficient information within communities.
• Judgmental attitudes are a reality.

The context of learners who participated included:

• Large numbers of learners in one school were from child-headed households.
• Learners experienced difficulty accessing health or social services in closed communities, i.e. their confidentiality was compromised.
• Rape and sexual violence was a ‘reality’
• Poverty levels were high.
• Access to social grants is difficult.
• There are known cases of HIV/AIDS within schools.
• Learners experience difficulties with disclosure, stigma and community pressure.

Teachers interviewed reported that:

• They use eKasi in teaching Life Orientation, Arts and Culture and Languages with grades 8-12.
• They have an abundance of material on HIV/AIDS but it is difficult to adapt material for different grades and learning areas.
• eKasi is used to facilitate learning.
• Learners have positive attitudes to eKasi and it is easy to organise lessons using the comic as a vehicle.
• Learners enjoy entering competitions, predicting and debating on various issues raised in the comics.
• eKasi provides a springboard for different activities like posters, letter writing, information dissemination, role playing, dramas, speeches
• The character, Thandi, is viewed as a ‘life-advisor’
• eKasi part of curriculum activities and supported by other advocacy initiatives run by non-governmental organisations and community-based organisations.
• Educators have conflicts with their own belief systems, perceptions and attitudes.
• Adequate support systems are needed as learners require access to these and educators are required to assist (e.g. with social grants, requiring appropriate documentation).

The presentation includes analyses of readers’ letters to eKasi and suggestions made by learners. It reports on the Behaviour Change Communication Model of Family Health International used and reflects on how eKasi fits in with it. It maintains that there is strong adherence to this model, as eKasi is an element of an overall communication strategy, and that eKasi is effective because of the societal-fictional context match. However, it reports difficulty in measuring behaviour change, though interviews suggest that the probability and possibility is high. The presentation confirms that eKasi increases knowledge of HIV/AIDS and other lifestyle issues, but that futher structures need to be put in place, to support these messages.

Findings establish that the comic is cost-effective, as working on 5 readers per comic it works out to 10c a reader. There is a need for follow-through campaigns and maintenance of messages in order to maximise impact. In order for individual shifts in knowledge to take place, perceptions and attitudes must be matched by societal shifts.

For a copy of the full report please send a note to the address below with your request.