Event Impact Assessment of SAFE Educational Theatre for HIV/AIDS

During the second half of 2006, the Ford Foundation sponsored an impact assessment of the work of Sponsored Arts for Education (SAFE). SAFE is a United Kingdom charity and Kenyan non-governmental organisation that uses the professional arts, primarily theatre, to promote health education issues within the Kenyan community. The purpose of the assessment was to establish the effectiveness of using high quality theatre as an intervention to break the silence, stigma, superstition, and discrimination that surround HIV/AIDS, and provide communities with accurate health information. The report shows that the plays are designed appropriately and are appealing to the majority of the audience. However, it is also imperative that developing areas of concern are identified so they can be properly incorporated into the productions.

As part of the assessment, pre and post show questionnaires were developed along with a questionnaire which was to be carried out in the days following a performance. Two teams of eight members from SAFE's two leading theatre companies, SAFE Ghetto and SAFE Pwani, were trained in impact assessment, thereby providing SAFE with an inbuilt monitoring and evaluation system for the future.

According to the report, increases in knowledge were particularly significant in the areas of understanding anti-retro viral treatment (25% increase), realising that you were unable to tell if someone was infected by looking at them (30% increase), and learning about Post Exposure Prophylaxis for rape (40 - 50% increase). Changes in attitude included at least a 20% increase of acknowledgement that people with HIV have a future and 30% increase of acknowledgement of the need to protect oneself. 70 - 80% of respondents said they would be more likely to use a condom after the show, and 95% of post show respondents said they would be more likely to be tested.

Actual behaviour change was measured by voluntary counselling and testing (VCT) attendance rates. During SAFE Pwani’s collaboration with Kilifi District Hospital, they recorded a four-fold increase in patient attendance at their VCT unit. Earlier in the year another hospital had recorded a three-fold increase in the month after SAFE's tour, and in Nairobi a Medicins Sans Frontiers project in Mathare slum recorded over 500 people attending their clinic as a result of the five performances in the area, with over 50 people being immediately enrolled in their free HIV/TB treatment programme. At the coast, a collaboration with a mobile VCT unit resulted in more than a quarter of the audience coming forward for testing.

The evaluation contains a number of recommendations. The report states that when identifying new communities to perform to, the research teams need to systematically gather a list of baseline indicators. These indicators should include VCT attendance, ARV treatment rates, condom use, and sexual risk practices. Monitoring tools should also be refined with comprehensive and accessible analytical spreadsheets. The monitoring dataset will need to be developed further to show clear trends in the impact of theatre directly on actual behaviour.

The report also asserts that SAFE has a responsibility to conduct follow-up programming with their targeted communities, and all company members should go through regular HIV/AIDS peer education and counselling training. Mobilisation prior to each tour must continue to improve, in order to increase attendance. The report concludes that the assessment shows a huge increase in knowledge, awareness, and behaviour change following a performance, thus demonstrating the effectiveness of theatre as a communication medium.