Uganda Joint Behaviour Change Communication Survey

This 143-page report discusses findings from a survey to evaluate health behaviour change communication interventions supported by the United States Agency for International Development (USAID) in Uganda, under the AFFORD/Uganda Health Marketing Group together with other implementing partners in Uganda. The survey particularly focused on assessing the effectiveness of HIV, family planning, malaria, and maternal and child health communication at both national and district levels. Overall, the findings indicate a high level of exposure to all of the communication campaigns, and significant associations of exposure to improved knowledge and positive behaviour changes.

The evaluation comprised a household survey of 7,542 men and women between 15 and 54 years of age residing in 27 districts of Uganda between November 2010 and November 2012. Each implementing partner supported data collection in districts where they are active. The report discusses levels of exposure and associated behavioural variables for specific health communication interventions conducted during the 12 months prior to the survey. (See note below for the list of communication interventions under review.) It also reports on combined effects of HIV communication, family planning communication, malaria communication, and maternal and child health communication efforts.

In terms of exposure, the findings indicate that health communication programmes under review had widespread reach. For example, during the 12 months preceding the survey 78.8% of respondents reported seeing or hearing about family planning from at least one of the interventions, and 84.8% of respondents had been exposed to any of the HIV communication campaigns. Exposure to malaria communication was slightly lower at 67% of respondents.

Across the four major focus areas of the project (HIV, family planning, malaria, and maternal and child health communication), the evaluation found positive associations between exposure and knowledge, discussions, and behaviour change. For example, while controlling for age, sex, rural or urban residence, marital status, educational level or wealth, those who had been exposed to any of the family planning communication interventions "were significantly more likely to currently use a modern family planning (FP) method, discuss FP with their partner, and want an ideal family size of four or less." Similarly, "exposure to any HIV communication was associated with a higher likelihood of condom use at last sex and intentions to circumcise among uncircumcised male respondents. Exposed respondents were also three times more likely than those who were not exposed to know that male circumcision reduces HIV risk, two times more likely to state that male circumcision is beneficial, and two times more likely to discuss male circumcision with others." In terms of malaria, exposure was associated with increase in testing before treatment of 4% among women and 8% among men, but there was no impact associated for other key outcomes such as getting treatment within 24 hours of fever onset, and sleeping under a mosquito net.

For the interventions related to maternal and child health, as well as the Integrated Health Communication Platforms, survey data is only presented regarding the individual campaigns. However, there are still indications of positive associations. For example, in just one of the maternal health focused interventions, STAR SW, 69.2% of respondents living in districts where the campaign operates had seen or heard the antenatal campaign. "Respondents exposed to the campaign who were pregnant or delivered a baby in the previous 12 months were significantly more likely to attend ANC four or more times than unexposed respondents."

In terms of the Integrated Health Communication Platforms, the report includes data about the Rock Point 256 Radio Serial Drama, which 53% of respondents between the ages of 15 and 24 years had listened to at least once in the previous 12 months. Of these listeners, 67% stated that they listened weekly or more often. "Listeners were significantly more likely to report using condoms at last sexual intercourse, having one sexual partner, talking with their partner or spouse about family planning, and knowing the HIV status of their partner or spouse during the 12 months before the survey."

Note:
Intervention included in the assessment were: Smart Choices campaign, Nurse Mildred campaign, GENEXT campaign, Marketing of family planning products i.e Pilplan, Injectaplan, Protector condoms, O condoms, NewFem, Softsure (Family planning); Sexual Networks Campaign, Go Together, Know Together Couple HIV Counseling and Testing Campaign, Stand Proud, Get Circumcised Campaign (HIV Communication); United Against Malaria, Power of Day One, Stop Malaria in Your Community/ Mrs. Anopheles (Malaria); Saving Mothers Deliver at a Health Facility campaign; STAR SW Antenatal Care campaign; Promotion of Aquasafe water purification tablet for safe water; Promotion of Restors and Zinkid oral rehydration therapy and zinc supplements for diarrhea management (Maternal and Child Health)