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The Integrated Multi - media Campaign for HIV/AIDS awareness and Sexuality Information, Education and Communication (SIEC): The Nigeria Experience.

Introduction:

The Integrated multi - media Campaign for HIV/AIDS awareness and Sexuality Information, Education and Communication project took off in Bida Emirate Council of Niger State, Nigeria with funding support from John D. and CatherineeT. MacArthur Foundation, Chicago, USA in 1998. The communication project which was all embracing and encompassing was a direct intervention strategy to the need to deal with or combat the alarming rate of HIV/AIDS epidemic in the intervention area. An earlier study (baseline data) had indicated that 83.3% did not know what HIV/AIDS is all about while only 12% could state means of transmission of sexually transmitted diseases (STDs) including HIV/AIDS.

The communication intervention was described as integrated on two premises:

It sought to campaign to raise awareness, provide information and educate the target population about issues bothering on safe motherhood including human sexuality, reproductive health and sexually transmitted disease including HIV/AIDS using several media supports.

The target population was not just women of reproductive age but also men who are principal stakeholders in reproductive health decision making as well as youths (both in and out of school youths) with Sexuality Information, Education and Communication (SIEC) component of the project targeted at selected secondary schools in Niger State, Nigeria.

This multi - media communication project like many others takes into cognizance a combination of various media recognizing the religious, cultural and socio - economic diversity of the target audience. A media strategy of this nature provides means and way through which all members of the community will be reached effectively since without doubt varied media will appeal to various people depending on their individual preferences, accessibility and literacy levels (Kakovole et al, 1997; Kiragu et al, 1996; Rimon et al, 1994; Singhal and Rogers, 1999). This is justified as according to Yahaya (2001) the idea of integrated multi - media development communication model came into being because of realization of the fact that no one single channel is enough for the mobilization of target of change programmes or transferring packages developed by the scientists across to intended beneficiaries. Also, coming up with any intervention programme of this nature for the benefit of a target audience requires, a baseline information where situations, peculiarities, needs, media use pattern, priorities and preferences of the target audience are articulated and studied. Therefore, a combination of several of these media offers a lot of promises and advantages.

The Project Description

This communication intervention project borrowed from the integrated multi - media development communication model developed by Yahaya in 1998 (figure 1). The model explains the one - way flow of information from development situation analysis through objectives, programme packaging and use of multi - media channels to disseminate to target audience with the expected outcome triggered by information from the multi - media channels. These sub components according to Yahaya (2001) have specific features and functions to enhance the entire workability of the model. In this regard, the development situation analysis means interaction of experts from all areas of human endeavour (health, education, agriculture, and environment) with the aim of solving a specific social problem or combination of problems taken into consideration resources available and the felt need of the target population as experts interact. The programme packaging aspect deals with coming up with a professionally articulated actions and packages that are result oriented ready for dissemination and diffusion through various media ranging from electronics to prints, entertainment and interpersonal in the multi - media channels component of the model. This is done with the realization of the strenghts and weaknesses of each medium hence, all the media serve complimentary role where one or two of these media are not effective or efficient. While the target audiences are viewed broadly to include professionals, farmers, youths, ruralities and urbanities it is expected that there will be a change in Knowledge, Attitudes and Practices of the beneficiaries or the multi - media approach will facilitate adoption or enhance technical competence.

According to Yahaya (2001) the feed forward mechanism operates on its own and interaction loop emphasizes continuous interaction between stages for adjustment and additional information from one stage that needs to be incorporated. While the environment sub - system acknowledges the relevance of the entire social system development, hence, the model is not operating in isolation, the monitoring and evaluation provides avenue for the experts to obtain information through feedback on continuous basis in the communication process.

It is against this back ground that the integrated multi - media communication campaign was executed by the Centre for Communication and Reproductive Health Services (CCRHS) Bida, Niger State, Nigeria for reproductive health education of the inhabitants of this province. The reproductive health communication packages were disseminated using the exogenous and indigenous media. The procedure involved distribution of 8,000 posters, 10,000 handbills and 3,000 stickers strategically distributed to a target population of 50,000 people. In addition 2,000 audio tapes containing vital information in HIV/AIDS, protection of women and girls rights, and family planning messages were distributed television jingles and radio enlightenment programmes were held twice a week, while drama sketches, folk music performance, outreach programmes were held at different communities in the project area. However, preceding the communication intervention campaign were courtesy calls to traditional and community leaders who gave their blessing in the traditional way to the programme which is an important feature in communal live in the study area (Yahaya 2001).

Significantly, the entertainment component of the multi - media package borrowed from the experiences gained in Mexico and Philippines. Olajide (2002) asserts that in both countries, a similar music campaign made use of popular teenage singers to teach their fellow adolescents about sexual responsibility. In an attempt to utilize the potency of entertainment in music and drama, the services of reigning young folk musical group by Umar Lanle and Nma Gongoni and popular dramatist, comedian and radio actor stage named Ndayagi were sought. Both the music group and Ndayagi participated in many community outreach programmes to sensitize the target groups mainly women, youth, drivers, motorcycles riders and youth volunteers about family planning, sexual responsibility, dangers of unwanted pregnancies, HIV/AIDS and other related sexually transmitted diseases epidemic (Yahaya, 2002).

It must be emphasized that in Nigeria, it was only the attempt of John Hopkins Universitys Centre for Communication Programme (JHU/CCP) that had consciously and intentionally educated Nigerians through music. King Sunny Ade and Onyeka Onwenu, two of the Nigerians leading singers participated in the JHU/CCP programme when the duo sang Wait for Me and Choices. According to Singhal and Rogers (1999) the two songs became big hits recorded high degree of success as music video of the two songs were broadcast on national television network. Other songs by musician that teach social order and morals were unintentional as was the case in the early years of emergence of entertainment - education strategy as a tool for social change in the late 1960s. This was evident in Simplemente Maria ( Peru), Hum Log and Tinka Tinka Sukh (India), Oshin (Japan) and Costa Ricas Dialogo.

One significant fall - out of this attempt was the production and publication of two books from the field experience of the communication campaign project. The first is a 45-page play about the problems of gender inequality in contemporary Nigeria in general and Nupeland (the project area) in northern Nigeria in particular, while the second is a 58-page publication titled "Indigenous Music for Entertainment - Education: Lesson from AIDS: Batan Na ewu ezana in Bida Emirate of Niger State which x-rays how music can be used to create awareness about health or any other development issues in order to find solutions to problems associated with these issues.

The Sexuality Information, Education and Communication Components

In view of the critical nature of adolescent stage in the life of any individual and the global concern regarding the recent scourge of HIV/AIDS has brought to the fore the urgent need to deal with adolescent reproductive health without delay. This requires that the adolescent population be adequately informed and educated about the dangers inherent in reckless social life in the face of unavoidable socialization process which has taken various forms and dimensions in most recent times.

Given the scaring statistics in 1998 that 60% of all reported cases of HIV/AIDS came from the age group 15-24 years who constitutes more than 50% of the national population, it was unanimously agreed that the adolescent population should be properly informed and educated about issues bothering on their sex and sexuality via sexuality education. It is the belief of the proponents of this education that it will afford young people the opportunity to acquire adequate knowledge, skills and responsible attitudes in order to prevent and reduce sexually transmitted diseases including HIV/AIDS. This belief is further reinforced by many adolescents victims cases that relied on inaccurate and incorrect information from peers and peer influence as basis of their reproductive health decision making, hence, several cases of abandoned babies by teenagers, unwanted pregnancies, criminal abortion and misuse or drug abuse.

It is in realization of the aforementioned that a three- pronged approach to mobilization, information and education of in-school youths in secondary schools in Niger state was formulated by the Centre for Communication and Reproductive Health Services, Bida, Niger state. These approaches are advocacy (visits and workshops/ seminars), training and production and distribution of Information, Education and Communication (IEC) materials (books, face - caps and t - shirts, stickers, posters and handbills).

The advocacy component of this strategy was executed through visits to traditional rulers, principal executive office holders (Governor, Commissioners and heads of relevant government parastatals related to education, health and youth development), Legislatures and relevant State House of Assembly committees. Advocacy workshops were also organized for principals of secondary schools and honorable members of the state house of assembly. All of these are deemed necessary and important in view of controversies generated at the introduction of sexuality education in school curriculum in Nigeria and most specifically in northern Nigeria. Hence, in each of these workshops, emphasis was placed on the imperatives for HIV/AIDS prevention and the need to carry along the adolescents population in the struggle against this pandemic been the most vulnerable group given all sorts of experimentations (sexual, drug, gangsterism) inherent in this stage of human development.

The training segment of the campaign is been prosecuted with central training workshop organized for selected teachers from three educational zones of Minna, Bida and Kontagora in Niger state. Training workshop were also organized in zones for students who in their own rights are leaders (peer educators) in their respective schools. It was aimed at increasing and improving knowledge, attitudes and practices of sexuality education and behaviour of youths in secondary schools in the state. It was also envisaged to complement the efforts of trained teachers to teach sexuality education in schools. At the end of the training workshop teachers were mandated to conduct a step- down training for at least three teachers in their respective schools, liaise with their principals to set up steering committee for the teaching of sexuality education as school subject and to form Comprehensive Life Education Club (CLEC) in schools with trained peer educators becoming automatic pioneer members of the club.

Information, Education and Communication (IEC) materials were produced to enhance the project smooth take - off in schools as well as serve as useful reference materials in teaching sexuality education. Training manual and peer educators guide were produced on the fundamental premises that:

- the ultimate responsibility for the successful implementation of this project rests on teachers.

there is a strong reason to strengthen the pedagogical skills of teachers as they are not likely to have had prior experience of handling salient aspects of sexuality education.

probing questions from students during peer educators training necessitated peer educators guide which though was produced within the content of the curriculum, answers some of the questions raised by students during the workshop.

Others IEC materials produced are 1,000 pairs of face caps and shirts 1,000 copies of ten different stickers, 1,500 copies of posters covering personal skills, means of HIV/AIDS transmission and human development and 2,500 copies of handbills covering sexuality and media care during pregnancy, gender roles, modern contraceptive methods, sexual behaviour and risks associated with abortion.

Result

A post - intervention evaluation of the multi - media campaign revealed that awareness of HIV/AIDS epidemic rose to 100%as against 83.3% non - awareness in the baseline data. Also, majority (about 85%) could state combination of methods of birth control. Precisely, 72.3% of respondents in intervention communities rightly identified three methods (Condom + Contraceptive pill + Withdrawal) and 91.6% indicated sex and blood transfusion as means of HIV/AIDS transmission. This implies that higher percentages in project communities are highly informed about how HIV/AIDS spread compare to about 12% that were aware of the means of transmission in the pre - intervention survey.

The post - intervention survey also laid credence to effectiveness of the entertainment component of the multi - media intervention package. Yahaya (2002) reported that a higher proportion 67.4% prefers the audio tape waxed based on field and outreach programme experiences. On the comprehension of the message on audio tape, 58% of the respondents highly understood the message and on creation of awareness 53% of the respondents indicated that they became aware of HIV/AIDS epidemic via the entertainment and education provided in the audiotape.

An independent assessment of the two books which the entire project effort produced is quite revealing and illuminating. Haruna (2001) wrote that the moral of the play "Ignorance is a Disease" is obvious, it reminds the society that male and female must constantly complement each other and the publication underscores the fact that the price of gender equality is eternal struggle against male chauvinism and religious bigotry. On the other hand, while the drama creates awareness of the danger of gender discrimination, "Indigenous Music for Entertainment - Education: Lesson from AIDS: Batan Na ewu ezana in Bida Emirate of Niger State creates similar awareness in the case of AIDS which today is unarguably the most deadly disease besieging the working population of the African continent and the world over. Again, as with the case of girl-child the book has succeeded in mobilizing people at all level of society to the cause of the deadly and dreaded HIV/AIDS.

While the sexuality information, education and communication project is on- going, evidences from the in-built monitoring and evaluation indicate and imminent success story. With enthusiasm as evident in the unprecedented increase in number of volunteered schools in the concluded and future training programmes for teachers and peer educators, increase in number of students for peer educators clubs (initially targeted at 30 per school but now exceeding 100 per school) and the general favourable disposition of government official to project implementation, the target set for the project will be far exceeded. For instance, the project intended the training of 150 peer educators in three years (50 per year) but has trained 131 peer educators in the first year of its execution. The attraction and unprecedented enthusiasm generated by the production of Training Manual for teachers and Peer Educators Guide for students as well as the IEC materials especially the face- caps and t - shirts are additional boost to project pursuit in years to come.

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