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Final Report for the
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3. Supportive Interventions: Information Dissemination and Materials Development Establishment of a Resource Center on HIV/AIDS FCO 36472/56472
Background The Kenya AIDS NGOs Consortium (KANCO) was formed in 1990 and is a coalition of NGOs and religious organizations with an interest in HIV/AIDS and STI activities in Kenya. It currently has 320 members, and is governed by an advisory committee of six elected NGO representatives. The goal of KANCO is to encourage networking between members and the government for the purpose of preventing the spread of HIV and other STIs and caring for those affected. Very early on KANCO members realized the need to have access to practical and appropriate information and materials addressing their needs and interests. KANCO's secretariat was mandated to solicit funds to establish a Resource Centre and related information services. In response to this need AIDSCAP developed a subagreement with KANCO (with supportive funding from ActionAid), and the Resource Centre was opened in January 1995. The intended beneficiaries of the Resource Centre include KANCO members, government health workers, community educators, and communities infected and affected by HIV/AIDS and other STIs. The needs assessment conducted by KANCO in 1994 confirmed the lack of practical information on HIV/AIDS in Kenya, and provided useful baseline data from which to develop the Resource Centre's collection and information services. Thirty-one months later the Resource Centre handles an average of 250 inquiries per month through visits, letter, fax, E-mail and telephone. KANCO is now considered an important source of HIV/AIDS/STI information in Kenya by many NGOs, government health workers and community workers. Objective The project's objective was to expand to capacity of KANCO members to promote effective AIDS control programs in their communities, in order to contribute to the overall AIDSCAP goal of reducing high risk sexual behavior in target populations. The specific objective was to establish a networking mechanism for NGOs, religious organizations, government, private sector and local and international organizations concerned in HIV/AIDS/STI prevention and care activities, in order to:
To assist KANCO in carrying out the project, an agreement was drawn up with the Appropriate Health Resources and Technologies Action Group (AHRTAG), to provide on-going technical assistance. Accomplishments The Resource Centre has within its operating period been able to amass a wide range of HIV/AIDS materials making it a reputable HIV/AIDS focal reference point. This wide collection include journals, books, research works, give-away materials, computer databases, video tapes, audio tapes, slide sets, condoms etc. Three information packs on special topics (AIDS counseling, condoms, and home-based care) were produced and circulated to members. Data collected on user satisfaction with services showed that 94% of these users said the Resource Centre was a convenient source of information. The findings of the external evaluator also showed that the Resource Centre was cited as the primary source of HIV/AIDS information for those interviewed. Technologically, the Resource Centre has been equipped with modern communication devices that link it with the wider world of health information. These include video facilities, computer databases such as Popline, E-mail, World Wide Web, Internet, and fax. A key achievement of the Resource Centre is the part it has played in networking diverse organizations with diverse programs. These include church-based programs, international and national NGOs, CBOs, researchers, trainers, HIV/AIDS consultants, and government departments. These networks were fostered not only through the regular quarterly meetings of the Consortium, but through a quarterly Consortium newsletter (produced under the Resource Centre agreement) and the development of the AIDS Information System (AIS), a database of information on NGOs' location, projects, target group, and activities. Coupled with this networking aspect is the liaison role the Resource Centre plays amongst government departments, churches, CBOs, NGOs, other resource centers, and international organizations involved in HIV/AIDS activities. The Resource Centre has also succeeded in taking on the role of clearinghouse for NGOs materials on HIV/AIDS. Many NGOs distribute materials through the Resource Centre whether for sale or give-away. Training to build the skills of Consortium members was also funded by AIDSCAP. Three workshops, one on counseling and two on home-based care, were held for a total of 100 people. Training in project development was also provided in two workshops, reaching 30 people in total. KANCO's end-of-project evaluation was a highly participatory process which, though complex and time-consuming, was a major achievement on KANCO's part which members enthusiastically endorsed. Participants commented that they felt that they owned KANCO and made valuable contributions about the way forward. Constraints Despite the availability of electronic communication resources, the vendors of these services often use equipment which cannot stand large loads. Most have few in-going telephone connections and slow modems. The situation is aggravated by the poor overall quality of the telephone lines. These factors slow up the work of accessing information. In addition to these infrastructural problems, the quality and value of the information available electronically is still largely Western-biased and is not yet of great value to Kenyans. It does not contribute much to the Resource Centre's objective of increasing members' access to practical knowledge, skills and information. With the increase in demand for its services from both KANCO members and the general public, the staff tend to be overloaded, with too many activities expected from them, both in regard to the Centre and the Consortium in general. A major emerging constraint is the imbalance of demand and supply. While very few organizations are able to produce materials for distribution, many organizations visit or call for materials to be supplied by the Resource Centre. Strict adherence to Resource Centre operational policies is double-edged and poses difficulties. Management is torn between strict adherence to lending policies which may mean low usage of the Resource Centre and lax adherence which may mean loss of control in the movement of valuable materials and too much time allocated to queries. Findings The Resource Center had a sound beginning based on the needs assessment. That study confirmed the lack of practical information on HIV/AIDS, and provided useful data from which to develop the Resource Center collection and materials. A final end-of-project evaluation involving both a desk review and focus group discussions with members revealed that: The inquiry service using both personal contact and mail is well established and the Resource Centre staff have access to the latest information on HIV/AIDS, research studies and training resources. The center is well equipped with relevant materials including videos, journals, books, training manuals, posters, pamphlets, and a wide collection of current international newsletters. The Resource Centre was also considered to have fostered networking and collaboration on HIV/AIDS issues. The one information pack, on AIDS counseling, produced at the time of the evaluation, was found to have substantial information and be relevant to users. However, it was suggested that more local information should be included in future. The importance of providing services to foster networking was confirmed by the finding that the AIDS Information System was the most widely used database in the Resource Centre. The quarterly KANCO Newsletter had also been received by 71% of those interviewed, who found it a useful resource. However, the evaluation suggested that awareness about both services should be increased, since they were still under used. Some people did not know that the AIS exists, while some did not received the newsletter regularly. The evaluation report set out detailed recommendations for improving the organization of the Resource Centre, in order to maintain and improve its existing high level of services. Most of the recommendations related to technical issues of indexing and accessing information. However, several suggestions brought out the need to strengthen local input and resources. It was noted that the Centre should increase the collection of materials from Kenya and Africa, that there should be greater district-level participation in developing future information packs, and that the Resource Centre should explore ways to increase networking at the district level, so that those at that level could benefit from sharing and exchange of information. It was suggested, for example, that the Centre could actively promote training and background resources for training that would meet the needs of KANCO members, including training in how to organize and use information. Lessons Learned The Resource Center was successful because it met the most important felt need of members. Members' need for information were further defined during the needs assessment which was carried out by the Resource Centre project. This assessment reviewed the existing HIV/AIDS information services provided by others. It also allowed KANCO to determine the gaps in information and address the expectations of Consortium members and other users of the Resource center. Although it is difficult to measure the use and impact of information provided, KANCO has found that some strategies maximize use and impact, such as using information in context, targeting it, and packaging it for the user. Monitoring is essential for ongoing assessment and feedback. Alternative methods of information dissemination are necessary to reach the wider community. There is a need to strengthen networking at the District level in order to make Resource center services more accessible to people. Technical support was vital for Resource Centre staff development. Conversely, building the skills of the Resource Centre users is necessary for effective use of available information materials. Electronic data bases need to be widely promoted and popularized. The Resource Centre can play a key role in identifying gaps for planning and developing new and well targeted IEC materials. This was demonstrated in the Resource Centre's collaboration with PATH's training materials development intervention (see below), as these links enabled PATH to target its materials in order to fill gaps rather than recreating the wheel. The Resource Centre realized the importance of monitoring and evaluation in project management to provide continuous feedback and help in identifying emerging needs. Working with AHRTAG, the Centre set up a detailed monitoring system to records how services were being used. This was complemented by a mid-term review and the data provided by the end-of-project (EOP) evaluation. The systems provide user, and supply and demand statistics that validate management decisions on service provision. Country Office Assessment The establishment of the Resource Centre has been one of AIDSCAP's most innovative projects. The Centre is the only one of its kind in the country providing a unique collection of materials and information services. The AIDS Information System, for example, is a focal point, which is used quite extensively by the National AIDS/STD Control Programme as a primary source of information on what is happening nationally. User assessment of the services indicates satisfaction as revealed by the end-of-project evaluation. However, strategies for other users outside Nairobi to access the service need to be urgently developed/strengthened so that the benefits can be truly national. Coupled with this, there is need to train users on some of the more sophisticated information services offered e.g. Popline. The role of AHRTAG cannot be over-emphasized in terms of providing quality technical assistance to the Resource Centre staff. Through their support, technical quality has been maintained. Process Indicator Summary
Technical Assistance to the Kenya AIDS NGOs Consortium on Materials Development FCO 23490
Background For effective AIDS prevention interventions, IEC materials are required to complement interpersonal communication efforts. The Kenya AIDS NGOs Consortium recognized that most KANCO members, however, did not have any formal training in IEC that would enable them to develop their own new materials or evaluate the usefulness and appropriateness of currently available materials for their target audiences. To improve this situation, and to strengthen materials development skills among individuals and institutionalize them within organizations, PATH was requested to provide technical assistance to KANCO members in all aspects of the process of media and materials development, including how to make best use of materials after their development and distribution. In response, PATH developed a long-term training approach that combined theoretical and practical studies over a two-year period. Objective The project's objective was to strengthen the capacity of local Kenyan institutions to carry out AIDS prevention activities by improving and institutionalizing IEC media and materials development skills among program staff of member agencies of the Kenya AIDS NGOs Consortium. Accomplishments PATH conducted a half-day meeting in February 1994 with representatives of organizations who had confirmed participation in the training. The meeting aimed to brief the representatives on the background and rationale for the NGO training and emphasize the need for nominated participants to attend all training sessions in the series. 29 participants, representing 24 organizations, attended. The first training session followed, on February 24-25. A pre-workshop questionnaire was administered, to obtain information on participants' expectations and prior experience with developing and/or using IEC materials. Participants were formed into teams, who would work together over the course of the project, both during the training sessions and in carrying out field activities. Teams then selected the target audiences, which were: couples, men, and youth (pre-adolescents, adolescents and out-of-school youth). The second training, on March 16-18, 1994, addressed focus group design. At this workshop, focus group discussion topic guides for all the target groups were developed, FGD sites selected and arrangement made for field work. Following the workshop, the groups conducted FGDs. The next three sessions, also held in 1994, focused on incorporating the FGD results into the materials design process. At the third training, PATH conducted a Facts and Feelings Quiz exercise to help participants think about information and questions on HIV/AIDS that may be controversial and help them identify their own areas of agreement and/or disagreement on these issues. The group also completed the FGD data summary. At the next session, participants were taken through the process of message design and materials development, following which they worked with graphic artists to draft materials. The fifth workshop focused on the pre-testing of materials. Site visits were then made to field test of the materials developed for all the target groups.. Workshops 6 - 8 took place in 1995 and early 1996. The focus was on updating participants, reviewing the pre-testing and revision process, and finalizing the materials. Workshop 7 included guest speakers who explained the production process, including how to prepare camera ready artwork, the process of computerized type setting, how to prepare color plates for printing, and reviewed the choices and cost implications of decisions about the different quality of paper, number of colors, and size of booklets and poster. Experts in video/TV and radio production were also involved in the training. The final one-day session addressed materials dissemination. Participants designed an order form for the materials they had produced. The form is currently being used by the KANCO Resource Centre, which became the distribution point for the finished materials. A total of 20 participants completed all the training sessions. In April 1996, PATH conducted a colorful seminar to launch/disseminate the materials, attended by over 120 participants. The Director of Medical Services performed the official launch. Eight materials were launched for the different target audiences, as follows: For urban youth, a laminated sticker, "A Careful Champion uses a condom" and a full color poster, "Using a condom means you really care"; for rural youth, a poster showing a rural scene, "AIDS is not witchcraft"; for schoolchildren, a booklet, "Peter and Anne discuss AIDS"; for men, a laminated sticker in both English and Swahili "A condom does it" "Mpira ni Hakikisho," and a poster "Your wife and Children need you"; and for couples, a play and discussion guide in English and Swahili, "Life, Love, and AIDS", "Maisha, Mapenzi, na UKIMWI", and a comic book based on the story in "Life, Love and AIDS". PATH set up a revolving fund for distribution and reprinting of the materials in order to ensure their continued production, as necessary. The fund is managed by the Kenya AIDS NGOs Consortium, which is distributing the materials through its Resource Centre. As part of setting up the fund, PATH trained representatives from seven leading KANCO members in the purpose and management procedures of a revolving fund mechanism to ensure that these were clearly understood and adhered to. Constraints Assuring consistent participation was not easy. In selecting nominees for the training, PATH had urged those nominating participants to select those fully committed to go through the entire series of training. This, however, did not happen in all cases and a few people dropped out of the process, and/or were not able to attend all sessions. Staff turn-over in most organizations also affected progress. Some members either changed jobs, were transferred, or went for further studies. Pre-testing and revision of materials progressed at a slower pace than anticipated because the training approach encouraged teams to take full responsibility for scheduling their time and activities. There were conflicts between regular work assignments and the requirements of the training program. When an activity is spread over too long a period, the enthusiasm among some participants decreases over time. This required greater efforts and follow-up by PATH/Kenya to maintain momentum. The revolving fund appears to have had mixed success, since some of those requesting the materials have not been willing to pay for them. Lessons Learned Centralized training involving many agencies should be conducted through short and intensive courses. This will ensure that drop-out rate and other problems mentioned such as diminishing motivation and trainee retention are minimized. It is important to keep groups in a training course such as the one conducted by PATH as homogeneous as possible. This avoids the problem of varied interests, for example in addressing target groups of youth, men, women etc. Having a focused group helps to keep momentum going in discussing the concept, message development and pre-testing. This model of materials development is very cost effective as most NGOs often do not have either the technical or financial resources to develop high quality educational materials. The design pooled expertise and resources and yet managed to accommodate the different needs of various groups. Country Assessment The training model used for this project proved to be very successful both in producing good, needed materials and in upgrading the skills of representatives from several NGOs. Several participants stated that they had found the skills valuable in working on materials development in their parent organizations. The Kenya AIDS NGOs Consortium plans to repeat this model of time-lapse training that combines training with practical activities to train district-level NGOs in accessing and organizing information. It is worth noting, however, that most participants thought the course should have been spread over six months, rather than two years. In addition, the materials have proved popular with other AIDS prevention institutions. 25,000 copies each of two of the posters (one targeting rural youth, the other husbands/family men) were reprinted by NASCOP to mark World AIDS Day 1996. It should also be noted that the initial printing run was expanded in the reprints for the workplace materials subproject. Process Indicator Summary
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