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Advocacy and Communication Strategy to Support the Implementation
of Revised ART, PMTCT and Infant Feeding Guidelines in Zimbabwe
2010Keeping Up With the World Health Organization:
Adopting New Treatment Guidelines
Advocacy and Communication Strategy to Support the Implementation
of Revised ART, PMTCT and Infant Feeding Guidelines in Zimbabwe
2010
Keeping Up With the World Health Organization:Adopting New Treatment Guidelines
Developed by SAfAIDS in collaboration with the AIDS and
TB Programme, Ministry of Health and Child Welfare
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
i
Acronyms
AIDS Acquired Immune Deficiency Syndrome
ACSM Advocacy Communication and Social Mobilisation
ART Antiretroviral Therapy
ARVs Antiretrovirals
ASO AIDS Service Organisation
CBO Community-Based Organisation
CBV Community-Based Volunteer
CDC Centers for Disease Control and Prevention
CHAI Clinton Health Access Initiative
CHS College of Health Sciences
DMO District Medical Officer
EGPAF Elizabeth Glaser Pediatric AIDS Foundation
ESP Expanded Support Programme
HBV Hepatitis B Virus
HIV Human Immunodeficiency Virus
IEC Information, Education and Communication
JSI John Snow, Inc
LSU Logistics Sub Unit
MSF Médecins Sans Frontières
NAC National AIDS Council
MoHCW Ministry of Health and Child Welfare
MOU Memorandum of Understanding
MRD Media Resource Desk
PLHIV People Living with HIV
PMTCT Prevention of Mother-To-Child Transmission
SAfAIDS Southern Africa HIV and AIDS Information Dissemination Service
SCM Supply Chain Management
SRH Sexual and Reproductive Health
SRHR Sexual and Reproductive Health Rights
TB Tuberculosis
UZ University of Zimbabwe
VCT Voluntary HIV Counselling and Testing
WHO World Health Organization
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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Acknowledgements
This advocacy and communication strategy, ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’, has been developed by the Ministry of Health and Child Welfare (MoHCW), AIDS and TB Unit, in collaboration with Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS). The Ministry of Health and Child Welfare is grateful to the members of the Adaptation Committee for their technical expertise and input during the development of this document. Thanks are due in particular to the following key personnel for their instrumental role in the development of this communication and advocacy strategy:
Tsitsi Apollo National ART Programme Manager, MoHCW
Joseph Murungu Deputy ART Programme Coordinator, MoHCW
Andrew Nyambo Advocacy Communication and Social Mobilisation (ACSM) Officer, MoHCW
Angela Mushavi PMTCT and Paediatric HIV Coordinator, MoHCW
Rumbidzai Mugwagwa Deputy PMTCT Coordinator, MoHCW
Ancikaria Chigumira Acting Deputy Director, Nutrition, MoHCW
Betty Muhlwa Training Officer, AIDS & TB Unit, MoHCW
Denver Raisi Deputy Logistics Subunit (LSU) Manager, MoHCW
Misheck Ndlovu Supply Chain Management (SCM) Coordinator, MoHCW
Solomon Mukungunugwa District Medical Officer (DMO), Mazowe, MoHCW
Lois Chingandu Executive Director, SAfAIDS
Sara Page-Mtongwiza Deputy Director, SAfAIDS
Monica Mandiki Country Representative, SAfAIDS Zimbabwe
Vivienne Kernohan Information Production Manager, SAfAIDS Zimbabwe
Mary Leakey New Business Development and Communications Manager, SAfAIDS Zimbabwe
Tinashe Moses Visual Communications Consultant, SAfAIDS Zimbabwe
Special mention also goes to the following organisations; the World Health Organization (WHO), the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Centers for Disease Control and Prevention (CDC), University of Zimbabwe College of Health Sciences (UZ-CHS), Médecins Sans Frontières (MSF) Spain, MSF Holland, the Clinton Health Access Initiative (CHAI), John Snow Inc (JSI) and Zvitambo.
The development of this strategy has been made possible through support from the Expanded Support Programme (ESP).
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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Foreword
Zimbabwe has achieved signifi cant milestones in the multi-sectoral response to the HIV epidemic, as evidenced by the progressive sliding trend in the incidence and prevalence rates, as well as the increase in access to and availability of HIV prevention, care and treatment services. The Government of Zimbabwe remains committed to ensuring high quality care for all People Living with HIV, including vulnerable and at risk populations. The adoption of the revised WHO 2010 guidelines for antiretroviral therapy for adults, adolescents and children, Prevention of Mother-To-Child Transmission (PMTCT) and infant feeding, is an indication of the commitment to the scaling up of evidence-informed quality services for People Living with HIV (PLHIV) in Zimbabwe.
The guidelines advocate for earlier initiation of PLHIV on more patient friendly regimens and earlier initiation of prophylaxis for PMTCT. Whilst we endeavour to mobilise resources to facilitate the complete roll out of the new guidelines, a phased approach to implementation is being adopted. The advocacy and communication strategy aims to support the coordinated and standardised implementation of the revised HIV treatment and prevention guidelines, through the dissemination of accurate and target specifi c information, as well as minimising confusion and negative feedback around the adoption and implementation of the guidelines.
The Government of Zimbabwe aims to fully implement the new guidelines within the following three years, and revisions and changes to the phasing strategy will be communicated as and when necessary. In the meantime, I urge you to make use of this Advocacy and Communication Strategy to guide Antiretroviral therapy (ART), PMTCT and infant feeding service provision and to enable roll out of the revisions to be conducted in a standardised and coordinated manner, as we work together to address the HIV situation in Zimbabwe.
Brigadier General (Dr.) G. GwinjiPermanent Secretary
Ministry of Health and Child Welfare, Zimbabwe, 2011
Contents
Acronyms ........................................................................................... i
Acknowledgements ............................................................................ ii
1. Introduction .................................................................................. 1
1.1 Background ................................................................................1
1.2 Why an Advocacy and Communication Strategy? .............................2
2. Communication Strategy Goal and Objectives ................................ 4
2.1 Specific Objectives of the Advocacy and Communication Strategy ......4
2.2 Expected Results .........................................................................5
3. Target Group ................................................................................. 6
3.1 Service Provider Level Interventions ..............................................6
3.2 Funding and Technical Partner Interventions ....................................7
3.3 Policy Level Interventions .............................................................7
3.4 Community Level Interventions .....................................................8
3.5 Media Level Interventions ............................................................9
4. Advocacy and Communication Strategy Activities ........................ 10
4.1 Rapid Appraisal .........................................................................10
4.2 Information Materials for Service Providers ...................................10
4.3 Information Materials for Donors and Technical Partners .................11
4.4 Information Materials for Policy Makers ........................................11
4.5 Information Materials for Community Members and General Public ...11
4.6 Information Materials for the Media .............................................12
5. Managing the Advocacy and Communication Strategy ................. 14
6. Eighteen Month Implementation Plan .......................................... 16
Table of Figures
Figure 1: Model showing strategy for collaboration in theimplementation of the advocacy and communication strategy .......2
Figure 2: Model to show the advocacy and communicationstrategy in action ..................................................................14
Figure 3: Proposed Implementation Plan page .......................................18
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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1. Introduction
1.1 Background
In November 2009, the World Health Organization (WHO) released a rapid advice on Antiretroviral Therapy (ART) and Prevention of Mother-To-Child Transmission (PMTCT) of HIV, including infant feeding, intended to improve HIV prevention and treatment at individual, national and global levels.
The Government of Zimbabwe adopted these international guidelines, adapting them for country specific implementation and replacing the previous ART guidelines of 2006 with the release of ‘Guidelines for Antiretroviral Therapy in Zimbabwe’, in May 2010.
There are significant differences between the 2010 guidelines and those issued in 2006, necessitating a phase-in and phase-out approach towards full adoption of the new guidelines. The transition to new guidelines demands sensitisation of beneficiaries, stakeholders and service providers on the roll out process as accurate information is critical to ensure support of the transition strategy, curtail misconceptions and distrust and reassure all stakeholders and beneficiaries on the ethical soundness of the transition strategy. Possession of accurate information will facilitate scale up and adherence and bolster efforts to improve HIV treatment and prevention in Zimbabwe.
This advocacy and communication strategy has been developed through comprehensive consultation with key stakeholders, guided by the new WHO guidelines adaptation committee.
Whilst this advocacy and communication strategy has been developed specifically to support the roll out of the revised WHO guidelines on ART, PMTCT and infant feeding, it is acknowledged that there are a number of partners with a role to play in advocacy and communication, and it is envisaged that this strategy will feed into and complement the broader national communication and advocacy strategies. Similarly, the Ministry of Health and Child Welfare (MoHCW) recognises that a number of civil society organisations, private and public partners are implementing communication and advocacy activities on issues which interlink with the topics to be addressed by this strategy. This publication aims to provide a framework for collaboration, enabling roles and responsibilities to be identified and distinguished, in order to guard against replication of efforts, ensure that messages and information disseminated are compatible and that individual advocacy and communication efforts complement each other, as well as the national strategy. The document also aims to provide a streamlined and harmonised framework for resource mobilisation and donor support. Figure 1 depicts a suggested model of collaboration.
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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Leaders(Community + National)
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Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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Due to the dynamic nature of the epidemic and the subsequent need for flexibility with regard to response mechanisms, this strategy may be revised or adapted, as required, to cater for situational changes. Such revisions will be communicated to stakeholders.
1.2 Why an Advocacy and Communication Strategy?
By the end of December 2010, a total of 326,241 patients i.e. 297,338 adults and 28,903 children below 15 years of age, were accessing antiretroviral therapy from the public sector. About 63,7% of the patients on ART are females, whilst 8,9% are children. Most ART patients (99%) are receiving first line ART regimens, while 1% (2,648) are on second line regimens (National ART Progress Report, December 2010).
According to the 2009 national HIV estimates, and using a CD4 threshold of 350 for initiation of ART, an estimated 593,168 people are in urgent need of ART.The new guidelines, whilst improving HIV treatment and prevention through the introduction of earlier ART initiation and providing for more efficacious regimens, also exert increased pressure on the health delivery system. Sustained efforts will, therefore, be required to mobilise resources and inform people of the planned changes and expected implications, whilst also reassuring them that the changes constitute an improvement in HIV treatment and prevention efforts.
Access to antiretrovirals (ARVs) is already viewed with scepticism amongst certain sectors as, for a number of reasons, some PLHIV continue to encounter challenges in accessing the treatment services they require. It is critical, therefore, that people be informed about the strategy that is in place, what it means and the steps that are being taken to ensure universal access. There should be a nation-wide common understanding of the situation at hand. This means that, even prior to approaching service providers, people should be well informed of the possibilities to remain on the old, or be moved to the new, treatment regimens. Similarly, pregnant women need to understand the reasons for, and implications of, the new treatment regimens they are likely to be initiated on. Service providers also need to be adequately informed and prepared so that they can interface comfortably with an informed clientele.
Elimination of vertical transmission of HIV is possible through scale up of PMTCT (about 90% of infections in children are due to vertical infection), assuming the continuity of adequate supplies to meet PMTCT requirements. There is need to support the roll out strategy through sensitisation and coordination of all stakeholders, including civil society, the private sector, donors and, most importantly, the community (especially pregnant women, women of child bearing age and their partners), to enable universal access to these services. Furthermore, health service providers and community members must be supported to address the reasons for low uptake of PMTCT services, including infant feeding recommendations. It has recently been found that a number of women are receiving conflicting advice regarding PMTCT and infant feeding, hindering national efforts to eliminate paediatric transmission of HIV. One example is the high proportion of women introducing solid foods prior to the six
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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month exclusive breastfeeding period advised by the WHO. Early introduction of solid foods is primarily a result of a mother’s fear that low food intake will result in the amount of breast milk produced being inadequate to sustain her child. Whilst mothers are encouraged to increase their nutritional intake during pregnancy and breastfeeding to ensure good health, the amount of food the mother takes has no bearing on the amount of breast milk produced, except in very extreme circumstances. Materials developed as part of this advocacy and communication strategy will help health service providers to communicate these links between a mother’s nutritional status and that of her child, as well as to sensitise community members and partners on these issues, to reinforce good practices in PMTCT and infant feeding, towards ultimately eliminating vertical HIV transmission in Zimbabwe.
It is vital that accurate information be provided to community-based organisations (CBOs) and the private sector to enable mainstreaming of PMTCT into existing activities and to bolster efforts to mobilise resources for this key area of work. It is also important to create synergies with existing campaigns and guidelines for related programmes and conditions, e.g. tuberculosis (TB), malaria, hepatitis B (HBV), sexual and reproductive health and rights (SRHR) and maternal and newborn health. This is possible only through clear communication and understanding of the broader HIV prevention and treatment strategies being implemented.
The advocacy and communication strategy outlined herewith proposes a multi-faceted, holistic and comprehensive national communication strategy. Central to this strategy is a desire to reach all key population strata with relevant and accurate information to support the roll out of the new ART and PMTCT guidelines, by diffusing potential backlash and opposition born of fear or lack of understanding; facilitating buy-in and support from all levels; ensuring a standardised treatment response by all service providers and for all patients, and providing an enabling environment for the new guidelines to be implemented successfully.
The implementation of an effective national advocacy and communication strategy is vital to the successful roll out of the new Antiretroviral Therapy Guidelines for Zimbabwe, harmonised in line with new WHO guidelines to improve HIV treatment, reduce vertical HIV transmission and enhance the quality of life for PLHIV.
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2. Communication Strategy Goal and Objectives
The overall goal of the strategy is to contribute to the reduction of HIV transmission and improve the quality of life for People Living with HIV (PLHIV)through supporting the roll out of the revised 2010 HIV and AIDS guidelines for ART, PMTCT and infant feeding.
The implementation of the advocacy and communication strategy will result in more effective roll out of the guidelines, by steering public opinion to ensure positive responses to, and buy-in and support of, the revisions.
2.1 Specific Objectives of the Advocacy and Communication Strategy
The advocacy and communication strategy aims to:
• Support the implementation of the revised HIV treatment and prevention guidelines, through the dissemination of accurate and target-specific information
• Minimise confusion and negative feedback around the adoption of the revised HIV treatment and prevention guidelines by guiding and shaping public opinion to promote positive attitudes and a supportive and enabling environment amongst men, women, youth, national and community leaders, service providers, private sector and media personnel
• Promote early testing and treatment of HIV
• Promote early HIV testing and booking for all pregnant women and women of child-bearing age and their partners, to enable access to treatment in order to minimise, and ultimately eliminate, vertical transmission of HIV, during labour and post-partum
• Disseminate accurate information in line with the revised guidelines around infant feeding, to promote HIV-free survival of infants
• Harness existing information dissemination channels to reduce the cost of disseminating information around the revised treatment guidelines
• Provide a framework for action for all stakeholders to facilitate mutually reinforcing and harmonised collaboration, in line with national strategies and priorities
• Facilitate integration of HIV, TB, sexual and reproductive health (SRH), malaria, Hepatitis B (HBV) and maternal and neonatal health programmes
• Provide a framework for harmonised and structured resource mobilisation.
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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2.2 Expected Results
• Increased understanding, buy-in and support of the roll out process of country-adapted revised WHO HIV and AIDS guidelines amongst policy makers, service providers, the private sector, the community at large and specifically, PLHIV
• Increased tolerance by communities and other stakeholders of efforts and strategies adopted by the Government of Zimbabwe to achieve universal access to ART and elimination of vertical HIV transmission
• A more coordinated approach to roll out of the new ART, PMTCT and infant feeding guidelines, and resource mobilisation thereof
• Increased uptake of HIV-related services (early HIV testing, family planning, uptake of PMTCT, inclusive of early booking and adherence to infant feeding recommendations).
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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3. Target Group
The advocacy and communication strategy aims to reach all key stakeholder groups with relevant information about the new ART guidelines being adopted in Zimbabwe. The target groups are as follows:
• Service providers
→ Health workers (including village health workers and community-based volunteers (CBVs) as strategic information dissemination hubs)
→ AIDS service organisations, community-based organisations and non-governmental organisations
→ Networks of PLHIV → Private sector
• Funding and technical partners
→ Donors → Technical organisations and committees
• Policy makers
→ National policy makers and leaders (politicians, parliamentarians, constituency leaders, etc.)
→ Community level custodians of culture and community information hubs (traditional leaders, church leaders, etc.)
• Community members
→ General public (both urban and rural) including young people, adolescents, men and women
→ PLHIV (both those currently on HIV treatment and those not yet initiated)
→ Pregnant women, women of childbearing age and their partners → Workforces
• Media
→ Journalists, reporters, etc. → Popular and influential public figures and opinion leaders, including
Goodwill Ambassadors, musicians, artists, radio DJs, presenters, etc.
3.1 Service Provider Level Interventions
It is important for service providers not only to be equipped with knowledge and skills to manage the transition from the old treatment regimens to the new, but also to be able to interface effectively with an informed community. Information and messages will target public and private service providers at all levels of care. Service providers need to be able to generate understanding amongst clients regarding the new treatment regimens, including the phasing out and prioritisation strategy, to allay anxiety related to delayed transition.
Community and primary health care workers such as village health workers and other community-based volunteers are key and strategic information sources for
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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community members. As such, their engagement and integration is crucial to a national communication strategy. These cadres, who interact with community members on a personal level and outside the sphere of clinical infrastructures, will be appraised of the new guidelines and assimilated into the communication strategy, through provision of appropriate tools to aid community information dissemination.
The workplace is also a key and strategic institution for the dissemination of information to men and women, particularly those of childbearing age. Materials developed for popular consumption will, therefore, be distributed through workplaces as a means to reach these key end-user beneficiaries. Similarly, networks of People Living with HIV will provide strategic communication channels for the dissemination of information to PLHIV. Information targeted at clinic, medical and hospital staff (private and public sector), as well as AIDS service organisations (ASOs), will ensure coherent and coordinated communication of information on the revised guidelines, and support management of the roll out process.
3.2 Funding and Technical Partner Level Interventions
The support of funding and technical partners is critical to the sustained implementation of the revised ART, PMTCT and infant feeding guidelines, as continued and sustainable material support is required for effective roll out. Information will be packaged for the benefit of donor and technical agencies to aid buy-in and resource mobilisation.
3.3 Policy Level Interventions
Whilst there is commitment amongst policy makers and leaders to scale up access to and the availability of HIV treatment in Zimbabwe, it is imperative that policy makers and leaders are fully acquainted with the revised guidelines and the implications for health delivery. Support and buy-in of leaders is vital to ensure commitment of the necessary resources - both material and human - required for effective implementation of the strategy. Furthermore, all policy makers and leaders must be fully cognizant of the new policy implications to enable confident and standardised responses to potential backlash or resistance. Policy makers and leaders have the responsibility of garnering public support for the new guidelines and as such, it is imperative that all policy makers and leaders support the changes wholeheartedly, whether involved in the health sector or otherwise. The implementation of the new guidelines will have cross cutting implications and cannot be viewed purely as a health issue. The advocacy and communication strategy aims to renew political will and commitment and to effectively implement revised HIV treatment guidelines and encourage:
• Mobilisation and commitment of resources to systematically coordinate existing strategies and generate stakeholder (including donor, civil society and private sector) commitment to support guideline implementation at national and community levels
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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• Improvements in accountability for HIV treatment and for the realisation of commitments made with regard to targets set
• Standardised understanding and articulation of the new guidelines and the implications thereof, to be able to address concerns regarding ART, PMTCT and infant feeding, at national and community levels
• Receptiveness and responsiveness to the emerging policy issues around implementation of the guidelines, to enable timely policy revisions where necessary.
Whilst policy makers and leaders are commonly considered to be those at national level, the significance of community and traditional leaders in information dissemination cannot be overlooked, as well as the importance of their support in ensuring a harmonised approach to communication. Community level custodians of culture, leaders and community information hubs such as church leaders, influential in their ability to communicate accurate information at community level, will also be targeted in this communication strategy.
At the policy maker level, messages will focus on raising awareness of the intricacies of the revised ART, PMTCT and infant feeding guidelines, how the new and old treatment regimens will be phased in and out respectively and the expected impact of the implementation of these guidelines on the socio-economic development of the nation and on HIV prevalence. Emphasis will also be on highlighting the role of leadership in informing and supporting their constituencies to understand the longterm expected results of these guidelines.
3.4 Community Level Interventions
The strategies being proposed at community level aim to mould community attitudes and perceptions on HIV treatment, particularly with regard to perceiving the revised guidelines in a positive light. The strategy also aims to ensure buy-in of the new requirements and guidelines, from a patient or potential patient’s perspective, at community level, e.g. to support the idea that patients should be initiated onto ART before experiencing HIV related illness. Whilst information dissemination involving custodians of culture, traditional leaders, community-based volunteers, village health workers and community-based organisations, which have already been highlighted, are intended to increase understanding at community level as the end target group, direct involvement of community members focusing on key groups, is also integral to the success of a communication strategy.
The messages at this level will be clear, concise, instructive and relevant to the needs of community members. Communication strategies will target different key groups including:
• PLHIV who are on HIV treatment: to provide assurance that the Government of Zimbabwe is scaling up access to the new regimens in a systematic manner within available capacity and that the new guidelines are intended to better serve PLHIV, whilst ensuring that demand is managed, and to dissipate anxiety related to the prioritisation strategy
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
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• PLHIV who know their status but are not yet initiated on ART: to explain the reasoning, and garner support for the criteria identified for initiation on the new treatment regimens, and for earlier initiation on treatment
• Pregnant women, women of child bearing age and their partners: to promote HIV testing and seeking of comprehensive antenatal care; explain the benefits of such and ‘normalise’ testing and antenatal care, in an effort to minimise and ultimately eradicate vertical transmission of HIV. Strategic promotion of male involvement and community sensitisation will support efforts to scale up PMTCT
• Workforce: whilst it is acknowledged that the majority of workers are involved in informal sector employment, the workplace is still a strategic entry point to reach men and women of productive and reproductive age with key information. Strategic alliances with workplaces, including both private and public sector, will be forged and programmes serving the world of work will be created to facilitate access to information through the various media developed as part of this strategy
• General public (both urban and rural): including young people, adolescents, men and women: whilst information disseminated through village health workers and community-based volunteers as well as other clinical infrastructures and institutions, is effective as a means to reach key groups with targeted information, other members of society, who have less incentive or tendency towards seeking health promotion information, will be reached through mass media campaigns and subliminal messaging. This form of information dissemination aims to sensitize the general populace without discouraging or causing ‘information fatigue’.
3.5 Media Level Interventions
The media has substantial influence over public opinion and their buy-in and support can have either a very positive or negative impact on roll out of a national strategy. Ensuring that media personnel are accurately informed about the issues at hand and support the introduction of the revised guidelines, will facilitate accurate, relevant and positive reporting. Bringing the media on board effectively will play a key role in influencing all other key stakeholders.
Specific materials and messages targeting each of these groups will be linked through design aspects and messaging which will be common to all materials developed under the strategy, giving the campaign an identity and branding. This will make campaign materials instantly recognisable, making them more relevant to the individual and reinforcing key messages.
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4. Advocacy and Communication Strategy Activities
4.1 Rapid Appraisal
• Prior to development or implementation of the advocacy and communication materials and initiatives, a rapid appraisal, including a literature review, as well as key informant and stakeholder interviews, will be conducted to identify potential issues that service providers and community information disseminators need to be appraised on and prepared for. The rapid appraisal will also guide stakeholder mapping and key message development, and inform material content development to ensure relevance and effectiveness.
4.2 Information Materials for Service Providers
• Sensitisation tools and reference guide: the guidelines will be repackaged into easy-to-access sensitisation tools and a reference guide, including treatment protocols, for service providers at all levels. The kit will include a booklet with clear sections indicating what the changes are and how to communicate these changes, as well as posters to be displayed in consultancy rooms and health institutions. The guide, which will have multiple user-modalities, will also act as a tool for existing trainers, including those involved with networks of PLHIV, to sensitise participants on the revised guidelines, taking advantage of the opportunities presented by any ongoing trainings or workshops being conducted. It will include information on the reasons for revised guidelines; detail on the phased approach to implementation; address frequently asked questions and common concerns, and by containing all the essential relevant information, will enable quick and easy reference during consultation and interfacing. This will ensure reaching all service providers with key information and facilitate a standardised response to the queries and questions likely to be faced, enabling effective management of negative feedback (and preventing de-railing of the implementation of the guidelines), as well as facilitating a national sensitisation campaign
• The same sensitisation tools and reference guide will prove valuable to AIDS service organisations, community-based organisations, non-governmental organisations, private sector focal people, networks of PLHIV, and other health communicators, by providing a concise breakdown of the guidelines and associated implications
• Sensitisation workshops: Sensitisation workshops will be conducted throughout Zimbabwe on how to communicate the treatment revisions using the sensitisation tools and reference guide as the primary training tool. Once trained, the sensitisation trainers are expected to take advantage
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of any existing health trainings or activities to sensitise participants on the new guidelines. Circulars will be disseminated to all service providers using existing channels and systems, to alert the pool of trainers to any communication opportunities (ongoing trainings, etc) to enable sessions for sensitisation on the new guidelines to be incorporated.
4.3 Information Materials for Donors and Technical Partners
• Donor’s brief and budget: a donor’s brief highlighting, in particular, progress made and gaps identified, including funding deficits and opportunities to support the national strategy, will be developed and updated as necessary. An electronic database will be developed as a means of sharing the donor e-bulletins to minimise costs. This will support the mobilisation of required funds.
4.4 Information Materials for Policy Makers
• Sensitisation tools and reference guide: the sensitisation tools and reference guide detailed under the Information Materials for Service Providers section, will be disseminated to policy makers and leaders. This will enable accurate understanding of the issues amongst policy makers, aiding the dissemination of standardised information
• Policy maker sensitisation meeting: a national sensitisation meeting for policy makers and service providers will be conducted to ensure that the importance of being fully cognizant of the changes is recognised.
4.5 Information Materials for Community Members and General Public
• TV and radio programmes: ‘Positive Talk’, a TV and radio series pioneered by SAfAIDS which enables frank and open discussion around key health topics, has gained a lot of popularity and a large following in Zimbabwe. During each episode, experts are invited to share information on a given topic and community members pose questions to the experts for responses. The programmes have received, and continue to receive, positive feedback and are an effective mass media strategy to disseminate accurate and relevant information. As such, the format will be adopted as a means to disseminate key information to the wider public
• Leaflets: leaflets focusing on the three key areas of change (ART, PMTCT and infant feeding) will be produced for wide distribution in Zimbabwe. The leaflets will contain critical information simply articulated for the general public, on each of the key thematic areas. Community health personnel, including village health workers and community-based volunteers, will be engaged for dissemination of the leaflets
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• Posters: a series of posters will be developed, each aimed at specific groups (e.g. general public, pregnant women, women of child-bearing age and their partners), to promote the new guidelines using target-specific messaging. The posters will promote the national efforts to improve health care in Zimbabwe and will motivate all Zimbabweans to play their part in supporting the initiative, minimising vertical transmission and reducing HIV prevalence. Posters will be distributed to places of public gathering, e.g. salons, kiosks, restaurants, bus terminals and workplaces, among other key distribution points
• Subliminal messaging: for population groups, particularly young people and men who are less inclined to seek information on health promotion strategies, subliminal messaging will aid the dissemination of information in a more subtle manner, in an effort to engage these individuals and stimulate a desire for further information. Subliminal messaging will be positive and highlight the individual benefits of the revised treatment and prevention guidelines, as well as disseminating the key messages and encouraging effective branding of the strategy. Such messaging will take the form of printing ‘info-bytes’, catchphrases and short reminders, on goods typically used by community members, e.g. on match boxes, cell phone top-up cards, etc.
4.6 Information Materials for the Media
• Media briefings: periodic media briefings will be conducted for journalists, reporters and other media personnel at key stages of the roll out of the treatment guidelines, e.g. prior to each stage of phasing, to ensure positive and accurate reporting. The media personnel, sensitised and trained on general HIV reporting through previous activities, will be briefed on the new treatment guidelines, and the importance of precise and positive reporting reiterated
• Media flashes: regular updates on the key issues will be posted, using existing media communication channels, such as the SAfAIDS media resource desk. This web-based resource site is regularly visited by journalists seeking information for upcoming articles and reports, and is a key strategy for guiding reporting on HIV
• Newspaper column: a regular column will be published in a national newspaper, in a question-and-answer format. In each column, a different question relating to the revised guidelines will be posted and answered by the respondent, an experienced doctor
• Sensitisation of popular public figures and opinion leaders: popular public figures and opinion leaders will be engaged and sensitised on the guidelines, in an effort to motivate these influential figures to harness their public appearances as a means to support the treatment changes.
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
14
EXPECTED OUTPUTS:- Greater understanding- Better service delivery- Increased demand
implementation
OVERALL GOAL:Decreased HIV incidence and
improved quality of life for PLHIV
Service Providers:- Health Workers
- Village Health Workers- Community Volunteers
- ASOs, NGOs, CBOs- Donors
Policy Makers:- National leaders
- Community leaders- Custodians of culture
- Traditional leaders- Church leaders
Media / Communications:
- Journalists
Community:- PLHIV
- Pregnant women, women of childbearing age
& their partners- Young men and women
- Workforce- General Public
buy-in and supportbu
y-in
and
support
buy-in and support
INPUTS:
relevant information
ART Advocacy and Communication Strategy: Towards Adoption of the New WHO Guidelines
Figure 2: Model to show the advocacy and communication strategy in action
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
15
5. Managing the Advocacy and Communication Strategy
Different partners will support the implementation of the advocacy and communication strategy with the Adaptation Committee providing guidance. The Ministry of Health and Child Welfare and SAfAIDS will take the leading role and have overall responsibility for coordination and implementation of the strategy, ensuring harmonised roll out and effective integration with other key communication sectors. Whilst specific roles and responsibilities will be refined with input from all relevant parties, initial guidelines for the division of key roles and responsibilities have been indicated below and are further elaborated in the implementation plan.
Role of Government:
• Mobilise and leverage adequate resources for implementation of the advocacy and communication strategy
• Provide relevant information and input to ensure appropriateness of advocacy and communication strategies and information materials
• Review, approve and endorse strategy, methodology and content of the various information packages
• Create an enabling and supportive environment for successful implementation of the advocacy and communication strategy
• Provide expertise and where necessary, resource persons, to facilitate sharing of relevant and accurate information at the various platforms.
Role of SAfAIDS:
• Update, where necessary, the advocacy and communication strategy
• Coordinate relevant subcommittees instituted to provide input and expertise for material content
• Facilitate repackaging of existing guidelines into user-friendly, accessible and target specific tools, and develop, edit, design and print target oriented information materials
• Promote harnessing and integration of existing and currently under-utilised distribution channels, such as community-based health workers, and potential strategic points of entry, such as the workplace and networks of PLHIV, into the advocacy and communication strategy, which also draws on more conventional methods
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
16
• Develop and coordinate a monitoring strategy, drawing wherever possible on existing monitoring channels to prevent replication, to inform on the impact of the advocacy and communication strategy and facilitate refinement of implementation modalities.
Role of Stakeholders and Partners:
• Support roll out of the advocacy and communication strategy and the adoption of the new WHO guidelines for ART, PMTCT and infant feeding in Zimbabwe
• Engage and consult MoHCW during the implementation of activities which are associated with ART, PMTCT or infant feeding, or that may have an impact on the activities to be implemented as part of this communication and advocacy strategy
• Support and complement Government strategies and priorities
• Resource mobilisation
• Ensure sustainability of the roll out.
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
17
6. Eighteen Month Implementation Plan
Implementation of the Advocacy and Communication Strategy has been divided into three broad phases, according to initial priority. Phases will be rolled out in line with available funding and need. Implementation of the plan is expected to be conducted over an eighteen month period beginning in January 2011. Ideally, each phase represents a period of approximately six months during the 18 month total implementation period, but this is heavily dependent on the availability of funding:
Phase 1: priority sensitisation of service providers and policy makers, in preparation for initial roll out of revised treatment guidelines. Phase one has been further divided into phase 1A and phase 1B, each representing aproximately a three month period. Phase 1A represents activities to be implemented with funds which have already been secured. Phase 1B represents high priority activities for which funds have not yet been secured.
Phase 2: sensitisation of communities, PLHIV, potential patients, beneficiaries and media on the new guidelines to manage response.
Phase 3: promotion of services to scale up demand and increase uptake of improved HIV treatment, PMTCT and infant feeding strategies and services, contributing to reduced HIV transmission and enhanced quality of life for PLHIV.
Figure 3 details the proposed implementation plan, in line with the phased approach.
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
18
Fig
ure
3:
Pro
po
sed
Im
ple
men
tati
on
Pla
n
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
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se
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ost
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ntity
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at s
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omm
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akeh
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litat
ion
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omm
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embe
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ervi
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I clin
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xx
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spor
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400.
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ple
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ey
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terv
iewe
d
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ana
lysi
s an
d re
port
prod
uctio
n
xPr
ofes
sion
al fe
es45
0.00
290
0.00
Key
issu
es id
entif
ied
Key
stak
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appe
d
1.4
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mes
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de
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essi
onal
fees
450.
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450.
00Ke
y m
essa
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et g
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1.5
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oval
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s de
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ped
and
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es id
entif
ied
by a
dapt
atio
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mm
ittee
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her s
take
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grou
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elop
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cilit
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ort a
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mes
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view
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rt re
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bmitt
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1.6
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oval
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d ad
optio
n of
mes
sage
s
xn/
a*
*Fee
dbac
k/
appr
oval
to b
e co
mm
unic
ated
el
ectro
nica
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n/a
n/a
n/a
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paig
n m
essa
ges
and
rapi
d ap
prai
sal
repo
rt re
view
ed
Feed
back
form
s su
bmitt
ed
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
19
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
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se
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hase 3
Item
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t C
ost
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ntity
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l C
ost
2De
velo
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itisa
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tool
s an
d re
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e (fo
r se
nsiti
satio
n of
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vice
pr
ovid
ers,
hea
lth p
erso
nnel
, AS
Os, C
BOs,
VHW
s,
polic
y m
aker
s, n
etwo
rks
of P
LHIV
, priv
ate
sect
or
foca
l peo
ple,
etc
)
2.1
Repa
ckag
ing
of
new
guid
elin
es in
to
sens
itisa
tion
tool
s an
d re
fere
nce
guid
e
xx
Cont
ent
deve
lopm
ent
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ng
Desi
gn &
layo
ut
Prof
essi
onal
fees
450.
00
450.
00
450.
00
450.
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5 2 2 2
2250
.00
900.
00
900.
00
900.
00
Draf
t sen
sitis
atio
n to
ols
and
refe
renc
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ide
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lope
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2.2
Revi
ew
and
appr
oval
by
ada
ptat
ion
com
mitt
ee a
nd o
ther
ke
y st
akeh
olde
rs
xn/
a*
*Dra
ft gu
ide
to
be s
ubm
itted
el
ectro
nica
lly;
revi
ew p
roce
sses
to
be
cond
ucte
d du
ring
exis
ting
foru
ms
n/a
n/a
n/a
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itisa
tion
tool
s an
d re
fere
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guid
e re
view
ed
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back
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s su
bmitt
ed
2.3
Fina
lisat
ion
and
appr
oval
of
sens
itisa
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s an
d re
fere
nce
guid
e
xx
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essi
onal
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450.
003
1350
.00
Prin
t-rea
dy
sens
itisa
tion
tool
s an
d re
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guid
e in
pl
ace
and
appr
oved
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t app
rova
l for
m
sign
ed b
y M
OH
2.3
Prin
ting
of
sens
itisa
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s an
d re
fere
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guid
e
xPr
intin
g2
4000
0.00
8000
0.00
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00 c
opie
s of
se
nsiti
satio
n to
ols
and
refe
renc
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ide
prin
ted
3Tr
aini
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f Tra
iner
s (T
oTs)
on
sens
itisa
tion
of s
ervi
ce p
rovi
ders
us
ing
tool
s de
velo
ped
3.1
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lopm
ent
of tr
aini
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nd
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der
sens
itisa
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plan
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ofes
sion
al fe
es45
0.00
145
0.00
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ning
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st
akeh
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r se
nsiti
satio
n pl
an in
pla
ce
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
20
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
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se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
3Tr
aini
ng o
f Tra
iner
s (T
oTs)
on
sen
sitis
atio
n of
ser
vice
pr
ovid
ers
usin
g to
ols
deve
lope
d (c
ontin
ued)
3.2
Faci
litat
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of
ToTs
for p
rovi
ncia
l tra
iner
s (1
0 pe
ople
pe
r pro
vinc
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be
train
ed –
at l
east
10
0 to
tal;
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s,
PAAC
S pl
us H
IV
foca
l peo
ple)
: 4
x 1/2
day
ToTs
of
45
peop
le to
be
con
duct
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xPr
ofes
sion
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es
Tran
spor
t
Venu
e hi
re
Conf
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ce p
acka
ge
Acco
mm
odat
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Tran
spor
t re
imbu
rsem
ents
Stat
ione
ry
Equi
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t hire
(P
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, PA
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ente
r ho
nora
rium
s
450.
00
0.10
200.
00
30.0
0
120.
00
50.0
0
250.
00
250.
00
100.
00
4
2500 4
180 90 90 4 4 4
1800
.00
250.
00
800.
00
5400
.00
1080
0.00
4500
.00
1000
.00
1000
.00
400.
00
180
prov
inci
al To
Ts,
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s an
d PA
ACs
train
ed o
n ho
w to
se
nsiti
se s
ervi
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s on
revi
sed
treat
men
t gui
delin
es
4 wo
rksh
op re
ports
de
velo
ped
M&
E to
ols
(regi
stra
tion
form
s,
feed
back
form
s,
etc)
com
plet
ed
3.3
Casc
ade
sens
itisa
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sess
ions
at
dist
rict,
ward
and
co
mm
unity
leve
l to
be
cond
ucte
d by
pro
vinc
ial
train
er o
f tra
iner
s (s
ensi
tisat
ion
and
refe
renc
e gu
ide
to
be d
istri
bute
d at
ca
scad
e tra
inin
gs)
and
mon
itore
d by
DA
CS a
nd P
ACS
xx
xx
n/a*
*Exis
ting
train
ing
and
com
mun
icat
ion
oppo
rtuni
ties
to b
e us
ed b
y tra
iner
s to
se
nsiti
se s
ervi
ce
prov
ider
s on
the
new
guid
elin
es
n/a
n/a
n/a
Exis
ting
com
mun
icat
ion
oppo
rtuni
ties
harn
esse
d by
pro
vinc
ial
sens
itisa
tion
train
ers
to s
ensi
tise
serv
ice
prov
ider
s on
new
tre
atm
ent g
uide
lines
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
21
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
3Tr
aini
ng o
f Tra
iner
s (T
oTs)
on
sen
sitis
atio
n of
ser
vice
pr
ovid
ers
usin
g to
ols
deve
lope
d (c
ontin
ued)
Deve
lopm
ent o
f ci
rcul
ars
to b
e di
strib
uted
thro
ugh
exis
ting
chan
nels
–
train
ed s
ensi
tisat
ion
faci
litat
ors
to b
e in
vite
d to
all
heal
th
train
ing
even
ts a
nd
allo
cate
d gu
idel
ine
sens
itisa
tion
slot
xx
xx
n/a*
*Exis
ting
stru
ctur
es
and
oppo
rtuni
ties
to b
e us
ed fo
r se
nsiti
satio
n of
se
rvic
e pr
ovid
ers
and
heal
th
pers
onne
l at
dist
rict,
com
mun
ity
and
ward
leve
l
n/a*
n/a*
n/a*
Circ
ular
s to
be
dist
ribut
ed, t
hrou
gh
exis
ting
chan
nels
, to
heal
th in
stitu
tions
and
pe
rson
nel,
when
ever
ne
cess
ary,
to fa
cilit
ate
info
rmat
ion
shar
ing
4Se
nsiti
satio
n of
pol
icy
mak
ers
on th
e ne
w gu
idel
ines
and
stra
tegy
4.1
Faci
litat
ion
of a
pol
icy
mak
er
sens
itisa
tion
mee
ting
to d
isse
min
ate
sens
itisa
tion
tool
s an
d re
fere
nce
guid
es
and
sen
sitis
e po
licy
mak
ers
on th
e co
mm
unic
atio
n an
d ad
voca
cy s
trate
gy
(100
par
ticip
ants
; ½
day
mee
ting)
xPr
ofes
sion
al fe
es
Venu
e hi
re
Conf
eren
ce p
acka
ge
Stat
ione
ry
Equi
pmen
t hire
(P
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, PA
syst
em)
Pres
ente
r ho
nora
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s
450.
00
200.
00
30.0
0
250.
00
250.
00
100.
00
1 1
100 2 2 5
450.
00
200.
00
3000
.00
500.
00
500.
00
500.
00
100
polic
y m
aker
s se
nsiti
sed
on re
vise
d tre
atm
ent g
uide
lines
1 m
eetin
g re
port
deve
lope
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M&
E to
ols
(regi
stra
tion
form
, fe
edba
ck fo
rms,
et
c) c
ompl
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5De
velo
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t of a
don
or’s
br
ief a
nd b
udge
t5.
1 Pr
oduc
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of
bi-a
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ors
brie
f / b
ulle
tin a
nd
budg
et (o
ne b
rief
to b
e de
velo
ped
in e
ach
phas
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xx
xx
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deve
lopm
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gn &
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essi
onal
fees
450.
00
450.
00
450.
00
450.
00
6 3 3 3
2700
.00
1350
.00
1350
.00
1350
.00
Draf
ted
polic
y br
ief d
evel
oped
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
22
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
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utP
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se
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velo
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don
ors
brie
f and
bud
get (
cont
inue
d)5.
2 Re
view
of
dono
rs b
rief a
nd
budg
et b
y ad
apta
tion
com
mitt
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ther
ke
y st
akeh
olde
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xx
xn/
a*
*Dra
ft do
nors
brie
f to
be
subm
itted
el
ectro
nica
lly;
revi
ew p
roce
sses
to
be
cond
ucte
d du
ring
exis
ting
foru
ms
n/a
n/a
n/a
Dono
rs b
rief a
nd
budg
et re
view
ed
Feed
back
form
s su
bmitt
ed
5.3
Fina
lisat
ion
and
appr
oval
of d
onor
s br
ief a
nd b
udge
t
xx
xPr
ofes
sion
al fe
es45
0.00
313
50.0
0Fi
nalis
ed d
onor
s br
ief
and
budg
et d
evel
oped
an
d ap
prov
ed
Prin
t app
rova
l for
m
sign
ed b
y M
oH
5.4
Deve
lopm
ent
of a
n el
ectro
nic
dono
r dat
abas
e to
di
ssem
inat
e do
nors
br
ief a
nd b
udge
t
xPr
ofes
sion
al fe
es45
0.00
145
0.00
Elec
troni
c do
nor
data
base
in p
lace
5.5
Diss
emin
atio
n of
don
ors
brie
f and
bu
dget
thro
ugh
elec
troni
c da
taba
se
xx
xn/
a*
*don
ors
brie
f an
d bu
dget
di
ssem
inat
ed
elec
troni
cally
n/a
n/a
n/a
Dono
rs b
rief a
nd
budg
et d
isse
min
ated
to
all
dono
rs re
cord
ed
in d
onor
dat
abas
e
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
23
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
6De
velo
pmen
t of l
eafle
ts
on th
e ne
w tre
atm
ent
guid
elin
es, f
or w
ide
diss
emin
atio
n
6.1
Cont
ent
deve
lopm
ent f
or 3
le
afle
ts, d
etai
ling
new
guid
elin
es fo
r:
• AR
T
• PM
TCT
• In
fant
feed
ing
xx
Cont
ent
deve
lopm
ent
Editi
ng
Desi
gn &
layo
ut
Prof
essi
onal
fees
450.
00
450.
00
450.
00
450.
00
6 3 6 6
2700
.00
1350
.00
2700
.00
2700
.00
3 dr
afte
d le
afle
ts
deve
lope
d
6.2
Revi
ew
of c
onte
nt b
y ad
apta
tion
com
mitt
ee a
nd o
ther
ke
y st
akeh
olde
rs
xn/
a*
*Dra
ft le
afle
t to
be s
ubm
itted
el
ectro
nica
lly;
revi
ew p
roce
sses
to
be
cond
ucte
d du
ring
exis
ting
foru
ms
n/a
n/a
n/a
3 le
afle
ts re
view
ed
Feed
back
form
s su
bmitt
ed fo
r 3
leaf
lets
6.3
Fina
lisat
ion
and
appr
oval
of 3
leaf
lets
xPr
ofes
sion
al fe
es45
0.00
313
50.0
03
prin
t-rea
dy
leaf
lets
dev
elop
ed
and
appr
oved
3 Pr
int a
ppro
val f
orm
s si
gned
by
MoH
6.4
Tran
slat
ion
of
each
leaf
let i
nto
both
Sh
ona
and
Ndeb
ele
xTr
ansl
atio
n30
0.00
618
00.0
03
leaf
lets
tran
slat
ed
into
Sho
na
3 le
afle
ts tr
ansl
ated
in
to N
debe
le
6.5
Prin
ting
of le
afle
tsx
Prin
ting
0.25
3000
00.0
075
000.
0010
0,00
0 co
pies
of
each
of t
he 3
leaf
lets
pr
inte
d (3
00,0
00
copi
es in
tota
l)
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
24
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
7Pr
oduc
tion
and
airin
g of
TV
pro
gram
me
– Po
sitiv
e Ta
lk a
nd T
V sp
ots
7.1
TV p
roga
mm
e pr
oduc
ed (2
x 13
epi
sode
s)
xPr
oduc
tion
cost
s
Prof
essi
onal
fees
Prom
os
3000
.00
450.
00
500.
00
26 6 40
7800
0.00
2700
.00
2000
0.00
2 x 1
3-ep
isod
e TV
pr
ogra
mm
es p
rodu
ced
7.2
TV p
rogr
amm
e ai
red
(2 x
13
epis
odes
)
x (13
epis
odes
in
P2)
x (13
epis
odes
in
P3)
Airin
g co
sts
2500
.00
2665
000.
002
x 13-
epis
ode
TV
prog
ram
mes
aire
d
8Pr
oduc
tion
and
airin
g of
radi
o pr
ogra
mm
e –
Posit
ive
Talk
and
spo
ts
8.1
Radi
o pr
ogam
me
prod
uced
(2 x
13 e
piso
des)
xPr
oduc
tion
cost
s
Prof
essi
onal
fees
Prom
os
2000
.00
450.
00
500.
00
26 6 40
5200
0.00
2700
.00
2000
0.00
2 x 1
3-ep
isod
e ra
dio
prog
ram
mes
pro
duce
d
8.2
Radi
o pr
ogra
mm
e ai
red
(2x 1
3 ep
isod
es)
x (13
epis
odes
in
P2)
x (13
epis
odes
in
P3)
Airin
g co
sts
1500
.00
2639
000.
002
x 13-
epis
ode
radi
o pr
ogra
mm
es a
ired
9De
velo
pmen
t and
pla
cing
of
a we
ekly
new
spap
er c
olum
n9.
1 Id
entif
icat
ion
of
suita
ble
news
pape
r to
prin
t col
umn
and
‘doc
tor’
to
write
the
colu
mn
xn/
an/
an/
an/
aSu
itabl
e ne
wspa
per
iden
tifie
d
9.2
Colu
mn
cont
ent
deve
lopm
ent
xx
Cont
ent
deve
lopm
ent
– ho
nora
ria fo
r ‘c
olum
n do
ctor
’
100.
0052
5200
.00
Cont
ent f
or 5
2 ne
wspa
per c
olum
ns
deve
lope
d
9.3
Plac
ing
of c
olum
n in
ne
wspa
per (
once
pe
r wee
k)
x (26
colu
mns
pl
aced
in
P2)
x (26
colu
mns
pl
aced
in P
3)
Plac
ing
of c
olum
n20
0.00
5210
400.
00W
eekl
y co
lum
n fe
atur
ing
in a
ne
wspa
per
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
25
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
10
Sens
itisa
tion
of m
edia
pe
rson
nel o
n th
e ne
w gu
idel
ines
as
well
as th
e im
porta
nce
of a
ccur
ate
and
sens
itive
repo
rting
ar
ound
the
new
guid
elin
es
– ga
in m
edia
buy
-in
10.1
Fac
ilita
tion
of
3 m
edia
brie
fings
(e
ach
for 5
0 jo
urna
lists
and
m
edia
per
sonn
el):
• Ha
rare
• Bu
lawa
yo
• M
utar
e
x (3 m
edia
br
iefin
gs
in P
2)
Prof
essi
onal
fees
Tran
spor
t
Venu
e hi
re
Conf
eren
ce p
acka
ge
Acco
mm
odat
ion
Tran
spor
t re
imbu
rsem
ents
Stat
ione
ry
Equi
pmen
t hire
(P
roje
ctor
, PA
syst
em)
Pres
ente
r ho
nora
rium
s
450.
00
0.10
200.
00
30.0
0
120.
00
50.0
0
250.
00
250.
00
100.
00
3
1500 3
150 75 75 3 3 6
1350
.00
150.
00
600.
00
4500
.00
9000
.00
3750
.00
750.
00
750.
00
200.
00
150
med
ia p
erso
nnel
br
iefe
d on
revi
sed
treat
men
t gui
delin
es
M&
E to
ols
(regi
stra
tion
form
s,
feed
back
form
s,
etc)
com
plet
ed
10.2
Dev
elop
men
t of
eve
nt re
ports
xPr
ofes
sion
al fe
es45
0.00
313
50.0
03
med
ia b
riefin
g re
ports
dev
elop
ed
10Up
datin
g of
trai
ned
jour
nalis
ts a
nd m
edia
pe
rson
nel t
hrou
gh
regu
lar p
ostin
g of
med
ia
flash
es th
roug
h m
edia
re
sour
ce d
esk
(MRD
)
10.3
Pos
ting
of a
t le
ast o
ne fl
ash
per
mon
th fo
llowi
ng th
e m
edia
brie
fings
x (6 m
edia
fla
shes
po
sted
in
P2)
x (6 m
edia
fla
shes
po
sted
in P
3)
Prof
essi
onal
fees
450.
003
1350
.00
At le
ast 1
med
ia
flash
pos
ted
per
mon
th fo
llowi
ng th
e m
edia
brie
fings
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
26
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
11Se
nsiti
satio
n of
pop
ular
pu
blic
figu
res
and
opin
ion
lead
ers
such
as
Good
W
ill A
mba
ssad
ors
11.1
Fac
ilita
tion
of 1
bre
akfa
st
mee
ting
for 5
0 pe
ople
per
qua
rter
x (2 b
/fast
m
eetin
gs
in P
2)
x (2 b
/fast
m
eetin
gs
in P
2)
Prof
essi
onal
fees
Venu
e hi
re
Conf
eren
ce p
acka
ge
Acco
mm
odat
ion
Tran
spor
t re
imbu
rsem
ents
Stat
ione
ry
Equi
pmen
t hire
(P
roje
ctor
, PA
syst
em)
Pres
ente
r ho
nora
rium
s
450.
00
200.
00
30.0
0
120.
00
50.0
0
250.
00
250.
00
100.
00
4 4
200
100
100 4 4 8
1800
.00
800
.00
6000
.00
1200
0.00
5750
.00
1000
.00
1000
.00
800
.00
4 br
eakf
ast m
eetin
gs
cond
ucte
d, 1
per
qu
arte
r, wi
th 5
0 pe
ople
atte
ndin
g ea
ch m
eetin
g
M&
E to
ols
(regi
stra
tion
form
s,
feed
back
form
s,
etc)
com
plet
ed
11.2
Dev
elop
men
t of
eve
nt re
ports
xx
Prof
essi
onal
fees
450.
004
1800
.00
4 br
eakf
ast m
eetin
g re
ports
dev
elop
ed
12De
velo
pmen
t of p
oste
rs
on th
e 3
key
them
atic
ar
eas
(ART
, PM
TCT
and
infa
nt fe
edin
g) to
pr
omot
e ne
w gu
idel
ines
an
d in
crea
se u
ptak
e
xCo
nten
t de
velo
pmen
t
Editi
ng &
pro
ofin
g
Desi
gn &
layo
ut
Prof
essi
onal
fees
450.
00
450.
00
450.
00
450.
00
6 3 6 6
2700
.00
1350
.00
2700
.00
2700
.00
3 dr
afte
d po
ster
s de
velo
ped
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
27
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
12De
velo
pmen
t of p
oste
rs
on k
ey th
emat
ic a
reas
(A
RT, P
MTC
T an
d in
fant
fe
edin
g) to
pro
mot
e ne
w gu
idel
ines
and
incr
ease
up
take
(con
tinue
d)
12.2
Rev
iew
of c
onte
nt b
y ad
apta
tion
com
mitt
ee a
nd o
ther
ke
y st
akeh
olde
rs
xn/
a*
*Dra
ft po
ster
s to
be
subm
itted
el
ectro
nica
lly;
revi
ew p
roce
sses
to
be
cond
ucte
d du
ring
exis
ting
foru
ms
n/a
n/a
n/a
3 po
ster
s re
view
ed
Feed
back
form
s su
bmitt
ed fo
r 3
post
ers
12.3
Fin
alis
atio
n an
d ap
prov
al o
f co
nten
t for
3 p
oste
rs
xPr
ofes
sion
al fe
es45
0.00
313
50.0
03
prin
t-rea
dy
post
ers
deve
lope
d an
d ap
prov
ed
3 pr
int a
ppro
val f
orm
s si
gned
by
MoH
12.4
Tran
slat
ion
of
each
pos
ter i
nto
both
Sh
ona
and
Ndeb
ele
xTr
ansl
atio
n10
0.00
660
0.00
3 po
ster
s tra
nsla
ted
into
Sho
na
3 po
ster
s tra
nsla
ted
into
Nde
bele
12.5
Prin
ting
of p
oste
rsx
Prin
ting
0.50
6000
030
000.
0020
,000
cop
ies
of
each
of t
he 3
pos
ters
pr
inte
d (6
0,00
0 co
pies
in to
tal)
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
28
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
13Su
blim
inal
mes
sagi
ng
(‘inf
o-by
tes’
) to
prom
ote
revi
sed
heal
th p
rom
otio
n st
rate
gies
to g
roup
s wh
o te
nd to
be
less
incl
ined
to
seek
hea
lth in
form
atio
n
13.1
Iden
tific
atio
n of
wid
ely
dist
ribut
ed
prod
ucts
to b
e pr
inte
d wi
th
subl
imin
al m
essa
ges
(3 p
rodu
cts
to
be id
entif
ied
for s
ublim
inal
m
essa
ging
)
xn/
an/
an/
an/
a3
prod
ucts
to b
e pr
inte
d wi
th s
ublim
inal
m
essa
ging
iden
tifie
d
13.2
Sig
ning
of
MOU
s wi
th
man
ufac
ture
rs o
f id
entif
ied
prod
ucts
xn/
an/
an/
an/
aM
OUs
sign
ed w
ith 3
pr
oduc
t man
ufac
ture
rs
13.3
Mes
sage
de
velo
pmen
t and
de
sign
of m
essa
ge
/ bra
ndin
g
xPr
ofes
sion
al fe
es45
0.00
313
50.0
0Su
itabl
e an
d re
leva
nt
mes
sage
s id
entif
ied
13.4
Prin
ting
of g
oods
with
m
essa
ges
xPr
intin
g0.
0520
0000
010
0000
3 pr
oduc
ts p
rinte
d wi
th s
ublim
inal
m
essa
ges
– 2,
000,
000
prod
ucts
prin
ted
13.5
Dis
sem
inat
ion
of p
rodu
cts
– th
roug
h ex
istin
g ch
anne
ls
xn/
an/
an/
an/
a2,
000,
000
prod
ucts
in
circ
ulat
ion
bear
ing
the
deve
lope
d m
essa
ges
14Di
ssem
inat
ion
of
all m
ater
ials
14.1
Dis
tribu
tion
of IE
C m
ater
ials
de
velo
ped
xx
xx
xx
xDi
strib
utio
n
*Dis
sem
inat
ion
will
prim
arily
be
thro
ugh
prov
inci
al,
dist
rict,
ward
an
d c
omm
unity
se
nsiti
sers
as
well
as V
HWs,
CB
O, C
BVs,
etc
to
redu
ce c
osts
0.01
*
4000
0040
00.0
0Di
strib
utio
n pl
ans
for a
ll m
ater
ials
de
velo
ped
in p
lace
Advocacy and Communication Strategy to Support the Implementation of Revised ART Guidelines in Zimbabwe ‘Keeping Up With the WHO: Adopting New Treatment Guidelines’
29
Act
ivity
Sub
-Act
ivity
Tim
e lin
eB
udge
tE
xpec
ted
outp
utP
hase
1AP
hase
1B
Pha
se
2P
hase 3
Item
Uni
t C
ost
Qua
ntity
Tota
l C
ost
15Ha
rnes
sing
of e
xistin
g in
form
atio
n di
ssem
inat
ion
chan
nels
to e
nhan
ce a
nd
com
plem
ent t
he s
trate
gy
(e-fo
ra; n
ewsl
ette
rs, e
tc)
15.1
Dis
sem
inat
ion
of in
form
atio
n on
the
revi
sed
guid
elin
es u
sing
ex
istin
g ne
wsle
tters
, e-
foru
ms
and
othe
r cha
nnel
s an
d pl
atfo
rms
xx
xx
xx
n/a
n/a
n/a
n/a
Info
rmat
ion
rega
rdin
g th
e ne
w tre
atm
ent g
uide
lines
di
ssem
inat
ed th
roug
h ex
istin
g ch
anne
ls
16Im
plem
enta
tion
of
the
Advo
cacy
and
Co
mm
unic
atio
n St
rate
gy to
Su
ppor
t the
Impl
emen
tatio
n of
Rev
ised
ART
Gui
delin
es
in Z
imba
bwe
16.1
Pur
chas
e of
re
quire
d eq
uipm
ent
Digi
tal C
amer
a
Trip
od
2000
.00
500.
00
1 1
2000
.00
500.
00
1 di
gita
l cam
era
purc
hase
d
1 tri
pod
purc
hase
d
Subt
otal
1384
00.0
017
2400
.00
2223
00.0
017
9950
.00
7130
50.0
0
Adm
inis
trativ
e co
sts
(10%
)13
840.
0017
240.
0022
230.
0017
995.
0071
305.
00
Tota
l15
2240
.00
1896
40.0
024
4530
.00
1979
45.0
078
4355
.00
MINISTRY OF HEALTH ANDCHILD WELFARE, AIDS AND TB UNIT:
P.O. Box CY 1122, Causeway, Harare, Zimbabwe
Tel: +263-4-702446, +263-4-792981
Tel/Fax: +263-4-795191
SAfAIDS17 Beveridge Road, Avondale, Harare, Zimbabwe.
Tel: +263-4-336193/4 Fax: +263-4-336195
E-mail: [email protected]
Website: www.safaids.net