Findings from Africa’s Voices Foundation’s interactive radio programme aired on 2nd December 2016 for UNICEF Somalia
Africa’s Voices Foundation (AVF)
Africa's Voices Foundation (AVF) designs mixed methods research projects that "are grounded in social science theories, engage citizens through digital channels, and deliver robust, credible evidence to inform development and governance programmes." This project was designed to gather information on Somali beliefs and practices concerning HIV/AIDS.
From the Executive summary: "In late 2016, Africa's Voices Foundation deployed a communication for development and social research intervention using interactive radio on the topic of HIV/AIDS, specifically, stigma against those living with the infection and disease. In partnership with Hargeisa (Somalia)-based MediaINK, the show was broadcast on 26 FM radio stations across Somalia, with a range covering 70% of the Somali population. A total of 6793 people participated in the show by sending free SMS [short messaging service] messages; 45.8% of participants were women. 8624 messages were received of which 3890 were estimated to be suitable for in-depth analysis of collective beliefs."
As stated here, because there was a steady upturn in prevalence of new cases of HIV/AIDS in the previous decade with poor access to treatment, the concern of supporting government and local partners to deliver testing and treatment services needed to be linked to community norms and health practices. In order to design effective behavioural change intervention and communication for development (C4D) programming to improve knowledge and to shape social norms and individual attitudes, the project sought an understanding of the beneficiaries' beliefs, opinions, and practices, including variations between groups.
The project sought to clarify answers to the following questions:
- What are the collective beliefs in regard to acceptance versus discrimination of people living with HIV/AIDS (PLWHA), and how do these vary between demographic groups?
- Is the practice of people requesting a HIV/AIDS test during antenatal care (ANC) visits associated with perceived acceptance of PLWHA in their community, and how does this practice vary between demographic groups?
To meet United Nations Children's Fund (UNICEF) data needs and address knowledge gaps, AVF worked with UNICEF Somalia's HIV/AIDS team to place questions on the radio in November of 2016 using wording decided together with partner MediaINK. Based on audience participation in the radio shows, AVF sent follow-up SMS questions using UNICEF's Rapidpro platform asking for demographic information and health practices. Answers were coded for a thematic analysis.
Conclusions and recommendations include the following:
- "Participants clearly perceive stigma against PLWHA in their communities (57.6% of messages expressed perceived lack of acceptance from their communities)....However, perceived stigma was strikingly high amongst younger groups (15-19) who live in major urban centres.
- These variations among groups in perceived acceptance of PLWHA are important, as people in major urban centres who perceive that their community accepts PLWHA were twice more likely to ask for an HIV test in an antenatal check-up....
- The most common explanation for stigma against PLWHA is the belief that HIV/AIDS is easily spread....Corresponding to this, one common reason given by those who perceive that PLWHA are accepted by the community is that HIV/AIDS is not easily spread..... C4D programming that combats misconceptions around HIV/AIDS transmission will therefore be key to reducing discrimination against PLWHA....
- Other prominent reasons for stigma against PLWHA in the community include estimations of the disease’s severity, insistence that PLWHA be 'quarantined' to a medical facility, fear of PLWHA and perceptions that the community lacked understanding of the disease. Conversely, those who understood that PLWHA could lead normal lives as members of the community argued that they should be accepted so that appropriate social, psychological and medical support could be provided.
- Our qualitative analysis suggests that religious beliefs and ethics are a strong positive basis for insisting upon community acceptance of PLWHA, even though morality and God are also invoked as reasons for discrimination....
- Our data suggests that people in Mogadishu and SCZ [South-Central Zone] are less likely to have asked for an HIV/AIDS test, compared to other major urban centres and zones....
- Using C4D and mass media to expose people to the voices and experiences of PLWHA, may contribute to changing social norms that lead to increasing uptake of HIV/AIDS tests...[by] broadcast[ing] voices of people supporting PLWHA and testimonials from PLWHA that defy misconceptions and bring about more favourable social norms."
The results suggested that interactive radio can be used as a research tool for HIV/AIDS: "Hypotheses can be tested ahead of programme decision-making and new lines of enquiry can be explored. Follow-up SMS survey questions can be targeted to specific audience to build knowledge around priority groups....Participation and engagement is likely to build over time with successive shows....[I]nteractive radio research can track social change over time... [T]echniques in machine learning show promise of extending manual coding to larger datasets thereby offering a means to scale up and speed up analysis..."
Africa's Voices website, February 15 2018.