In 2011, the Tulane University School of Public Health and Tropical Medicine was commissioned to conduct a post-project evaluation and cost-effectiveness analysis of the Southern African Regional Social and Behaviour Change Communication Program in eight countries of southern Africa. The Regional Programme combined the HIV/AIDS prevention and treatment mass media of the Soul City Institute for Health and Development Communication (IHDC) and its local affiliates with the community-based approaches of the Community Media Trust (CMT) and the Southern Africa HIV and AIDS Dissemination Information Services (SAfAIDS). The primary objectives of the evaluation were: (1) to measure program reach and outcomes in the general population and in high risk populations; (2) to assess the marginal effect of each of the partners’ communication activities controlling for prior and concurrent HIV/AIDS communications efforts; (3) to assess the value added of the combined interventions of the three partners; and (4) to calculate the costs per person reached of the behaviour change communication interventions of each of the partners.The effects of the Regional Programme interventions varied greatly depending on the nature of the media mechanism and the outcomes examined. Radio and print media for Soul City had consistently measurable effects across indicators of the antecedents to behaviour change - knowledge, attitudes, community norms, stigma and interpersonal communication - but to a lesser extent on indicators of behaviour change. In contrast, the evidence in support of OneLove television programming on most indicators of attitudes, knowledge, norms and behaviours was small or limited. That effects were more frequently detected among the precursors to behaviour change – rather than actual behaviours – is in line with the majority of behaviour change theories. In this respect, the three years of the Regional Programme may have been insufficient to have achieved broad behaviour change, though the research design cannot tell us whether longer periods of exposure would have yielded more statistically significant effects or larger effect sizes. There was limited evidence that the combined approach of the partnership substantively improved overall effectiveness. Even so, alternative assessments of the regional approach that make use of pooled analyses of the evaluation country data may yield more robust findings regarding the common messaging of the regional approach. Other topics which have only been touched on in the current evaluation – such as the complicated economic relationships surrounding intergenerational sex and gift-giving, the effects of differential timing of exposure, and the combination of effects of different media – are likely to require more extensive analysis.
Hutchinson, P.; Wheeler, J.; Silvestre, E.; Meekers, D.; Anglewicz, P.; Hembling, J.; Cole, E.; Keating, J. External Evaluation of the Southern African Regional Social and Behaviour Change Communication Programme. Synthesis Summary. Tulane University, USA (2013) 22 pp.