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Innovative Demand Creation for VMMC in
Zambia
SOCIETY FOR FAMILY HEALTH Dr. Albert Machinda, Project Director
QualitativeResults:JourneyMapping
• 2years3monthsfromawarenesstocircumcision
• MajordropoffduetoCognitivedissonance
• 3Strategiestoreducedissonance:
ü Decreasenegativeneartermconsequences
ü Increaseneartermbenefits
ü Compresstime
94%Aware 34%Circumcise
11%Advocate
SOCIALLYSUPPORTEDBELIEVERS
Base:alluncircumcisedmen,n=1189
SELF-RELIANTBELIEVERS
FRIENDSDRIVENHESITANTS
INDIFFERENTREJECTERS
SCAREDREJECTERS
KNOWLEDGEABLEHESITANTS
TRADITIONALBELIEVERS
17%
27% 6%
11%
19%
9%
10%
Moderatepotential(11%ofuncircumcisedmen),buthighcommitmentandlikelihoodtoadvocatetowideaudience;needtoovercomesomedissonanceissue.
Moderatepotential(9%),buteasyconversiontoactionandhighlylikelytoactasadvocatesforfriendsandtosomeextentothermen.
Moderatepotential(10%),butthekeybarrierisconcerninsafetywhichreducemotivation– increaseoftheircommitmentisrelativelyeasybyaddressingtheirissues.
Largepotential(20%),butratherlowmotivationandneedinadditionalassuranceinneedofVMMC.Butcanbeeasilyconvertedbystrongadvocacyaroundthem.
Largepotential(17%)butlowmotivationandstrongconcerns,includingfearsandembarrassment–needalotofsupport.
Largepotential(27%),buthardtocrack;absenceofmotivationandalmostnoconcernsorfears,butcouldbereachedviaadvocatesinthecommunity.
Smallpotential(6%),noneedinsupport;haveveryhighcommitmentdrivenbytradition.
SEGMENTPRIORITIZATION:SEVENSEGMENTS
FROMDATATODESIGN
• Prioritizationofsegments• WorkshopforInsights• Designtailoredapproaches• AdaptTypingTool
SITUATIONAL ANALYSIS
5
STEP 1: SEGMENT PRIORITIZATION: CRITERIA BY ALL SEGMENTS
HUMANCENTEREDDESIGNAPPROACH
Hygiene:HeneedstohearaboutthehygienebenefitsofVMMC butalsotounderstandexactlyhowtheyareachieved.He’sskepticalaboutthecleanlinessaspectanddoesn’tunderstandthelinkbetweenhygieneandreducedinfections.Showingamodelofforeskin,andexplainingabouthowtheexposedskiniseasiertowashhelps.Mentionofwomenhereembarrassesthem.
Riskreduction:Heneedstounderstandthemeaningof60%protection,buttounderstandtherisktheyalsoneedbasicinformationonwhatanSTI is.It’simportantnottooverwhelmhim,asthisisanewconcept,buttogiveenoughbasicinformationtoappreciateriskreduction.
PainManagement:Hewantstoknowthatthepainisbearable.
Healing&Aftercare:Hewantsverydetailedinformationonwhattodotocareforhimselfafter,eventothelevelofwhattemperatureofwatertodrinktostayhydrated.Sincehe’slessinformedaboutsexhealsoneedstoknowwhyamancan’thaveitforsixweeks.
Popularity:ItisbesttoemphasizethattheMOH approvesofVMMC enoughtowantittobefree.
NationalPride:MOH approvesofVMMC andheisbeingaresponsiblemanbyhelpingreachanAIDSfreegeneration.
WhatdoesMr.Greenneedtohear:
POPULARITYPAINMANAGEMENTRISKREDUCTION
NATIONALPRIDE
FRIENDSDRIVENHESITANTS:MR.GREEN
HEALING&AFTERCAREHYGIENE
MostRelevantIPC Tools:60%Jar:KeepitbasicPain-o-meter:EmphasisonhealingHygieneMessaging:PenisModelBuddysystem:Chancetojoin
ValueStatement:“NowthatIknowhowVMMCworkstokeepmecleanandhealthy,whywouldn’tIwanttodotheresponsiblething?”
SITUATIONAL ANALYSIS
PROCEDUREWALKTHROUGH
TRUEORFALSEWHEEL SEXWHEEL BUDDYSYSTEM
60%JAR VIPWAITINGROOM PAIN-O-METER
HCD APPROACH: PRE-TESTING AND PROTOTYPING
HYBRID IPC PILOT DESIGNTAILOREDAPPROACHES- JOBAIDSPERSEGMENT
HYBRID IPC PILOT
Pilotednewapproach• 6-monthpilot,August2016- February2017• 5-daytrainingofhealthpromoters
DEMANDCREATIONPILOT: MEASUREMENT&PHASE1PILOTRESULTS
Zambia VMMC Program PilotIndicators
Project Outcomes Efficiency (increasedconversionrate)andeffectiveness(increasedMCs)
Programmatic Indicators Client age distribution,HPproductivity,effectiveIPCformat(groupsize)andsetting(locationofclients)
SITUATIONAL ANALYSIS
358
301
148
212
100
Avg.ReceivedFullIntervention/HP
Avg.AppointmentBooked/HP Avg.ActualMCs/HP
PILOTFINDINGS:JOURNEYCASCADE
INTENT
ANTICIPATE
182
1631
1042426
77 44
412
4146
2327
1104
170 88
10-14 15-19 20-24 25-29 30-34 35ANDABOVE
ConversionrateofClientsReachedbyAgeGroupAug2016– Feb2017(n=6926)
91% ofclientscircumcisedbetween15-29yearsduringpilotperiod
44%
39%
45%
39%
52% 33%
Circumcised ClientsReceivedFullIntervention
PILOTFINDINGS:ClientConversationRatebyAgeGroup,Aug-Feb2017(n=8,227)
39%
756536 504
820
272 311 202
1698
1099 1091
1394
526720
398
45% 49% 46% 59% 52% 43% 51%
PILOTFINDINGS:VMMCBookedvs.Actual,AllSegments(n=6,926)
SITUATIONAL ANALYSIS
1.Datadeliverymatters.Presentation,user-friendlinesskeyconsiderations.
2.Mustalignoutreachstructure/communicationchannelswithsegmentationapproach.Tailoringiskey!
3.Jobrequirementsmaychangeandextratraining/timemaybenecessary
4.M&Esystemupdatesmayberequired;nearreal-timedataextremelybeneficial
CHALLENGES & LESSONS LEARNED
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