Handout 1.1
Pre-workshop ACSM Quiz
Name:
Country
Date:
1.
Advocacy, communication, and social mobilization
have the same objectives and target audiences.
‰True ‰ False
2.
Training medical providers to improve their counseling
skills is an example of a communications activity.
‰True ‰ False
3.
The goal of advocacy activities is to increase TB
awareness among as many people as possible.
‰True ‰ False
4.
What does “KAP” mean?
5.
The Cough-to-Cure Pathway is a new diagnostic test
for screening TB patients.
‰True ‰ False
6.
“Stakeholders analysis” is a technique for assessing
the importance and influence of various people and
groups who affect a TB project or intervention.
‰True ‰ False
7.
Most communication messages only need to be
disseminated through the media once.
‰True ‰ False
8.
It is more important to implement ACSM interventions
quickly (because behavior change takes time) than it
is to collect and analyze data and evidence to design
the interventions.
‰True ‰ False
9.
ACSM activities are essential components for
reaching and sustaining national TB control targets.
‰True ‰ False
10.
Identifying problems that TB patients have in adhering
to treatment is an example of a “barriers analysis.”
‰True ‰ False
11.
Television is always the most effective method of
communication.
‰True ‰ False
12.
The main goal of monitoring is to provide
management and staff with information to make
decisions.
‰True ‰ False
13.
The main goal of social mobilization activities is
increasing TB knowledge of journalists and politicians.
‰True ‰ False
14.
Assessing ACSM needs may include various research
methods.
‰True ‰ False
15.
Tools and technical support to countries for ACSM
planning and implementation can be accessed free of
charge from the Stop TB Partnership.
‰True ‰ False
1
Handout 1.2
ACSM Challenges
Challenge # 1
In a country called Arana, the National AIDS Control department is in a mess. Because
of inefficiency and poor administration, its donors withdrew funding. The department is
now understaffed, demotivated, and ineffective. In contrast, the National TB Control
program is vibrant, productive, and efficient. It is well appreciated by the donors for its
professional management and has been receiving increasing levels of funding. The TB
program is not very interested in improving coordination with the AIDS control project,
which is seen as slow and burdensome.
In Arana, however, the majority of new TB cases are among HIV-positive people, and
the lack of coordination between the two programs is affecting the ability of people coinfected with TB and HIV to access diagnosis, care, and treatment. TB case detection
rates are not increasing as had been expected because of the rising stigma associated
with the link between TB and HIV, so that people do not go to health services for fear of
being diagnosed with HIV.
What steps would you, as the ACSM officer in Arana’s NTP, take to remedy this?
1. What advocacy actions need to be taken to improve the situation?
2. What communications actions might be important?
3. What social mobilization work is most critical?
2
Challenge # 2
In the country of Siriland, a major donor is planning to fund a mass media campaign
encouraging people with TB to go immediately for voluntary HIV counseling and testing.
Their reason for funding this is a decision taken recently in the donor country’s
government to make a concerted push for simultaneous testing for TB and HIV, in the
wake of emerging XDR-TB. As an official of the National TB Program, you are
concerned that such a direct communication in the mass media will be viewed out of
context and will fuel rising levels of fear and stigma. However, you are equally
concerned that by objecting too strongly you might jeopardize future funding for your
own country program.
As the ACSM Officer for Siriland, what action and activities would you
recommend for dealing with this situation?
1. What advocacy actions could be taken to improve the situation?
2. What communications messages might be important?
3. Are there social mobilization actions that could contribute to your goal?
3
Challenge # 3
In the country of Indalia, recently, a high-profile minister has come forward to speak
about his personal experience with TB disease and treatment. However, he also
revealed that he travelled abroad to receive medical treatment because he did not
believe he could get the kind of care he needed in Indalia. While his acknowledgment
that he has TB and is being treated could have had a very positive effect on stigma
reduction, the fact that he does not have confidence in the country’s TB control program
has seriously weakened the NTP’s media campaign asking people with suspected TB to
go for early diagnosis at their local public health facility. As a branch of the government,
the NTP is hesitant to contradict a minister. However, inaction could jeopardize the
outcomes and targets of the TB control activities.
As the ACSM Officer for Indalia, how would you deal with this predicament?
1. What advocacy actions need to be taken to improve the situation?
2. Are there communications actions that might be important?
3. What social mobilization actions could support your goals?
4
Challenge # 4
In the country of Monga, the new government is offering mass amnesty to large
numbers of incarcerated people and new trials to those who were prosecuted as
political prisoners under the previous regime. As a physician who works with the prison
system and a special advisor to the National TB Program, you are aware of the high
rate of prevalence of TB among prisoners in Monga. The prisons of Monga have weak
health care systems, and people with TB are generally not treated, or they receive
medicines intermittently. You are concerned about the increase in TB transmission that
could be caused by such a large number of people with TB being released into the
general population, as well as the negative consequences for the individuals being
released, who may not know where to get continuing treatment and thus are at risk for
MDR-TB. At the same time, you understand the unfairness of their incarceration and do
not want to recommend a quarantine.
As the ACSM Officer for Monga’s National TB Program, what would be your best
course of action to address this?
1. What advocacy actions could be taken to improve the situation?
2. Are there communications actions that might be important?
3. What social mobilization actions could be useful?
5
Challenge # 5
In the country of Grewali, TB control has been effectively decentralized. TB diagnosis
and treatment services are now available right at the village health center level. TB staff
are highly motivated and very well trained. However, the disbursement of TB control
funds is still a centralized activity controlled by the Ministry of Finance. Their system
slows down the release of the money to the local bank account and follows a lengthy
procedure under which the district-level official has to seek permission from the Ministry
prior to each withdrawal. Fresh funds are not sanctioned until the previous withdrawal is
accounted for satisfactorily. Because of these delays, money sat unused for over a
year, and the National TB Program failed to meet its Global Fund objectives. As a
result, the next tranche was not released and future funding was suspended. The
program is soon to run short of critical diagnostic supplies and drugs for TB treatment.
At the same time, the Ministry of Finance is sensitive to criticism and resists any
suggestions about third-party financial management by a professional international
agency.
What steps would you, as the ACSM officer in Grewali’s NTP, take to bring about
a change in the financial management mechanism and address the immediate
crisis?
1. What advocacy actions need to be taken to improve the situation?
2. Are there communications actions that might be important?
3. Are there social mobilization actions that could be useful?
6
TB patients do not have
a say in issues
concerning policy,
diagnosis, or treatment
1
3
2
What is the problem?
#
Involvement of patients in
issues concerning policy,
diagnosis, and treatment
What change is needed?
MOH
7
Who has the power to
create the change?
Country: _____________ Challenge #: ____
Advocacy Activities
Handout 1.3
TB patients
Who is the advocate
(change agent)?
TB patients participating in
key MOH meetings, e.g., TB
ICC and major TB activities World TB days
What activities will influence
the people in power?
The health providers are
not communicating
effectively with patients
about TB treatment.
1
3.
2
What is the problem?
#
Improving health care
providers’ interpersonal
communication and
counseling skills.
What change is
needed?
8
Health program
managers
(secondary)
Health care providers
(primary)
Who are you trying to
reach? (target
audience)
Country: _______________ Challenge #: _______
Communication Activities
Handout 1.4
To improve patient’s
adherence to
treatment, it is
important that your
patient understands the
treatment process
completely.
What message(s) needs
to be communicated?
Flip charts
IPCC training
What communication
channels could be used?
There is shortage of facilities
that offer TB and HIV
services.
1
3
2
What is the problem?
#
The number of facilities
should increase.
What change is needed?
9
MOH, regional
health officials
Who is in your
target audience?
Country: _______________ Challenge #: ______
Social Mobilization Activities
Handout 1.5
PLWHAs and people
with TB
Who could be the
social mobilizer
(change agent)?
Establishing a community
action group of PLWHAs
and people with TB to
advocate for accessible
services.
What are potential social
mobilization activities?
3
2
1
Ex
Reach the target of 70%
case detection by 2010
National TB Control
Objectives
10
Case detection is only 55%, below the target
of 70%
TB Control Challenges and Gaps
2. High level of stigma related to TB and HIV prevents people from
attending services.
1. Lack of sufficient human resources to staff all microscopy
centers.
Possible Contributing Factors
TB control goal: ________________________________________________________________________
Country: _______________________________
National TB Control Objectives, Challenges, and Gaps
Handout 2.1
TB Control
Objectives
ACSM Objectives
11
ACSM Activities
Completed
In
progress
Halted
Activity Status
Not
begun
Not
planned
but
desirable
Country ACSM goal: ______________________________________________________________________________________________________
Country: _____________________________________
Country ACSM Activity Status
Handout 2.2
5
4
3
2
1
ACSM activities not yet
implemented that we would
like to start in the next 6–12
months
12
What TB control objective does
this activity support?
Country: _____________________________
ACSM Gaps and Opportunities
Handout 3.1
Reasons for implementation
delays (barriers)
Factors/resources that can
support implementation
Handout 3.2
Research Case Studies
CASE STUDY A
Country A has on of the top ten highest TB burdens globally. Due to social, religious,
and cultural traditions, men and women access health services differently. For example,
women in rural areas are not allowed to visit health facilities unaccompanied. The
National TB Program would like to study gender differences in knowledge and attitudes
towards TB in urban and rural communities, and to compare male and female TB healthseeking behavior. Previous research suggests that knowledge of TB is poor; however it
is not known what the differentials are between women and men, or rural and urban
residents. Social isolation and rejection of people with TB disease is high, as well as
misconceptions about TB transmission. TB is a disease to be feared, particularly by
married women who are worried about consequences if they tell their husbands they are
infected.
Questions:
1. What research methods would you recommend be used to find out more?
2. What are key areas of inquiry/questions that you would suggest exploring?
3. Does the existing data provide you with any initial insight into what types of ACSM
interventions could be most effective?
CASE STUDY B
Country B ranks third among the top ten high-burden countries for TB. Next year, the
National TB Program is planning to lead a TB prevalence survey that will be
administered to 10,000 people in all provinces of the country. According to existing data,
awareness of TB as a curable illness is high; however, accurate knowledge of
transmission and symptoms is low. Very few people voluntarily present for TB screening,
and TB is generally detected when the patient’s infection is advanced. Local TB doctors
have indicated that patients are often surprised to learn that TB screening and treatment
are free.
Questions:
1. What research methods would you recommend be used to find out more?
2. What are key areas of inquiry/questions that you would suggest exploring?
3. Does the existing data provide you with any initial insight into what types of ACSM
interventions could be most effective?
13
CASE STUDY C
In Country C, initial research and experience suggest that TB patients are not treated
very well by medical staff. Medical staff look down on the patients, and some of them
fear being infected by the patients. Initial visits to clinics reveal that visual and oral
privacy and confidentiality of medical records are not observed. Nurses come and go
from the exam rooms abruptly, interrupt the doctors, and leave doors open. There is a
significant problem with patients who don’t return after their initial visits, and with
incomplete treatment. The NTP and nongovernmental partners know that they want to
conduct training of medical providers as part of their communications strategy.
Questions:
1. What research methods would you use to find out more about the providers’ situation
and reason for their poor performance?
2. What research methods would you use to find out more about the patients’
experience?
3. What are key areas of inquiry/questions that you would suggest exploring?
4. How would you measure impact of the planned training of providers?
5. What kinds of elements should be included in the training of providers? In the
education of patients or the public?
14
Handout 3.3:
Assessing Needs through Research
Country: ___________________________
Instructions:
•
Work in your country groups. Read, discuss, and respond to the following questions.
•
Designate a representative to report back to the large group.
1. Describe the research or needs-assessment methods that have been used in your country to
assess needs for advocacy, communication, or social mobilization.
Ź Were the methods qualitative or quantitative?
Ź How many people were surveyed, interviewed, or observed?
Ź In your experience, what were the most useful methods for your programming?
2. How did you use the results of the research or needs-assessment activity?
Ź What dissemination activities were conducted to ensure sharing of the research
results?
15
3. Give an example of a situation when you would choose to use qualitative research methods,
and explain why.
4. Give an example of a situation when you would choose to use quantitative research methods,
and explain why.
16
Handout 3.4
Ten Steps to Developing a Strategic Advocacy Plan
Ten steps to developing a strategic advocacy agenda
Advocacy is often a helpful tool in achieving public health goals through policy change. Given
the many different methods to influence policies and the limited resources usually available to
do so, it is important to assess your options and tactics strategically. Below are ten steps that
you may find helpful as you determine your program’s advocacy objectives and activities.
Step 1: Establish a process for assessing and understanding the challenges and needs
of the target population.
•
•
Conduct a needs assessment of the affected population or use data already collected.
Develop a process for ongoing feedback and input from the target population.
Step 2: Identify policy changes that would
address the needs of the target population.
Examples:
•
•
Increased resources
Enforced, changed, or new policies or
regulations
Conduct a policy scan:
• Track government funding histories.
• Identify supportive policies/regulations that
exist but are not being enforced.
• Identify policies/regulations that exist but
should be changed.
• Seek gaps that need to be filled with new
policies/regulations.
Step 3: Identify decision-maker(s) who have the power and influence to change policy to
address the needs.
Examples:
•
•
•
•
Politicians (elected & appointed officials)
Social leaders.
Government agencies
International bodies
Step 4: Determine why decision-makers have not implemented the desired change.
Examples:
• Too expensive
• Not a priority
• Lack of understanding
• Lack of community demand
Step 5: Identify opposition to the policy change and the reasons for their opposition.
•
•
•
Who are opposing the policy?
What are their key arguments?
With whom do they have influence?
Step 6: Assess your institution’s strengths and weaknesses in advocating for the policy
change.
Examples:
• Expertise
• Spokespeople
• Relationships/influence
• Unique niche
17
Step 7: Identify others who have a similar interest in addressing the problem.
Assess risks/benefits of your organization’s partnership with each one.
Examples:
• Patient coalition
• Professional organization
• Faith-based organization
• Activist/advocacy organization
Hint! Include those who could be partners, but currently
are not.For example, you may want to reach out to
businesses or others with political influence that could be
affected—directly or indirectly—by the policy change, but
have not yet been actively engaged in the issue.
Step 8: Identify advocacy activities and messengers that could influence those in
power.
Examples of activities:
• Meeting with decision-makers
• Public event
• Petition
Examples of messengers:
• Media
• Celebrities
• Patients
• Experts
• Peers
• Donors
Be strategic!
Identify a set of criteria to assess and select among
each of your options.
Consider using the following criteria:
• Level of influence the activity would have on
decision-makers.
• Level of risk to your program/institution in
pursuing the activity.
• Resources that would be needed.
• Access to effective messengers.
Step 9: Assess current and future resources that could be accessed to pursue the
change.
Examples:
• Financial
• Human
• Intellectual
• Networking
Step 10: Determine how to evaluate progress and success.
Outputs measure whether the advocacy activities have been carried out successfully.
Outcomes measure the effectiveness of the advocacy activities in achieving identified goals.
Examples:
Outputs
• Public statement of support from decision-maker
• Number of signatures on petition
• Number of attendees at a rally
Outcomes
New resources allocated
Law passed/changed
Regulation implemented/changed
•
•
•
18
Handout 3.5
Strategic Advocacy Planning
Country: ______________________
Advocacy objective:______________________________________________________________________
Step
Your Own Example of Each Step
1. Assess the situation and define
the challenge(s).
Example: Insufficient resources, not
enough TB clinics, lack of training
2. Identify policy changes that would
address the needs of the target
population.
Example: Changes in budget
allocation processes, lifting of hiring
freeze
3. Identify decision-maker(s) who
have the power and influence to
change policy to address the
needs.
Example: Minister of Health and/or
Finance
4. Determine why decision-makers
have not implemented the desired
change.
Example: Too expensive, not a
priority, lack of understanding
5. Identify opposition to the policy
change and the reasons for their
opposition.
Questions to answer:
• Who is the opposition?
• What are their key arguments?
• With whom do they have
influence?
6. Assess your institution’s
strengths and weaknesses in
advocating for the policy change.
Examples:
• Expertise
• Spokespeople
• Relationships/influence
• Unique niche
19
Step
Your Own Example of Each Step
7. Identify others who have a similar
interest in addressing the
problem. Assess risks/benefits of
your organization’s partnership
with each one.
Examples:
• Patient coalition
• Professional organization
• Faith-based organization
• Activist/advocacy organization
8. Identify advocacy activities and
messengers that could influence
those in power.
Examples of activities:
• Meeting with decision-makers
• Public event
• Petition
Examples of messengers:
• Media
• Celebrities
• Patients
• Experts
• Peers
• Donors
9. Assess current and future
resources that could be accessed
to pursue the change.
Examples:
• Financial
• Human
• Intellectual
• Networking
10. Determine how to evaluate
progress and success.
Outputs measure whether the
advocacy activities have been carried
out successfully. Outcomes measure
the effectiveness of the advocacy
activities in achieving identified goals.
Examples:
Outputs
• Public statement of support from
decision-maker
• Number of signatures on petition
• Number of attendees at a rally
Outcomes
New resources allocated
Law passed/changed
Regulation implemented/changed
•
•
•
20
Handout 3.6
Steps in Developing a Strategic Communication Plan
#
1
2
Step
Define the TB control problem and
the behavioral change you want to
see.
Identify the audiences affected by the
problem.
Examples:
•
•
FGD analysis
•
•
KAP survey
FDGs
•
•
KAP survey
Focus group discussions
What resources
outside the NTP
could help?
Research
agency
NGO
Stakeholder analysis
People in rural areas.
Migrant workers.
Medical providers.
Identify the appropriate channel for
reaching the audiences effectively.
Examples:
•
•
•
•
4
•
•
•
KAP survey
Focus group discussions (FGD)
Exit interviews
• DHS questions
Examples:
• Community stakeholder
• Low case detection—we want
consultation to identify individual,
people to report to a health facility as
family, and societal barriers to
soon as they experience TB
health-seeking behavior
symptoms.
• Mistrust of health services—we want
to improve providers’ communication
and counseling skills.
• Stigmatization and fear of TB—we
want to decrease stigma.
•
•
•
3
Examples of tools & activities
Radio.
Community theater.
Leaflets, posters, billboards.
Training.
Plan the content and style of
communication.
Examples:
• Messages.
• Dialogue and discussions.
• Interactive communication.
• Endorsements.
Advertising or
design agency
NGO
21
#
Step
5
Determine how you will evaluate your
progress and success.
Examples of tools & activities
ACSM focal
point, working
group,
consultant
Examples:
•
•
What resources
outside the NTP
could help?
Identify measurable indicators.
Establish an evaluation plan before
implementing.
6
Make a draft strategic communication
plan.
7
Stakeholder review of draft strategic
communication plan.
8
Identify advocacy resources to
strengthen your communication
campaign.
Outline:
• Key findings
• Strategic directions
• Objectives
• Audiences
• Interventions
• Content
• Media
• M&E
• Work plan
•
Conduct stakeholder workshops
to review the plan.
ACSM focal
point, working
group,
consultant
ACSM focal
point, working
group,
consultant
ACSM focal
point, working
group,
consultant
Examples:
•
•
9
Community leaders.
Football stars or other celebrities.
Finalize strategic communication
plan.
•
Launch it publicly with media,
field staff and NGOs.
22
NTP with
ACSM focal
point, working
group,
consultant
Handout 3.7
Strategic Communication Planning
#
Step
1
Define the problem and
behavioral change(s) you
want to see.
2
Identify the audiences
affected by the problem.
3
Identify the appropriate
channel for reaching the
audiences effectively.
4
Plan the content and style of
communication.
5
Determine how you will
evaluate your progress and
success.
6
Make a draft strategic
communication plan.
7
Stakeholder review of draft
strategic communication
plan
8
Identify advocacy resources
to strengthen your
communication campaign.
9
Develop final version of
Strategic Communication
Plan.
What information already exists?
What data need to be gathered? How to collect it?
What activities would you plan?
23
Develop community
support to encourage
people with cough to go for
evaluation.
Ex
3
2
1
Increase public support for
adequate DOTS facilities.
Ex
SM Objective
Increase number of health facilities that
offer DOTS services.
PLWA
24
Increase number of people with cough
who go to a DOTS center for evaluation
Community
leaders
District Health
Officers
Communication objective
Village elders
(Media)
TB groups
Advocacy objective
Advocacy and/or Communication
Objective Supported
Communities
SM Audience
Country: _____________________________
Developing a Social Mobilization Plan
Handout 4.1
Individuals with cough
MoF
MoH
Target Audience
Community leaders use their
community meetings and forums
to deliver three messages:
1) Early diagnosis for cough is
important to keep the
community healthy.
2) TB is a curable disease and
treatment is free.
3) Anyone can get TB, and
members of the community
with TB should not be
discriminated against.
Media to be mobilized to cover
the event and report on the
shortage.
Event at a health facility that
lacks services in which
community leaders, PLWA, and
TB groups highlight their need
for more DOTS centers and
services.
SM Activity
5
4
SM Objective
SM Audience
25
Advocacy and/or Communication
Objective Supported
Target Audience
SM Activity
Handout 4.2
Cough-to-Cure Pathway Analysis
The Cough-to-Cure Pathway was developed as an analytical and planning tool for the Stop TB
Partnership by the Academy for Educational Development. The model maps out the ideal
pathway of behavior for an individual with TB, as well as possible barriers that may work against
successful diagnosis and cure. Barriers may be related to patient factors (lack of money for
transport to health facility), provider factors (poor relationships with patients), community behavior
(pervasive stigma related to TB) or flaws in the systems in which they operate (poor accessibility
of TB services).
Country: ____________________________
Reasons why ideal
behavior is not
occurring
ACSM interventions to
promote ideal behavior
Individual level
Group level
System level
Individual level
Group level
System level
Individual level
Group level
System level
26
Activities
National
representatives
with support of
NGO will approach
NTP Director for
debriefing from this
workshop and
sharing draft plan
of action.
Objectives
Advocacy to
stakeholders
(including
ministry of
information,
journalists
association) to
increase
knowledge and
deepen
understanding
No ACSM strategy but ACSM components are included in the 2006–2010
national TB plan.
Implementing IEC activities, but not ACSM.
No ACSM guidelines.
No ACSM technical group, focal points, champions.
Little knowledge among stakeholders and key players of ACSM or how
ACSM can contribute to the national goals.
Support from
MOH for
attendance at
ACSM
workshop—they
expect
something back.
Team at workshop
with support from
NGO (PATH).
27
Opportunities
& Resources
Available
No additional
resources
needed.
Challenges &
Resources
Needed
X
1
2
3
4
5
6
7
8
9
10
Timeline (months)
October 2007 to July 2008
NTP must approve and then will submit to MOH for approval.
11
12
1. Advocacy to stakeholders (MOH, NTP, NGOs, donors, journalists) to
increase support for ACSM.
2. Form a focal point team at national level within NTP.
3. Complete a draft ACSM strategy with MOH endorsement.
4. Review current IEC plan and develop it further to include A, C, and SM
components where needed.
5. Build onto the Interagency Country Coordinating Committee group to form
an ACSM Technical Working Group.
•
•
•
•
•
Who Is
Responsible for
Implementing
Who must approve or support this plan:
What we would like to accomplish in the next ten
months:
Current status of ACSM:
Country: CAMBODIA
Sample Country ACSM Action Plan
Handout 4.3:
on TB and
ACSM with the
goal of
approving and
supporting the
ACSM
strategy.
Objectives
Sensitization
workshop for NTP,
MOH, and other
stakeholders on TB
and ACSM’s
contribution to TB
control targets.
Tools from the
regional ACSM
workshop will be
compiled and
packaged.
Stakeholders will
include: NGO
partners working
on TB, professional
organizations (e.g.,
journalists’
association and
pharmacists’
association),
Ministry of
Information (MoI).
Activities
CENAT/NTP
Who Is
Responsible for
Implementing
28
MOH/NTP
expects this from
the team
participating in
the five-day
ACSM
workshop.
ACSM capacity
at national and
provincial level.
ACSM technical
expertise incountry
Opportunities
& Resources
Available
Budget for travel;
venue and
meeting
package;
printing of ACSM
tools;
Technical
support from
PATH and WHO
TB focal person.
Challenges &
Resources
Needed
1
x
2
3
4
5
6
7
8
9
10
Timeline (months)
October 2007 to July 2008
11
12
Objectives
CENAT/NTP and
ACSM team
NTP/PATH
MOH and MoI
Small group
meetings among
NTP/MOH/NGO to
introduce ACSM.
Sensitization
workshop for
journalists from
national and
provincial level;
80–100 journalists
will be invited to
participate.
Activities
Who Is
Responsible for
Implementing
29
Support from
NTP for ACSM;
ACSM team
knowledgeable
and willing to
advocate for
ACSM strategy
inclusion;
Tools from
regional ACSM
workshop
available to
share with
partners and
stakeholders;
GFATM financial
support.
Documents on
global TB
situation;
Documents on
country TB
situation;
National
guidelines and
plans;
Technical and
communications
expertise;
NTP and PATH
available
Opportunities
& Resources
Available
Technical
support from
PATH to
organize
workshop;
Technical
support from
PATH to develop
“TB- Make It
Your Issue”
advocacy
package—both
electronic and
hard copies—
which will include
fact sheets on
global and
country situation
on TB; NTP
Budget for travel
to and from
provinces for the
provincial ACSM
team;
Power point
presentation on
ACSM and how
it can contribute
to national
targets;
No additional
budget is needed
for this activity.
Challenges &
Resources
Needed
1
x
x
x
x
x
4
3
2
x
5
x
6
7
8
9
10
Timeline (months)
October 2007 to July 2008
11
12
Form a focal
point team at
national level
with NTP.
Objectives
Develop TOR for
ACSM focal point
team.
NTP appoints
ACSM focal team;
both national and
provincial level.
NTP submits
Activities
All tools and
evidence
needed to
enable the
formulation of
the ACSM focal
point team.
Capacity on
CENAT/NTP
30
Opportunities
& Resources
Available
Who Is
Responsible for
Implementing
guidelines;
2006–2010
Strategic Plan;
stories from the
field;
Support from
Ministry of
Information to
mobilize the
journalists;
Some journalists
may not be
interested to
participate if
workshop is
conducted during
special event.
Budget for ½ day
sensitization
workshop to
cover training
package costs
and printing
costs.
Equipment (i.e.,
laptop with LCD
projector and
screen; camera)
Endorsement of
ACSM focal
point team from
MOH.
Additional
capacity building
on ACSM for
ACSM focal
Challenges &
Resources
Needed
x
1
x
2
3
4
5
6
7
8
9
10
Timeline (months)
October 2007 to July 2008
11
12
Complete a
draft ACSM
strategy with
MOH
endorsement.
Objectives
Official request for
TA to support the
development of the
ACSM strategy.
Designate a
support team from
JICA, FHI, PATH,
NTP, and ACSM
focal point team.
Organize and
conduct working
review meetings.
Organize and
conduct a
stakeholder
workshop for
ACSM draft
strategy review.
request letter for
approval to MOH.
Activities
CENAT/ NTP;
technical bureau;
and ACSM focal
point team
Who Is
Responsible for
Implementing
31
NTP/Technical
bureau national
level supports
this activity.
National and
province has
capacity on
ACSM
Global-Regional
ACSM tools
available
Updated IEC
plans available
ACSM
Champions on
ACSM
Opportunities
& Resources
Available
Technical
support from
PATH to work
with NTP and
ACSM team to
develop draft
ACSM.
Funds to support
consultancy and
the development
of the ACSM
strategy.
Budget for
review meetings.
Budget for
stakeholder
review
workshop.
Time for NTP
ACSM and
partners
input/comments.
team.
Budget for
provincial ACSM
focal point team
to travel to and
from provinces.
Challenges &
Resources
Needed
1
2
3
4
x
5
x
6
x
7
x
8
x
9
x
10
Timeline (months)
October 2007 to July 2008
11
12
Technical
direction from
PATH and other
partners.
IEC team and
ACSM focal
person.
CENAT/NTP/ACSM
focal point team
Designative a
review team from
PATH/JICA/FHI
and other relevant
donors.
Small meetings
conducted to
review and modify
the IEC plan.
Develop TOR
Appoint ACSM
technical working
group
Request letter for
approval from
MOH
Technical working
group meets every
three-months
Update the IEC
plan to include
ACSM
components.
Build on to ICC
to form an
ACSM
technical
working group.
32
IEC plan
available ACSM
tools
ACSM capacity
national and
provincial level
ACSM expertise
among review
team
NTP/Technical
bureau
Activities
Objectives
Opportunities
& Resources
Available
Who Is
Responsible for
Implementing
Technical
support from
PATH
Donor approval
for revisions
Availability of
review team to
provide timely
comments
No additional
funding is
needed for this
activity
No additional
budget is needed
for these
meetings.
Challenges &
Resources
Needed
x
1
x
2
x
x
x
4
3
x
5
x
6
x
x
7
8
9
x
10
Timeline (months)
October 2007 to July 2008
11
12
Objective
Activities ±
What can you
do to make
this happen?
Who is
responsible for
implementing?
Who must approve or support this plan:
What we would like to accomplish in the next _____
months:
Current status of ACSM:
Country: _____________________
Country ACSM Action Plan
Handout 4.4
33
Opportunities
& resources
available
Challenges &
resources
needed
1
2
3
4
5
6
7
8
Timeline
9
10
11
12
Example:
Radio
campaign
targeted at rural
audiences to
raise
awareness that
TB treatment
through DOTS
is free.
Example:
Lobby Ministry
of Finance and
MOH to
streamline
financial
management
mechanism for
ACSM funds
(GFATM and
other donors).
ACSM Activity
Number of people listening to radio
campaign.
Number of radio spots aired.
Number of radio spots produced.
Number of meetings with MOH and
MOF representatives.
Advocacy analysis completed and
strategy planned.
Process Indicators
(Are the expected activities moving
forward?)
Country: __________________________
Planning for Monitoring & Evaluation
Handout 5.1
34
Increased case detection.
Local or NTP TB data.
Health facility records.
Module added to TB prevalence survey or
DHS, or KAP survey.
% of population who know that TB
treatment through DOTS is free.
Increased # of people presenting to health
facilities for evaluation.
Project reports
Observation
Financial management agency appointed.
Funds dispersed more rapidly and in time
to complete planned ACSM activities on
schedule.
Track funds through accounts payable, etc.
Monitoring & Evaluation Methods
Financial management policy improved.
Results Indicators
(What outcomes and impacts do you
expect? Have things changed as a result
of your work?)
Example:
Training of
community
leaders in
social
mobilization to
support TB
control.
ACSM Activity
35
Population covered by active trained
leaders.
Proportion of TB patients completing
treatment.
Number of TB patients supported by the
community for DOT.
Number of leaders who conduct
social mobilization activities within
one month of training.
Number of people trained.
Number of communities in which
community members volunteer to support
TB activities as a result of social
mobilization activities.
Results Indicators
(What outcomes and impacts do you
expect? Have things changed as a result
of your work?)
Training materials produced, piloted,
and revised.
Process Indicators
(Are the expected activities moving
forward?)
Local or NTP TB data.
Project reports.
Interview a sample of Provincial and
District TB managers.
Interviews with community leaders and
community members.
Monitoring & Evaluation Methods
ACSM Activity
36
Process Indicators
(Are the expected activities moving
forward?)
Results Indicators
(What outcomes and impacts do you
expect? Have things changed as a result
of your work?)
Monitoring & Evaluation Methods
Handout 5.2
Post-workshop ACSM Quiz
Name:
Country
Date:
16.
Advocacy, communication, and social mobilization
have the same objectives and target audiences.
‰True ‰ False
17.
Training medical providers to improve their counseling
skills is an example of a communications activity.
‰True ‰ False
18.
The goal of advocacy activities is to increase TB
awareness among as many people as possible.
‰True ‰ False
19.
What does “KAP” mean?
20.
The Cough-to-Cure Pathway is a new diagnostic test
for screening TB patients.
‰True ‰ False
21.
“Stakeholders analysis” is a technique for assessing
the importance and influence of various people and
groups who affect a TB project or intervention.
‰True ‰ False
22.
Most communication messages only need to be
disseminated through the media once.
‰True ‰ False
23.
It is more important to implement ACSM interventions
quickly (because behavior change takes time) than it
is to collect and analyze data and evidence to design
the interventions.
‰True ‰ False
24.
ACSM activities are essential components for
reaching and sustaining national TB control targets.
‰True ‰ False
25.
Identifying problems that TB patients have in adhering
to treatment is an example of a “barriers analysis.”
‰True ‰ False
26.
Television is always the most effective channel of
communication.
‰True ‰ False
27.
The main goal of monitoring is to provide
management and staff with information to make
decisions.
‰True ‰ False
28.
The main goal of social mobilization activities is
increasing TB knowledge of journalists and politicians.
‰True ‰ False
29.
Assessing ACSM needs may include various research
methods.
‰True ‰ False
30.
Tools and technical support to countries for ACSM
planning and implementation can be accessed free of
charge from the Stop TB Partnership.
‰True ‰ False
37
Handout 5.3
Final evaluation form
1. What I liked most about the training
2. What I would suggest changing or improving about this training
3. What was your greatest area of learning from this training?
4. In what area did your skills improve the most?
5. What specific feedback do you have for the trainers/facilitators?
6. What other comments do you have?
38