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I’ve spent the last couple of days in a room full of experts, researchers, communicators, donors, programme people discussing how to increase the uptake of voluntary medical male circumcision (vmmc as they called it) among men 25-49 years old in countries in east and southern Africa as a way to reduce the spread of HIV, and ultimately create an HIV free generation.

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It’s not really my area of specialisation, but I was fortunate to be invited as a person who has done a lot of communication work for awareness and prevention of HIV generally.  I learnt a lot.  They discussed things like maybe vmmc should be repositioned so it’s not so closely associated with HIV, but more so with Hygiene and maybe even sexual attractiveness, and reducing female cervical cancer.  They also discussed how to get female intimate partners more involved as a primary audience because they are influencers in men’s life.  Ok hold on – for years we’ve been talking about how women aren’t empowered to decide how, when, and where to have sex, with the man totally in control of that decision, they can’t get a man to wear a condom, but now they can influence a man to cut his penis?  Wow!  So what are we saying, did the health campaign’s empower women too much?

In that same discussion – which I was lucky to be a panelist on – Hally Mahler who works in Tanzania as the Chief of Party for JHIPEGO – a USAID Project – she explained that while women could be great influencers, they can also be deterants because they didn’t want to have six weeks of abstinence while their partner healed, so they’d rather go to another man for that sexual pleasure – and the men now this.  In Zambia, they say women are scared that the partners would find being circumcised as the reason for men to go out and be unfaithful!

Times have changed indeed – women in Africa are acknowledging that they have sexual needs and not afraid to admit it!  

Enough of my sidebar, going back to my observations of the conference, I’ve been at several of these meetings, conferences etc where all these different people come together and I find it’s usually the same things being said – researchers want more money for research, so that everything can be evidence based, donors are agreeing with this, but saying they want results now!  And programme people (or are they implementers) are wanting to put more money into communication, while there are the those in the middle – not sure who they are – who are naysers about putting money into communication/mass media programmes.

Obviously as a person who is into communications and content development, I’m a strong advocate for putting more money into good quality content.  But I think everyone has to work together.  The researchers have the information to inform the content, the implementers on the ground have the networks and links into the service providers to ensure that when the demand is created the services are there for the uptake.  Too often these groups, when designing a programme are not in the same room.

I’ve been to tenders where organisations say they want to launch a comprehensive communication campaign to get a certain behaviour adhered to and so they’re now putting out a tender for 2 billboards, 3 TV PSAs and 2 radio spots.  Erm yeah, that’s going to get you a comprehensive campaign.  Not to say that they need to have loads more, but if they don’t have the media spend to flood the market, then it’s not really worth it and their money is better spent in a cheaper medium like leaflets – as long as their target audience can read.  But I am a strong believer that communication campaigns done well and sustained can work – there is lots of evidence for this, especially in the commercial world.

My point is they should be engaging an agency in the begining to tell them what they need to do.  People bring agencies in at the last minute and then question the agency as to why their campaign isn’t working – which could be for a multiple reasons starting with they didn’t really do a proper communication brief to the agency.  If an agency clearly understands what it is you’re trying to achieve, it makes it easier for them to plan a campaign for you – and all aspects of the campaign.  That’s another thing I don’t really understand about public sector, why they do this whole piecemeal thing – splitting out a campaign isn’t about making it fair, it’s just complicates your campaign and makes it harder to manage and control and makes quality control a nightmare.

Another one of my observations was how little we heard from local people.  I’m a big believer in local knowledge.  As I sat with other African colleagues at lunch, or during tea breaks, we laughed about how African’s are too polite, they’d rather let their Western colleagues go down a path that is culturally inappropriate than tell them it won’t work – don’t want to hurt their feelings, and obviously a lot of people still having their insecurities that the West are more superior than us poor, little Africans, in fact one person observed that the conference was about ‘white women telling black men to cut their penis’ – (i found that funny).  But I did wonder why we’re not pushing our own solutions – I’m not talking about the to cut or not cut issue here – but even when I look at all the communication campaigns we do for our clients, we’ve never been approached by the Ministry of Health or any such entity (except on governance issues, then it is the Zambian government we work directly with), so why are locals not pushing their own health campaigns to ensure they are culturally relevant and appropriate?

We have enough experience now to say we can, why aren’t we discussing our own learners, our own challenges?  Why is it enough to let the West try to solve our problems?  I don’t know.

I met a lovely man from India, also in communications (in the private sector) Ram Prased from Final Miles.  Not only was he hilarious, and honest, but he told me about how his company didn’t wait for a client to come along, that they’d tackle issues that they thought were important to them.  And maybe that’s what we need to do.  It is hard because everything in Zambia is so expensive, but I think, certainly for us at Media 365, we’re too passionate about what we do to wait for someone to ask us our honest opinion on how we think things should be done, on what should be communicated and how it should be communicated (we do have this knowledge too – not saying we’re right, but we’re just not really asked to even try it out), and just go ahead and produce what we really want to.

I’m inspired to do it because we need to start shouting about our success not, some random campaign that frankly no one I know ever heard about.  When I sort out our cashflow, believe me, we’ll be on it!  Watch this space.  And at least I met interesting people at the conference!  

In the meantime, we should keep the conversation going about VMMC – it’s an interesting one for sure.

*I refer to programme managers, meaning public health professionals

Sometimes I feel stuck in the middle. I sort of fell into what I do because I felt we (young people, my sisters etc) could make a difference in the lives of other young people – specifically young women who were getting pregnant and kicked out of school – that archaic rule that said pregnant girls could not stay in school (despite only having sex ed in the 12th grade!). So my sisters and I coupled that desire to help educate our peers with our passion for writing – or perhaps we’d watched too much Press Gang! – and formed Youth Media, soon followed up by our first publication Trendsetters.

Soon after I learnt about the enter-educate approach – using entertainment to educate your audience. It makes sense – who doesn’t love watching an entertaining programme, or reading an interesting magazine, if you can use those channels to educate people then even better. And when you think about it, they’ve been doing this for years! I learnt a lot of what I know from TV! Law and Order has taught me loads about the legal system (even if not all of it is relevant to Zambia, but you’d be surprised how much is).

Trendsetters was set up in that way. It was a magazine that appealed to young people, dealt with their issues, but also weaved in sexual and reproductive health messages into the different articles. But it wasn’t that simple, there were other factors that made young people make the risky decisions they were making. Yes education was a large part of it, but like all people, young people take many emotional, physical, spiritual and other considerations when making a decision. A huge part that we found played a roll in the harmful decisions young people made was the lack of self-esteem. The mission of Trendsetters became to empower young people to become responsible citizens that made healthy decisions in all aspects of their life.

Trendsetters became a definitive guide for being a young person in Zambia. Since we stopped publishing it (for reasons not worth mentioning here), there has been no publication that has met the needs of young people.

I eventually moved on to work for MTV – creating TV programmes to reach young people globally with HIV prevention messages. In my eight years there we produced a TV film, a couple of drama series, talk shows, documentaries, forums etc.

It was amazing to work with some of the most creative and talented people in the world. I loved every minute of it and learnt so much from them. But what frustrated me, and to some extent the creatives as well, was the clients thinking they were the creatives and telling the producers, directors, writers etc how to do their jobs.

Funnily enough, it never happened the other way. The creatives were pretty grounded with knowing they knew what they knew but were in no way experts at developing an HIV project for young people in rural towns (as an example). I soon realised that I needed to take the middleman role – understanding both sides of the coin – unfortunately it did mean I had to sacrifice what I thought was my passion and instead manage relationships and expectations.

It does get a bit frustrating. On one hand, I do understand why the HIV programme managers wanted to ensure that all the messages were delivered correctly, there has been enough examples of mass media gone wrong. But it also kind of disrespects the creatives. They need to be left alone to do their craft and what they’re good at – creating TV programs to appeal to audiences and keep them engaged and tuned in regularly.

If you put too much of the social good stuff to a script and lose the drama, no one wants to watch a pro-social drama series. But give me ER, Law and Order, Girlfriends, Grey’s Anatomy – all popular shows that have managed to weave in social health messages. It’s about finding the balance. What I’ve seen that works is creating the stories first and then slotting in the sexual health messages. Because let’s face it, sexual health is very much a part of our lives, whether we acknowledge it or not.

There is a place for the SRH programme managers and that’s as consultants. But they are not yet producers, scriptwriters or directors, so should give those experts the opportunity to do what they do, after all, they wouldn’t like it if someone less qualified that them told them what to do would they?

Until then the middlemen like myself will continue to exist, people who understand both sides of the table and ensure everyone gets what they need without frustrating the other. Or there is another way.

At Media 365 we have a process we follow to try to avoid these problems – called Blueprint 365. This is the process we follow to ensure that we know exactly what the clients what before we go and produce anything and based on what the clients tell us – so even as clients, they really need to know what they’re trying to achieve – and we develop it the best way we know how. This is why I believe in starting with the end in mind. What is it that you’re trying to do? You keep asking yourself this question at every stage of the project or programme development to make sure it’s all tying in to the end goal. The inception report that we develop outlines exactly what the key messages are, and what the process is for developing storylines, characters etc. Once these processes are signed off, we can go ahead and create the programme, giving the clients milestone moments for approval – but they also know they only have a certain number of times for feedback or they are charged for additional hours and of course we no longer guarantee the deadline will be met. The reality is that when you don’t plan properly, it is easy to change the goalposts and ultimately someone has to pay for that.

Another organisation that I admire and who definitely keeps the creatives and the programme managers separate is Hollywood Health and Society. They get all the information they need from the programme managers, or might even get in the programme managers to debrief the script writers of some of Hollywood’s biggest shows – like the ones I mentioned above – once the brief is over, the scriptwriters do their thing. The result of the debrief is only seen when the show airs. Of course this is slightly different because the development agency puts no money into the production of the show, when they are paying the production costs they do want to ensure it delivers on all the messages they paid for. But if you remember what I said in the beginning, it’s not that simple. The issues as well as humans, are much more complex than what can be told in a 44 minute programme.

Seeing the holistic picture is much more important. There is only so much a TV show is going to do, and then what? This is really where the programme managers expertise should be focused on. How do we ensure that the information learned from the TV show translates into action? What are the services to support this? If we’re telling people to get tested, where can they get tested? Are the service providers aware that there is a campaign that will push them to get tested? Is there a mechanism for the audience to find more information etc. These are not questions or issues that the scriptwriter or producer will concern themselves with – they are focussed on creating an compelling story that will make the audience think and hopefully reconsider preconceived notions. But programme managers should be thinking about these additional elements if they want their programme to be successful – and not whether the adults (who aren’t even the target audience) think that a love scene is too sexy and if a character could give a (unnatural) public service announcement in their script!

There is a way programme managers and creatives can work together in harmony and that’s by respecting each others roles and working together on the big picture. I look forward to hopefully seeing this work in 2012!