Working Worldwide

C-Change works worldwide and is implementing programs and research in Africa, Eastern Europe, and Central and South Asia.

NAMIBIA. In many PEPFAR programs, non-governmental organizations (NGOs) rely on community organizations and volunteers to reach communities with critical HIV and AIDS messages and interventions. In many cases, staff and volunteers have minimal training and access to tools for reaching communities, families, and individuals to achieve positive behavior change. C-Change is working with PEPFAR partners to build the capacity of NGOs to design and implement behavior change communication interventions that address prevention, testing, and care and support practices. C-Change will build a sustainable network of skilled people and organizations to develop and support quality communication interventions. Capacity-building strategies include formal and informal training, mentoring, and direct technical assistance to improve the effectiveness of their interventions.

MADAGASCAR. Madagascar has rich bio-diversity. However, local and national organizations have concluded that conservations efforts to sustain and maintain this bio-diversity will be offset by population growth unless the birth rate (as high as 6.9 in some areas) declines. Integration of reproductive health information into environmental activities has become a national priority. C-Change is assisting in this effort and drawing on its previous success among youth with an HIV/AIDS prevention program -- the Ankoay (eagle) program. To be certified as Ankoay status, youth groups carry out HIV/AIDS, hygiene, adolescent reproductive health and environmental activities, which they select from "best practices" activity menus. C-Change will dramatically scale up the Ankoay model with scout troops, schools, and sports team.

LESOTHO. UNAIDS predicts that seven out of every eight HIV infections in the coming year will be directly or indirectly related to multiple concurrent partnerships (MCP). C-Change is implementing research and developing activities that address the complex behavior patterns of MCP. At the request of Lesotho’s National AIDS Commission (NAC) and Ministry of Health (MOH), C-Change is assisting with the implementation and dissemination of the National HIV/AIDS Communication Strategy. C-Change is also working to identify ways to prompt community dialogues around the issue of MCP and to address the social norms that support the related behaviors. Social Surveys, a regional partner in South Africa, has completed the field work for the formative research on kinship networks and the barriers to discussing MCP that exist within communities. This research will inform messages and intervention strategies for a national BCC campaign.

ALBANIA. Albanian couples’ use of modern contraceptives is among the lowest in the European region. There is high reliance on traditional contraceptive methods and emergency contraception for family planning purposes. Abortion is also common. C-Change is using behavior change communication (BCC) to increase the use of family planning services available in the private and public sectors, to counter misconceptions about family planning interventions and methods, and to improve informed choice for contraceptives. An integrated communication program is focused on changing social norms among young men and women in Albania. It includes a media campaign to develop cutting-edge, dynamic messages for broadcast and print media and community-based interventions. The program is also working with the Albanian Institute of Media to train journalists as family planning ‘champions’ by providing information on promoting healthy reproductive behaviors and lifestyle.

EUROPE AND EURASIA. Health care consumers exercised few health care rights, responsibilities, and protections in the former Soviet Union. Since its downfall, unfortunately, few investments have been made to change the behavior of individuals and families to assume greater responsibility for their health. Additionally, since the 1990s, the profile of illnesses has changed from those related to infectious diseases to chronic (non-communicable) illnesses, e.g. diabetes, cancer, and heart disease, that are related to lifestyle choices such as alcohol, smoking, physical activity, diet, and environment. USAID charged the C-Change program to examine the region's experience in motivating health care consumers to take more responsibility for their health and determine how USAID and other donors can make their assistance more effective in this area. To this end, C-Change made field visits to three distinct geographical regions within Europe and Eurasia--Kyrgyzstan, Albania, and Armenia--and examined health consumers' perceptions and practices regarding their health care and health care services in order to provide recommendations for strengthening the effectiveness of interventions to empower health care consumers.

C-Change produced an assessment report and made a presentation on the results of the assessment at the "WHO International Conference 30th Anniversary of the Alma-Ata Declaration on Primary Health Care," in Almaty, Kazakhstan on October 15-16, 2008. This conference reaffirmed that health is a fundamental human right and that its attainment requires the action of many social and economic sectors in addition to the health sector. A key point made in the C-Change assessment was emphasized in the conference's closing statements: "Without empowerment, progress in primary health care (PHC) is not possible."