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Development action with informed and engaged societies
The Communication Initiative
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
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Evidence: Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique

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Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique

Editor's note: Click here for a summary of this evaluation on The CI site.

Name(s) of author(s)?:

Maria Elena Figueroa, Patricia Poppe, Maria Carrasco, Maria Dirce Pinho, Felisberto Massingue, Maria Tanque, and Amata Kwizera

Who published this paper, article, book (chapter) or other publication?:

Journal of Health Communication International Perspectives, 21:5, 554-563, DOI:10.1080/10810730.2015.1114050.

What are the best extracts that highlight the evidence for the impact of a communication for development, social change, behaviour change, public engagement, or informed citizen strategy on a development issue and priority?:

The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009–2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions (Tchova Tchova Histórias de Vida: Diálogos Comunitários (TTHV), which translates as Push Forward Life Stories: Community Dialogues), the program sparked critical thinking and open dialogue among participants. The program had two main components: (1) facilitated community dialogues (TTHV sessions) based on the African Transformation gender tool (Underwood, Brown, Sherard, & Abdur-Rahman, 2011) but adapted to HIV/AIDS prevention (Pinho & Poppe, 2009) and (2) a Tchova Tchova radio magazine. The HIV/AIDS prevention gender tool used principles of adult education proposed by Freire's empowerment education (Freire & Ramos, 1974), which emphasizes that knowledge comes not from experts but rather from collective dialogue and from within. The tool included nine video and written profiles of real Mozambican trendsetters, known in the literature as positive deviants (Sternin & Choo, 2000; Tuhus-Dubrow, 2009). In the profiles, the men, women, and couples tell their stories of how they overcame gender, cultural, and social barriers, such as domestic violence, alcohol abuse, and the subordination of women, to make positive changes in their lives that impacted HIV treatment and prevention. This article measures the program's effectiveness based on a sample of 462 participants and 453 nonparticipants, 51% of whom were women and 49% of whom were men. As a result of the TTHV sessions, participants were statistically more likely than non-participants to have positive gender attitudes (64% vs 35%), positive non-stigmatizing attitudes about HIV (52% vs. 30%), were more likely to report discussion with their partner about HIV (88% vs. 72%), and were less likely to report have multiple sexual partners (2% vs. 7%), all of which are known to predict lower HIV transmission rates.

To which development issue does this evidence and impact data relate?:

Gender equity, HIV prevention

To which strategic approach(es) does the evidence and impact data relate?:

Community dialogue, radio reality shows

What research methodology (ies) was/were used to produce this evidence and impact data?:

Post-only population-based sample survey of 462 participants and 453 nonparticipants in two provinces. The sampling of participants (intervention group) followed two stages. In the first stage a random sample of program districts was selected, and in the second stage a systematic random sample of men and women, in equal numbers, who had participated in the TTHV sessions was drawn from the selected districts. Because participants in TTHV may have been self-selected individuals who agreed to participate, the sample of nonparticipants (control group) was drawn from a list of men and women who had agreed to participate in the next round of TTHV sessions but had not done so at the time of the survey. The analysis compared outcomes between the intervention and control groups using analysis of variance for continuous variables, such as number of shared household tasks, and cross-tabulations for binary variables. F-statistics for analysis of variance and chi-square statistics for cross-tabulations were used to assess whether the identified differences were statistically significant (p < .05). Multivariate regression analysis was used to control for potential confounders and to account for sample differences between the intervention and the control groups. Goodness-of-fit statistics were reported for each regression model.

What is the URL to access this paper, article, book (chapter) or other publication?:

https://www.tandfonline.com/doi/abs/10.1080/10810730.2015.1114050

Why was this research evidence found to be useful?:

It justifies the use of community-based dialogue to produce normative change in gender and HIV-related attitudes and related behaviors in the household, as well as to reduce the prevalence of risky sexual behavior (having multiple sexual partners).

Participating organisations in the Global Alliance for Social and Behaviour Change - Building Informed and Engaged Societies were asked to identify, in their opinion, the 5 most compelling research and evaluation studies that demonstrate the direct impact of this field of work on a major development issue. This was one of the nominees. For the full compiled list, please click here. For the compilation of the key impact data across all research evidence identified, please click here.