Perceptions of the COVID-19 Vaccine and Other Adult Vaccinations in Malawi: A Qualitative Assessment.

In Malawi, various brands of the COVID-19 vaccine have been offered to the population, but factors including fear of side effects or other risks, uncertainty about benefits, and misinformation created hesitancy toward them. In early 2022, 4% of Malawians were fully vaccinated for COVID-19. Despite multiple promotion efforts, by August 2022, COVID-19 vaccination nationwide was around 15%.

"We have this, with my husband, we live in harmony": exploring the gendered decision-making matrix for malaria prevention and treatment in Nampula Province, Mozambique.

Background: Conceptualizing gender dynamics and ways of bridging entrenched gender roles will contribute to better health promotion, policy and planning. Such processes are explored in relation to malaria in Mozambique.

Methods: A multi-method, qualitative study using focus group discussions (FGDs) and in-depth interviews (IDIs) explored the perspectives of community members, leaders and stakeholders on malaria.

Association of Mass Media Communication with Contraceptive Use in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys.

Literature abounds with evidence on the effectiveness of individual mass media interventions on contraceptive use and other health behaviors. There have been, however, very few studies summarizing effect sizes of mass media health communication campaigns in sub-Saharan Africa. In this study, we used meta-analytic techniques to pool data from 47 demographic and health surveys conducted between 2005 and 2015 in 31 sub-Saharan African countries and estimate the prevalence of exposure to family planning-related mass media communication.

A Theory-Based Socioecological Model of Communication and Behavior for the Containment of the Ebola Epidemic in Liberia.

The Ebola virus disease that emerged in the West African countries of Liberia, Sierra Leone, and Guinea in 2014 created an unprecedented public health emergency that caught national and international organizations off guard. Despite available guidelines to respond to public health emergencies, coordinated action to control the disease only came almost 6 months after what is now considered the first human contact with the virus. Theory-based frameworks, like the ideation model and the pathways framework, are important tools for guiding research and the design of communication activities and strategies to effectively impact on the more likely determinants of the intended behavior.

Use of SMS-Based Surveys in the Rapid Response to the Ebola Outbreak in Liberia: Opening Community Dialogue.

During an emerging health crisis like the 2014 Ebola outbreak in West Africa, communicating with communities to learn from them and to provide timely information can be a challenge. Insight into community thinking, however, is crucial for developing appropriate communication content and strategies and for monitoring the progress of the emergency response. In November 2014, the Health Communication Capacity Collaborative partnered with GeoPoll to implement a Short Message Service (SMS)-based survey that could create a link with affected communities and help guide the communication response to Ebola.

Voluntary medical male circumcision among adolescents: a missed opportunity for HIV behavioral interventions.

Objective: Voluntary medical male circumcision (VMMC) is one of the first opportunities for adolescent males in African countries to interact with the healthcare system. This study explored the approaches used during adolescent VMMC counseling and whether these strategies maximize broader HIV prevention opportunities.

Methods: Qualitative interviews were conducted with 92 VMMC clients ages 10-19 years in South Africa (n = 36), Tanzania (n = 36), and Zimbabwe (n = 20) and 33 VMMC providers across the three countries.

A Framework for Health Communication Across the HIV Treatment Continuum.

Background: As test and treat rolls out, effective interventions are needed to address the determinants of outcomes across the HIV treatment continuum and ensure that people infected with HIV are promptly tested, initiate treatment early, adhere to treatment, and are virally suppressed. Communication approaches offer viable options for promoting relevant behaviors across the continuum.

Conceptual Framework: This article introduces a conceptual framework, which can guide the development of effective health communication interventions and activities that aim to impact behaviors across the HIV treatment continuum in low- and medium-income countries.

Regarding realities: Using photo-based projective techniques to elicit normative and alternative discourses on gender, relationships, and sexuality in Mozambique.

This paper argues for the methodological merit of photo-based projective techniques (PT) in formative HIV communication research. We used this technique in Mozambique to study multiple sexual partnerships (MSPs) and the roles of social and gender norms in promoting or discouraging these behaviours. Facilitators used ambiguous photographs and vignettes to ease adult men and women into discussions of sexual risk behaviour and HIV transmission.

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

Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. 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.

HIV Testing Among Young People Aged 16-24 in South Africa: Impact of Mass Media Communication Programs.

Knowing one's serostatus is critical in the HIV prevention, care and treatment continuum. This study examines the impact of communication programs on HIV testing in South Africa. Data came from 2204 young men and women aged 16-24 who reported to be sexually active in a population based survey.

HIV communication programs, condom use at sexual debut, and HIV infections averted in South Africa, 2005.

Background: Since the 1990s, communication programs in South Africa have promoted HIV prevention, especially condom use. Although HIV prevalence stabilized after 2000, surveys have not clarified how prevention behavior contributed to that change. We present a secondary statistical analysis of the 2005 national South African Human Sciences Research Council survey that reveals how condom use at sexual debut-which normally occurs before infection from unprotected sex-may have contributed to the reduction in HIV infection.

The effect of a joint communication campaign on multiple sex partners in Mozambique: the role of psychosocial/ideational factors.

Mozambique is one of the countries in sub-Saharan Africa most affected by the HIV epidemic. Multiple and concurrent sexual partnerships (MSP/CP) have been recognized as one of the key drivers in the rapid spread of HIV in the region. Though HIV prevention programs have been successful in increasing condom use and HIV testing, reducing the practice of MSP/CP has been more difficult.

Impacts of four communication programs on HIV testing behavior in South Africa.

This paper aims to evaluate the impacts of four communication programs on promoting HIV testing behavior among sexually active individuals in South Africa. The four programs, implemented by Johns Hopkins Health and Education in South Africa, are aimed to promote HIV prevention behaviors, as well as gender-based violence prevention, tuberculosis screening and treatment, and reduction of alcohol consumption. Launched between 2009 and 2010, they all promoted HIV testing.

Character recognition as an alternate measure of television exposure among children: findings from the Alam Simsim program in Egypt.

Evaluation of effects of mass media-based health interventions requires accurate assessments of exposure, which can be difficult to obtain when young children are the primary audience. Alam Simsim, the Egyptian version of Sesame Street, aired nationally in Egypt to teach preschoolers about numeracy, literacy, and gender-equitable attitudes. The purpose of this article was to assess the effect of the program through a first-of-its-kind household-level survey that interviewed caretakers (n = 426) and preschoolers (n = 486).

Using health education theories to explain behavior change: a cross-country analysis. 2000-2001.

Scholars within the fields of public health, health education, health promotion, and health communication look to specific theories to explain health behavior change. The purpose of this article is to critically compare four health theories and key variables within them with regard to behavior change in the area of reproductive health. Using cross-country analyses of Ghana, Nepal, and Nicaragua (data sets provided by the Center for Communication Programs, Johns Hopkins University), the authors looked at the Health Belief Model, Theory of Reasoned Action, Extended Parallel Process Model, and Social Cognitive Theory for these two defined objectives.

The psychosocial context of young adult sexual behavior in Nicaragua: looking through the gender lens.

Context: Understanding the nature and magnitude of gender differences in sexual norms among young adults in Nicaragua, and how these differences affect sexual behavior, is important for the design of reproductive health programs.

Methods: A representative cross-sectional survey was conducted in six departments in the Pacific region of Nicaragua in 1998. A total of 552 never-married women and 289 never-married men aged 15-24 were interviewed about their perceptions of social pressure to engage in premarital sex; perceived social approval of and attitudes toward premarital sex and premarital pregnancy; perceived sexual activity among peers and siblings; communication with parents on sexuality issues; the psychosocial context of sexual debut; and preferred sources of information on sexuality issues.

Impact of supervision and self-assessment on doctor-patient communication in rural Mexico.

Objective: To determine whether supervision and self-assessment activities can improve doctor-patient communication.

Setting And Participants: Six supervisors, 60 doctors in their last year of training, and 232 primary health care patients at rural health clinics in Michoacan, Mexico.

Design: The main evaluation compared post-intervention measures in control and intervention groups.