Advocacy, communication and social mobilization (ACSM): your ally - - PowerPoint PPT Presentation

Advocacy, communication and social mobilization (ACSM): your ally in TB prevention and care efforts

Amie Bishop, MSW, MPH PATH Dubrovnik, 28 May 2009

Challenges to TB Control in the Region

• Socioeconomic crises-past and

present

• Inefficient services and poor

funding

• Slow adoption of DOTS
• Disaffected health care staff
• Poor drug use practices

(providers and patients); emergence of MDR-TB

• Lack of effective educational

strategies

• HIV epidemic emerging
• Stigma and discrimination
• Weak or struggling civil society-

TB patients have few advocates

• Poor social support for

vulnerable populations

All of these can be addressed by ACSM!

What is ACSM?

Advocacy (A)

• Building political commitment

and influencing policymakers to ensure sustainable financial support, policies, and other resources

Example: advocacy to ensure ministerial orders, funding allocations, and policies support the WHO European Regional Plan to Stop TB

What is ACSM (2)

Communication (C)

• Improving TB-related

awareness, knowledge and attitudes and encouraging positive behavior change to increase the likelihood

• f early detection and

treatment success.

• Improving interpersonal

communication and counseling between patients and program providers.

Communication examples

Training providers

• n communication

skills to improve client-provider relationships

ACSM (3)

Social Mobilization (SM)

• Community engagement and

action to ensure sustainability, self-reliance, and integration of TB control into overall community priorities.

• Influencing social norms and

creating more favorable environments in which affected communities can have a role in guiding TB control interventions.[1]

[1] World Health Organization. Advocacy, Communication, and Social Mobilization (ACSM) for Tuberculosis Control: A Handbook for Country

• Programs. WHO/HTM/STB; 2007.

Stigma and discrimination

• Stigma greatest barrier

to care for people with HIV and/or TB – HIV associated with drug use, sex work – TB associated with prisons, alcoholism, homelessness

• Providers unsupported,

lack information

ACSM is interlinked

A C SM

Challenges

• Socioeconomic crises-past and present
• Inefficient services and poor funding
• Slow adoption of DOTS
• Disaffected health care staff
• Poor drug use practices (providers and

patients); emergence of MDR-TB

• Lack of effective educational strategies
• HIV epidemic emerging
• Stigma and discrimination
• Weak or struggling civil society-TB patients

have few advocates

• Poor social support for vulnerable populations

Advocacy

Communication

Social Mobilization

Strategic Planning and Evaluation

Satisfaction with Doctors' Explanation of TB Treatment Options

N=312 (10 facilities in Kyiv and Donetsk, 2004) 37% 15% 22% 26% 51% 34% 15% 1% 0% 10% 20% 30% 40% 50% 60%

Donetsk Kyiv

Very dissatisfied Dissatisfied Satisfied Very satisfied

ACSM objectives must be:

• Data driven (needs

assessments through surveys, interviews, focus groups,

• bservation, etc)
• Measurable and

achievable

• Tied to overall TB

control program goals

The Power of ACSM

• Mobilizing political

commitment and resources for TB.

• Improving case-

finding and treatment adherence.

• Combating stigma

and discrimination.

• Empowering people

affected by TB.

Amie Bishop, MSW, MPH abishop@path.org

www.path.org