ABSTRACT
Since the first case of HIV and AIDS in Nigeria, and the epidemics continually evolved with, Nigeria having a pathetic situation of fluctuating prevalence rate. In the bid to forestall this undulating situation of HIV and AIDS prevalence rate, NACA published the National HIV and AIDS BCC Strategy. Despite the availability of the document, Nigeria still experienced fluctuated HIV prevalence rate. In 2008, NACA launched the revised HIV and AIDS NPP for Nigeria, to provide the States with minimum package of prevention activities. Drawing from the NPP, the National HIV and AIDS BCC Strategy, 2009-2014 was published with the major goal to reduce the rate of spread of HIV infection in Nigeria by 25% by year 2014. The study, therefore evaluated the implementation of this document in the prevention of HIV and AIDS in Nigeria.
The study adopted the qualitative design with a study population of thirteen HIV and AIDS implementing organisations registered with NACA in 2008. Sample size of three HIV and AIDS implementing organisations located were selected using the simple random sampling technique and the purposive sampling to select two study areas; Ogun and Oyo States of the South-west Nigeria. Face-to-face interviews were conducted on Key Informants from the three HIV and AIDS implementing organisations, selected staff and AIDS professionals to solicit information for appropriate evaluation. The face and content validity were adopted to ensure that each item on the measuring instrument had logical connection to research objectives and questions. Reliability test was carried out by administering the research instrument to two respondents who had knowledge of the document under investigation. The research instrument of unstructured interview guide was self-administered to the key Informants. Interview responses from the key Informants were transcribed and content analysed based on identified themes in the objectives and research questions of the study.
Result showed that the communication strategy employed by NACA in the implementation of the document under review met the set goal of ensuring media message harmonisation, consistency and effective. The fluctuation of HIV and AIDS prevalence rate within the period of 2011 to 2015 was addressed; stemming the rate of fluctuation from 4.1% in 2010 to 3.1% by 2015.This identified 3.1% HIV prevalence rate in Nigeria is commensurate to the set goal of NACA, as the agency met and surpassed the goal of reducing the rate of the spread of HIV infection in Nigeria by 7.6% reduction. The operational plan of the document under review provided the implementation modalities with players represented at all levels of society. The M&E process as integrated in the NNRIMS and the Operational Plan, 2007-2010 were adopted as the M&E framework.
The study concluded that the implementation of the document under investigation in the prevention of HIV and AIDS in Nigeria was justifiably successful, and the prevalence rate of HIV infection was stemmed. The study recommended that the NACA continues the dissemination of HIV and AIDS information to the Nigeria citizenry to maintain this achievement.
Keywords: Behaviour Change, Development Communication, Evaluation, Communication Strategy, Prevention.
ABBREVIATIONS
AIDS – Acquired Immune Deficiency Syndrome
ANC – Ante-Natal Clinics
ARFH – Association for Reproductiveand Family Health
ART – Anti-Retroviral Therapy
ARV – Anti-Retroviral
BCC – Behaviour Change Communication
CiSHAN – Civil Society for HIV and AIDS in Nigeria
CRH – Centre for the Right to Health
CSO – Civil Society Organization
FCSW – Female Commercial Sex Workers
FHI – Family Health International
FMOH – Federal Ministry of Health
FSW – Female Sex Workers
HEAP – HIV/AIDS Emergency Action Plan
HIV – Human Immunodeficiency Virus
IBBSS – Integrated Biological and Behavioural Surveillance Survey
ICAP – International Centre for AIDS Care and Treatment Programme
IDUs – Injecting Drug Users
LACA – Local Action Committee on AIDS
LGA – Local Government Area
NBS – National Bureau of Statistics
M&E – Monitoring and Evaluation
MSM – Men who have Sex with Men
NACA – National Agency for the Control of AIDS
NARHS – National HIV/AIDS Reproductive Health Survey
NGO – Non-Governmental Organisation
NNRIMS – Nigeria National Response Information Management System
NOP – NNRIMS Operational Plan
NPP – National Prevention Plan
OI – Opportunistic Infections
OVC – Orphans and Vulnerable Children
PATHS – Partnerships for Transforming Health Systems
PLWHA – People Living with HIV and AIDS
PMTCT – Prevention of Mother-to-Child Transmission
PWDs – People with Disabilities
SACA – State Agency for the Control of AIDS
SFH – Society for Family Health
STIs – Sexually Transmitted Infections
TB – Tuberculosis
UNAIDS – Joint United Nations Programme on HIV and AIDS
USAID – United States Agency for International Development
CHAPTER ONE
INTRODUCTION
- Background to the Study
Development communication as a purposive communication driven by the need for positive change and improvement of life, situation or something constitutes the focus of health communication. With the emergence of development communication in the 1950s (Imoh, 2007, p. 20), and the recognition to development in the early 1960s (Moemeka, 1994 p. 23); many wonder if this discourse amongst scholars has impacted on health communication particularly HIV and AIDS in Nigeria. The human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) is one of the greatest natural challenges that have become a bane and concern for humans in recent times (Ilo & Adeyemi, 2010, p. 1). The impact of the development communication discourse amongst scholars on the health communication of HIV and AIDS prevention in Nigeria calls for evaluation. Globally, HIV and AIDS epidemic has remained a major public health, social, economic and developmental challenge (Nigerian Health Review, 2006 & UNAIDS Global Report, 2010). The technical report of the 2010 national HIV Sero-prevalence Sentinel Survey reveals that:
The HIV and AIDS pandemic has continued to constitute serious health and socio economic challenges for more than two decades. In underdeveloped and developing countries, it has reversed many of the health and developmental gains over the past three decades as reflected by indices such as life expectancy at birth and infant mortality rate among others. (Federal Ministry of Health, 2010, p. 2)
According to Kanki and Adeyi (2006, p. 4), the first case of HIV and AIDS in Nigeria was reported in 1986, and the HIV and AIDS epidemics have continued to evolve in Nigeria since this period (Federal Ministry Health, 2010, p. 2). In 1991, the Federal Ministry of Health (FMOH) conducted the first sentinel sero-prevalence survey in Nigeria. In this survey, and in subsequent surveys conducted in 1993, 1999, and 2001; pregnant women attending antenatal clinics (ANCs), patients with sexually transmitted infections (STIs), patients with tuberculosis (TB), and female commercial sex workers (FCSWs) provided the population for HIV sero-prevalence estimates (Oruonye, 2011, p. 104).This first sentinel surveillance survey showed the national HIV and AIDS prevalence rate to stand at 1.8% in 1991 (FMOH, 2010, p. 2); and the prevalence rate steadily increased from 1.8% in 1991, to 3.8% in 1993, 4.5% in 1995, 5.4% in 1999, and 5.8% in 2001.
Nigeria had a grip of this undulating growth of the HIV and AIDS epidemic, with the national adult infection rate at 5.8% in 2001 but witnessed a decline to 5.0% in 2003 (FMOH, 2001; 2004). Nigeria is Africa’s most populous nation with a population estimated at well over 120 million in 2002. The National Policy on HIV and AIDS of 2003, indicate that more than 3.5 million Nigerians were infected with the virus in 2002. In the same year, HIV and AIDS epidemic killed 1.7 million people, orphaned 1.5 million children, which totalled the 3.5 million Nigerians living with the virus in 2002 (Peterson & Obileye, 2002, p. 3).
