26 The college runs a small medical clinic that provides general ambulatory services. According to the nursing sister at the LCE health center (personal communication 24/09/2013), the clinic is fully accredited to provide HIV testing and counseling, anti-retroviral treatment and related services. The satellite campus does not have a clinic. As a result learners are oriented on HIV and AIDS issues and given print IEC materials (produced by the Population Services
International and Phela Health and Development Communications) during their one-week orientation provided at the main campus at the beginning of every academic year.
1.10 THE HEALTH EDUCATION AND PROMOTION SERVICES IN
27 According to the MoH (2005), the Health Education Division in Lesotho was established in 1972 by a British medical consultant as merely an educational wing (known as Health
Education Unit) of the Mother and Child Health and Family Planning Programme at Tšakholo Health Center in the Mafeteng District. When the government realised that other programmes could benefit from similar services, this unit’s scope was increased and in 1981 it was
promoted to become a division and was charged with the responsibility of planning and management of national health education and health promotion activities.
According to the MoHSW Policy (2003: 7), HED is committed to achieving equity in empowering communities and individuals to make healthy choices and also to ensure that public policies facilitate those choices. It also commits to empower people to exercise their rights and responsibilities as well as help in the shaping of their environment into systems and policies that are conducive to health and wellbeing, because it is regarded as a strategy for the promotion of good health. It is also used as a tool for providing education on existing health problems and the methods of controlling them; that is why HED acts as a mouthpiece for all other programmes in providing education on health issues. The fact that many partners are developing and implementing BCC related interventions that have not been centrally audited by MoHSW, has led to uncoordinated, and sometimes conflicting, messages on health related issues. To control this, in 2011 HED established a coordinating body called the Behaviour Change Communication Messages Clearing Warehouse Committee (MoH: 2005).
This Committee is intended to provide technical guidance in the development of all BCC messages and to ensure that all messages disseminated in the country are accurate and do not send out unintentional messages. It is made up of HED, Disease Control Division (DCD), Family Health Division (FHD), United Nations Agencies like UNICEF, WHO and the United Nations Population Fund (UNFP) as well as private organizations such as ALAFA, PSI, Lesotho, Christian Health Association of Lesotho, Lesotho Planned Parenthood Association and Phela Health and Development Communications. The Committee is guided by Standard Operating Procedures (SOPs) and is scheduled to meet twice a month, or as often as required,
28 under the chairmanship of the office of the Director General of Health Services assisted by HED and the secretariat of DCD.
According to MoH (2005), the Committee aims to ensure the dissemination of coordinated and accurate messages, at national, district and community level, on HIV prevention,
treatment, care and support, mitigation and impact; to promote evidence-based research as a prerequisite for the development of BCC interventions and; to provide technical guidance on mainstreaming of information flow. The SOPs further indicate that the committee’s specific roles are to: review all final IEC materials developed by stakeholders before their printing and dissemination; update BCC focal points through an appropriate knowledge management system and mechanism countrywide; provide technical guidance to partners in the development of BCC messages on HIV whenever needs arise; develop and share BCC messages and guidelines with all stakeholders in the country; sensitize all stakeholders about the existence of the clearing warehouse and the monitoring and controlling of HIV and AIDS information flow in country.
This study, therefore, directly addresses the commitments and aims of this committee. It is hoped to enhance the committee’s work by providing a theoretical framework for analyzing BCC messages and contribute to the committee’s work by presenting in-depth feedback on the case study of tertiary level student responses to IEC text materials and images.
Guidelines that govern the BCC committee, as contained in the SOPs, show that it was mandated to see to it that a secretariat is put into place before its operations commence, as all messages are to be submitted to the secretariat at least three working days before its sitting.
Also, all cleared messages are to be returned to the owners within three working days. The SOPs highlight that once misleading information is found to have been disseminated through media channels, radio, television, posters and brochures for example, an immediate stoppage of dissemination is pronounced and such material is recalled. Following this, a corrected and approved version conveying the same condemned message is provided. Issues that are scrutinized include, among others: clarity, accuracy, and relevance of the information.
29 After the committee has reviewed and commented on the materials, the producer is expected to incorporate the comments and to bring it back to the committee for clearance. Acceptable materials are endorsed with the HED logo and can then be circulated in the country.
According to the MoH (2005) the mandate of HED also includes: development of a comprehensive health education policy; steering the planning, management and control of national health promotion activities; producing and distributing researched IEC materials;
fostering social education, political actions and healthy lifestyles; facilitating communication in support of health to monitor progress and impact of education, including IEC materials, and advocating for agenda setting for health promotion programmes at all levels. In health
facilities HED focuses on patient health, in workplaces it focuses on occupational health, and with school health programmes it focuses on learners and community health. These materials are not only meant to educate people about the HI virus, how it is spread and how it can be avoided, but they are also meant to educate them on how they can accomplish and maintain high self-efficacy against HIV infection.
In 2004 Kimaryo et al. (2004) advised the government of Lesotho to use print IEC materials to fight HIV, because these materials are able to reach masses of people at the same time, to illustrate information given in one-on-one settings or serve as reference to remind people of information they received earlier. They also indicated that IEC materials can be used to teach people skills by providing hands-on experience or by illustrating step-by-step approaches.
That is, IEC materials should give people complete information so that they can become knowledgeable and be able to make informed choices. Thus, it is argued that effective IEC materials can positively influence peoples’ attitudes, perceptions and help build their self- efficacy and decision-making processes towards avoiding risky behaviour and leading healthy lifestyles. IEC materials are also expected to change peoples’ values and to promote
transformational learning towards the prevailing HIV scourge.
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