BRIDGE II Project Toolkit
BRIDGE II was a five-year (2009-2014) HIV prevention program funded by the United States Agency for International Development (USAID). The overarching goal of BRIDGE II was to promote normative behavior change and to increase HIV preventive behaviors among the adult population in Malawi. Four key objectives provided focus for achieving this goal:
- Individual perception of HIV risk and self-efficacy to prevent HIV infection strengthened,
- Communities mobilized to adopt social norms, attitudes, and values that reduce vulnerability to HIV,
- Prevention interventions strategically linked to services, and,
- Malawian institutions supported for effective leadership and coordination.
BRIDGE II was a multi-level HIV prevention program, intervening at the individual, community, district and national levels to influence norms and behavior. Key interventions included: a mass media campaign, reality radio programming, community mobilization, transformative tools, referral and linkages, and capacity building.
A documentary of the BRIDGE II program was created, in both short and long versions, which can be viewed in the YouTube playlist below.
BRIDGE II's Theoretical Foundation
Two broad theoretical perspectives informed the development of BRIDGE II interventions. The first, the Risk Perception Attitude Framework (RPA) (1), focused on two key variables – risk perception and self-efficacy beliefs – to promote HIV prevention behaviors. The second, the Social Ecological Framework (2), is built upon the principles that compelled BRIDGE II to consider and address the social milieu and structural characteristics fuelling Malawi’s epidemic.
Risk Perception Attitude (RPA) Framework
According to the Risk Perception Attitude (RPA) framework, perceptions about one’s risk for a disease are usually not sufficient to motivate people to take preventive action. However, when high risk perceptions are coupled with strong efficacy beliefs, people are motivated and able to engage in self-protective behaviors. As articulated in a number of theories of health-behavior change, the RPA framework conceptualizes perceived risk as a motivator of change, which needs to be facilitated by a belief that something can be done to avert the threat; individuals need to feel efficacious in their ability to change if change is to occur (3). The RPA was used to inform the design of the different phases of the Tasankha campaign.
The BRIDGE II project was based on the Social–Ecological framework that calls for a strategically integrated response where interventions at one level (individual, community, service, or institutional) affect drivers of HIV infection at other levels. It articulates the effect individual knowledge and self-efficacy have on behavior change, and demonstrates the importance of addressing structural or social drivers like traditional practices, integrated services, and coordinated leadership. Using this framework, the BRIDGE II Team links cutting edge research in behavior/social change theory to the practical realities of program implementation.
The Components of BRIDGE II
- Tasankha Mass Media Campaign
- CheniCheni Nchiti? Reality Radio Program
- Radio Diary Program
- National Dialogue Media Campaign
District and Community Level
- Community Mobilization
- Community Wide Events
- Transformative Tools
- Engaging People Living with HIV
- Couple Communication
- Linking People to Services
- Support for Workplace Interventions
- Capacity Building
- Collaboration and Coordination
Highlighted Program Achievements
- Over 1,000,000 people across Malawi reached with HIV prevention messages through the Tasankha media campaign.
- Over 350,000 men and women reached with HIV prevention and positive living messages through BRIDGE II Transformative Tools: The Journey of Hope Toolkit, the Planting Our Tree of Hope – Positive Prevention Toolkit, and the African Transformation Toolkit.
- Over 201 Chenicheni Nchiti? radio programs aired across 13 radio stations, and 320 Radio Diary programs aired on 16 radio stations in Malawi to engage people in dialogue about HIV and AIDS prevention, treatment, stigma, and positive living for people living with HIV and AIDS.
- More than 55,000 couples received counseling using The Happy Married Life: A Couple Counseling Guide, which helps couples to communicate better and protect themselves from HIV and AIDS, and also promotes positive living for couples affected by HIV or AIDS.
- 24 support groups for people living with HIV implemented BRIDGE II activities and conducted radio listening groups wherein they listen to and discuss the Chenicheni Nchiti? and Radio Diaries programs.
- More than 200,000 people in Malawi successfully referred for HIV testing, prevention, and treatment services.
- More than 20,000,000 male condoms distributed by trained Informal Condom Distributors over a one and a half year period.
- Over 17,736 people (10,042 men and 7,694 women) reached with HIV prevention messages and activities in their workplace.