Behaviour change and how it relates to HIV

Posted By : Lestimes Posted Date : August 29, 2014 In Opinion Comments Off

• 0.00 / 5 5
• 1 / 5
• 2 / 5
• 3 / 5
• 4 / 5
• 5 / 5

BEHAVIOUR Change Communication (BCC) may be difficult as most of us who are involved in it can acknowledge, but we are probably barking up the wrong tree.
Most of us, even the so-called experts, have a tendency of focusing on the communication part of BCC.

However, I would really urge us to look at it differently and begin focusing on the starting BC (Behaviour Change) because I strongly feel BCC should be more about changing behaviour and not about the medium of transmitting information.

In as much as Information, Education and Communication (IEC) help inform us about things we should be informed about, it falls short of providing us with strategies and methods and the positive reinforcements or appeals that would really help and change and sustain the desirable behaviours. We should empower those that we communicate with to have a sense of self-efficacy to adopt new, health-protective behaviours.
Behaviour change is more a changing thought process that eventually affects behaviour not how much or how often we bombard people with the right information. The minute we use this new approach, we will start focusing on the behaviour theories and psychology and not so much on communication and media theories.

Over time, it has become clear that while IEC has been an effective system in raising awareness about health and HIV, it has largely been ineffective in changing behaviour. In Sub-Saharan Africa, more than 90 percent of people in the hardest hit communities report awareness of the virus but there is little evidence to demonstrate a concomitant decrease in HIV transmission or in high risk behaviours. The awareness achieved is often insubstantial and not accompanied by any skills development in individuals to protect themselves from infection. Behaviour change approaches recognise that presenting facts alone does not ensure a shift in attitude and that change may take some time to occur. BCC goes beyond an informational or scientific approach to one that combines facts and often emotional appeals.
The principles for HIV and AIDS communication campaigns include, but are not limited to:

• Realistic goals: We should ensure that we set achievable goals to our target audience, according to them. For example, we usually say sex workers should leave the streets and go sell vegetables. But in as much as this feels right to us the designers of the messages, does vegetable-selling appeal to the sex worker? We often say, “Yes, because it does not have the same risks as sex work”. But let me analyse the situation for you. We should know how much the sex worker makes per night, how much money his/her needs require, how many hours he/she works to accumulate that money and now the crucial questions; will selling vegetables in an already congested market provide for all his/her needs? Is he/she equipped with managing the cashflow? Does he/she have the time to work during the day? If we cannot answer these questions convincingly, then it may not be a good intervention for the sex worker.

•  Behaviour substitution instead of elimination: Often we want the target audience to eliminate the old behaviour instantly and we do not provide the new behaviour that would substitute the old undesirable one. For instance, we simply tell a man to stop having multiple concurrent sex partners. How about telling him to reduce the number of sexual partners gradually and methodically? Do we know why he has multiple partners? Do we know how the love situation is at his home? Do we know if he feels like a man that he is at home (in control) or does he only feel like a man in control when he buys favours on the street? I know one long-haul driver who said, “it is good to have a girlfriend in every town because then I can get a decent sleep. But if she is expecting something else, I give it to her.” Can you really change his behaviour without addressing his sleeping comforts?

•  Environmental support for behavioural change: Behaviour change cannot be done on an outreach or with a few counselling sessions. Some people need two, others need 10 so that they do not relapse into old undesirable behaviours. Counsellors, support groups, family and the community need to be in a position to help the client on a desirable path in order for the behaviour to change.

• Cost-effectiveness: Is often the culprit of why we often do a rushed job (focusing more on IEC and less on BCC). But do we budget for the whole continuum or do we only focus on IEC and communication? Often this is the case.

• Programme accessibility to intended audience and attention to legal and socio-cultural obstacles to change: Behaviour change should be done in context and also be culturally sensitive.

We often tell our young girls that they should be pure when they get married like the girls in the Bible. This is good teaching and I applaud it, but do we know how old those girls in the Bible were when they got married? A lot of them were between the ages of 12 and 18. Now the demands of life require that at the age of 18, you go to college and spend another four years then start working, maybe another two years before you get married.

With the kind of exposure and independence that a modern woman has, we should provide alternatives. When abstinence is the only sure and primary way to prevent HIV, we should be in a position to provide plan B and C where possible. One learned friend of mine said let us make sure they are alive first, then try to help them change their behaviour gradually.
By the time they know what to do, they will still be HIV negative.

- See more at: http://lestimes.com/behaviour-change-relates-hiv/#sthash.l4pTjb7x.dpuf

Koli-a-malla

23. Tsamaea hantle  (Koli-a-malla)

Khulu e siile mahe lepalapaleng,

E siile bana ba masea feela,

Ho ikhoantlella ha ba ho tsebe,

Mathata a hloele manolo holimo.

Raka le shoetsoe ke molebo,

Ea neng a re fatela o ile,

Seriti sa rona se ts’irohile,

Joale re aparetsoe ke bofifi.

Lefu la noha ke ho tsamaea e le ‘ngoe,

Hoja ena le molekane,

O ne a tla hlaba mokhosi,

Mabotho a teteane.

Pitsana e ntle ha e jele,

Batho baa fela rona rea sala,

Ho sala rona liesola,

Liesola ntho tse hlokang thuso.

Khoeli e apohetsoe ke maru,

Naleli e khanyang e re siretse,

E siretse mekunyane e e-so ho bone,

Linala li e-so ho chore tsa ho sela-sela.

Re aparetsoe ke bofifi,

Maikutlo a rona a sithabetse,

Pelo lia uba meea e faats’e,

Pelo li nts’o ha re je letho.

Batho re ithoetse meli,

Pelesa e neng e le meja,

E jara mathata a rona ka moka,

Joale e re siile feela.

Khomo boela haeno u holile,

E ea ho bo-nkhono lithakong,

U ba bolelle mathata mahlonoko,

Taba tsa faats’e lena ha li fele.

U ke o re rapelle ho ba baholo,

Khapu-khapu ea mahlohonolo,

Tle ke re lebale sohloho sena,

Seo u re sieang ho sona kajeno.

Ka Teboho C MOHLABI

12.  ‘Me Montsoali

Ka thari a mpepa,

Ka sejana a mphepa,

Ka matsoho a nkuka,

Ka lesoai a nkotlolla,

Le ‘na ke be motho.

Ka manala a nphatela,

Ka likhapha a nthapella,

Ka ho hlobaela a nkoietsa,

Ka litsieane a ntefella,

Sekolong ho rua tsebo.

Ka ho itima a mphomosetsa,

Ka motlopotlo a mphelisa,

Ka tlhatsuo a ntlhohonolofatsa,

Ka ho ntheha lebitso ka itseba,

Lefaats’e le metsoalle ea ntseba.

Ka lits’omo a nthuta,

Ka lipale a nkelellisoa,

Ka maele a nkeletsa,

Ka metlae a nthabisa,

Ke tle ke phelisane le ba bang.

Ke monna ke holile joale,

Ke litelu ke liphaka-phaka,

Ke hopola tsa bonyaneng,

Ke li bona joalo ka ts’omo,

Chee! ke li fetile ka thuso ea ‘me.

‘Me o nthapelle ho Molimo,

Nthapelise ke phele,

Ke ka tlholeho ke o sotlileng,

Hoba marabe o jeoa ke bana,

Oona o sale ele mokukutoane.

Ka Teboho C MOHLABI

Lesotho Inauguration 2015 part 2

Is your Company a Frankenstein?

When a company is managed properly, a sense of humanity prevails; after all, companies are human creations, run by humans. But far too many firms operate like some terrifying Frankenstein-style mashup of a human being. The result scares customers, as it should. If you spot a company like this – whether you are a customer or employee – running away may be your best move.

The head doesn't know what the body is doing. 
In department after department, day-to-day activities are grossly out of touch with the supposed strategy of the firm. The result is a flailing creature, wobbling down the road, wasting time and energy, and scaring the heck out of the "local townspeople."
Management says one thing, but rewards far different behaviors. They say: we're all about customers. They reward: sell, sell, sell.
As I write these words, there are four days left in the month. Any company that tells its sales force to "go all out" to deliver sales before the end of the month is making a conscious decision to ignore customer needs in favor of company profits. That's scary, because if you hurt customers, they tend to – you guessed it – run away.

The voice isn't genuine. 
An organization focused on the needs of other people speaks with a genuine human voice. But a company obsessed with sales quotas and pushing products sounds like a creature without a brain. Its attempts to sound human are jarring and off-putting.
"If 250,000 people like our Facebook page, then one lucky customer will win $1,250," roars the ugly creature. What's in it for the other 249,999?

The creature has no heart. 
Companies are people serving people. Each of us have needs and emotions. Many of us have other human beings who depend upon us. But too many business decisions ignore – or minimize – human needs, and reduce situations down to nothing more than numbers.
The best organizations both foster loyalty among their employees and offer loyalty in return. When times get tough, they band together instead of attacking each other (yes, laying off a loyal and capable employee is like attacking your own self.)
Heart is what drives people forward. A company without a heart will never compete as successfully as one whose heart is beating strongly.

Feedback gets ignored. 
A Frankenstein company fears feedback; it just sounds like angry people chasing the creature down the road. Such a firm thinks feedback equals complaints, and "complaints waste time."
Wrong, ugly monster.
The reality is that feedback tells a company how to get stronger and more competitive. It's like free advice. The faster and better a company gets at acting on feedback, the more human it will seem. The simplest definition of corporate intelligence is having something of value to say, and knowing what will be of value to different people.
In previous decades, Frankenstein companies could lumber through the world, because many firms were just too large to overcome these challenges. We accepted such subhuman behavior from companies.
Today, technology makes it possible to aim much higher, and social media creates a compelling reason to do so, because individuals are so quick to spread the word about companies that frighten them.
This Halloween, ditch the corporate monsters.

If you want to hear more from me, just click the Follow button below. You can also download my free guides at Kasanoff.com, or read my book with Michael Hinshaw Smart Customers, Stupid Companies. On Twitter, I'm @NowPossible.

5 Compelling Reasons Why Marriage Wasn't Meant to Be Monogamous

By now, you've probably heard about Jada Pinkett Smith's recent interview that many people took to mean that she might be cool with the famous Fresh Prince of Bel-Air getting some extra fresh on the side.

And although Ms. Smith clarified her comments, the online world is still buzzing about the topic of monogamy and open marriage.

Related: 15 ways women are ruining their sex lives

While personally I can barely summon the energy to have sex with my own husband (three kids in four years has that effect on some of us, ok?) and the thought of the work it would require to not only embark on, but carry out, an actual affair just makes me tired, clearly not all marriages are monogamous.

In The Little Book of Heartbreak: Love Gone Wrong Through the Ages (Pengiun Press, 2013), author Meghan Laslocky gives a little background on the history of marriage and provides some compelling evidence in support of "debunking monogamy."

1. Marriage as we know it is a fairly recent invention.

In the history of marriage, the concept of marrying for love is a relatively new one; traditionally marriage was constructed as more of a business proposition of sorts, with each partner benefiting, usually socially, politically, or financially from the union. It wasn't until the 18th century Enlightenment that the idea of marrying for love became popular.

2. Doing it like they do on the discovery channel = not monogamous.

 In her book, Laslocky points out that in the animal kingdom, species that are thought to be monogamous are actually, usually not. In fact, of the 4,000 mammals in the animal kingdom, she states that less than 3% are monogamous to start out-and that monogamy is often in appearance only. For instance, a pair of "lovebirds?" Well, usually one of `em is indulging another lovebird on the side.

3. Couples that reproduce together, stay together.

She goes on to explain that many "monogamous" mammals in the animal world, especially the lovebirds, practice "social monogamy"-that is, raising a family with one mate while enjoying a romantic rendezvous every now and then. Scientists conclude such behavior is helpful to ensuring survival of the species, as the males spread their seed around for all to enjoy while the females get the help they need to raise all those hatchlings. Which, as she points out, puts another whole meaning to that "Are You My Mother" book we all know and love, right?

4. Society rules?

Laslocky's book also cited a study that showed that fewer than half of all modern societies forbid extramarital relationships within a marriage; in fact, many cultures don't see affairs or flings as deal-breakers to a successful marriage.

5. To each his or her own.

A 20-year long study of 164 couples, half of whom were not monogamous found that the spouses reported no difference in their perceived happiness nor was the rate of divorce any higher in the "open" marriages.

However, in the end, I'm just not buying it..

While this all makes for an interesting conversation (especially if you drop these little tidbits to your husband while eating B.L.T. pizza with him, although a word of warning-he probably will choke on that piece of bacon), I have to say that I'm just not buying it. Sure, it may be "natural" in the animal world for mates to fool around on each other, but it's also "natural" for some animals to eat their own offspring. Obviously, we have all evolved a bit to overcome some of our primitive urges and instincts.

So, sorry Mother Nature, but I'm just going to have to disagree with you on this one.

- By Chaunie Brusie 

Is Multiple and Concurrent Sexual Partnerships really a Cultural and or a Traditional Practice among Basotho?

One fact that we cannot deny is that Multiple and Concurrent Sexual Partnerships is one of the biggest drivers of HIV spread in Lesotho.  What I have a problem with is when it is called a traditional or a cultural practice.  Those of you who have been with me in fora where this kind of topics are discussed will bare me witness that I oppose it in the strongest terms.

Traditionally, there were contexts where a man could have sexual relations with a woman or women other than his wife, but this were sanctioned or regulated.  Look at the following contexts.

Traditional Contexts:

Ho nyalloa lebota –  This is where a family which does not have a boy marry a girl so that the children she fathers will be children of that family.  Lobola is paid, a girl is married, and a man (married or unmarried where the unmarried has been initiated) has relations with that girl for the purpose of fathering a child or children.  I am not sure in the case of the married man if his wife knew, but I want to believe it was made with the utmost discretion for her not to know.

Ho nyalloa lebitla – The same context as above but the difference here is that the family did have a boy and the boy dies before he could marry.  The girls who is married is called the wife of the deceased man and the children fathered are that of a deceased man.

Ho senya ngoana –  Basotho believed in proper spacing of children and if a woman was still breastfeeding, her husband was not allowed to have relations with her or even sleep in the same room with her.  Such a man would be allowed to have relation with a woman in the village or nearby village under strict sanctions of the elders (remember that he was not sleeping around with whomever he pleased but a woman sanctioned by those who had authority to do so).  Also remember that a child could be breastfed up to 3 or 4 years.

Ho ephola monna ea hlokang bana – If a man was impotent and could not give his wife children, a man of good standing and good genes, was selected by those who had authority to do so and he would biologically father a child or children for that family.  He did not have any ties to the child or woman and could never claim it as his own.  (Remember when there are no children in a household, it is still solely blamed on to a woman?  It is because a man could traditionally be covered in this manner if it was him with the challenge of fathering babies.)

Ho kenela – When an elder brother died before he could have children or if the wife was vulnerable and needed to be taken care of, the younger brother was expected to father children for his late brother.  If the younger brother was married, the same discreet methods to sneak him in to his brother’s household were used but if he was not married, he was expected to marry his late brother’s wife.   

Ho nyala sethepu – Though this is not traditionally a Basotho practice if you look at the literature far back, it became a norm among Basotho (have you noticed that Bathepu are Nguni and not Sotho and this kind of polygamous marriage is called Sethepu?)

Well even so, a man could not just go propose to a woman and marry her as his second wife.  Sethepu was sanctioned by the elder wife and she is the one who used to choose the second wife for her husband.  The first wife gained matriarchal powers by controlling the chores of the household, raising the babies from the second wife if she chose and drawing a time table about when the man of the house could be with which wife.  Sometimes it happened because the matriarch needed more children for the household and was not in a position to provide them herself.  It could be that she is barren or is too old to have children herself.  (do you remember Sarah and Hagar in the Old Testament?)

Ringing similarities about all the contexts above are:

·         Such relations were sanctioned by the elders or people who were authorised to do so and not the man engaging in them.

·         The man who is involved in these relations did not have his own discretion about who, to have those relations with.

·         It was always for a purpose other than the personal pleasures of such a man.

·         “Mosali ke oa likhomo” which means that all children born to a married woman are the children of the husband and of the family no matter if he biologically fathered them or not.

I must acknowledge that there has always been a practice (that has always and still is frowned upon) of Ho boka.  Since it was and still is frowned upon, can we honestly call it a culture or traditional practice? I think not.  Ho boka is a practice where a man acts on the affectionate feelings he has for a woman that he has not married.  You can simply call it adultery because the English meaning that is closest is just that.

Ho boka is not sanctioned by elders, it is at the discretion of the people doing it alone and the purpose is always for enriching one individual and pleasure of another (or both people).

In essence what is happening now that we have a tendency to wrongly defend as culture or tradition is Ho boka and that is wrong?

When the missionaries came to Lesotho with their new traditions, cultures and religion, a lot of the traditional norms highlighted above were gotten rid of and this created a socio-cultural vacuum.

Ho boka then became more prominent as the authorities that used to regulated social norms were gotten rid of.  Ho boka became even worse when men went to work for long periods in the mines in South Africa in order to pay hut tax and to provide the new western creature comforts that they never had or knew in the past.

By: Teboho C MOHLABI