Thesis Chapters by Amos Zikusooka
Uganda’s ABC approach to the prevention and control of HIV/AIDS has gained prominence and
garnere... more Uganda’s ABC approach to the prevention and control of HIV/AIDS has gained prominence and
garnered controversy in recent years. Several studies have praised the approach for its remarkable feat
in reducing HIV prevalence rates, while others, especially recently, have started to criticise and
question this alleged success. Studies from the Ministry of Health’s sero-behavioural survey (2005)
and UNAIDS’Aids Epidemic update (2005) have reported that despite years of dramatic success,
Uganda stands at the brink of reversed HIV/AIDS success with prevalence rates stagnating between
6-7% of the total population for the last five years. Although several researchers and development
agencies have tried to study this stagnation problem, the majority of their writing centres on issues
like; government of Uganda bias in favour of ‘AB’ of the ‘ABC,’ the U.S Government’s Emergence
Plan for Aids Relief, which critics say, emphasises certain aspects of the campaign and downplays
others, and “complacency and aids fatigue” among members of the target audiences.
While this study does not explore all the above propositions, it adds to this debate and attempts to
explain the above stagnation problem from a communications angle; looking specifically at the
efficacy of ABC messages in relation to their design, reception and impact. Who designs ABC
messages and how are they designed? How relevant are the designed messages to members of the
target audiences? How do audience members receive and react to these messages and what impact, if
any, do these messages have on their target populations? The academic impetus driving this study
emanates from Prochaska et al’s (1992) Stages of Change model and Bandura’s (1986) Social
Cognitive Theory, both of which are part and parcel of the wider health communications and
behaviour change communications.
From in-depth qualitative interviews with ABC message designers and a largely open-ended
questionnaire with the different ABC audiences, the study reports that the current stagnation in
Uganda’s HIV reduction efforts is partly, communication related. The manner in which ABC
messages are designed is not entirely reflective of the audiences’ dynamic and complex socio-cultural
environment. Specifically, the MoH’s HEPU and ACP and the UAC have not fine-tuned the ABC
model to suit the dynamic and challenging circumstances of intended receivers. The majority of
messages like; Be Responsible, Say No to Un-safe Sex…Use a Condom are too general and do not
address the current “stages of change” to which audience members lie on the behaviour change
continuum.
The study recommends that while the ABC model has had tremendous success over the years, it needs
to be fine-tuned and energized to suit new trends and circumstances of the target audiences. It needs to
go beyond raising awareness and include what Bandura (1986) calls “self-efficacy factors,” which are;
skills building, motivation, modelling, social support enhancement and confidence building. The
design of ABC messages should also be targeted, tailored and customised to suit the needs and
circumstances of various audiences at their respective stages of change.
Papers by Amos Zikusooka
Pathways to Public Relations
Chapter 14 This chapter examines significant factors that have influenced the development and app... more Chapter 14 This chapter examines significant factors that have influenced the development and application of public relations in Uganda. Particular attention was paid to ways in which public relations was implicitly or explicitly practiced and understood in Uganda. Amos Zikusooka observed that the professional term public relations in Uganda has been misconceived at three levels: the practitioner, who often has limited knowledge and understanding of what constitutes public relations, the general public, whose understanding of the field is still embedded with ubuntu cultural interpretations of public relations as everybodys business and relating well with people, and the organizational management, who often relegate public relations practitioners to the roles of publicity and media relations. The environmentalists and civil society activists raised the issue in e-print and broadcast media, particularly FM radio, by staging a Save Mabira Crusade. The activist groups involved in the campaign included local and international civil society organizations and NGO.
International Social Science Journal, 2019
The relationship between gendered power relations and sexual behaviours of adolescents has been l... more The relationship between gendered power relations and sexual behaviours of adolescents has been limitedly explored in Uganda. A 2015 cross‐sectional survey covering 16 purposively selected districts of Uganda assessed perceptions and associations of gender norms measured using the Gender Equitable Men scale and sexual behaviours among adolescents (N = 867). Findings indicate that behavioural intention to use contraception was moderately correlated with a gender equitable norm towards reproductive health and pregnancy and disease prevention among girls, r = .23 (p < .01; 95% CI .14‐.31) and boys, r = .22 (p < .01; 95% CI .12‐.31). A moderate correlation was found between self‐efficacy to use condoms and the norm towards reproductive health and pregnancy and disease prevention among girls, r = .29 (p < .01; 95% CI .20‐.37) and boys, r = .30 (p < .01; 95% CI .21‐.38). This indicates persistent inequitable gender norms that affect health service uptake among adolescents. Add...
Uganda’s ABC approach to the prevention and control of HIV/AIDS has gained prominence and garnere... more Uganda’s ABC approach to the prevention and control of HIV/AIDS has gained prominence and garnered controversy in recent years. Several studies have praised the approach for its remarkable feat in reducing HIV prevalence rates, while others, especially recently, have started to criticise and question this alleged success. Studies from the Ministry of Health’s sero-behavioural survey (2005) and UNAIDS’Aids Epidemic update (2005) have reported that despite years of dramatic success, Uganda stands at the brink of reversed HIV/AIDS success with prevalence rates stagnating between 6-7% of the total population for the last five years. Although several researchers and development agencies have tried to study this stagnation problem, the majority of their writing centres on issues like; government of Uganda bias in favour of ‘AB’ of the ‘ABC,’ the U.S Government’s Emergence Plan for Aids Relief, which critics say, emphasises certain aspects of the campaign and downplays others, and “complacency and aids fatigue” among members of the target audiences. While this study does not explore all the above propositions, it adds to this debate and attempts to explain the above stagnation problem from a communications angle; looking specifically at the efficacy of ABC messages in relation to their design, reception and impact. Who designs ABC messages and how are they designed? How relevant are the designed messages to members of the target audiences? How do audience members receive and react to these messages and what impact, if any, do these messages have on their target populations? The academic impetus driving this study emanates from Prochaska et al’s (1992) Stages of Change model and Bandura’s (1986) Social Cognitive Theory, both of which are part and parcel of the wider health communications and behaviour change communications. From in-depth qualitative interviews with ABC message designers and a largely open-ended questionnaire with the different ABC audiences, the study reports that the current stagnation in Uganda’s HIV reduction efforts is partly, communication related. The manner in which ABC messages are designed is not entirely reflective of the audiences’ dynamic and complex socio-cultural environment. Specifically, the MoH’s HEPU and ACP and the UAC have not fine-tuned the ABC model to suit the dynamic and challenging circumstances of intended receivers. The majority of messages like; Be Responsible, Say No to Un-safe Sex…Use a Condom are too general and do not address the current “stages of change” to which audience members lie on the behaviour change continuum. The study recommends that while the ABC model has had tremendous success over the years, it needs to be fine-tuned and energized to suit new trends and circumstances of the target audiences. It needs to go beyond raising awareness and include what Bandura (1986) calls “self-efficacy factors,” which are; skills building, motivation, modelling, social support enhancement and confidence building. The design of ABC messages should also be targeted, tailored and customised to suit the needs and circumstances of various audiences at their respective stages of change.
Global Journal of Health Science, Jul 11, 2018
Many adolescent girls start sexual activity early which exposes them to health risks of HIV and u... more Many adolescent girls start sexual activity early which exposes them to health risks of HIV and unplanned pregnancies. However, adolescent girls are less likely than boys to initiate discussion or demand use of condoms. Multiple sexual partnerships among girls are reported to be on the rise with eminent transactional sex and premarital relationships. The unmet need for contraception among adolescent girls is also high. A cross-sectional survey covering 16 districts in Uganda assessed the socio-cognitive factors associated with condom use, multiple sexual partnerships and contraception use among sexually active adolescent girls (N=255). There were strong associations between feeling confident to discuss contraceptive methods with a partner (OR = 9.41, 95 % CI = 3.54, 25.06), being comfortable to use contraception (OR = 30.61, 95% CI = 4.10, 228.64), discussing contraception use with someone (OR = 10.53, 95% CI = 5.61, 19.78), and contraception use. Whereas knowledge was found to have no significant relationship with service uptake, information services remain important in clearing any misconceptions and addressing any health concerns. It is imperative to explore communication factors including skills development and providing adequate health information to guide dialogue among adolescents and their key influencers.
Journal of Communication in Healthcare
Introduction: Uganda's Obulamu? campaign delivered messages relevant to life stage to address evo... more Introduction: Uganda's Obulamu? campaign delivered messages relevant to life stage to address evolving health needs of audiences at times they were likely to change behaviors. We estimated Obulamu?'s effects on HIV/AIDS, family planning, maternal and child health, tuberculosis, malaria, and nutrition behavioral outcomes. Methods: We conducted repeated cross-sectional household surveys with women, men, and children's caregivers in 2015 and 2017 in 16 districts using multi-stage probability sampling weighted by population. Eleven pre-specified outcomes were evaluated in multivariable weighted regression models. Results: Survey 1 included 2,377 households with 4,012 individuals and survey 2 included 2,398 households with 3,563 individuals. After controlling for time and potentially confounding factors, we observed notable increases among people exposed to topicspecific messages in condom use with at least one non-marital, non-cohabiting partner in the last six months; recent male circumcision; seeking tuberculosis screening/testing for self; seeking tuberculosis screening/testing for child; delivery of baby in a facility; and caregiver seeking advice or treatment for child under five years with fever. Exposure did not appear to influence knowledge of antiretroviral therapy, delay sexual debut, breastfeeding infants and all of the household's pregnant women/children less than five years sleeping under a net the night before the survey. Conclusion: Exposure to topic-specific messages was associated with improvements in six of the eleven outcomes. Across the health priority areas, we observed improvements in select HIV/AIDS, tuberculosis, and maternal and child health outcomes. We did not observe effects of exposure on select outcomes in the areas of family planning, malaria, or nutrition.
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Thesis Chapters by Amos Zikusooka
garnered controversy in recent years. Several studies have praised the approach for its remarkable feat
in reducing HIV prevalence rates, while others, especially recently, have started to criticise and
question this alleged success. Studies from the Ministry of Health’s sero-behavioural survey (2005)
and UNAIDS’Aids Epidemic update (2005) have reported that despite years of dramatic success,
Uganda stands at the brink of reversed HIV/AIDS success with prevalence rates stagnating between
6-7% of the total population for the last five years. Although several researchers and development
agencies have tried to study this stagnation problem, the majority of their writing centres on issues
like; government of Uganda bias in favour of ‘AB’ of the ‘ABC,’ the U.S Government’s Emergence
Plan for Aids Relief, which critics say, emphasises certain aspects of the campaign and downplays
others, and “complacency and aids fatigue” among members of the target audiences.
While this study does not explore all the above propositions, it adds to this debate and attempts to
explain the above stagnation problem from a communications angle; looking specifically at the
efficacy of ABC messages in relation to their design, reception and impact. Who designs ABC
messages and how are they designed? How relevant are the designed messages to members of the
target audiences? How do audience members receive and react to these messages and what impact, if
any, do these messages have on their target populations? The academic impetus driving this study
emanates from Prochaska et al’s (1992) Stages of Change model and Bandura’s (1986) Social
Cognitive Theory, both of which are part and parcel of the wider health communications and
behaviour change communications.
From in-depth qualitative interviews with ABC message designers and a largely open-ended
questionnaire with the different ABC audiences, the study reports that the current stagnation in
Uganda’s HIV reduction efforts is partly, communication related. The manner in which ABC
messages are designed is not entirely reflective of the audiences’ dynamic and complex socio-cultural
environment. Specifically, the MoH’s HEPU and ACP and the UAC have not fine-tuned the ABC
model to suit the dynamic and challenging circumstances of intended receivers. The majority of
messages like; Be Responsible, Say No to Un-safe Sex…Use a Condom are too general and do not
address the current “stages of change” to which audience members lie on the behaviour change
continuum.
The study recommends that while the ABC model has had tremendous success over the years, it needs
to be fine-tuned and energized to suit new trends and circumstances of the target audiences. It needs to
go beyond raising awareness and include what Bandura (1986) calls “self-efficacy factors,” which are;
skills building, motivation, modelling, social support enhancement and confidence building. The
design of ABC messages should also be targeted, tailored and customised to suit the needs and
circumstances of various audiences at their respective stages of change.
Papers by Amos Zikusooka
garnered controversy in recent years. Several studies have praised the approach for its remarkable feat
in reducing HIV prevalence rates, while others, especially recently, have started to criticise and
question this alleged success. Studies from the Ministry of Health’s sero-behavioural survey (2005)
and UNAIDS’Aids Epidemic update (2005) have reported that despite years of dramatic success,
Uganda stands at the brink of reversed HIV/AIDS success with prevalence rates stagnating between
6-7% of the total population for the last five years. Although several researchers and development
agencies have tried to study this stagnation problem, the majority of their writing centres on issues
like; government of Uganda bias in favour of ‘AB’ of the ‘ABC,’ the U.S Government’s Emergence
Plan for Aids Relief, which critics say, emphasises certain aspects of the campaign and downplays
others, and “complacency and aids fatigue” among members of the target audiences.
While this study does not explore all the above propositions, it adds to this debate and attempts to
explain the above stagnation problem from a communications angle; looking specifically at the
efficacy of ABC messages in relation to their design, reception and impact. Who designs ABC
messages and how are they designed? How relevant are the designed messages to members of the
target audiences? How do audience members receive and react to these messages and what impact, if
any, do these messages have on their target populations? The academic impetus driving this study
emanates from Prochaska et al’s (1992) Stages of Change model and Bandura’s (1986) Social
Cognitive Theory, both of which are part and parcel of the wider health communications and
behaviour change communications.
From in-depth qualitative interviews with ABC message designers and a largely open-ended
questionnaire with the different ABC audiences, the study reports that the current stagnation in
Uganda’s HIV reduction efforts is partly, communication related. The manner in which ABC
messages are designed is not entirely reflective of the audiences’ dynamic and complex socio-cultural
environment. Specifically, the MoH’s HEPU and ACP and the UAC have not fine-tuned the ABC
model to suit the dynamic and challenging circumstances of intended receivers. The majority of
messages like; Be Responsible, Say No to Un-safe Sex…Use a Condom are too general and do not
address the current “stages of change” to which audience members lie on the behaviour change
continuum.
The study recommends that while the ABC model has had tremendous success over the years, it needs
to be fine-tuned and energized to suit new trends and circumstances of the target audiences. It needs to
go beyond raising awareness and include what Bandura (1986) calls “self-efficacy factors,” which are;
skills building, motivation, modelling, social support enhancement and confidence building. The
design of ABC messages should also be targeted, tailored and customised to suit the needs and
circumstances of various audiences at their respective stages of change.