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Case Study of the Psi Social Marketing Program in Cameroon

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Case Study of the Psi Social Marketing Program in Cameroon CASE STUDY OF THE PSI SOCIAL MARKETING PROGRAM IN CAMEROON POPTECH Report No. 97-113-061 May 1998 by Alan Handyside Regina Dennis Alpha Sy Prepared for Edited and Produced by U.S. Agency for International Development Population Technical Assistance Project Bureau for Global Programs 1611 North Kent Street, Suite 508 Office of Population Arlington, VA 22209 USA Contract No. CCP-3024-Q-00-3012 Phone: 703/247-8630 Project No. 936-3024 Fax: 703/247-8640 E-mail: [email protected] The observations, conclusions, and recommendations set forth in this document are those of the authors alone and do not represent the views or opinions of POPTECH, BHM International, The Futures Group International, or the staffs of these organizations. TABLE OF CONTENTS LIST OF ABBREVIATIONS .............................................................................................................. v EXECUTIVE SUMMARY............................................................................................................... vii LESSONS LEARNED........................................................................................................................xv 1. BACKGROUND ON AIDS................................................................................................... 1 1.1 Methodology............................................................................................................... 1 1.2 AIDS Worldwide........................................................................................................ 2 1.3 African Seroprevalence ................................................................................................2 1.4 African Growth........................................................................................................... 6 1.5 AIDS Per Capita ......................................................................................................... 8 2. BACKGROUND ON CAMEROON.................................................................................... 11 2.1 People......................................................................................................................... 11 2.2 Economy and Political Perspectives.......................................................................... 11 2.3 Demographics ............................................................................................................ 13 2.4 Background on the Health Sector from 1985 to 1996 .............................................. 14 2.5 Cameroon Government Health Policy .......................................................................15 2.5.1....................................................................................................Financial Support 15 2.5.2...............................................................................................Donor Contributions 16 2.6 Organizational Structure of the Ministry of Public Health....................................... 16 2.6.1.............................................................................. Structure of the AIDS Program 17 2.7 MOPH HIV/AIDS Policy.......................................................................................... 19 2.7.1...Psychosocial Rights of HIV-Infected Persons and Their Close Associates 20 3. EPIDEMIOLOGICAL ASPECTS OF HIV/AIDS IN CAMEROON.................................. 23 3.1 Seroprevalence among Pregnant Women ................................................................. 24 3.1.1............................................Seroprevalence of Syphilis among Pregnant Women 25 3.1.2........................................ Epidemiology of Other Sexually Transmitted Diseases 26 3.2 Blood Donors............................................................................................................. 26 1 3.3 High-Risk Groups...................................................................................................... 28 3.3.1.................................................................................Studies among Armed Forces 28 3.3.2.......................................................................................Studies among Prostitutes 29 3.3.3.....................................................................Studies among Tuberculosis Patients 30 3.4 Regional Information................................................................................................. 30 3.4.1................................................. North, Extreme North, and Adamaoua Provinces 31 3.5 Official Reporting of AIDS Cases in Cameroon, 1985 to 1996............................... 32 3.6 Comparison between Official Statistics and Those Collected in the Provinces.................................................................................................................... 35 3.7 Summary of Mortality Related to AIDS ................................................................... 36 3.8 Summary.................................................................................................................... 37 4. POPULATION SERVICES INTERNATIONAL................................................................. 39 4.1 History........................................................................................................................ 39 4.2 Social Marketing Project Funding............................................................................. 43 4.3 Sales ........................................................................................................................... 44 4.4 Distribution ................................................................................................................ 47 5. BEHAVIOR CHANGE ......................................................................................................... 49 5.1 Demographic and Health Survey............................................................................... 49 5.2 High-Risk Groups...................................................................................................... 49 5.2.1............................................................................................... Knowledge of AIDS 49 5.2.2........................................................................................................... Condom Use 50 5.2.3.................................................................................................Number of Partners 52 5.2.4...............................................................................Sexually Transmitted Diseases 53 6. CAMEROON COMPARED TO OTHER COUNTRIES.................................................... 57 6.1 Condom Sales............................................................................................................ 57 6.2 Condoms per Capita .................................................................................................. 58 7. FAMILY PLANNING........................................................................................................... 59 7.1 Family Planning Background.................................................................................... 59 7.2 Family Planning Policies........................................................................................... 59 2 7.3 Cameroon versus Other Population Services International Markets........................ 60 8. OTHER PRODUCTS ............................................................................................................ 63 8.1 Sexually Transmitted Disease Kit ............................................................................. 63 8.2 Oral Rehydration Salts............................................................................................... 63 9. OTHER ORGANIZATIONS ................................................................................................ 65 9.1 The Ministry of Public Health and Its Relationship with Nongovernmental Organizations............................................................................................................. 65 9.2 Nongovernmental Organizations............................................................................... 65 9.2.1 ..........................................................The Society of Women and AIDs in Africa 65 9.2.2.....................................................The Association of Single Brothers and Sisters 67 9.2.3.................................................................................African Women and Progress 68 9.2.4............................................ Cameroon National Association for Family Welfare 68 9.2.5....................................................................................... Cameroon Health Project 68 9.2.6...............................................Cooperative for Assistance and Relief Everywhere 69 9.2.7........................................................................ Women, Health, and Development 69 9.2.8..................................... Institute for Research and the Study of Human Behavior 70 9.2.9...................................................................................................... "Caution AIDS" 70 9.2.10 Commercial Sex Workers .............................................................................. 70 9.3 Religious Health Facilities......................................................................................... 72 9.3.1...........................Federation des Eglises et Missions Evangeliques du Cameroun 72 9.3.2..................................................................... Catholic Missionary
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