5) Description of health product/service offering: The project addresses HIV and AIDS by tackling stigma and discrimination at youth and community levels. Through screening of documentary films made by African filmmakers with facilitators trained in how to use film to create personal and informative discussions, people are more able to understand how HIV and AIDS affects their lives. Because the films are about real people facing real situations, and not didactic, the audience is provided space to ask for information that they can relate to and want to have. Thus information about prevention, stigma, gender, and treatment leads to people with normally little access to this information to understand and act upon the health care options available. This includes voluntary testing and counselling and access to preventative measures as well as anti-retroviral treatment. There are 38 short and documentary films, plus a Facilitators Guide, 18 local language versions, and a facilitator training programme in 10 countries of Southern Africa. The films have been screened by more than 20 broadcasters around the world, and at over 170 film festivals on all continents.

6) Description of innovation: Most documentaries are screened by television, very few are shown in dedicated screenings to multiple audience groups in both rural and urban areas. Many people in Southern Africa do not have access to television. Steps for the Future uses both television broadcast as well as facilitated non- broadcast screenings that reach groups of people at schools, community groups, HIV and AIDS support groups, prisons, police, army, mines, and other at-risk and marginalised population groups. We have developed a unique methodology and curriculum for training facilitators in how to use film as a tool for discussion, as well as for training trainers in this skill. This allows further in-country training to take place with support from the STEPS training team. The screenings are mostly conducted using mobile video cinemas, and have been taking place in Lesotho, Namibia, Mozambique, Malawi, South Africa, Zambia, Zimbabwe, with planned screenings in Botswana and Swaziland this year. The films have been versioned into 18 different local language groups providing access to people throughout the region, literate or illiterate, in remote as well as urban areas. In Lesotho we have developed a mobile video cinema system using self- generated power from a 4 wheel drive vehicle to screen the films in areas that have no electricity.

7) Operational model: We provide the documentary films in local languages with support material and guides on how to facilitate discussions using the films. This involves training facilitators through partnerships with organisations and individuals.

8) Human resources: The Steps for the Future core team comprises six people working in training distribution, finance and management. Twelve trainers of trainers from five countries have graduated, with a further twelve to be trained from other countries in the region this year. More than 300 people have been trained as facilitators in ten countries, with planning for another 800 in the next few years. Many others are involved in support functions. The GIPA principle (greater involvement of people living with HIV and AIDS) is followed, so that most of the trainers and many of the facilitators are HIV+.

9) Key operational partnerships: Partnership is central in our work, as we are a small organisation, but with resources that can be used for people throughout Southern Africa, as well as other parts of the world. We have strategic partners in countries in the region that screen the films, as well as to train more people in facilitation techniques. These partnerships extend further at national level, and so include businesses, mining companies, army, police, local HIV and AIDS support groups, youth groups, schools, tertiary institutions, NGOs, government departments, embassies.

10) Financial Sustainability

          • Fees charged to clients?: Yes

          • How do you assure affordability?: Institutions and organisations that can afford to purchase the films on DVD or VHS provide some additional income to support copies or services to groups that can't afford this. Trainers in other countries can charge for the workshops they give on facilitator training at a regionally determined level, again depending on the ability of the requesting organisation to finance this. There has been a solid funding base to provide the services to people who cannot afford to pay.

          • Earned incomes as a percentage of operating costs: 5%

          • Other funding sources: As the programme involves mostly low-income groups it is difficult to make it self-sustainable. Development agencies are requested for funding in order to support screenings of films, local language versions, as well as training of facilitators.

          • Strategy for long-term sustainability: To train as many trainers as possible employed by other organisations working in HIV and AIDS so that the programme can be run in a decentralised way. The films are distributed for sales through agreement with distributors worldwide.

11) Current and Future Impact

          • Total number of clients: million+

          • Clients in the past year: 200,000+

          • Percentage of low-income clients: 90%

          • Impact: It is very difficult to know how many people exactly have benefited as many screenings and use of the film are done by a wide group of people and organisations who have bought the fims or been given them. The impact, observed and analysed by independent evaluators, have shown that there is a direct effect through change of attitude towards people who are HIV+ or living with AIDS, through greater access to information, through voluntarily testing and/or getting access to treatment, and sexual behaviour change.

          • Overall "market": Very hard to quantify - some films are still being shown by broadcasters. Non-broadcast usage also depends on understanding how films can be used as a resource, and this spreads exponentially as more facilitators and trainers are trained. There is interest from other areas affected by HIV and AIDS, such as Eastern Europe, India and other parts of Asia, as well as South and Central America. This has been followed up through workshops, meetings, distribution of films and support material, advice.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: To train another 12 to 20 Trainers. To train another 800 facilitators. To solidify strategic partnerships with organisations in more countries in Southern Africa. To target youth through making Youth Video Diaries and training the participants to be peer educators.

13) Policy change: For leadership - political and social - to take a greater role in decreasing stigma and discrimination of people living with HIV and AIDS. And for health systems to provide much greater access to voluntary testing and counselling, and access to anti-retroviral treatment.

14) Origin of the initiative: The initiative was started by Iikka Vehkalahti and Don Edkins. Iikka is a commissioning editor at YLE, the Finnish public broadcaster, with extensive contacts and experience in broadcasting. Don is a South African documentary filmmaker and producer with extensive experience in media and development.

Contact Information:
Don  Edkins
Executive Producer
Steps for the Future
(NGO)
7 Glynnville Terrace, Gardens
South Africa
Tel: +27 21 465 5805
Fax: +27 21 465 5806
Email: steps@dayzero.co.za
Website: www.steps.co.za