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Letter from the Gounffy Reprcsentative The PSI social marketing program's second year was largely one of scaling-up operations

-

expanding our activities nationwide and improving our ability to target greater numbers of at-rtsk

groups, particularly those with little 0r n0 access to mass media This expansion is succeeding thanks to the financial support of our many donors and the active contributions of our local partners, including the National and Provincial Committees for the Control of AIDS, Ministry of Information and Culture, Ministry

of Education,

HIV/AIDS Trust, Lao Youth Union, Lao Trade

Union, Lao Women's Union, CARE, Red Cross, Save the Children, GTZ and Nonivegian Church

Aid.

Each of these various organizations and their staff deserve a special 'thank you' for their

efforts in increasing the reach and impact of our program. I would also like to congratulate the entire PSI/Laos staff continue

-

for it is their talent, hard work, commitment, and determination which

to make the social markeiing program a

success.

The program's notable achievements in ihe year 2000 include:

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The pSl Sales Team distributed nearly 2,5 million condoms, indicating an estimated 100% increase in condom use since Number One was launched in April 1999 Number Qne

to 'non{raditional outlets',

increased by 567% over

r

1

999

-

and distribution of

such as beer shops, discos and guesthouses,

figures.

The PSI Communications Team introduced the Mobile Video Unit program to bring behavior change communications

to hard-to-reach target groups. The behavior change

campaign

was extended further through a series of regional training seminars involving over 70 representatives

of the Lao mass media and traditional arts, which resulted in the development

and dissemination of a plethora of HIV/AIDS-related media to audiences around ihe country.

r

The PSI Marketing Team organtzed Southeast Asia's first-ever, regional HIV/AIDS Awareness Concert in recognition of the year 2000 World,A|DS Campaign. Performers from Laos and all of its neighboring countries displayed thetr musical talent and educated an audience of over 20,000 people about HIV/AIDS and the importance of condom use.

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The PSI Research Team conducted ground-breaking research on key barriers t0 condom use

in Laos, which is helping PSI and other local organizations develop more effective behavior change activities.

I

PSI signed

a Memorandum of Understanding with the Ministry of Information and Culture,

formalizing our close collaboration with the Lao mass media and traditional arts and extending possible future areas

of cooperation to other priority health issues,

including

birlh spacing, malaria prevention, and maternal and child health. ln spite of these and other achievements by PSl, the Lao Government and other organizations, the general health needs of Laos remain immense, We hope to have the opportunity in 2001 and beyond to expand our social marketing program to address other key health issues to fulfill our standing commitment to substantially improving the health of the people of Laos'

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Wno b PSI ? opulation Services Inte rnatronal

(PSI) is the leading social marketing organizatron in the world, with projects in more than 50 countries on 5 continents. An intern attonal, non-profit group with headquafiers in tilZashington DC and

London, P SI develop s and implements ptograms worldwide to empower low-income individuals and communities to \ead healthier lives. Around the world, PSI uses social marketing techniques to improve health through programs

increasing the practice of birth spacing, preventing the spread of HIV/AIDS and other STDs, and improving maternal and child health. PSI social markering programs achieve health imp act by

conducting innovatle, culturally appr opr tate e du cational campaigns and linking these to the widespread

aYailabilitr- of high quality, af f ordable products which are packaged according to local needs.

PSI social marketing products include male and female condoms, hormonal contraceptives, insecticide-t reated mosquito nets, iodated salt, oral rehydration salts, multivitamins and home-based clean water systems. Vherever PSI works, it develops and strengthens local partners, including government and local industry. PSI trains these partners in soctal marketing techniques and collaborates closely with them to develop and implement effective and sustainable preventive health

campaigns. PSI social marketing projects serve as an imp ofiant complement to public sector efforts

to improve the health of low income, at-risk populations. In Laos, PSI is working with the HIV/AIDS Trust and the National Committee for the Control of AIDS (NCCA) to implement a national condom soctal marketing campaign to help reduce the spread of HIV and other STDs. In partnership with the Lao Ministry of Health, PSI

is also exploring other health probleffis, such as birth spacing and

malarta control, where social marketing can make a difference. PSI has Memoranda Of ljnderstanding with the Ministry of Health, National HIV/AIDS Trust and the Ministry of Information and Culture.

laos Gouffi Profile T

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official numbers appear low; but a compr:ehen,iiur:,nl'ood-t0s


hat ls

Marffil nU? PSI social marketing

works because it focuses intensiuely on the end user, By understanding people, educating communities, empoultering Gonsumer$ and

worklng closely with our local partnetrs, socia! marketing proiects

deliuer high impact at low cost,

PSI behauioral research provides project staff with a sound understanding of the people they want

to reach. Research enables ther"n

to

learn where major gaps in knowledge, attitudes and behavior lie and how these gaps can be filled most effectively, Behavioral research serves as a useful tool for developing product packaging and behavior change communications campaigns. Market research

helps staff determine which social marketing products are most needed, where and at what price,

P$l behavior change c{lmnilunications reach target groups with key messages presented in innovative and appealing ways, which capture and hold the audiences'

attention, PSI communications educate people and boost the image of health products through mass media, traditional arts, special events, and interpersonal counseling, PSI comrnunications also heighten the visibility of priority health problems, providing

a catalyst for open discussion 0n

health issues at all levels from the political arena to the familv table,

2

sensitive


ocial marketing is a powerful method for enabling behavior change on a large scale and

in a cost-effective manner.

PSI

projects empower individuals to lead healthier lives by providing them with critical health information presented in ways that are easily understood and accepted. In turn, these educational campaigns are linked directly with easy access to high quality products and services offered at affordable prices in convenient outlets. Thus,

people learn to understand and demand zS

better health, they are able to immediately satisfy this demand through the avatlabiliry of PSI's high qualiry affordable products. All of them ate packaged attractively and include an instructional insert in the local language. At its core, PSI social marketing works because it focuses intensively on the end user. By understanding people, educating communities,

empowering consumers and working closely with our local partners, social marketing projects deliver high impact at low cosr.

P$! $ocial Marketing Program in Laos Under the auspices of the Lao PDR HIV/ AIDS Trust, PSI was invited in late 1998

to implement a multi-year, nationwide

HIV/

AIDS social marketing campaign. This

project is changing behavior by educating large segments of the population (including higher risk groups) about HIV/ AIDS and ensuring that high quality, affordable condoms are available when and where people need them most, The H IV/AIDS social marketing project's objectives are to:

r

Conduct behavioral and market research to develop an effective, culturally-appropriate project and

to monitor its imoact over

r

time

Develop and implement innovative behavior change communications using mass and other media to inform the Lao people about HIV/AIDS

and to increase condom use arnono vulnerable groups

I

Introduce and expand the availability

of high quality, affordable

condorns

throughout the country, beginning

with traditional health outlets and progressing

to non-traditional

outlets,

such as guesthouses and beer-shops

I

Increase local capacity by forging solid partnerships with government

and non-governmental organizations As in the other countries where

P$l marketing

activities ensure that people have widespread access to social marketing

P$l collaboration

products. PSI sales staff work closely with commercial, government,,and NGO partners to

Working closely with government and private partners alike to develop and implement

build an extensive, reliable network that makes social marketing products consistently

pr0grams, PSI instills a broad sense of 0wnership and c0mmitment to social

available

to urban and rural people alike.

An

important aspect of this effort is to make products available in'non-traditional' outlets, such as mini-markets, kiosks, guesthouses, night clubs, truck-stops, beauty parlors, and beer shops, which are often more convenient to consumers than'traditional' health ouilets, such as clinics and pharmacies,

eff

m

ensures that activities are

ective and sustainable in the long run.

arketin

g

,

PSI's donors are highly valued as part of

this partnership without their

financial and in-kind contributions, projects would not be oossible,

it

operates, PSI is committed

to creating

a strong, sustainable local

organization,

Its office in Vientiane is staffed almost entirely by Lao people to ensure that programs are effective - that is prograrns created by Lao people for Lao people. The PSI Laos program is structured around four key departments: Research, Communications, Marketing and Administration,

3


arketi ng ffilhunications

lr

distribution

collaboration

Ar Dr

ndng ?uople During 2000 PSI conducted the following research studiesl Knowledge, Attitudes and Practices Suruey (KAP) on sexual behavior and condom use Rapid Market Assessment on oral contraceptivesn STDs, condoms and oral rehydration salts

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Consumer Profile Suruey Focus Group Discussions on

aspirations of urban men Focus Group Discussions on barriers

to condom use Focus Group Discussions on trust in a partner as a reason tor non-use Focus Group Discussions on negotiating condom use Focus Group Discussions on

aspirations of rural and urban women Focus Group Discussions pre-testing Number One promotional slogans,

graphics and materials Puppet show impact evaluation

Right Mingnakham Pangnasak (right), a PSI research assistant conducts a suruey at a Uientiane pharmacy to evaluate the impact of the l*lumber One promotional campaign. The social marketing program uses such research to ensure it is etfectively addressing the needs of pharmacists - vital partners in the P$l proiect .

4

esearch provides the social

marketing pro gram with information to finely tune its behavior change communications campaigns. Information on target groups' knowledge, attitudes and behaviors allows PSI to culturally adapt activities so thatthey ate both appropnate and effective. Identifying targetgroups and collecting data on these groups provide the Communications and Marketing De

parurrents w.ith

critical

information to ensure campaigns are effective. Research also allows PSI to monitor the progress of its work, to see what it is doing right

and what it is doing wrong. Pretesting materials and messages helps insure that they will have a high imp act on the apptoprrate target groups. To these ends PSI uses a selection of research techniques including consumer profile surveys, focus group discussions and in-depth interviews.

PSI research is done hand in hand with local partners. Over the last 2 years PSI has trarned and utilized 30 field researchers who conduct quantitative studies. This \rear a field work teamfrom the Lao

Youth ljnion was trained in

'Fieldwork

Techniqu

es

and


Barrisr$ to condom use One important aspect of HIU/AIDS prevention is encouraghrg peopb b pdect themselves by consistently using condoms. To accunpfidr [ils il ls nccostry to know why people do not use or do not like using condoms. Thb past year PSI research identified 5 gimary reasons wlry some people may nd use condoms.

Trust' is the most frequent reason grven for nol-use

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ol eordoms wrth any rype oi pirtrer

trd

use condoms with prostitutes, but not with girtfthnds, beoause I

lterr.p

Male governmed woilcer

"l use condoms with my clients, but not with nry regqhr bqfrlerds," Comnschl rex woder

Methodology' end 'Fieldwork Techniques for Distribution

Surveys' . In ad,dition, a representative of the Lao Trade IJnion was trained to moderate focus group discussions. Mingngakh am Pan gnasak, Research Assistant, joined PSI after completing a degree in Australia. One of her roles is to mode rate during Focus Group Discussions: "fJnderstanding the emotions and the dynamics within a group is vital to stimulating free discussion. Sometimes pafitcipants are shy, so it is important to respect people's limits and to help rhem ro enjoy and benefit from these sessions. I feel privileged to have the opportuniry to meet new people and learn about society around me and the more I Iearn,, the more effective I can be in my work." Top: Understanding perceptions of masculinity and young men's attitudes towards sexual health is an important outcome of focus group discussions. Ghanging behaviors that put men and their partners at risk of STD's and HIU/ AIDS is a key part of PSI's behauior change communications strategy in

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5


rnarketi ng icommunications

distribution

collaboration

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Communltl os SI educates communities

through

an extensive portfolio of media activities. Mass Media channels include television, radro and newspapers. Interpersonal communications include puppet shows, spe ctal events and the project's new Mobile Video ljnit. IUlass Media

An active partnership with the Lao rnass media has produced a n-icle

range of television and

rzrclict

programs and publicattons on HI\' AIDS and condom usc: r Television programs created for

5 stations include short messagcs, s and c onc e rt bro adcasts. Television advertisements promoting PSI's Number do cume ntarie

One condom brand are parrrcularly popular. Seng, 23, saw Number One advertisements on television. He subsequently spotted Number One condoms in a pharmac\r. "Now I use condoms every time I visit sex workers. The advertisement made me aware of the bad effects of HIV infection. Because Number One is cheap and reliable, I can afford to use it every time." il Radio spots broadcast all )lear

round on B natronal and local stations. IJsing a local scriptwriter, PSI developed and broadcast

6

a

10

episode radto drama on National Radio. The show reached around 200/o of the Lao population. While the show was on the air more than 100 phone-in calls were received. Bounma Heungmany, 67, was one of 30 winners of a lucky draw for listeners. "Today's youth have difficult challenges to face and it is hard to change bad attrtudes towarcls sex and drugs. I will tell 1rI\- nephen-s. nieces rrncl r.illage r-otrth ubout Fil\- AIDS even- clar-. becliusc \-ollltg peoplc afe ollr lllost r-allutirle 1'c.\ollr'cc.

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Printed media include the major newspapers and magazines. These

carry regular advertisements, educational spots and articles by PSI. The Ministry of Health asked PSI to produce a speciaIHIY/AIDS

issue for it's 'Health' monthly newspapet. Over 3,000 copies were distributed to health professionals around the country. To complement the mass media campaign and reinforce important lnessages about HIV/AIDS and conciolls. PSI has developed an cxfen.si\-e range of edu cational and

il

$aued hy ilumber One ln partnership nuith Lao Teleuision, PlSl has produced some cutting edge TU spots aduertising Number One condoms. In one spot a girl canies a goldfish home in a plastic container which bursts. A nearby pharmacist helps by filling a lfumber One condom with water and putting the fish inside, while ffie caption reads "llumber One can saue yout life". This innovatiue idea meant ilrat a condom could be shown on Lao Television for he first time.


W PSI Gommunications during 2000

t,i

fi ",.

f

promotio nal meterials. These stickers, posters, leaflets, caps, Tshirts, pens, k"y chains ancl calendars have served to raise the profile of Number One and improve the image of condoms. Or.er 720,000 items were distributed

throughout the \reat during numerous cultural festivals and sports events and as competition prizes in nightclubs.

A Young w$man reads a illurnber One candCIm leaflet at a festival, PSI has uevelopsd a rangfi sf educationa! and promotional nraterials. ilIesigned to reinforce mass media and

2,459 educational poster sets nn

interBersonal communications, they are distributed in large quantities at spods and cultural events nationwlde.

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UUC

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to

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SCNOOIS

3,000 year 2000

calendars

7


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Interpersonal Gommunications Puppet shows, cultural events, concerts and school visits provide the communications team with an opportunity for close rnteraction

with the public. This \reat

PSI

strengthened its capactty to reach

people in remote parts of Laos when it acquired a'Mobile Video Ijnit', the first of its kind in the country.

I

PSI supports the Ministry of Informatron and Culture's Puppet Troupe, which travels around the country, passing through rural villages, urban ateas and schools. Special edu cattonal Number , One

puppet shows are very popular with all age groups and well attended. In one Luang Prabang high school, 300 students, parents and teachers cheered as Mr.

Number One battled

his

archenemies Mr. STD andMr. AIDS.

I

In betu'een scenes the

audience

notably, in honor of the year 2000 PSI joined

takes part in competitions designed

\World AIDS Camp argn,

to test and consolidate knowledge

forces with the Ministry of

transfer.

Information and Culture and the National Committee for the Control of AIDS to organ rze South East Asia's first-ever regional AIDS concert. Music stars from Laos and

I

Cultural festivals and concerts also provide opportunities to reach

Iarge numbers of people. The annual That Luang festival in Vientrane regularly draws 7-I .5 million people from aII social groups and ethnicities and from all over the country. PSI pafitcipates in this festival every \rear, making direct contact with attendees who can then spread health messages to their home villages. More then 60,000 Number One condoms were distributed during the festival in 2000.

This last year PSI orgamzed major music concerts in 4 provinces:

Khammouafle, Champasack, Luang Prabang and Vienti ane. Most

all of its bordering countries - China, Myanmar, ThalIand, Cambodta and

Vietnam- performed hit songs. In between sets, they spoke to the audience about FIIV and the importance of safe beh avror, especially men's role in helping to prevent the spread of the virus. An estimated 20,000 people attended the show, later broadcast in its entirety on National television and radto. Re-runs were arced by popular demand. r The Information Board, a series of 3 educational HIV/AIDS posters


targeted to schools, was introduced

to 280 directors, teachers and students during spe cral launch presentations. 2,400 sets have been distributed to over 805 schools. Inthamala Sithimolada, a PSI Communi cations Agent, visits schools to talk about the posters and

conduct a question and answer session for students 16-18 years old. "I love to talk to these young people and answer questions they have had in their heads for a long time, such

as 'How does someone with HIV feel?', '\7here did the virus come

from?'or 'Can I catch it from mosquitoes?'. There is great demand for these sessiofls, and even young people from outside the school ask to come." I The PSI Mobile Video lJnit, introduced in October 2000, is a four wheel drive vehicl e that is fitted

with audiovisual equipment powered by n generator, which can be easily set up and, dismantled in just about any environment. The tirst of its kind in Laos, rhe Mobile

Video lJnit aims to provide education for all, reaching rural and mobile populations with engaging visual pro grams. Inte tactive multim edta shows interw eave educational messages with videos to draw crowds. A qurz, which broadcasts paftrcipants' faces on the big screen, is particularly popular. Khamtonh Volachack, PSI Video

Production Manager, previously worked for Lao National TV. At PSI he is learning to use new digital video technologies. "At PSI I work with skilled people. It is a creative environment and we do good, socially responsible work." Having received training from a Japanese IJN Volunteer, Khamtonh is now confidently making documentaries and editing shows for the MVll, using the project's d,igital editing studio. "Now I can work faster and the quality is very good."

Lef* ililr. Flumber One triumphs over fifir, $TD and illlr. AID$, P$1, the ftilinistry of lnformatioil and Gulture, and the Hationnl Puppet Troupe ilaus collaharated toproduGsa$erie$ofpopu|areducaliona|puppstshauus.Thgsgtourt.he countryn taking health me$$ags$ ta villass$ and sehools" Top: Uideo material broadcast on P$l's Mobile Uideo Unit are edited hy P$l's video production rnanager, Khamtonh Uolachack u$ing a digital editin$ *uite. Programs include educational documentaries, aduertisements and excerpts

from rnusic concerts organised by P$1. Ihis in-house technical facility will enable PSI to dub materials into minority languages in the future.

I


:fuarketl ng distnibution

communications

collaboration

Or|ng Consur"ners he PSI

commun rcations

camp argn is Ieading to a significant increase in demand for, and use of , condoms. Responding to this demand, PSI sales and marketing staff work hard

to ensure that Number One is avatlable, affordable and acceptable

to the majonty of the population, parttcularly groups at higher risk.

Sythong Nouansengsy,

PSI

Marketing Manager, comes from a comme rcral background of marketing Beer Lao and AJL\ brand cigarettes, two of the most successful Lao companies. He now

enjoys the challenge of achieving success with affordable products that improve people's lives. He has developed incentives for his regio nal sales agents, including special motivatronal tools for sales to non-t raditional outlets-these typically b.,y in smaller quantities than pharmacies. He is setting up a rural distribution network by collaborating with partners from mass org antzations such as Provinctal Committees for Control of AIDS, the Lao \7omen's lJnion,

"Transportation costs are borne by the other organisations as part of their normal actwities. Thus, there

is little extra cost involved in developing and using these nefworks. The bottom line is that the end users end up paying an affordable price throughout the country. This nefwork will become increasingly valuable when we start distributing other social marketing products nextyear andbeyond. \We need to have consistent, reliable access to communities in remote ateas who need our products."

Lao Youth ljnion and Non ental Org anrzations.

As a result of

Governm

effective

200

Humber Ohe distribution has doubled since last year with an msreaslns focus on non-

2000 2000

E

II

traditional outlets

1

999

-----I ---

Number One distribution {millions)

10

150

1m

50

1999

------

ilumber One distribution: Non Traditional Outlets (thousands)

-


promotions and a highly motivated sales staff, Number One condom

distribution has exceeded aIl expectations, rising over 7000/o from 7 ,IBB,7 32 condoms in 7999 ro 2,445,7 32 in 2000 for a roral distribution figure of 3,534,464 srnce the project started in April 7999. 750/o of these condoms were distributed through NGO nefworks (in primarily hard to reach areas) , Z5o/o were

distributed through government programs run by the National and Provincial Committees for the Control

of AIDS and 600/o were distribured through priv ate,, comm ercial markets. As of the end of 2000, Number One was being distributed through a total of I,295 active outlets in aII

provinces around the country. Distribution through non-traditional outlets, such as beer shops, guesthouses, bars and nightclubs increased substantially this year by 5670/o from 29,772 in 1999 to 168,804 in 2000. This number is expected to continue to rise signifi cantly in the year 200I and beyond. In a random survey in Vienti ane, B 9o/o of pharmacies were found to be selling Number One, and 840/o of these had received informatton on HIV/AIDS prevention and family planning from PSI sales staff over the last 5 months.

There is clearly a high demand for Number One condoms amongst end users because more than 750/o of all condoms distributed in 2000 were 're-orders'from outlets alreadv actively selling Number One. One Vienti ane ph armacist dispenses advice with the condoms he sells: "Most of my customers are young men between 15 and 79 years old. NormalIy they are not shy to ask me how and when to use condoms and I don't mind answering their questions. I like selling Number One condoms because young people know the brand and the pSI sales team gives me good training on STD's and HIV/AIDS."

i

P'acking condom$. Effective distibution chanhefs and a high quality,

affordable product mean that an increasing number of people arc being empowered to buy Number One condoms. Repeat purchases of lfumber One are high; curendy 75o/o of sales are re-orders from existing outlets.

11


etl n

h Partners he social marketing Program has made several great achievements over the Past year thanks larg"ly to the continuing active suPPort of its partners. The MinistrY of

Information and Culture has

provided much of its me dra access free of charge and made its PuPPet troupe avatlable to Put on IH^IY / AIDS educational shows around the country. The 3 PSI launches this

year in

Luang

P tabang, ChamPassack and Khammouane provinces were well attended bY important local officials including Provincial Governors, Vice

Governors, Presidents of National and Provin ctal Committees for the Control of AIDS, Directors of the Lao Vomen's ljnion and representatives from the HIV/AIDS Trust, IJNAIDS, IJSAID and IJNDP,

each bringing their Particulat

knowledge and skills to the proceedings. Ongoing communication with these Partner

org anrzattons imProves effectiveness by strengthening teamwork' Close co-ordination with the National Committee for the Control of AIDS and the National AIDS Trust has been and will continue to be essenttal for strategic coordination as the NationalHIY/AIDS Strategic Plan covering 2002-200 5 is

12

ftnalrzed. Mass ot ganrzatrons such as the Lao Vomen's andLao Youth lJnions are importantpartners since they have develoPed natio naI community-based networks that extend to every villa ge and ate used for education, product distribution and reseafch. PSI collaborates with NGOs who have complementatY skills and knowledge. This Yeat PSI worked with Save the Children Australia to develop Behavior Ch ange Communications Indicators and share lessons learned. A joint workshop was conducted u''ith Health Frontiers for the National Faculty of Medical Resources on communication with hosPital and clinic patients about condom use' HIV/AIDS aNd STDS. CARE, WhiCh also works on HIV/AIDS/STD education, has distributed over 160,000 Number One condoms. In total 11 NGOs have distributed over 370,000 condoms. Siham ano Bannavofig, Communications Managet atPSI, sPends

a

signifi cant amount

of

time

traveling to the 18 provinces of Laos for meetings with governors and high-level staff. "Building good public rel attonshiPs with key decision makers is the foundation for the smooth functioning and effectiveness of our Program here

in Laos. \flhen PeoPle understand that

we

are

offering information and

products that helP People to

safegu ardtheir health, they ate very

excited and keen to contribute resources and even become

personally involved." Media professionals have been eager to collab orate in order to improve and exPand the nattonal media response to HIV/AIDS. In March 2000 a P Sl-org anrzed workshop for representatives of 5 southeln provinces focused on developing skills and discussing plans for development of new media materials. Their subsequent suppo rt meant that the Project was

granted free Placement for educational sPots on 5 Provin ctal television statiofls, and free broadcasting on 5 radto stations for 6 months.

In April an intensive workshoP for Lao mass media representatives from 7 northern Provinces was held in Luang Ptabang. PattrciPants

learned about improving commun rcations skills and developed Plans for new IH'IV / AIDSISTD-related media materials' Enthusiasm amon g attendees led to 71 rudto stations offering PSI free antime for me dta cre ated bY workshop patttcipants for a period of 6 months.


The lmportance of Donorc 6

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Sihamano Bannavong, (standing) and other PSI staff meet to discuss futrrc communications proiect with the lao media. ,,The support and enthusiasm of lao media partners has led b widespread recognition of the Number One brand."

13


2000_annual_report