15 involving village meetings and more informal methods, including Theater for Development
TFD. Through theater, it is possible to engage a broad spectrum of villagers—including young and old, and men and women—to discuss issues that can be difficult to address in formal
meetings. These include early sex initiation, low condom use, superstitious beliefs and poor leadership. The action plans outline steps to confront the root causes of the spread of HIV. They
also include sections that address how to help vulnerable groups, such as orphans, widows, People Living with AIDS PLWA, the elderly and those physically challengeddisabled.
In 2010, UZIKWASA broadened the VMACs to include wider representation of influential village leaders e.g. businessmen, youth leaders, religious leaders, etc.. A program was
implemented to increase leaders’ awareness and commitment and to improve their technical capacity to address HIVAIDS. This leadership program also included a gender-strengthening
component, because gender inequity plays a significant role in the spread of HIVAIDS and village development at large. To encourage learning, UZIKWASA also launched a best VMAC
competition and exchange visits between well-performing and lesser-performing VMACS.
1.4 Assessing Behavior Change and Project Impacts
As described above, the BALANCED and Pwani projects undertook two surveys: in 2009 to set a baseline and design project interventions; and in 2012 to measure the impacts of the PHE
activities. This report analyses the two data sets and explores four questions:
1. To what extent and how has the status of population, socio-economic, health, and
environmental conditions changed in the Saadani National Park Area between 2009 and 2012?
2. Are there any changes in perceptions andor behaviors that can be attributed to project
interventions? 3.
Based on the experience from implementing integrated PHE in the Saadani National Park area, what are the recommendations for future projects?
The following section describes the survey methods used in 2009 and 2012. Thereafter, the survey results are presented, followed by conclusions and recommendations.
2 Survey Methods for the 2009 and 2012 Behavior Monitoring Surveys
This study considered a cross-sectional design using quantitative methods and face-to-face interviews of sample respondents. Data from the surveys were triangulated with data from
previous surveys conducted in the area and qualitative information from other sources focus group discussions and key informant interviews with, for example, local government leaders.
All survey procedures were approved for human subjects concerns by the URI Internal Review Board.
2.1.1 Survey Instrument
Both questionnaires 2009 and 2012 were translated into Swahili. For a copy of the 2012 survey, see the 2013 BALANCED
“Tool for Conducting Population, Health, and Environment
16 Behavior Monitoring Surveys”
Torell et al. 2013. The first survey was pre-tested in the Bagamoyo District by individuals with prior survey experience. The instrument was finalized,
based on pre-test findings, and contained socio-demographic, health, coastal conservation and climate change-related questions as well as opinion questions on PHE linkages. The second
survey was not pretested because it was almost identical to the first survey.
2.1.2 Survey Areas
The questionnaires were administered in eight villages surrounding the Saadani National Park, Tanzania. There are 10 villages bordering the park with a total population of approximately
35,000 persons. Eight of the 10 villages were selected to participate in the survey—six in the Pangani District: Sange, Mikocheni, Mkwaja, Buyuni, Mkalamo, and Mbulizaga. Two villages,
Saadani and Matipwili, were located just across the border, in the Bagamoyo District see Figure 2. The six villages in Pangani were selected because they were already engaged in conservation
and HIVAIDS prevention activities implemented through the Sustainable Coastal Communities and Ecosystems Tanzania Project, which was a predecessor to the Pwani Project. There was an
interest in adding a FP component to the ongoing health and environment activities in Pangani, creating a full-fledged PHE program. Hence, the six villages in Pangani were considered project
villages.
The two villages in Bagamoyo were involved in some conservation and economic growth activities, but did not have any healthHIVAIDS component. There were no plans to introduce
FP activities in these villages, and they were therefore considered control villages. However, over time, Saadani village became more involved in fuel-efficient technologies, livelihoods and
PHE peer education. Both Matipwili and Saadani were involved in mariculture zoning and elephant tracking activities, and hence neither village ended up being control villages, except for
the HIVAIDS prevention and BCC activities.
17
Figure 2. Map of SANAPA and villages surveyed 2.1.3
Data Collection Methods
The target respondents for the survey comprised individuals in the reproductive age group 18-49 years. Sixty households were randomly-selected per village, with the goal of interviewing 50
households per village. The enumerators were given a one-day training to discuss the nature, purpose, survey procedures, human subjects’ protections, fieldwork techniques and specific
aspects of the study to be carried out by the team. Social preparation e.g. courtesy calls to local officials was also conducted by the enumerators and project coordinators to secure permission
and support from the local authorities in conducting the survey.
Developing a sampling method is a balance between collecting perfectly representative data and what is practically doable. Optimally, one should aim to select the respondents which are all
members of a household systematically so that, across the entire sample, all possible household member-types are represented in the same proportions as in the population. This means using a
18 random sampling method to get an approximately even number of men, women, young and old
household members. In the 2009 survey, the so called Kish method McBurney 1988 was used. This method randomizes the household selection and the selection of the subjects from within a
household. This method proved to be impractical; it resulted in numerous visits to households where the randomly selected household member could not be interviewed, as they were not
home. In the 2012 survey, we developed a simplified sampling method: households were still randomly selected, but the methodology allowed more flexibility in selecting the person to
interview in each household. For example, if an enumerator had been assigned to interview a young woman in a household but only a young man was at home, the enumerator could
interview the young man and target a young woman at the next household. The enumerators followed a predefined procedure in instances where the randomly selected household members
could either not be located or did not fit the sample requirements i.e., age outside of 18-49. The enumerators were instructed that if they arrived at the randomly selected household and no one
was home and not close nearby in the village that a new household should be selected using the following approach: if the household originally on the list was on the north side of the street, flip
a coin to determine if you visit the house to the left west or right east of the original house. If the flipped coin lands on heads, visit the house to the left. If the flipped coin lands on tails, visit
the house to the right. In each case, the enumerators noted which household was selected.
For both surveys, after the interviewer identified the respondent in the household, the interview proper was performed. Informed consent was secured prior to conducting the surveys and 100
of potential participants agreed to participate. All respondents were interviewed in Swahili, and their answers were recorded on the questionnaire during the interview. In total, 437 individuals
were interviewed in 2009 235 females, 202 males
1
and 410 individuals 201 females, 207 males
2
in 2012. On average, it took between 45 to 60 minutes to complete the surveys. In 2012, seven key informant interviews were conducted with individuals that have participated
in two or three integrated activities using a semi-structured interview questionnaire. The individuals interviewed were all from project villages the Pangani District and included CBDs,
PEs, SACCOS members and those that participate in beekeeping and using fuel-efficient technologies for baking and cooking.
2.1.4 Data Processing and Analysis
