'Less is more': Assessing the effectiveness of a HIV prevention

program for long distance truckers in India after the re-designing in

implementation structure

Vasudha Rao, The Avahan Truckers Program, India

Original design

Focus on 2.5 million long distance truckers

Select 36 truck stops across national highways

Provide outreach, condoms and clinical services in each halt-point

Partner with TCI, India’s largest trucking company

Low reach and

accessibility of program (40%)

Low program awareness (12%)

Low service uptake (7%) Limited brand recall

Resources were not allocated optimally

Insufficient standardization of services

Continued communication fatigue

Limited branding and visibility

Early Data

Diagnosis of Problem

Need for a new design

Learning from successful marketers

Mc Donald’sConvenience and accessibility Universal standardization

TupperwareLearning peer outreach from the pioneers of direct marketing

Evolution of the Program Design and Redesign2003 2006

Redesigning strategiesIntelligent Placement of Services Standardization of services

Listening and responding to customer Surround sound communication

Synchronization of services

Intelligent placement of

services

Standardizing services and

building a quality brand

Innovative surround sound Communication

approach

Listening and responding to the

customer

Less is more

2004 2005 2006 2007 2008 2009 20100

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

0

10

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63% 67%

79%

90%95% 94%

91%

374580

910

2791

35764045 4327

90 253 382 515 641 682 717

%ge of truckers among those utilising clinical services per month per clinic

# of truckers contacted at least once per month per site

# of individuals (truckers + non-truckers) utilising clinical services per month per clinic

36 Interventions

17 Interventions

ResultsProgramme exposure and service utilisation indicators in last 12 months

Survey 11

(N=1402)Survey 22

(N=1407)Adjusted OR3 (95%

CI)Programme exposureVisited khushi clinic 20.5 62.8 6.7 (5.6-7.9)Watched street plays/nukkad natak 10.4 56.1 11.3 (9.2-14.0)Participated in health exhibitions 6.3 34.8 8.6 (6.7-11.1)Participated in film shows 4.1 23.7 7.8 (5.8-10.6)Attended trucker festival 12.4 24.7 2.4 (2.0-3.0)Received audio cassettes 14.1 28.5 2.5 (2.0-3.0)Service utilisationReceived health card 13.1 21.7 1.8 (1.5-2.2)Attended health camp 6.2 18.9 3.7 (2.8-4.8)Received condom 13.4 22.0 1.8 (1.5-2.2)Received one-one counselling 15.4 20.8 1.5 (1.3-1.9)Referred to VCTC4, detoxification centre 2.3 8.7 4.1 (2.7-6.1)

Outcome indicators Survey 11

(N=1402)Survey 22

(N=1407)Adjusted OR3 (95%

CI)Aware of STI-related symptoms 74.8 82.4 1.5 (1.3-1.9)

Experienced STI-related symptoms in last 12 months22.4 27.4 1.2 (1.0-1.5)

Sought treatment from khushi clinic for STI$15.9 49.9 5.6 (3.8-8.2)