Abstract:
Behaviour change communicators and health experts often assume that individual beliefs and perceptions hold the
key to explaining health behaviours, thereby ignoring the extraneous constraints that obtain in the individual’s
environment. Access to basic resources, such as food clothing and shelter, can be central to developing an
understanding for health transactions, particularly in severely resource-deprived populations found in rural and
informal urban dwellings, where basic survival at times overrides all other considerations. In such situations,
specific livelihood improvement programmes targeting the intended beneficiaries and other key players in a given
health intervention could be an incentive for the adoption and uptake of the intervention. This study examined the
possible effects of socio-economic incentives to complement communication campaigns to improve the uptake of
voluntary medical male circumcision (VMMC) for the prevention of HIV/AIDS in Siaya County of Kenya. Using
multi-stage sampling, we purposively selected two sub-counties, Bondo and Rarieda, from where, using the
snowball technique, we drew a sample of 370 male residents aged 18 to 49 years, mainly from the fish landing
areas of the two sub-counties. We conducted two focus group discussions with men and women residents, besides
in-depth interviews with five managers of the programme. Results were drawn from direct and indirect questions
touching on socio-economic issues covered in the qualitative and quantitative research instruments and from
anecdotal evidence. We found that, besides conventional prevention and treatment programmes, combating
HIV/AIDS through VMMC in low-income populations requires reasonable investment in economic assistance to
the intended beneficiaries of VMMC and those with the potential to influence their decision. These activities
should be integrated in the wider programme implementation spectrum with clear structures that serve as entry
points for health message delivery points.
