Couple communication has been shown to positively influence health behaviors, including uptake of family planning, HIV counseling and testing and condom use.

Data from Tanzania Capacity and Communication Project’s (TCCP) 2011 household baseline survey suggested that couple communication was low:

• 63% of women and 50.8% of men had discussed FP with their main sexual partner in the past 12 months
• 39.7% of women and 24.0% of men had discussed going for an HIV test with their partner

TCCP, therefore, sought to develop an integrated, interactive, entertainment-education platform that modeled effective couple communication, with the ultimate objective of improving health outcomes such as family planning, maternal and child health, and HIV prevention and treatment.

Aiisseee! was designed to target couples of reproductive age.

Grounded in the Ideation Model, the program aimed to influence:

• Couple communication
• Couple connectedness
• Relationship satisfaction
• Shared decision-making
• Social norms around romantic relationships
• Knowledge and skills of health topics in order to impact health outcomes

The program was designed to meaningfully engage both contestants and the wider audience, approach serious issues in a humorous way, and ‘push the envelope,’ without being aggressive or culturally insensitive. The program sought to model couple connectedness through mass media in order to increase reach, while simultaneously addressing the subject in an in-depth enough manner to create sustainable change. 

For the radio series, the creative agency (Khanga Rue Media), radio station (Clouds FM), and radio personalities (Adam Mchomvu and Gea Habib) were selected through competitive procurement and audition processes. The team developed a structure and question synopsis for the first 13 episodes. The name Aiisseee! (“I say!”), common Swahili slang, was selected for the program name, given its use to express shock or surprise. 

Based on feedback from the radio game show's first season, the team expanded outside of Dar es Salaam and did regional recordings in two other regions, which included playing the game on stage, and recording outdoors where it drew more of a crowd. Five regional radio stations agreed to air it for free, again increasing the show's reach. 

Early into Aiisseee!’s radio broadcast, the team was approached by multiple media houses, who, recognizing the show’s success and commercial viability, expressed interest in adapting Aiisseee! for television. TCCP issued a Request for Proposals to media houses to adapt Aiisseee! for television. TCCP, Khanga Rue Media, and Azam Media entered into a public-private partnership in which Azam Media agreed to provide free airtime, promotional spots, and PSAs. Azam was free to make the program a commercial broadcast. Sixteen TV episodes were produced through  with the creative agency and Azam TV, which are posted on the Aiisseee! YouTube channel.

Still from TV show recording

Implementation

The radio game show's first season launched in January 2014 and aired for 26 weeks on Sunday evenings in five-minute segments during the female co-host’s regularly scheduled program. Promotional spots which aired each week showed highlights from the previous episode, mentioned the previous week’s winners, and promoted the upcoming episode. As a program sponsor, TCCP placed two of the project’s PSAs from other campaigns in each episode.

Aiisseee!’s Facebook and Twitter accounts were used to promote the program, pose questions to fans, provide links to full-length episodes and YouTube links to street interviews, post relationship-related content, and encourage fans to play the Aiisseee! Facebook app. Aiisseee! also shared its theme music as a ringtone. Aiisseee!’s artwork reflected the same playful nature of the program. Graphical elements were used for social media executions and in print and promotional materials, such as t-shirts, stickers, banners, tire covers, and pens.

The second season of the radio program began in August 2014. Clouds FM aired a weekly repeat broadcast, increased the number of promotional spots aired per program, and agreed that episodes could be repackaged for broadcast on regional radio stations after initial broadcast. All 52 programs were re-packaged and distributed to regional radio stations to broadcast at no cost at a time of their convenience. Stations were free to make their own promotional spots, seek sponsorship, and retain any revenue generated from the program.

The television program began airing on Azam TV in July 2015. 

Monitoring 

TCCP conducted an internal qualitative post-test exercise at the end of Season 1 to seek operational input for the design of the next season. Two sets of focus group participants listened to a randomly selected episode and provided feedback on areas for improvement. TCCP, Khanga Rue Media, and Clouds FM also held regular review meetings throughout the season to make quick adjustments and determine how to increase reach and impact.

Qualitative research findings from Season 1 recommended:

• Improved transitions between studio and street sessions
• An easier way for listeners to track contestant couples throughout the show
• Expansion to additional regions to improve reach
• Diversified recruitment mechanisms

Stakeholder review recommended further reinforcement of health messages by the co-hosts, repeat weekly broadcasts on Clouds FM, additional promotional spots, and a re-packaging of previously aired episodes for broadcast on regional radio stations in order to increase reach.

Omnibus Survey Results:  

The April 2014 survey found an estimated audience of almost one million (964,249) listeners age 18 or above. By August/September, listenership had more than doubled, with 8.9% of respondents reporting that they had listened to the program in the last 3 months. 

The January 2015 survey found that exposure to Aiisseee! was 6.4%,  and it grew to 6.9% in May 2015.

The May 2015 Survey found::

• 16.7% reported discussing it with someone else, with 65.2% of those talking to a friend or neighbor, 34.8% to a family member, and 30.4% to their spouse or main sexual partner
• 12.3% of exposed participants reported doing something to improve their relationship as a result of listening to Aiisseee!, including talking more (41.2%), spending more time together (29.4%), going on dates (5.9%), and other (35.3%).

Social Media Statistics:

June 30, 2014:

• The Aiisseee! Facebook fan-base had grown to 53,666 followers. The majority of the total fan base was male (76%), aged 18-24 and located in Dar es Salaam.
• The Facebook app had 3,524 lifetime total users.
• Aiisseee! TV and radio host Vanessa Mdee (@VanessaMdee), had over 43,000 followers
• SoundCloud episodes of the program had been played 5,278 times
• The Aiisseee! ringtone received 1,564 plays and 90 downloads

September 30, 2015:

• The Aiisseee! Facebook fan-base had grown to 113, 513 fans, 71% of whom are male, with the majority in the 18-34 age group.
• On average, 98,274 of fans were online daily
• Aiisseee! content reached over 19,307 accounts daily with an average 281,023 daily impressions
• @AiiSSEEE had tweeted 589 times and had 405 followers
• The program’s YouTube channel had 7,876 views

TCCP conducted a national, household-based, cross-sectional project midline survey in April 2014 with a nationally representative sample of 4,000 respondents (2,060 males and 1,940 females) aged 15-49 years, randomly selected from urban/peri-urban and rural areas to evaluate the program’s impact. Interview data was collected using tablets and interviewers were gender-matched to participants.  

Results/Key Findings

Just three months after Aiisseee! Season 1 launched, 19.1% of men and 10.3% of women had been exposed to the campaign

In multivariate and/or propensity score analyses, exposure was significantly associated with:

• Improved increased HIV prevention knowledge
• Sexual protection self-efficacy
• Sexual risk communication
• Discussing HIV testing with a partner
• Likelihood of having ever been tested for HIV
• Condom use with last primary sexual partner 

Season two surveys suggested that use of a subtle yet provocative, humorous approach could create a comfortable forum for addressing hard-to-discuss issues in a non-confrontational way, ultimately leading to behavioral impact.

Aiisseee! has now been aired free of charge on 5 regional radio stations, adapted for television, and is being broadcast at no cost to the project through a public-private partnership with a media house that recognized the program’s social significance and commercial viability.

Recognition

Coverage of the game show was highlighted on these sites:

• Ads of the World
• Contagious Magazine
• Soul Beat Africa
• Health Communication Capacity Collaborative (HC3) blog