DREAMS MOÇAMBIQUE · DREAMS MOÇAMBIQUE. Core package of interventions delivered in All DREAMS...

DREAMS MOÇAMBIQUE

Core package of interventions delivered in All DREAMS districts

erventions delivered in All DREAMS districts

10-14 years old

Girls

Community and/or school – based HIV and Gender based Violenceprevention with focus on preventing HIV through avoiding sexual risk.

Adolescent friendly health servicesPost Violence care Social Asset buildingEducational subsidiesCommunity mobilization and Gender norms activitiesParenting/ caregivers programsSocio-economic strengthening for caregivers

BoysCommunity and/or school – based HIV and Gender based Violence

prevention with focus on sexual risk avoidanceParenting/ caregivers programs Socio-economic strengthening for

caregiversActive linkages to Medical Circumcision, Counseling and Testing and

adolescent friendly health services.Gender norms activities

15-19 years old

Adolescent girlsHIV Counseling and testingContraceptive method mix, condom promotion and distributionAdolescent friendly health servicesPost Violence care School- based HIV and Gender based Violence prevention including

preventing HIV through avoiding sexual risk.Social asset buildingEducational SubsidiesSocio-economic approachesCommunity mobilization and Gender norms activitiesParenting/ caregivers programsSocio-economic strengthening for caregivers

Adolescent boysSchool based HIV and Gender based Violence preventionGender norms activitiesParenting/ caregivers programsActive linkages to Medical Circumcision, Counseling and Testing

and adolescent friendly health services.Linkages to Care and Treatment servicesMale engagement activites





20-24 years old

Young WomenHIV Counseling and testingContraceptive method mix, condom promotion and distributionAdolescent friendly health services Post Violence care School- based HIV and Gender based Violence prevention including preventing

HIV through avoiding sexual risk.

Social asset building Educational Subsidies Socio-economic approachesCommunity mobilization and Gender norms activities Parenting/ caregivers programs Socio-economic strengthening for caregivers

Young MenSchool based HIV and Gender based Violence preventionGender norms activitiesParenting/ caregivers programsActive linkages to Medical Circumcision, Counseling and Testing and

adolescent friendly health services.Linkages to Care and Treatment servicesMale engagement activites

•4 IPs were working in schools across 5 districts

• IP consolidation: one IP will conduct school-based activities in all DREAMS districtsLack of standardization in

school-based activities

•Layering tool protocol approved and implementation in process for all partners at the end of FY18.

•Close monitoring of coordination of services in order to reduce the lack of information about layering from partners.

Some IPs unable to adopt layering tool

•Preventing Sexual Violence and Preventing HIV trough avoiding Sexual Risk curricula

DREAMS shifted to the 9-24 age band

•Clinical partner shift in Zambezia province, Friends in Global Health (FGH) will take over ICAP.

•Expansion of DREAMS package to Maputo Province:

• Namaacha

• Matutuine

Geography for DREAMS

Challenge Solution

DREAMS Programmatic Shifts for COP18

Recruitment

Update Girl Roster semi-annually to identify mobile AGYW

Strengthen linkage between Key Populations and DREAMS programs

Programming

Expand access to vocational training for out-of-school 15-24

Preventing HIV trough avoiding sexual risk and delay of sexual debut for

adolescents

DREAMS Ambassadors draw attention to challenges faced by AGYW

Monitoring

Ensure all IPs consistently use the layering tool by the end of FY18

Focus group sessions with DREAMS beneficiaries for continuous feedback

DREAMS Best Practices to Expand in COP18

• Parenting/caregivers programs

• HIV & violence prevention

• Community mobilization and norms change

• Social Asset building

• Education subsidies


• Socio-economic approaches, VLSA

• HIV & violence prevention in schools

• Post violence care

• Layering tool

• Sessions for Gender based violence reduction for males

• Adolescent health friendly services

• HTS

• Contraceptive method mix and condom promotion

• Adolescent health corners


• Linking men to HTS, VMMC, care and treatment

EGPAF JHPiego

Community based services

for Southern Region

World Education

What are our partners doing in Gaza Province-

Chokwe- Xai Xai- Limpopo- Chongoene


• Community mobilization and norms

change








• Layering tool



• HTS





FHI 360-CHASS

JHPiego

FHI 360- CHASSWorld Education

What are our partners doing in Sofala

Province- Beira












• Layering tool



• HTS





Friends in Global Health,

ICAPJHPiego

World Vision-SCIP-ZWorld Education

What are our partners doing in Zambezia

Province- Quelimane- Nicoadala


• Layering tool



• HTS





Ariel F. JHPiego

What are our partners need to do in Maputo

Province- Namaacha - Matutuine

FHI 360-Co-Vida







Through FY17, # of New Diagnoses at 1st ANC for 15-19 Year

Olds Dropped in DREAMS Districts

668 713

1,4081,640

240 191 200 173

0

200

400

600

800

1000

1200

1400

1600

1800

2000

15-19 yrs 15-19 yrs 15-19 yrs 15-19 yrs

FY17 Q1 FY17 Q2 FY17 Q3 FY17 Q4

# o

f H

IV+

Adole

scents

PMTCT_STAT_POS_NEW in DREAMS vs Non-DREAMS Districts Among

15-19 Year Olds, FY17

Non-DREAMS DREAMS

1.9%

3.7%

8.6%

3.5%

5.1%

9.2%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

10-14 yrs 15-19 yrs 20-24 yrs 10-14 yrs 15-19 yrs 20-24 yrs

Males Females

Yie

ld

# o

f Te

sts

Number of HIV Tests and Yield by Sex and Age in DREAMS Districts, FY17 Q1 - FY18 Q1

Number of HIV Tests Yield

15 – 24 is a Time of Extreme Vulnerability for

HIV Acquisition among AGYW

High increase for10 -14 OVCs served

by DREAMS districts in Q2

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

Chokwe Xai-Xai Limpopo Beira Nicoadala Quelimane

10-14 3,336 2,574 2,457 5,251 7,168 7,115

15-17 2,560 1,865 1,174 5,249 3,300 4,619

18-24 2,043 1,284 482 5,464 647 197

10-14 15-17 18-24

AGYW GEND_NORM Participants in DREAMS Districts

SAPR1 FY18

-

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

10-14 15-19 20-24

Beira Xai Xai Cidade Xai Xai Distrito Chokwe Quelimane Nicoadala

3,477

2,778

1,548

Number of AGYW receiving

contraceptive method mix6828

3770

8304

6961

55

12140

11957

2123

7675

12803

124

19945

1101 2

771

1584

1356

30

2658

376 1338

937

420

5

824

281 904

355

129

3 306

CHOKW E CIDADE DA BEIRA

CIDADE DE QUELIMANE

CIDADE DE XAI -XAI

NICOADALA XAI-XAI

Pilula Depo Provera Implant DIU Sterilization

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Beira Xai Xai Cidade Xai Xai Distrtio Chokwe Quelimane Nicoadala

10-14 15-19 20-24

11,781

4,264

5,3724,953

8,925

3,951

39,246 AGYW Participated in Girls

Clubs in FY18 Q2

-

1,000

2,000

3,000

4,000

5,000

6,000

Beira Xai Xai Cidade Xai Xai Distrtio Chokwe Quelimane Nicoadala

15-19 20-24

1,566

2,932

5,358

3,064

703

1,149

14,773 Active VSLA+ Participants FY18 Q2

2834 3

417

3668

1477

223

3747

4940

6186

5341

2811

1539

57346180

1106

4834

3523

1387

7023

CHOKW E CIDADE DA BEIRA

CIDADE DE QUELIMANE

CIDADE DE XAI -XAI

NICOADALA XAI-XAI

10-14 15-19 20-24

# AGYW participating in out of school safe spaces in DREAMS districts

Total number of beneficiaries included

in the layering tool 1 0 3 0

1692

2292

115

3 0 25

9

3659

3334

166

4 0 31

4

2195

1192

38

C H O K W E C H O N G O E N E C I D A D E D E XA I XA I

L I MP O P O B E I R A Q U E L I MA N E N I C O A D A L A

10-14 15-19 20-24

Prevention for 9-14 year olds

• Programming must be sensitive to sexual violence and other factors shaping

adolescent sexual behaviors (i.e. initiation rites, forced sex, transactional sex

for survival), especially among girls

• Choice or perceived choice about sexual activity is often nonexistent for

AGYW

• These programs must not blame youth or make them feel responsible or

ashamed for factors outside of their control, while at the same time providing

them with accurate information

benefits of delaying sexual debut when they have the ability to do so

employing comprehensive safer sex practices when they choose to

engage in sexual activity in the future

Discussao:

O futuro dos espacos seguros

• Inclusao dos modulos de prevencao de violencia sexual e prevencao

de HIV evitando o risco sexual para os adolescents e jovens

• Graduacao das adolescentes e jovens depois da completar o curriculo

de sessoes

• Que modulos adicionais podem ser incluidos

Discussao: SAAJ no distritos DREAMS

SAAJ especifico

• Espaço físico próprio com provedor qualificado

• Todas as componentes de SAAJ– Saúde sexual reprodutiva

– Planeamento familiar

– Testagem para HIV

– GBV prevenção e cuidado

– Paragem único para TARV

– Alguns SAAJ tem consulta da CPN

– Pode incluir atendimento em horas extras

SAAJ Alternativo– Todas as componentes de SAAJ mais sem o local especifico.

SAAJ integradoAtendimento en diversas portas de entrada por pessoas treinadas no pacote SAAJ

Cantinho de saúde escolar– Saúde sexual e reprodutiva

– Pacote mínimo de planeamento familial

– Referenciamento ao CS mais próximo para testagem de HIV e ITS

– Piloto de testagem de HIV na Universidade de Quelimane

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