Yathu Yathu

YATHU YATHU: FOR US BY US

The mission of the Zambian Adolescent Health Strategic Plan 2017-2021 is to “ensure equity of access to appropriate, quality and cost-effective adolescent-friendly health services…”. To achieve this mission, key principles of the Plan include providing comprehensive services that are decentralised, accessible, convenient, and actively involve adolescents. Adolescents and young people (AYP) aged 15 to 24 experience a high burden of HIV and other sexually transmitted infections, and a high number of adolescent girls and young women have unplanned pregnancies.

 

Improving the health and well-being of AYP in Zambia, and neighbouring countries, requires a concerted effort to provide sexual and reproductive health (SRH) services that are acceptable and accessible to AYP. There remains, however, a gap in our knowledge of how to deliver SRH services in a way that is acceptable to AYP, sustainable and (cost)-effective. The Yathu Yathu (For us, by us) study aims to provide such evidence. Through a cluster-randomised trial, this study will evaluate the impact of community-based, peer-led SRH services on knowledge of HIV status and coverage of key SRH services among AYP aged 15-24. The study will be conducted in two communities in Lusaka.

The intervention was designed with AYP in a formative research study in 2017/18. The Yathu Yathu intervention is made up of three components:

  1. Delivery of comprehensive SRH services by peer support workers, lay counsellors and a nurse at community-based places called hubs. These places were chosen by AYP because they are easy to access and they have been renovated to create a conducive environment for the AYP

  1. Innovative “prevention points card” (PPC) system. The PPC incentivises service use by allowing AYP to accrue points for accessing services and redeem rewards using these points

 

 

  1. Mobile phone-based support groups

 

An embedded mixed-method process evaluation will provide evidence of service acceptability, feasibility, and of AYP experiences with services. An economic evaluation will provide evidence of the costs and cost-effectiveness of the intervention package. Through these methods, this study will provide a rigorous and comprehensive evidence-base of whether Yathu Yathu can increase AYP access to SRH, thereby contributing to their health and well-being.

 

 

What is happening during this study?

 

Twenty zones (20) within the two communities have been included in this study. In ten (10) of these zones we are providing community based SRH services through Yathu Yathu hubs and offering AYP a prevention points card. AYP in the other ten (10) zones can access the same services at the local health facilities and will also be given a Prevention Points Card.

 

The sexual and reproductive health services delivered through the hubs will include services such as:

  • HIV testing including HIV self-testing
  • Screening for STIs and referral for treatment if needed,
  • Condoms, contraceptive information and advice including provision of contraceptives,
  • Information on Voluntary Medical Male Circumcision(VMMC), and Antiretroviral Therapy (ART) and referral to the local health facility