SCORE Annual Review 2016 17-21 October 2016 Venue: Jinja – Nile Resort Lydia Murungi Tomusange TA – Adolescent Health

DREAMS PROGRAM IMPLEMENTATION UPDATE

Area of operation AVSI Foundation District: Mukono Sub counties: Ntenjeru Mpunge Nama

PARTNERS DREAMS has 2 types of implementers Implementing Partner St Francis Hospital Service layering partners Makerere University Walter Reed Project RTI Communication for Health Communities (CHC) ASSIST project District leadership Health Facilities Community structures (VHTs, local council leaders)

Determined, Resilient, Empowered, AIDS –free, Mentored and Safe (DREAMS) Project Implementation framework Activities Goal Identification Assessment and enrollment and care plan Categories Combination social economic strengthening activities Village Savings and Loans Associations (VSLA) Apprenticeship Skills Financial literacy Community skills Enterprise selection planning and management AGYW in Transactional sex 15-24 years - 690 AGYW pregnant or with a child 15-24 years – 1,206 Mapped High prevalence or High risk spots** Referral from Linkage facilitators Referral from Health facilities and Schools, Referral from Police, CDO, PSWO Referral from CSOs, HIV partners Referral from structures and individuals: Peers, AGYW, CPC, Vulnerability Assessment and Needs Mapping: HH dev.t plan/ AGYW dev.t plan Family strengthening and access to critical services Social Asset Building (life skills trainings) HIV Counselling and Testing Violence prevention and Post Violence care Reduce risk of sex partners (Sexual partner characterization, VMMC) Parenting and care giver programs Interventions to mobilize communities for change like dialogues Referrals to critical services Reduced HIV Incidence AGYW in In school 10-14 years – 3,269 15-19 years – 1,610

DREAMS Enrollment 5,059 households 1163 coded +3,896 non vatted Households Membership 9,436 (5540 vatted (female 3272 and males 2268) +3896 non vatted AGYW 5,675: 1779 Coded + 3896 (not vatted)

Core Package of Interventions

Start up activities Enrollment of HHs and AGYW- Assigned unique codes Segmentation of groups (In school, Transactional sex, Pregnant/ Those with child) Identification of safe spaces and development of AGYW group development plan -100 safe spaces Recruitment of 36 Mentors Capacity Building TOT – Sinovuyo parenting teens model, TOT stepping Stones, GBV training, Life skills training, parenting training, VSLA training) Training peer facilitators in stepping stone methodology 28 VHTs and Linkage facilitators training on HIV and SRH

Training and Deployment of Mentors Mentors induction/orientation on DREAMS interventions Social Asset Building and Safe Space Model Group dynamics and Group management My Health My Choice, Healthy Choices for a Better future Mapping Sexual Networks Basic Counseling Skills Gender Norms & GBV Prevention M&E Tools including referral processes

Formation of safe space groups Induction meetings for AGYW ( 40-80 girls) which serve to Introduce DREAMS Activity to the girls Introduce the concept of Safe Space Groups and different identified segments Dividing AGYW into identified safe space groups segments Linking safe space groups segments to mentors Parents/Caregivers sensitization forums on DREAMS Introduce DREAMS Activity to parents of In-school AGYW Working with parents of Out of school AGYW

Results Progress Strengthening the family Interventions Progress Target Outputs % Strengthening the family Parenting/caregiver programs 2,000 460 23% Life skills training and stepping stones 3,515 176% Psychosocial support 1,244 62% Combined SES 1,633 58% VSLA   424 Community skills 404 Apprenticeship 89 Financial Literacy 24 Home Visiting 309 15% Adolescent Friendly Sexual Reproductive Health for girls Risk reduction messages 5,000 1,685 34% HIV Counseling and Testing services 3,000 1,741 Gender Based Violence 5 Strengthening the community Community dialogues 1,337 Decreasing risk in sexual partners Males accessing VMMC services 79

Parenting Training DREAMS uses the SINOVUYO parenting teens model It targets parents and their Teens It is a 14 module training with 8 joint sessions and 6 separate sessions Its complemented by the SCORE parenting model for the AGYW it doesn’t target.

Life skills and Stepping stone Training Stepping stone is an HIV prevention behavioral change approach Quote; “I have attained courage to speak out my mind after the life skills training unlike before when I never used to speak among my peers. I also encourage my fellow youth to go out to test for HIV and know their status. I am now knowledgeable about HIV/AIDS; if I got raped; I would rush straight to hospital by myself or insist I be taken there so I can benefit from PEP” Victoria AGYW

Psychosocial Activities Quotes; Bamwanje Saudah A- Kla- 0654-02 “l have really enjoyed, it has been a long time since l last played nyama nyama game” Namulema Teopista “ for sure this game has reminded me the good times l used to have with my siblings when we were still young , I think l should start playing it with my children”.

Community skills and Apprenticeship

Gender Based Violence Prevention There is increasingly reported cases of GBV after the learning sessions in the AGYW safe spaces We have protocols for dealing with GBV cases Quote “There is a belief that the women should have extra patience in relationships, while the men believe that they are meant to be aggressive and not assertive. As a mentor I strive every day to help people change their perceptions and prejudices around gender – as these are among the major causes of sexual and gender based violence.” Munnah – AVSI Foundation DREAMS Mentor

HIV Counseling and Testing Services Best Practice Worked in collaboration with MUWRP and KIFAD. HTS services were offered in the safe spaces/groups for the AGYW and their family members.

Linkage to care and treatment All the identified positive AGYW have been referred to the Health facilities for enrollment into care. Through case tracing, 80% have been linked and are accessing care.

Decreasing risk among male sexual partners SCORE has adopted the Sexual partner diversity assessment approach from population council as an entry point to identifying males to target. Characteristic of AGYW Interviewed # of groups Analyzed 8 # of AGYW interviewed 169 AGYW Age group 15-24 years

Male Partners characterizations

Most important reasons for involving with male partners

Program Response suggested by the AGYW

Risk Reduction among Sexual partners In collaboration with MUWRP organized community dialogues with male partners; 79 tested for HIV and were provided with condoms TT vaccination provided in preparation for VMMC services.

Quote “Before the DREAMS parenting and life skills training, I used to shout at my child and I did not really communicate well with my husband. Things have now changed. I love my child and treat her very well and through the parenting training module on couple relationship – I learnt how to relate better with my husband. We now share a very good relationship. Through Community skills training, I learnt how to make bags as an income generating activity and I am excited that I can used these skills to earn an income” Sharifa – AGYW

Challenges Change in Targets and focus categories Short implementation period with so many interventions to deliver Different modes of implementation with our partners MUWRP

Plans/opportunities Training additional staff in Sinovuyo Parenting Teens Model Training of additional peer facilitators in Stepping stones OVC Plus up – opportunities for ECD and additional Apprenticeships, and community skills

DREAMS Targets- COP 16/17 New VSLA formed 100 VSLA members 2500 Financial Literacy 3000 SPM Community skills 2000 Apprentices enrolled 700 Apprentices completed and on the job 600 Life Skills/ Stepping Stones Parenting skills Risk reduction messages - dialogues 5000 HCT and linkages to care and treatment

THANK YOU