1. Synergies for Adolescent and young people’s health and well-being Service packages and platforms Dr. Tajudeen OYEWALE, MD, MPH, PhD HIV Section, UNICEF New York

2. OUTLINE 1.UNICEF’s focus on adolescents 2.Service package for adolescent health and wellbeing 3.Platforms for service delivery 4.Adolescent engagement

3. UNICEF’s core areas of work with and for Adolescents

4. Service Package for Adolescent Health and Wellbeing Service package has to be cross- sectoral for adolescents Menu options across core prevention programmes and policy / structural actions to achieve a reduction in new HIV infection and promote cross- sectoral synergies Differential approach for different epidemic settings based on Country Data and Local Context Detailed Strategy Mix for HIV Prevention among girls and young women: A menu of Options Source: UNAIDS, UNICEF and WHO, HIV prevention among adolescent girls and young women: Putting HIV prevention among adolescent girls and young women on the Fast-Track and engaging men and boys, UNAIDS, 2016.

5. Tailor the service package Implementation Considerations Population Groups Geographic Settings Mix of interventions Examples of a combination HIV prevention package for high-prevalence sites in southern Africa Source: UNAIDS, Fast-tracking combination prevention: Towards reducing new HIV infections to fewer than 500 000 by 2020. UNIADS, 2015

6. Use Multiple Platforms Example on Site Options and Delivery Modalities for VMMC 1.Site Options a.Fixed Sites i.e. fixed structure in health facilities b.Mobile site like tents c.Outreach site like clinics and schools modified for VMMC activities 2. Service Delivery modalities a.Routine – within existing health services b.Campaign Platforms for delivering adolescent health programmes Source: Author School Community / Outreach Health Facilities Cloud Adolescent Engagement & Empowerment Policy Environment PEPFAR’s Best Practices for VMMC site operations available https://www.usaid.gov/sites/default/files/documents/1864/pepfar_best_practice_for_vmmc_site_operations.pdf https://www.usaid.gov/sites/default/files/documents/1864/pepfar_best_practice_for_vmmc_site_operations.pdf

7. Does the service delivery platform matter for adolescents and service coverage? In the Analysis of VMMC service delivery intensity and modalty in Tanzania and modality In Tanzania, for all age groups, with the exception of those above the age of 35, clients attending campaign services were significantly younger than those attending routine services (p =0.0001) in both campaign and routine service delivery combined. In Tanzania, majority of clients served during campaign (59%) were in the 10–14 years age group; The majority of clients served during routine service delivery (64%) were above 15 years of age (p,0.0001) In Zimbabwe, significantly more male circumcisions were done during campaigns than during routine service delivery, 64% vs. 36% respectively (p,0.00001) Source: Ashengo TA, Hatzold K, Mahler H, Rock A, Kanagat N, et al. (2014) Voluntary Medical Male Circumcision (VMMC) in Tanzania and Zimbabwe: Service Delivery Intensity and Modality and Their Influence on the Age of Clients. PLoS ONE 9(5): e83642. doi:10.1371/journal.pone.0083642

8. The engagement and empowerment of adolescents is also important as part of the synergy Our future: a Lancet commission on adolescent health and wellbeing. The Lancet: 2016. http://dx.doi.org/10.1016/S0140-6736(16)00579-1 http://dx.doi.org/10.1016/S0140-6736(16)00579-1 An interactive mobile phone and SMS-based programme, U-report provides confidential counselling via SMS and chat. Currently, there are 2.1 million U-Reporters across the globe.

9. UNICEF: Chewe Luo, Susan Kasedde, Shirley Mark Prabhu, Landry Dongmo Tsagwe and Paul Nary & The UNICEF Second Decade Matrix Group PSI: Nina Hasen Acknowledgements

10. Thanks