YATHU YATHU ("For us by us"): A Cluster Randomised Trial of community-based SRH and HIV services for adolescents and young people in Zambia

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Infectious and Tropical Diseases

Abstract

There are more than 1.8 billion adolescents and young people (aged 10-24) alive today, more than ever before in world history. Most of these live in developing countries, with many countries in Africa having 50% of the population less than 18 years old. HIV is the second leading cause of death in this age group and the number of new infections continues to rise. HIV infection, unwanted pregnancies and early marriage limit the potential of millions of young women yet services to prevent these are often not accessible to young people.
In Zambia, adolescents (10-19 years old) represent 25% of the total population. Zambia has the 5th highest adolescent birth rate in sub-Saharan Africa (the region with the highest rates in the world) and 44.7% of women under 20 reported an unplanned pregnancy. HIV prevalence rates in the Lusaka communities chosen for this study are 6.4% among 15-24 year old women and 1.6% amongst young men of the same age, rising rapidly thereafter. The Zambian Adolescent Health Strategy 2017-2021 recognises sexual and reproductive health (SRH) and HIV as the two leading priorities for health service planning with a mission "to ensure equity of access to appropriate, quality and cost-effective adolescent-friendly health platforms and an adolescent responsive health system as close to the people as possible."
When we ask young people in Zambia what SRH services they want they unequivocally tell us that they want services specifically designed for them, provided with them ("Yathu Yathu; For us by us") away from traditional health facilities where attitudes of health providers can still be stigmatising towards young people. In response, we have designed a community-based, peer-led intervention that makes use of innovative technology, including prevention points "loyalty card" to incentivise and measure service access and use, and support for uptake and adherence to services using virtual support groups. At the start of the study period, we will continue discussion with adolescent community advisory boards to refine the location, content and delivery of the community-based peer-led services.
This study aims to evaluate the process of establishing and delivering community-based peer-led SRH services, including HIV testing, treatment and prevention, in two urban communities in Lusaka, Zambia. The study will compare the uptake of SRH services by adolescents and young people aged 15-24 living in areas of the ten communities which were randomly allocated to have access to these community-based, peer-led services, compared to ten areas randomly allocated to have services provided via traditional health facilities. The study will measure whether the community-based peer-led services increased knowledge of HIV status and coverage of SRH services relative to standard of care areas. To measure knowledge of HIV status, we will conduct a cross-sectional survey in all sites 18-months after the intervention implementation and compare these outcomes between the intervention and standard of care sites. To measure coverage, we will use the data routinely collected at point of service access and use by the innovative prevention points cards system. The innovative chip-enabled prevention points "Yathu card" will enable service users to collect of SRH "prevention" points, which can be exchanged for goods and services, to encourage uptake of services and measure access. The study will also evaluate the use of mobile phone based support groups to enable adolescents and young people to adhere to medication such as anti-retroviral therapy used either as treatment for HIV or as pre-exposure prophylaxis (PreP).
The research will be carried out by Zambart a Zambian research organisation in collaboration with researchers from the London School of Hygiene and Tropical Medicine and Imperial College in the UK in partnership with the Zambian Ministry of Health, Society for Family Health and the SHM foundation.

Technical Summary

Yathu Yathu ("For us by us") is a two-arm cluster-randomised trial that will evaluate community-based, peer-led sexual and reproductive health services (SRH), including HIV prevention and treatment for adolescents and young people (AYP), in 2 urban communities in Lusaka, Zambia.
SRH services will be established in community spaces in collaboration with adolescent community advisory boards who will advise on the location, content and running of the services. Services offered will include contraception, condoms, HIV testing, STI screening and treatment, VMMC information and referral, ART support groups (face-to-face and via mobile phone), PEP/PrEP services and support groups (by mobile phone), menstrual hygiene products as well as information and support on a range of other subjects requested by young people.
The 2 communities are divided into 20 clusters that will be randomized to intervention or control arms. Each intervention cluster will have one community centre with services accessed either at the centre or the health facility. In the control clusters, services can be accessed at the health facility as per the national standard of care. The primary outcomes will be knowledge of HIV status, measured via a cross-sectional survey, and an indicator of coverage measured using an electronic prevention points "Yathu card" provided to all AYP, aged 15-24 years, living in the study communities. Secondary outcomes will include uptake and adherence of specific services such as ART, PreP, or modern contraceptives. In addition economic and qualitative enquiry will provide data on the costs and inputs required to establish the services, barriers and enablers to the use of the services and the experience of AYP in both control and intervention arms.
The study findings will help inform policy-makers on how to best provide SRH services for AYP.

Planned Impact

This research will directly benefit the communities where it is being conducted in Lusaka, Zambia. As highlighted in the Pathways to Impact, engaging adolescents and young people has been a critical part of this application from the outset. Over the past four years, the Yathu Yathu team has established a presence within the communities, developing a relationship through and with adolescent community advisory boards. The communities will continue to be engaged throughout the study, including in developing and conducting the intervention and the research, with some important employment opportunities, as well as benefitting from improved access to services. If the intervention has the desired effect, more adolescents and young people will be able to make important decisions in their lives to avoid HIV infection and unplanned pregnancies, both of which will improve the quality of their lives and their economic and social productivity in the communities where they live. Adolescents and young people who are engaged in the research process will gain important skills from the process and this may enable them to access employment and other educational opportunities in the future.
All services delivered through the Yathu Yathu intervention will be linked to and delivered in collaboration with existing Ministry of Health health facilities, including HIV treatment, prevention. The research will directly affect these health facilities, and health management professionals in Lusaka district and province, who will be able to observe the operations of the Yathu Yathu centres and learn lessons for the provision of services both within the health facilities as well as possibly in communities in the future. The research teams will gain important skills in community based research as well as new knowledge from the electronic and mobile phone based systems.
We plan to build on the existing relationships with national and regional authorities, international funders and agencies, to rapidly translate our findings into a comprehensive evidence base that supports decision making within and outside of Zambia. National and Regional policy makers will benefit from lessons learned from the implementation of the intervention and also the results of the trial. Through the P-ART-Y study, we have shown that rapid changes have been adopted by participating Ministry of Health health-care facilities following initial consultations, for example to implement adolescent corners in existing health facilities. We would anticipate that, should the implementation of the intervention be successful and coverage of services increase in a cost effective manner, then policy makers would adopt this model of adolescent-responsive services. This would be directly in line with the Zambian adolescent strategic framework with the results of the trial being available within the time frame of this framework (2017-2021) such that the intervention could be scaled up and introduced as policy in the next version of the guidelines.
Internationally, WHO and UN agencies have commissioned reviews of what works for adolescent SRH and have reached the conclusion that more rigorous evidence of high quality interventions is needed. The combined UN agencies have launched the Global Accelerated Action for the Health of Adolescents (AA-HA!) initiative in 2017 and so robust and rigorous evidence from a well-designed cluster randomised trial that incorporates many of the recommendations from this process and fully engages with adolescents and young people will be important to feed into this process and achieve the development goals by 2030. Funders, including PEPFAR and the Bill & Melinda Gates Foundation, with whom we already have an established relationships with, will benefit from the findings as it will provide information on what research is still required and direction on how to target their investments.
 
Description Membership of of national adolescent health technical working group
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact The Yathu Yathu study manager is a member of the monitoring and evaluation sub-committee of the national adolescent health technical working group. She advocated for the disaggregation of the sexual reproductive data for AYP in the national health information system which has been given serious consideration. This will make it possible for health facilities to access data for specific AYP bands and age categories and thereby result in better AYP targeted interventions.
 
Description Yaba guy che "for the guys": Intervention co-development to increase men's HIV service use
Amount £142,564 (GBP)
Funding ID MR/V031171/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 09/2021 
End 04/2023
 
Description SHM 
Organisation The SHM Foundation
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We are working with SHM to develop the mobile phone part of the protocol. The money was for the Insaka project which was part of the formative work for Yathu Yathu. My research team co-designed and implemented the pilot intervention and analysed the data in conjunction with SHM
Collaborator Contribution SHM brought mobile phone chat expertise to the partnership and we learned lessons form their p[revious work. They additionally won an award which provided funding for the pilot
Impact Report of the pilot project and an abstract submitted to AIDS impact
Start Year 2018
 
Description Zambart 
Organisation Zambia AIDS Related Tuberculosis
Country Zambia 
Sector Academic/University 
PI Contribution Intellectual input to research design. Training and mentoring of staff.
Collaborator Contribution Infrastructure: office space, data server and networking, transport, communications infrastructure Community Engagement: long standing relationships with community
Impact Not yet from this project; multiple in the past
 
Description Adolescent CAB and Adult CAB meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact Adolescent CAB and adult CAB members are representatives of the two communities. Scheduled CAB meetings were conducted to provide progress update of the study to the community representatives and to get feedback from them. The meetings usually provide useful feedback to the study team.
Year(s) Of Engagement Activity 2020,2021
 
Description Adolescent CAB and adult CAB meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Adolescent CAB and adult CAB members are representatives of the two communities. CAB meetings were conducted to provide progress update of the study to the community representatives and to get feedback from them. Some CAB meetings were specifically held to discuss issues arising from the community such as those to do with security concerns for staff and study participants. in total 5 CAB meetings were held between July and December 2019 and CAB members began to understand the study better.
Year(s) Of Engagement Activity 2019
 
Description COVID 19 video song 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This song was done to promote vaccine uptake among adolescents and young people, and addressed the common COVID-19 myths and misconceptions.. It was released on September 5, 2021. The song was written and composed by the Yathu Yathu Peer Support Workers and produced by a local community music and video producer from Chipata community. Its lyrics were a mixture of Nyanja and Bemba (two popular languages) and English.
Year(s) Of Engagement Activity 2021
 
Description Community dialogue meetings 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact The dialogue meetings were conducted to address the socio-cultural issues which parents and guardians were raising regarding adolescent and young people's sexuality. AYP complained that prevalent norms affected their access and use of sexual reproductive health and HIV services. The dialogue meetings aimed to help parents and guardians understand the value of contraceptives, condoms and other services with regard to improving adolescent health. In the end, some level of trust between AYP and older people was established. Most older people pledged to support their children to access hubs.
Year(s) Of Engagement Activity 2021
 
Description Community engagement activity 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Additional funds obtained from LSHTM to develop a music video with the peer support workers to inform study participants about COVID19, and how to protect themselves from COVID19. The song was developed by the peer support workers, and they appeared in the video.
Year(s) Of Engagement Activity 2020
 
Description Community preparedness activities 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Community preparedness involved conducting a minimum set of engagement activities in each community within a one-week period to introduce the study to key stakeholders and gatekeepers. This included doing the following in each community: holding adolescent and adult CAB meetings, a stakeholder meeting which was attended by our community based stakeholders, and community meetings to inform the community about the Yathu Yathu study. In total 8 preparedness activities were conducted involving 50 people.These activities were important to obtain permission to enter the two communities and to gain trust from key community stakeholders. A list of questions was generated and later developed into a frequently asked questions (FAQ) document.
Year(s) Of Engagement Activity 2019
 
Description Conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Poster presentation at IAS mexico City 2019
HIV prevention knowledge gaps on pre-exposure prophylaxis (PrEP) among adolescents and young people aged 15-24: Insights from formative research in two urban communities in Lusaka, Zambia.
Year(s) Of Engagement Activity 2019
 
Description Conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Poster presentation at conference on HIV in adolescents, Nairobi Kenya
Engaging adolescents and young people in designing a comprehensive community-based peer-led HIV and sexual reproductive health intervention: Lessons from a formative study in two urban communities in Lusaka, Zambia.
Year(s) Of Engagement Activity 2019
 
Description Conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact poster presentation at HIV and adolescents workshop Nairobi Kenya
'For us by us': Adolescents and young people's preferences for incentivised HIV and sexual reproductive health service delivery in Zambia.
Year(s) Of Engagement Activity 2019
 
Description Consultative meeting with Adolescent Health Technical Working Group members on Adolescent Health Strategy 2022-2026 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Representatives from the Yathu Yathu team attended, also as a member of the adolescent technical working group, to discuss the Yathu Yathu strategy and emerging findings from Yathu Yathu in order to feed into the development of updated Adolescent Health Strategy for the period 2022-2026.
Year(s) Of Engagement Activity 2021
 
Description Development of a community engagement manual 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact The community engagement manual was developed with input from Community Advisory Board (CAB) members. The purpose of the manual is to guide implementation of community engagement activities in the study communities. It contains guides on how to create buy-in from the community members, how to conduct mobilization activities, and tools to document mobilization activities and community response.
Year(s) Of Engagement Activity 2019
 
Description Development of study videos 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact A music video was made with the help of peer support workers and community representatives to inform study participants about COVID19, and how to protect themselves from COVID19. Four other information videos were made to promote the study. These were posted on Facebook and WhatsApp groups. The AYP became less fearful of covid-19 and attendance increased after re-opening the hubs. Other institutions requested for the videos.
Year(s) Of Engagement Activity 2019,2020
 
Description Dissemination of formative research findings 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact This half dissemination was intended to share the findings of the formative research phase of Yathu Yathu with other non-governmental organisations, community members, individuals who participated in the pilot study of a mhealth component of Yathu Yathu, in addition to sharing the proposed intervention and evaluation design with these key stakeholders. There were approximately 50 attendees. The presentations invited questions about the proposed intervention components and also informed community members about future planned activities.
Year(s) Of Engagement Activity 2019
 
Description Late breaking Poster presentation at CROI 2022 Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The primary outcome of Yathu Yathu was accepted as a late breaking poster presentation. A poster was prepared, describing the trial and presenting the primary outcome of the trial, alongside five slides with audio recording included in the submission.
Year(s) Of Engagement Activity 2022
 
Description Ongoing awareness and study promotion 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Community announcements and door to door sensitizations were done in all intervention zones. In addition, one-on-one discussions with community members were conducted. Health talks were conducted at the health facilities and in public gathering places such as water kiosks and child growth monitoring points. The community engagement team was supported by other study staff and ACAB members to implement these activities. Assisted referrals of study participants were done during these activities. The Yathu Yathu theme song which was produced by the Yathu Yathu Peer Support Workers and other songs popular with young people were played as part of entertainment during the above activities. There was an increase in visits to the hubs. There was acceptance of the study by the general public.
Year(s) Of Engagement Activity 2020,2021
 
Description Oral presentation at HIV & Adolescence Workshop 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral presentation by Madalitso Mbewe titled: 'Supporting the Supporter': Lessons Learnt From a Virtual Peer Support Intervention for Young Pregnant Women Living with HIV. This was a presentation on the nested Insaka sub-study. The objective was to share lessons learnt on how to support the individuals providing virtual social support to young pregnant women living with HIV.
Year(s) Of Engagement Activity 2020
URL https://academicmedicaleducation.com/hiv-adolescence-2021
 
Description Poster presentation at AIDS 2020 virtual 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact A poster presentation at the AIDS 2020 virtual conference on uptake of HIV testing services at the Yathu Yathu hubs during the pilot implementation phase. Presented by Mwelwa Phiri (Implementation manager).
Year(s) Of Engagement Activity 2020
 
Description Poster presentation at CROI 2022 conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Poster presentation at CROI 2022 of the key secondary outcome of the trial. The presentation allowed for development of a poster and submission of slides with audio describing the trial and results.
Year(s) Of Engagement Activity 2022
 
Description Poster presentation at HIV & Adolescence Workshop 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Chisanga Mwansa presented a poster titled: Experiences of Yathu Yathu hub services providers in delivering comprehensive sexual and reproductive health services to adolescents and young people aged 15 - 24 in Lusaka, Zambia. The analysis presented how hub staff considered the delivery of services to AYP as rewarding yet challenging. AYP's self-reported positive behavioral change stories, increased HIV testing at hubs and accessibility of HIV/SRH services, reaffirmed the importance of the role of the hub staff as presented in the poster by the quote: "Just adolescents testing for HIV is a success because they eagerly wait for three months to elapse; 'Test us, test us', they say". Hub staff reported improved interpersonal skills and confidence and that they had to overcome some of their own beliefs and prejudices about the appropriateness of some AYP using contraception and condoms: "I have learnt toleranceI can proudly say, my girl child when she reaches 15 years I will take her personally to access family planning".
Year(s) Of Engagement Activity 2020
 
Description Poster presentation at HIV & Adolescence Workshop 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Madalitso Mbewe presented a poster titled: Integrating technology and HIV services: Lessons learnt from the Insaka mobile phone-based virtual support group intervention for young pregnant women living with HIV aged 15-24 in Zambia. In this poster, she presents data from the Insaka Pilot and the main Insaka study nested within Yathu Yathu. Results show that, in the pilot study, 298 young pregnant women living with HIV were screened and 61 (20%) were eligible and included in the study. Consenting participants were placed in 6 virtual support groups. Participants unable to operate a basic smartphone were taught how to use emojis. Participants using emojis could not engage further than posting emojis. They neither responded to reactions to their emojis nor asked questions. Some participants mocked peers who only used emojis.
In main Insaka study nested within Yathu Yathu, out of 149 young pregnant women living with HIV screened in the intervention zones, 86 (58%) were unable to operate a basic smartphone. Consequently, only 63 (42%) of these YPWLHIV were included in the intervention and placed in 7 virtual support groups. Participants engaged in conversations amongst themselves and guest speakers; troubleshooting instructions were given on phone use as needed.
The poster highlights that technology-based interventions are an innovative way to create social spaces when physical spaces are limited (of particular relevance in a COVID-19 era). However, benefits may be limited considering participants' inability to access and use technology-based platforms and limited literacy.
Year(s) Of Engagement Activity 2020
 
Description Presentation at ADOLESCENT HEALTH SYMPOSIUM: "STRENGTHENING EVIDENCE-BASED PROGRAMMING TO IMPROVE AND SUSTAIN ADOLESCENT HEALTH" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The Insaka (nested sub-study) study manager lead the talk: Integrating technology and HIV services:Lessons learnt from the Insaka mobile phone-based virtual support group intervention for young pregnant women living with HIV aged 15-24 in Zambia, and the presentation: Supporting the supporter: lessons learnt from a virtual peer support intervention for young pregnant women living with HIV.
Year(s) Of Engagement Activity 2021
 
Description Presentation at ADOLESCENT HEALTH SYMPOSIUM: "STRENGTHENING EVIDENCE-BASED PROGRAMMING TO IMPROVE AND SUSTAIN ADOLESCENT HEALTH" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The Yathu Yathu Community engagement lead presented a talk titled: Sex before marriage is a sin: Addressing community norms regarding access to sexual and reproductive health services for adolescents and young people in the Yathu Yathu Trial in Zambia. This presentation won first prize in oral presentation for the Best Practices abstracts.
Year(s) Of Engagement Activity 2021
 
Description Presentation at ADOLESCENT HEALTH SYMPOSIUM: "STRENGTHENING EVIDENCE-BASED PROGRAMMING TO IMPROVE AND SUSTAIN ADOLESCENT HEALTH" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The Yathu Yathu study manager presented the abstract: Uptake of HIV testing among adolescents and young people attending peer-led community-based sexual and reproductive health services in Lusaka, Zambia: early results from the Yathu Yathu trial. This presentation won first prize in oral presentations under the Original Research category
Year(s) Of Engagement Activity 2021
 
Description Presenting data at conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Poster presentation at AIDS Impact conference, London 2019
Project Insaka: Qualitative assessment of the social and psychosocial content of text message data from phone-based support groups for adolescent, pregnant, HIV-positive women in Lusaka, Zambia.
Year(s) Of Engagement Activity 2019
 
Description Sensitization/ study promotion activities 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Sensitization activities were conducted to create awareness about the study. Some of the activities were conducted to respond to emerging issues from the community, including stories about possible unintended consequences of the study. Activities conducted included community meetings, door to door/ house to house visitations, and announcements using loud halers. In total 32 activities were conducted between July and December 2019 reaching 33,384 people.
Year(s) Of Engagement Activity 2019
 
Description Stakeholder dialogue meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact These meetings were intended to respond to specific rumours and misinformation circulating in the community, provide progress updates and to obtain feedback from different community interest groups. Parents and guardians appreciated the SRH services being offered at the hubs and became much more supportive to their children. The meetings helped to transform understanding about issues such as contraceptives, condoms and build trust between AYP and parents/ guardians.
Year(s) Of Engagement Activity 2020,2021
 
Description Stakeholder mapping 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This activity involved identifying local leaders, SRH service providers, church based organisations, and other community based organisations. 53 stakeholders were identified in the two communities, including the existing Adolescent community advisory Boards (aCABs). Membership and size of the aCABs were reviewed using a criteria that was developed with the input of the community representatives.
Year(s) Of Engagement Activity 2019
 
Description Study Exit Community Meetings 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Community members were informed and prepared for the ending of the study. They were also informed about when the primary and secondary outcomes of the study would be made available. Their views were sought regarding how they wanted the results of the study to be disseminated. Flyers were distributed with study exit messages and announcements were made using the public address system. Letters were written and distributed to churches and announcements were made during church services.
Year(s) Of Engagement Activity 2021
 
Description Virtual dialogue groups 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact WhatsApp groups were created by adolescent community advisory group members and supported by the community engagement staff to keep the AYP engaged at the peak of the Covid-19 situation, particularly when field work was temporarily suspended. This helped to keep the AYP interested in the study. Discussions on the groups also helped to continue with the delivery of comprehensive sexuality education and related topics.
Year(s) Of Engagement Activity 2020,2021
 
Description Visit by the Public health specialists and the Assistant Director of Health 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Two Public Health Specialists from the health facilities servicing the two communities where Yathu Yathu is being implemented visited the hubs. The Assistant Director of Health from the Ministry of Health headquarters also visited the hubs to learn more about the study with the possibility of replicating the Yathu Yathu model to other parts of the country. The Yathu Yathu field team shared their experiences and made recommendations to the Ministry of Health.
Year(s) Of Engagement Activity 2020