May 2019 was the start of a new impactful collaboration between Janssen Pharmeceutical Companies of Johnson & Johnson employees, government adolescent focal health workers, adolescent peer leaders, and adolescent specialists from our NGO partner, Baylor College of Medicine Children’s Foundation Uganda. Over six months, the participants applied their leadership and innovation skills to reach over 1,100 adolescents with health education and services, using small budgets of just £750 per team. All participants felt they had improved their leadership skills, and several described the programme as life-changing! This will have a lasting impact on the delivery of sexual reproductive health services to some of the 125,000 young people living in Kamwenge and Kitagwenda districts, Uganda.
“I hope to engage the adolescents more in finding solutions to things that challenge them in their health facilities. I believe they hold the answers” – Baylor Adolescent Officer
Project 1: Team Mahyoro
Team Mahyoro discovered that limited sexual health education is delivered at secondary schools. They found that myths and misconceptions about sexual health and HIV were common amongst teachers and students, and there was a lack of trust between students and their teachers.
The team organized a training of teachers and student leaders on adolescent sexual and reproductive health so they could act as educators and advocates for adolescent health in their schools.
300+ students received sexual and reproductive health education delivered by their teachers; 1 in 6 of these student then sought services
6 student leaders and 9 teachers are now Adolescent Focal Persons, contributing to a safer and more open environment in three schools for students to discuss sexual health issues.
48 students attended the new adolescent only clinic in November 2019 – more than double the number of adolescents that the health facility typically sees in one month!
The team is currently looking at options to scale up this innovation!
“[This programme] helps to build thinking capacity, to change the attitude of health workers, and helps people realise the strength in themselves and believe they can make it”- Ugandan health worker
Project 2: Team Ntara
This team found that Ntara health facility, which serves 80,000 people, provides excellent Adolescent Friendly Health Services to adolescents in HIV care, but that staff are overburdened and have little time to educate the wider community about the adolescent health services they provide. The team agreed that parents should also be educated on the importance of adolescent health and resolved to focus their innovation on increasing community awareness of adolescent sexual and reproductive health issues.
Team Ntara hosted a one-day Family Health Day to increase uptake of adolescent health services at the health centre.
450 community members were provided with quality information on adolescent sexual and reproductive health issues.
195 adolescents tested for HIV and 3 new HIV positives were identified and linked to care
25 people were provided with family planning services
68 were screened for STIs, and 25 young people who tested positive were treated.
“My mindset is the greatest weapon that I have to surpass any challenge in life” – Adolescent Peer Leader
Project 3: Team Bigodi
Team Bigodi found that that there are few interventions for HIV- adolescents to learn about Sexual Health and HIV prevention. The team was impressed by the impact HIV+ peer leaders were having in improving care for HIV+ adolescents and wanted to adapt use this model for HIV prevention amongst negative adolescents.
Team Bigodi carried out a two-pronged project for increasing knowledge of and access to SRH services for HIV- adolescents.
The three new HIV- peer leaders are now supporting fellow young people at Bigodi Health centre
The team reached 411 clients over a two-day outreach health camp
68 young people took up Family Planning services in two days – more than the total number for the Health Facility in 2018 (n=59)!
25 young people were screened for HIV and 45 people were tested for STIs
This model has been adopted by Baylor-Uganda as part of their DREAMS pilot.
Leadership Impact
One of the Uganda participants felt that the programme had “changed her life.” She said that it changed the way she perceived the world, improved her motivation at work and encouraged her to pursue further qualifications in nursing. Perhaps most importantly, she changed her opinion on the provision of Family Planning to adolescents. Before the programme, she refused to offer family planning to adolescents unless they were already young mothers. Now, she provides health education on the topic to all adolescents who enter the Health Centre.
Inspired by the field visits, an adolescent peer leader started a savings scheme with 40+ adolescents in HIV care at his facility. He encourages peers to save money from their transport refunds for their future. He believes the programme changed his life, and wants to see every adolescent in Uganda receive leadership training.
Building our programme impact
We hope this project will increase the number of adolescents accessing Family Planning and testing for HIV at the target health facilities, not only because of successful innovations, but also because the improved leadership skills. This programme will continue to change the mindsets of adolescent focal health workers, peer leaders and wider healthcare and NGO staff and they will consider adolescent health a priority. We have already had positive feedback from the new adolescent division of Uganda’s Ministry of Health and are looking forward to multiplying the impact started by Cohort 1!