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Synergies in Youth-to-Youth Provision of Sexual and Reproductive Health Education for conflict-affected refugee youth in Uganda

This idea aims to develop a specific SRH education curriculum for conflict-affected refugee youth in hopes of improving SRH behavior

Photo of robert hakiza

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What specific problem(s) are you trying to address?

Uganda hosts more than 1.5 million refugees & conflict-affected people, with over 50% women and girls. Though Uganda is praised for the support it provides to refugees, sexual and reproductive health (SRH) needs for women, girls and youth people are limited. SRH includes physical, mental and social-wellbeing, and is grounded in rights that involve sexual and reproductive freedom, autonomy, care and information. Results from a multi-methods study indicated that there are significant unmet needs concerning maternal & delivery care, comprehensive family planning services and education. Further, results demonstrate an equally concerning need for comprehensive sexual education due to rampant belief in myths and misconceptions surrounding SRH.

What are some of your unanswered questions about the problem(s) you are working to address?

Our first objective is to evaluate whether, in comparison with pre-intervention, adolescent women who attended SRH education will demonstrate increased knowledge of sexual transmitted infections (STIs). Our second is to examine if, in comparison with pre-intervention scores, participants who received the SRH education will report the following changes in scores at the post-intervention evaluation:(1) increased safer sex self-efficacy; (2) increased resilience; 3) increased social support; etc.

Explain Your Idea

We will develop and pilot-test a comprehensive SRH education curriculum that uses a comprehensive sexuality education (CSE) focusing on social contexts of SRH: gender equality, relationship power, and human rights. CSE will empower adolescents with skills to make informed sexual health decisions, while reducing risks of coercion, stigma, and depression. We recognize that sexuality is a sensitive subject that young prefer to learn from their peers. We will train peer educators on CSE, and equip them with the necessary toolkits needed for them to conduct multiplier trainings in their communities. We will use arts-based approaches to diffuse tension, minimize fear and encourage learning in a fun environment. Emerging evidence among adolescents indicates that sexuality education delivered through arts-based approaches is informative, inclusive, acceptable, and memorable for participants. Delivering CSE through art-based approaches such as body mapping, quiz boxes, drama, music composition and jeopardy will equip participants with a simulated environment on how address SRH needs. At the end of our CSE intervention, participants will demonstrate (1) increased safer sex self-efficacy; (2) increased resilience; 3) increased social support; (4) reduced depression; (5) reduced intimate partner violence; and (6) increased contraceptive access and use. The success of our intervention is informed by our belief in collective impact, were we collaborating with existing organization.

Name the three most important ways that your idea will address your identified problem(s).

This idea will allow us to: 1) Understand and assess SRH knowledge amongst conflict-affected refugees in Uganda; 2) Implement and provide a sustainable comprehensive sexual education curriculum to conflict affected adolescent refugees; and 3) Improve SRH knowledge amongst conflict-affected refugees in Uganda.

How is your idea unique?

This idea is quite unique as we will be synergising with another youth-led SRH organization in Uganda. Through this approach, we are creating a sustainable program that will allow for the sustained provision of SRH education for urban and rural conflict-affected refugee youth. This collaboration allows for the burdens associated with implementing such an idea and allows both organizations to leverage our strengths and weaknesses against one another. Consequently, this results in the engagement of various stakeholders, and allows us to ensure the success of this program if implemented. Further, give the vulnerable study population of this project, we will be using International Planned Parenthood Federation Framework for Comprehensive Sexual Education as it is a model that considers power dynamics that affect sexual choices and decision, which consequently affect the adolescent's development. This approach emphasizes sexual expression, sexual fulfillment, pleasure, and acceptance

What are some outstanding concerns or questions that you have regarding your idea?

Given the geographic choice of the project, we expect that the effects of culture, tradition and religion. These three affect discourse around SRH and therefore, we are fully aware of some of the challenges they may pose but intend on embedding mitigating strategies for each such as ensuring the curriculum has a youth-to-youth approach, and including cultural and religious leaders.

Who are your end users?

Conflict affected refugee youths who benefit by committing to attend a series of SRH education sessions that cover a range of topics. These sessions will provide them with accurate SRH information to help them become fully informed and autonomous in decisions regarding SRH. By improving their knowledge on SRH, we hope that this program will improve the SRH outcomes of refugee youth. These refugee youth will either be in a refugee settlement or self-settled in Kampala. In one cycle of this intervention, we hope to reach at least 80 youth (20 girls and 20 boys in each site).

Where will your idea be implemented?

  • Uganda

What is the primary type of emergency setting where your innovation would operate?

  • Prolonged displacement

Tell us more about the emergency setting that you intend to implement in

This project intends to work in Kampala, with possibility to be expanded to one refugee settlement in Uganda – the Nakivale. Further, we have collaborated with a number international organizations and researchers that have also done work at this settlement. As such, we do not foresee major challenges in implementing the proposed project. We will ensure that all local approvals, including ethics, and permission from the Office

What is your organization's name?

Young African Refugees For Integral Development (YARID)

Tell us more about you.

Young African Refugees for Integral Development (YARID) is a refugee-led organization based in Kampala that aims to empower refugees and displaced persons with Skills to become healthy, educated, self-sustaining and contributing members of society. We will also be collaborating with an emerging researcher African-Canadian researcher from the University of Ottawa. We recently supported her work focusing on exploring the reproductive health needs of Congolese refugees in Uganda. As such, she will be an extremely valuable resource in terms of up-to-date information and knowledge of Congolese refugees needs concerning reproductive health

Organizational Characteristics

  • Displaced person / refugee-led organization

What is the current scale of your proposed innovation?

  • Still in planning phase and does not exist yet

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

We are a refugee-led organization based in Kampala, Uganda. We are registered with the Ministry of Internal Affairs as non- profit organization Reg. N° S.5914/8933

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.

Website

www.yarid.org

How has your idea changed based on feedback?

We organized several consultative meetings with the end users to hear from them and to understand what their perceptions on Sexual reproductive health is. We have also discussed with parents, local leaders and partners involved in the SRH. We have learned that information regarding SRH are rarely discussed in families and that the youth are more conformable to learn from their peers. We have learned that there are still many myths, tabus and misconceptions on SRH. The valuable feedback we got from all of them and the OPEN IDEO community helped us to shape this idea.

Who will implement this idea?

The implementation of this idea will be composed by a full time staff of 3 people (one coordinator and 2 trainers) who will work with a partner organization to develop the course and to train refugee educators. The team will also benefit from advises of an international researcher. Other people will be volunteer youth from the community.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

In 2015 YARID team benefited from a Human-centered design training from AMPLIFY team, since then YARID has been using a Bottom up approach in all its programming and this has led to greater impact

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

Sexual and reproductive health needs for refugee women, girls and youth is limited. Results from a multi-methods study indicated that there are significant unmet needs concerning maternal & delivery care, comprehensive family planning services and education. Further, results demonstrate an equally concerning need for comprehensive sexual education due to rampant belief in myths and misconceptions surrounding reproductive health. This situation exposes them to STIs, unwanted pregnancies and death. There are knowledge gaps regarding efficacious SRH prevention approaches in conflicted affected areas, particularly for women and girls. At system level The SRH needs of this group of adolescents are often not included in national prevention programs, placing youth at greater risk.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

Impact: By 2021, we aim at training directly 1,200 educators who in return we expect will reach around 144,000 youths to make it a total of 145,200 Question: How do we create a youth to youth sustainable sexual reproductive health tool that will address the social cultural of youth affected by conflict?

What is it that most attracted you to Amplify instead of a more traditional funding model?

As a community-based organization that is already applying a human-centered design in its programming it makes sense to work with Amplify team. Amplify is more flexible than traditional donors, e.g. this is an early stage idea about a sensitive topic that would be implemented in a complex environment, so we need the ability to test different ideas with refugee youth and get feedback before institutionalizing the best solutions as a YARID program

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Between 1 and 2 years

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Between 5-10 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Between $50,000 and $100,000 USD

What do you need the most support with for your innovation?

  • Business Development / Partnerships Support

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14 comments

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Photo of Ruth Nara
Team

This is a great initiative, Robert. I believe that many adolescents will greatly benefit from this program. Using such an interesting approach, and a non-abstinence based curriculum is quite interesting. Wishing you nothing but the best!

Photo of robert hakiza
Team

Thank you so much Ruth for your comment and words of encouragement about this programme. This is the time that we need to come up together to support young people affected by conflict on the issues concerning SRH. I really appreciate your contribution and ideas to make this programme more better

Photo of Lunette Projects Lune Group
Team

Dear robert hakiza, wishing you best of luck and hoping for all success! This is an important initiative!

Photo of robert hakiza
Team

Thank you so much for your comment and words of encouragement. Please let us know in case of any suggestion to improve the idea.

Robert

Photo of robert hakiza
Team

The success of our intervention is informed by our belief in collective impact, were we collaborating with existing organization and groups within the community. With our long record of collaboration and working with hard to reach populations, we recognize that synergistic approaches have shown promise in reaching more community members with valuable information. We have identified organization and health centers that provide traditional SRH education. We hope to compare the effectiveness of the tradition SRH curricula with the CSE + Art-based curricula. We position SRH peer2peer education for sustained impact at scale through our collaborations with refugee-led organizations, schools and adolescent clinics.

Photo of Fidele Kabene Muhanuka
Team

How should we addressed such challenge when refugees parent hide to share with their daughters issues concerning sexual reproductive health.Is it a matter of cultural or ignorance?

Photo of robert hakiza
Team

Dear Fidele,

Many thanks for your comment and question. Yes it's true and that is what we have found during our meetings that the issues of Sexual Reproductive health are rarely discussed between parents and youths. I can say that it's both a matter of culture and ignorance.

Photo of Daniel Eyudu
Team

hey Robert,
I think this idea will help our fellow to make right decisions concerning their SRH and also bring services of SRH closer to them like the family planning methods to reduce cases of un wanted pregnancies
I would  to recommend you can use sports as a deliver tool for SRH Education.
Since soccer can mobilize youth from different communities both the boys and girls. 
Soccer as a game also has some disciplines it builds up on individual, helps to build self esteem and teaches people to make good informed decisions so that they can realize their future dreams.
good luck.

Photo of robert hakiza
Team

Dear Daniel,

Thanks a lot for your comment and suggestions. I totally agree with you that sport can be used as a tool to mobilize youth from different communities and this is something that we have been using since the inception of YARID. That is why as said earlier, we are planning to use arts-based approaches to diffuse tension, minimize fear and encourage learning in a fun environment. Emerging evidence among adolescents indicates that sexuality education delivered through arts-based approaches is informative, inclusive, acceptable, and memorable for participants. Delivering CSE through art-based approaches such as body mapping, quiz boxes, drama, music composition and jeopardy will equip participants with a simulated environment on how address SRH needs.

Photo of Jeunes Journalistes Sans Frontières
Team

with the poverty faced by young refugee girls, they are very exposed to different problems including rape, prostitution and others..
the realization of this program is a big step in the development and well-being of girls

Photo of robert hakiza
Team

Thank you so much for your comment and support to this project.
Much appreciated.

Photo of OpenIDEO
Team

Hi robert hakiza  and Team,

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but all critical information should be in the body of your contribution somewhere.

Some things Experts were excited about:
One expert shared, “YARID is using a rights and power-based curriculum, which includes an emphasis on consent and pleasure. That's fairly unusual in any SRH program, but even more unique for an initiative targeting adolescents. Their intention to partner with a local organization is also a key strength of this idea, though the novelty may come in the form of partnership rather than the fact of partnership ”
Another shared, “There's a lot that's positive in this idea, including the intentional inclusion of male and female youth and the use of CSE (rather than abstinence-only education or other fear messaging).”

Some questions Experts had were:
1) How will partners will be involved? What’s the scope of project in terms of targeted number of people reached/trained, etc.?
2) Have you considered newer ways of delivering the content, i.e., through technology and multimedia tools?
3) How do you plan to achieve positive health outcomes and address the obstacles young people face i.e. limited linkages and the likely loss to follow up/high turnover rates?
4) What would sustainably growing this program look like?

One expert want to share a couple of resources for inspiration in case it’s helpful for your intended delivery mechanisms:
http://tamasha.or.tz/ http://www.youthpower.org/
http://www.actforyouth.net/adolescence/

Thank you for sharing the important work you are doing.

In case you missed it, check out this Storytelling Toolkit (ideo.to/OZznV4) for inspiration on crafting strong and compelling stories as well as the recorded Office Hour (ideo.to/Gf1Cs6). Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is October 26 at 11:30PM PST.

Have questions? Email us at amplify@ideo.org

We look forward to reading more, and thank you for the important work that you are doing!

Photo of robert hakiza
Team

Dear OpenIDEO team,

Thank you so much for the positive comments and for sharing those useful resources. we can say that all comments, questions and shared resources have been a great support to shape this idea.
Please find bellow the responses to the experts questions:

1) How will partners will be involved? What’s the scope of project in terms of targeted number of people reached/trained, etc.?
Our SRH partners will participate in the development of the course, and the training of refugee educators. This curriculum will be developed in consultation with SRH experts both internationally and locally to ensure that the content is accurate and context specific. This will include the development of materials, tools, and resources that will be available to both the educators, and also the students registered in the program.
This out of school curriculum will employ varying educational approaches including role playing, discussion, media, to provide 8-sessions over a four week period (2 sessions per week), that focuses on each aspect of SRH knowledge mentioned in our idea. We intend on having a 1 cohort per round of the program that is comprised of 10 girls and 10 boys. Each session will be taught with only girls, and only boys to ensure facilitate and encourage a comfortable learning environment and mitigate issues related to gender.
Refugee educators or “trainers” will initially be directly from our organization, and we will have two trainers for each gender. As the program moves forward, and for every round, students that demonstrate interest and skills in SRH education will be asked to get additional educator training to then be a part of the program and administer the CSE.
The structure of the program will be one month of training and debriefing for educators and then one month of administering the program. For example, in one year, we hope to have six rounds of the program administered and reaching 60 refugee girls and 60 refugee boys, for a total of 120 student receiving information on sexual and reproductive health.
2) Have you considered newer ways of delivering the content, i.e., through technology and multimedia tools?
We will employ a multi-modal teaching approach that includes the use of technology and multimedia tools. The use of technology will be double-fold. That is, it will facilitate the educators to relay the material using interactive visuals, but also expose refugee student to such technology that they may have never used before. Further, this can be an incentive to encourage student to participate via a technological tool.
We also are also tabling ideas to develop an app or a text-response mechanism, by which students will have access to on their mobile phones, as phones are quite prevalent amongst said population. This app will provide the user accurate information about sexual and reproductive health and also potentially provide information on where to obtain SRH services.

3) How do you plan to achieve positive health outcomes and address the obstacles young people face i.e. limited linkages and the likely loss to follow up/high turnover rates?
We plan to achieve positive outcomes by providing information through safe, and comfortable means that will help refugee youth make informed decisions in regards to their sexual and reproductive health choices and behaviours. Essentially, behaviour communication change is embedded into the curriculum. Further, CSE has been shown as a positive and cost-effective solution to improve decision making in regards SRH. Research shows that refugee communities lack knowledge in regards to SRH due to various reasons, including culture and tradition. Our program intends on addressing that, and hopes to make adolescent refugees fully aware of the risks and consequences of various SRH decisions.
Further, this program will be administered by other refugee youth. This is where this program draws on its strength to encourage refugee youth to participate. Due to the nature of the program, various incentives such as using technology, providing costs for transportation, and also snacks during these sessions will ensure that participant attrition is kept to a minimum.

4) What would sustainably growing this program look like?
Once the curriculum and all educational materials are fully developed and we have piloted a few rounds, this program will become a routine program administered by YARID and our collaborating organizations. With our current collaboration, and with potential governmental engagement, we will administering this program to conflict –affected refugees in Uganda, with minimal financial requirements. Additionally, if awarded funds from openIDEO, we will be able to leverage this for additional funding to offer improvements. Further, this model will be tried and tested and hopefully can then be replicated in other refugee settings.

Photo of OpenIDEO
Team

Hi robert hakiza and team,

An important reminder, Refinement Phase closes this Thursday, October 26 at 11:30pm PST.

We can only consider complete submissions, so please make sure that you have reviewed the Feedback and Refinement Phase Checklists and answered all of the questions on the platform. Note that we added one more multiple choice question to the end of the form.

If you're having trouble figuring out how to edit your idea, please refer to this guidance: https://docs.google.com/document/u/1/d/e/2PACX-1vQUuV2N-wO8Oy8MysMAza3CbKUA1ZcMenollZjPh4FA0fGgIDcVXwWtEe6CLh36_Wik5AypEHixreFH/pub

Best of luck!