Question 4: It seems the main applicant is not a resident of Uganda and dose not clearly describe how they will engage with local partners on this activity can you expand on how you are currently or planning to work with local partners? Have you considered the costs that this may be involved?
Our response: Health[e]Foundation is an organization based in Amsterdam, the Netherlands. We have been working in Uganda since 2004 and we consider it to be our flagship country. We have a local country representative in Uganda and many strong partner organizations, such as TASO Uganda and HOCDA with whom we have been working on implementing the existing Health[e]Living program and with whom we plan to continue to work, as we start to develop the app for adolescents and introduce it in the Health[e]Living program. Costs have been considered and in order to continue our work in Uganda, and expand with the development of this new app, we will need to seek funding. We know that being selected as a TopIdea will definitely boost the progress of this idea. Being part of a cohort of top innovative organizations helping to solve pressing issues and receiving ongoing partnership support from the UNFPA Innovation Fund, including potential connection to other funder networks, and PR exposure we will open up doors to resources, knowledge, skills, funding etc.
Question 5: How do/will you partner with the government as they will need to be cleared for content and to use the CHWs?
Our response: We have been working with the Ugandan Ministry of Health since 2004 on our HIV[e]Education program. The Ministry has developed modules for the e-learning course and provided expert guest speakers for the workshops. In collaboration with TASO, we will consult with the Ministry regarding the content of our health related modules and our work with community workers.
Question 6: Using CHWs is also a good strategy as these are members of the communities where youth live and can support them easily. A concern is how you will address stigma and fear youth may face around getting services?
Our response: We do not depend on youth reaching out to services, because we involve a broad group of (outreaching) community workers in the training as explained under question 3. Because the participants of the Health[e]Living course actively reach out to adolescents, the issues of fear and stigma around services play less of a role. Of course fear and stigma will still play a role when adolescents talk to our participants, however the facilitation method promoted in the Health[e]Living program is designed to be aware of and reduce the negative impact of these influences in the education of young people. The facilitation method is introduced in the kick-off workshop, further explained in one of the e-learning modules and evaluated with and by participants during the follow-up workshop.
Thank you very much for the opportunity. We hope this response answers your questions and clarified our idea. In case there are any more questions or comments, please let us know.
First of all, we'd like to thank you for your efforts of studying our idea and the useful feedback we've received. Please find our response per comment or questions below and of course in the refined version of our idea.
Comment: One strength is the use of the same app to train the CHW and Youth. This way the information will be standardized and Youth can get support from the CHWs who will have been trained by an expert. The Uganda Government is rolling out its CHW strategy which will support scale and sustainability for such an effort.
Our response: Both apps will provide the user with the same knowledge, however the app for community workers will provide extra information about adolescence, how adolescents/people learn, child protection, facilitation and communication skills. The goal of setting both up with an app is to standardize information and increase the opportunities for the youth to seek support from the community workers and health services and for community workers to reach out to the youth.
Question 1: What’s the use rate of cell phones? There seem to be an assumption that youth will have access to smartphones and data to be able to use the app. How will this be addressed especially for youth in Uganda that live in rural areas?
Our response: We have assessed with the community workers we work with in our current program, that in urban areas between 20% and 70% of the youth uses a smartphone and in rural areas between 2% and 10%. We will receive more data about smartphone adoption among youth from TASO Uganda soon. Data by GSMA Intelligence states that smartphone adoption in the East Africa Community was 21% in 2016 and will be 55% in 2020. For the youth these percentages are higher compared to the general population. We believe that with the rapidly rising numbers of people using smartphones and internet, especially in Africa, we should start developing this app now, so that by the time smartphones and internet are more widely used we have a strong product that has been evaluated and improved.
Question 2: Can you provide more details around your plan to implement this work?
Our response: We have been running the Health[e]Living blended learning program for community workers working with adolescents for more than six years. Evaluations show how much the community workers enjoy and benefit from learning with the app and using it as an educational tool when educating youth in the community. We are now in the phase of refining the idea to develop an app for adolescents and asking feedback from both the community workers and youth. The next step will be to assess the technical options to address the necessary content before we develop a prototype. The Health[e]Living program is an existing program necessary to introduce the new app, after which the community workers can distribute the app among the youth they facilitate “regular” Health[e]Living activities with. Please see Table 2 Planning for more information.
Question 3a: How will you reach adolescents? Will this be done in schools? Then how do CHWs play a role?
Our response: To reach as many adolescents as possible, the target group for the Health[e]Living training are community workers and educators. They can be community health workers, social workers, counselors, peer educators, teachers etc. Participants are selected who professionally work with and/or reach out to young people to train them in life skills and SRHR. They are no requirements with regards to prior training or degrees. We select them based on criteria such as: motivation, outreach possibilities, digital literacy etc. That way this target group reaches adolescents in a variety of places, such as health care centers, schools, hospitals, sports clubs, churches, in their own networks, etc.
Question 3b: One expert shared, “One strength: blending education and the app one growth: I don't clearly see what the planning steps are. Will the CHW's be trained on the app information?
Our response: For more information about the planning, please see table 2 Planning. During the kick-off workshop of the Health[e]Living program CHW will be trained on how to download and use the app, so they can train the adolescents.
Question 3c: How regularly will the app be updated? Who is providing the technical info for the app? How will it be accessible in areas with limited internet and expensive data?
Our response: We do not yet have the answers to these questions, this will have to be decided with more input from the field and in collaboration with the IT company.
Thank your for you interest in our idea and your feedback. I think the technical part of this idea will indeed need some special attention once we get further into the developing stage of this idea. Linking up with local mobile service providers is indeed a good idea!
Regarding sustainability of the model. The community workers are employees of local community based organisation who are trained by Health[e]Foundation with a three month blended learning program in which we plan to introduce them to the app and train them in the use and distribution. For most of them the field work they do for the training is part of their daily work. We keep in touch with them after the training as well, but not as extensively as during. Our idea that as reaching out to adolescents is already part of their work and not something we ask them to do on top of their daily work, this will be motivating to them to make their outreach sustainable.