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Dear team,

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.

Dear Chenai,

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.

Dear Benard, Thank you for looking into our contribution and your question. To answer your questions, maybe it's good to start with saying that we now plan to implement this project in Sub Saharan Africa, most likely in Uganda as there we currently have the strongest network of CBOs and community workers. And how we think this approach is different, is that it combines two more common approaches, namely training and online/digital information sharing. So not only are adolescents provided with access to information, they will also be guided by trained community workers in accessing, understanding and applying the information they receive in their daily lives. What do you think? Is this something that distinguishes this project from others (in a good way)? Looking forward to hearing your ideas.