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Swaziland continues to implement the Combination Prevention Program implementing high impact interventions. Recently, Swaziland developed an HIV prevention minimum package designed to guide implementation of the combination prevention program. Joyful Hearts is using this guide to tailor interventions according to each population segments and implement a package of interventions appropriate for that population in order to reduce risk of infection. The package provides for the key interventions that need to be provided to achieve this goal. The comprehensive HIV Prevention package aims to:
The prevention interventions will be supported through the donors resources to implement combination prevention program in Swaziland. This overview provides details of what the interventions are, where they are implemented targeting whom and what to be done at what scale to contribute to the goal of reducing new infections and end AIDS as a public health threat.
The role of our outreach workers for all the target populations are as follows:
The combination prevention program targets the following key and priority populations to make further head way in reducing the HIV incidence in Swaziland. This support using local and global evidence aligned with the national strategic framework in targeting the following populations.
The interventions under SBC contribute to increasing comprehensive knowledge, risk perception, reducing risky behaviour and address social-cultural factors that accentuate risk and vulnerability.
3.1.In the school, the program continues to be an opportune platform to provide a conducive environment to deliver age-specific SRH/HIV prevention interventions including referral for uptake of services.
Support will also be provided for monitoring the implementation of the current LSE curriculum in secondary schools. The country aims to ensure that by 2020, at least 75% of young people (10–24 years) are reached with LSE in schools. Two M&E Officers will be recruited to support the monitoring of the LSE delivery in Schools. An additional layer for Adolescents and Youth in Secondary Schools will be the provision of Dignity packs (pads and soap) for girls to help keep them in school. Evidence from the region has shown that providing menstrual hygiene products to school-going girls increases school attendance (by 17.1%) 82 and has been linked to reduced STI prevalence (by 45%). Program evidence from implementation of this activity in the current grant is pointing to reduced absenteeism and improved self-esteem among recipients. As strategic modifications, the contents of the dignity packs have been reduced (to lower costs and make them more girl-focused) and vulnerability assessments will be done to deliver the packs only to the most vulnerable
3.2 Out of school Youth: The funding will continue to support evidence-informed methodologies for rural out-of-school youth (boys and young men and AGYW), including the Stepping Stones approach (risk reduction sessions and integrated HIV/SRH/TB mobile services) in different Tinkhundlas.
Funding is needed for further be used to support AGYW Health Promotion Activations aimed at engaging AGYW on risk reduction strategies and stimulate increased demand for and uptake of HIV/SRH (including a focus on contraception) and other relevant social protections services. Peer Champions will be provide experiential motivation for AGYW on positive health, dignity and prevention (PHDP), linking them to existing teen clubs and available social platforms amongst other things. These activations will utilise youth-friendly branding, interactive and entertaining methodologies. Local role models, Peer Mobilisers and Stepping Stone Facilitators will mobilize AGYW to attend activations. This activity responds to a key request for greater access to health information and quality youth-friendly health services, raised by AGYW during country dialogue. Mobile services will be provided during these events to provide SRH and HIV services.
3.3. Tertiary Institutions similarly to the main out of school interventions to support evidence-informed methodologies for youth in Tertiary institutions, using the approach by risk reduction sessions and integrated HIV/SRH/TB mobile services. The role of the Facilitators will be to conduct structured sessions with youth in all Institutions whilst the Peer Mobilisers who are themselves Tertiary students will be tasked with mobilizing the youth within their campuses, provision of condoms and facilitating referrals to health and social services,develop service directories for linkages in PMTCT, HTS, ASRH, VMMC, TB, PREP, PEP, GBV, CLUBS for all Tertiary institutions.
To increase uptake of integrated SRH/HIV services and reduce risky sexual behaviours among key populations (MSM, SWs) acomprehensive package of interventions and services will be expanded.
These will be redeployed into communities to provide the following package: