Young Health Programme (YHP



Umoyo Wama Youth Project

Young Health Programme – Zambia

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Annual Report July 2011 – June 2012

In collaboration with AstraZeneca and Planned Parenthood Association of Zambia

|AstraZeneca – Young Health Programme (Zambia) |

|Annual Report |

|July 2011 - June 2012 |

|Project name: | |

| |AstraZeneca Young Health Programme Zambia: Umoyo Wama Youth Project |

|Project location: |Chadiza Programme Unit, Eastern Province, Zambia (9 Communities ) |

|Project duration: |Three Year Project (July 2011 – June 2014) |

|Targeted Beneficiaries | |

| |The focus of the Young Health Programme in Zambia is on adolescents in the Chadiza District in the Eastern and Central Provinces. |

| |Chadiza is a remote rural area with traditional cultural practices that are associated with a high prevalence of early marriage and |

| |early pregnancy. Over three years the project is expected to reach over 55,000 people in Chadiza. |

| | |

| |Direct beneficiaries: 12,500 young people (7,500 girls and 5,000 boys) between the ages of 10 – 24 years in Chadiza. |

| |Indirect beneficiaries: 25,000 people comprising women, men, girls and boys in the general Chadiza population |

| |Additional beneficiaries reached through advocacy activities: 19,815 people at the district and national levels |

| | |

| |Goals and Objectives |

| | |

| |Goal: To improve the health and well-being of adolescents in Chadiza District |

| | |

| |Objectives: |

| |To mobilise community support and increase advocacy for improved access and quality of young people’s health services. |

| |To promote information sharing, education and communication for adolescents on relevant health issues. |

| |To strengthen and improve the existing health services to provide quality youth friendly services. |

| |The Young Health Programme in Zambia, which started implementation one year ago, is an initiative focused on adolescent sexual and |

| |reproductive health for young people in the Chadiza district. The programme is delivered in collaboration with a local partner Planned |

| |Parenthood Association of Zambia (PPAZ). |

| | |

| |Key highlights from Year 1 of the Young Health Programme in Zambia |

| | |

| |Four communities targeted to benefit from a range of activities aiming to improve the health and well-being of adolescents. |

| |The programme reached 2,408 young people directly and an additional 1,496 wider community members through broader awareness activities, |

| |benefiting 3,904 people in total |

| |Establishment of 4 Youth Friendly Corners in local clinics and training of health providers and youth counsellors to better enable |

|Outcomes |young people to access health information and services without discrimination – for example girls are able to access family planning |

| |services which were not available to them before |

| |Training up and supporting young people to become drama group members and peer educators and mobilise community members, raising |

| |awareness of adolescent health issues through sketches, drama, songs and poetry and helping to improve communication between adults and |

| |young people on sexual and reproductive health (SRH) issues |

| |Mass community sensitisations capitalising on multiple international celebration days |

| |Establishment of 8 school health clubs, holding weekly sessions to support pupils to discuss SRH issues and make informed choices |

| |The development of an advocacy strategy identifying specific target groups for levering support in addressing adolescent sexual |

| |reproductive health rights at a political level |

| |The commencement of a series of radio programmes bringing issues of adolescent health to the forefront, and generating interest around |

| |issues that are usually not openly discussed |

| | |

| |Summary of programme achievements to date |

| | |

| |During year one, the first phase of implementation focused on project start up processes and initial beneficiary training for youths who|

| |will be involved in the delivery of the project, followed by project delivery in the first wave of communities targeted (four). Project|

| |start-up included formalising Plan’s partnership with Government and PPAZ through a Memorandum of Understanding, launching the project |

| |with a start-up workshop for key stakeholders who will be involved in implementation over the life of the project as well as |

| |establishing baseline indicators for the situation of beneficiary youths. |

| | |

| |During this first year, project activities concentrated on four of the nine targeted communities. Mechanisms to organise community |

| |support and increase advocacy for improved access and quality of youth friendly health services have been established. The project also|

| |facilitated discussions for 2,408 young people reached directly (1,215 females and 1,193 males) while approximately 1,496 wider |

| |community members (851 females and 645 males) received messages indirectly on Sexual and Reproductive Health (SRH) issues. |

| | |

| |Service provision was boosted by providing training for the various trainings of 13 service providers including traditional healers, 21 |

| |peer educators, 16 drama group members, 8 children’s health clubs with 94 students, 16 youth counsellors and 17 key adult stakeholders |

| |including parents, elders and teachers, and Area Development Committee members (a board that spearheads development at sub-district |

| |level). This is reinforced by the support from key government institutions such as the Ministries of Health and Education. |

| | |

| |The aim of training the different volunteers is to reinforce the provision of comprehensive sex education among young people by creating|

| |awareness, availability and facilitating access of youth friendly services and SRH information at community, health centre and schools. |

| |Furthermore, the trainings are aimed at strengthening the referral systems in Chadiza District so that young people can access the |

| |support services required once a need is identified. |

| | |

| |Objective One: To mobilize community support and increase advocacy for improved access and quality of young people’s health services. |

| | |

| |The programme began with a stakeholder mapping exercise which involved meetings with various local authorities including representatives|

| |of the ministries of health and education. Together, specific targets for the project were identified for implementation including |

| |communities, health facilities and schools. A baseline survey was carried out and the draft results were used to feed into project |

| |design. During the project initiation, the project team met with officials from Health and Education departments to introduce the |

| |project and explain its purpose and visited selected health facilities and schools to look at the prospective project sites. A start-up |

| |workshop was held in October 2011 and involved 29 participants including representatives from the District Health and Education |

| |authorities. The workshop helped create a clear and common understanding of the situation of adolescent health in the area and the |

| |focus of the YHP, build links between the stakeholders, and launch project activities. |

| | |

| |Project implementation began after the start-up workshop and one of the first activities was training drama group members and peer |

| |educators from the four communities targeted by the project in Year 1. Training for drama group members focused on issues of SRH |

| |involved and supported the members to develop sketches focused on messages around health and rights on this theme. The members received|

| |drums and drama attire to support them in their activities. |

| |Additional training was also implemented to specifically engage community elders and enable them to understand the special needs and |

| |challenges of adolescents as they grow up, and to be able to effectively interact with and support them. Additionally the training |

| |aimed at encouraging participants to mobilise young people and advocate for youth friendly health information and services. |

| | |

| |The training participants also took part in the development of the advocacy strategy under the facilitation of the Plan Gender and |

| |Advocacy Coordinator from the Country office. The strategy spells out the target groups at community, district and national levels to |

| |influence policy in addressing and fulfilling sexual reproductive health rights of adolescents. This is a Young Health Programme |

| |strategy and it will be used to reach out to the communities and district officials on issues that affect young people. |

| | |

| |The project participated in a number of international days (2011 World AIDS Day, World TB Day, 2012 Youth Day and the Day of the African|

| |Child), taking each one as an opportunity to highlight relevant issues of adolescent health through community sensitisations and the |

| |distribution of t-shirts. One of the drama groups was invited to perform to guests at Plan’s 75th Anniversary Celebrations in Chadiza |

| |in March 2012, showcasing the work of the YHP to a wider audience. |

| | |

| |Objective two: To promote information sharing, education and communication for adolescents on relevant health issues. |

| | |

| |The project has been disseminating information among young people on a variety of reproductive health issues such as sexually |

| |transmitted infections (STIs), contraception and rights. Communities have been represented in the activities through the involvement of|

| |key members such as health providers, teachers and other community-based organisations. For example they have supported the process of |

| |selecting young people as Peer Educators and drama group members. Furthermore, Peer educators have been leading the discussions with |

| |peers and communities at large about issues relating to their sexual and reproductive health needs, including rights. The action plans |

| |are also developed by the Peer Educators in consultation with their communities. |

| | |

| |The Peer Educators also held one-on-one talks which were more comfortable for certain youths because of various specific issues and |

| |needs. |

| | |

| |The Peer Eeducators and drama groups have used communal meetings to reach many people by conducting 43 community sensitisations in the |

| |different zones. |

| | |

| |The four youth friendly corners previously formed provided a lot of support to the youths in terms of providing a suitable environment |

| |for SRH information sharing. These youth friendly corners were furnished with furniture and various board games which attracted a lot |

| |of participation by the youths. Youths who play these games told their friends about them and this attracted many of them to |

| |participate, including those who had never thought of attending an SRH session. |

| | |

| |During the reference period, the youths spent more time in the centres and that kept them busy. Some of them testified that spending |

| |time at the centre enabled them to think less of negative vices that could possibly lead to early indulgence in sex and later on early |

| |pregnancy. The centres continued providing SRH services through the trained peer educators. The topics during the sessions in the |

| |centres included: early unwanted pregnancies, risks of STIs and the dangers of HIV/AIDS. The peers also encouraged each other to focus |

| |on education as a way of becoming empowered to overcome different vices affecting the development and healthy growing of the youths. |

| | |

| |The trained youth counsellors provided counselling services to the youths under the age of 24 years at the youth friendly corners. In |

| |the period under review, they conducted a total of 6 group counselling sessions. These sessions consisted of an average of 10 to 15 |

| |people. |

| | |

| |They also provided a total of 17 individual counselling sessions and this was captured in a reporting tool developed for the programme. |

| |This involved individuals receiving one-on-one counselling sessions away from the group. This provided an opportunity for the youths to |

| |open up and freely obtain the services. These individual counselling sessions were a result of youth referrals from the massive |

| |community awareness campaigns. |

| | |

| |The YHP has worked very closely with the existing structures at the health centre, such as neighbourhood health committees, to support |

| |the programme. A separate committee (health centre advisory committee) has been established at each centre and the role of the |

| |committee is to focus on monitoring provision of the services specifically for adolescents and youths. |

| | |

| |The training of parents, traditional healers and local community leaders has established a strong partnership at community level because|

| |these leaders participated in the promotion of SRH. The formation of health clubs in schools has also provided a platform for the |

| |in-school adolescents to share information on SRH with each other. Four boys and four girls insakas were formed within the reference |

| |period and these helped increase youth participation in the issues of reproductive health. A total of 94 boys and girls were present |

| |during the boys and girls’ insakas, 37 males and 57 females. During these insakas adolescents were encouraged to freely take part in |

| |the discussions and exercises. The boys and girls also continued having weekly meetings to look into various issues of SRH. This |

| |provided an opportunity for them to freely interact without stigmatization. |

| | |

| |Through the above strategies, in particular drama, the project managed to create favourable environments for open discussions about SRH |

| |subjects that were previously considered taboo. This approach has been enhanced by the availability of support from peer educators, |

| |community development facilitators and service providers who offer counselling and information services to young people with concerns |

| |about child marriages, pregnancy and abortion. |

| | |

| |Peer Educators also participated in a traditional ceremony called Nc’wala in the Chipata District in Eastern province. This is an |

| |annual celebration showcasing the Ngoni tradition which people travel from across Zambia to attend. It presented an opportunity to |

| |reach a large number of young people with reproductive health information and the availability of services at the local youth friendly |

| |centres. |

| | |

| |The first Youth Action Movement meeting was held in March 2012 to provide a forum for peer educators to discuss challenges they faced. |

| |During this meeting challenges identified included there the fact that are no strong committee in place and also that the group did not |

| |have a work plan. As an outcome of the meeting an interim committee was selected and a work plan was developed to guide future |

| |activities. |

| | |

| |Twelve adolescents participated in the three day media training of Peer Educators. In April 2012. The training helped the adolescents to|

| |understand how to host a programme and deal with the audience on issues of SRH. The young people were very excited to have been part of |

| |the first group to be trained in the radio programme and this encouraged them. |

| | |

| |Twenty six radio programmes were recorded from all the four communities and are being aired on the ‘Feel Free’ community radio station. |

| |The project first consulted with stakeholders to identify a variety of participants to appear on the shows. These include health |

| |workers, young people, teachers, community leaders and men and women who carry out the initiation ceremonies. The programmes focus on |

| |adolescent health issues such as teenage pregnancies, STIs and cultural practices from a wide range of perspectives and get the wider |

| |population thinking and talking about these issues. |

| | |

| |The programmes include interviews that are conducted in the communities with the above mentioned groups and individuals to discuss |

| |issues of adolescent sexual reproductive health that affect the young people. The radio station has since aired 18 out of the 26 planned|

| |programmes and covers not only Chadiza, but also Chipata and other surrounding areas. There are 52 other series that have been planned |

| |for the second phase of the project. |

| | |

| |Training was also carried out for 12 media personnel drawn from Zambia News and Information Service (ZANIS), Zambia Daily Mail, Times of|

| |Zambia, The Post Newspaper, Mphangwe Community Radio, Feel Free FM, and Breeze FM to explore how media houses and the project could work|

| |together in delivering outcomes through broadcasting. The YHP trained the media personnel in SRH. This was done to familiarize them |

| |with SRH issues so that they could handle the topics with knowledge. |

| | |

| |The YHP used the media to convey messages on SRH. The Peer Educators were put as panellists to tackle SRH issues and they enjoyed being|

| |on air talking about various health challenges facing the youths. The media is used to transmit the SRHR messages to the general |

| |public. The panellists consist of Peer Educators themselves, traditional leaders, initiation advisors, Indunas (local chiefs |

| |representatives) and local community leaders. |

| | |

| |Objective Three: To strengthen and improve the existing health services to provide quality youth friendly health services. |

| | |

| |During the first few months of the project, activities took place to ensure that youth-friendly services started to be made available to|

| |young people in health facilities in the project area sites. These included youth counselling, targeted reproductive health information|

| |and the distribution of condoms. |

| | |

| |Training was carried out for 13 health service providers, both those who work in the clinics in the four targeted communities, and for |

| |information providers including traditional healers and community-distributors of condoms. The training focused on key SRH related |

| |topics and also wider behaviour-change management, communication and counselling skills. The training sought to equip the service |

| |providers with the skills to deal appropriately and sensitively with young people referred to them by the Peer Educators. The |

| |traditional healers were trained to also refer young people to the health clinics when they approached them with problems beyond their |

| |ability such as sexually transmitted infections. Additional training was held for youth counsellors covering similar topics with a |

| |greater emphasis on the counselling and communication aspects. The youth counsellors were equipped not only to provide counselling |

| |services to young people as required, but also refer them where appropriate to clinical services. |

| | |

| |A youth-friendly corner (YFC) was established in each of the four clinics targeted in the initial phase of the project. Each YFC was |

| |equipped with a variety of board games such as checkers. By creating the corners in each clinic, the project created a safe and fun |

| |space to encourage young people to visit the clinic, and to make it easy for them to access health services they may need. In each area|

| |a Quality of Care committee was established with representatives from the community. The committees were briefed on issues of |

| |adolescent health and agreed on a list of criteria to assess the quality of service provided to young people. The next step for the |

| |committees was to carry out assessments of their clinics against the criteria to be used to bench-mark progress. |

|Progress against |Please see Annex 1 Progress against logframe indicators |

|indicators | |

|Global Indicators |Please see Annex 4 Global Indicators |

|Project activities: |Please see Annex 2 Progress against activity plan |

|Project challenges: |The progamme has faced a number of challenges during the first year of implementation. |

| | |

| |The remote location of the project areas continues to create underlying logistical complications for many areas of delivery. In |

| |particular over the last few months the long distances between communities have made it difficult at times for peer educators to travel |

| |to locations for community sensitisations. This is particularly an issue during the rainy season when roads become more inaccessible. |

| | |

| |Retention of older adolscents is a common issue for the age group targeted by the project. During the first year, three of the young |

| |people trained up as volunteers by the YHP have left the project area for various reasons and so are no longer able to participate in |

| |delivering outreach activities. The programme is continuing to explore ways of keeping older adolsecents engaged in the programme and |

| |will train additional Peer Educators in Year 2. |

| | |

| |Some of the community health clinics (especially in Madzaela and Zemba) have very limited room and facilities which affects what space |

| |is available for the youth friendly corners. Plan has worked with the communities to identify the most appropriate space that can be |

| |utilised. The roof of the Zemba facility, which was blown off during the rainy season earlier this year, has since been replaced and the|

| |whole building renovated by the Government. |

|Sustainability: | |

| |Sustainability considerations are built into the design of the Zambia Young Health Programme and this is reflected in the participatory |

| |nature of the planning and delivery of activities. Key stakeholders including community members, district health personnel and local |

| |education authorities have been involved throughout the programme to date through activities such as the start-up workshop and |

| |establishment of youth friendly corners and school health clubs. Community members have been activity involved in the identification of |

| |young people selected to be trained as Peer Educators. |

| | |

| |[pic] |

| | |

| |In order to maintain the continued involvement of peer educators in the project, the programme has also begun introducing |

| |income-generation activities (such as rearing pigs) as part of the ongoing support provided to the young people. There is integration of|

| |SRH and Youth Friendly activities by the Department of Health into routine outreach programmes at the health centre level to further |

| |support the sustainability of the project activities. This is coupled with continued orientation of new health staff as service |

| |providers to address the challenge of staff turnover. |

| | |

| |At the field level, the majority of activities are delivered by local partner Planned Parenthood Association of Zambia (PPAZ) who is |

|Project management, |experienced in working on sexual and reproductive initiatives. Plan is directly involved in the implementation of the media and |

|monitoring and |advocacy activities and also in providing technical support and overall coordination and management of the programme. The programme is |

|evaluation: |enabled through Plan’s existing presence in the targeted communities through the resident Community Development Facilitators (CDFs), and|

| |wider project links with key stakeholders including government and local leaders. |

| | |

| |[pic] |

| | |

| |The health coordinator is based in the Programme Unit office in Chipata and oversees the work of PPAZ and the 9 CDFs resident in each of|

| |the targeted communities. He receives technical support from the Health Programme Manager based in the Plan Country Office in Lusaka. |

| | |

| |PPAZ and Plan jointly oversee project implementation, supervision and monitoring. The project team facilitate implementation of the |

| |activities, regular monitoring and the development of monthly and quarterly reports. Project impact is assessed by the project team |

| |against the indicators in the project log frame. |

|Quotes and photos: | |

| |“Before the onset of the project, I was a person who was unaware of sexual reproductive health issues. Now after working with my fellow |

| |youths on the Young Health Programme and having access to sexual health and rights information my mind has been opened as I am now |

| |knowledgeable on issues to do with STIs and HIV. When I was found with an STI three months ago, it was a bad experience, now because of |

| |the information I acquired from being involved in the project, I went to the health centre where I was given medication without delay. I|

| |now share what I have learnt with my fellow youths and encourage them to visit the health centre each time they experience problems |

| |around sexual health. This change has also been scaled up to the communities as youths are now free and are now open to come to the |

| |health centre to explain their sexual health problems to the health centre staff”. Elias Banda 25 – Peer Educator – Madzaela Health |

| |Post, Chadiza |

| | |

| |“I have benefited a lot from the project because before I ignored a lot of things especially issues to do with SRH but immediately after|

| |the training and the interactions I have had with my fellows members and peer educators I have learnt a lot about different STIs issues,|

| |teenage pregnancies, the importance of going for Voluntary Counselling and Testing and transmission of HIV”. Lilian Mwima, |

| |Parent/Counsellor- Madzaela Health Post |

| | |

| |“I really thank you for according me this opportunity to be part of this programme which is life serving, and in the community there is |

| |positive behaviour change and I have come to know the dangers of teenage and unwanted pregnancies and prevention methods of STIs and |

| |HIV”. Rose Jere, Youth Counsellor – Madzaela Health Post, Chadiza. |

| | |

| |Photos |

| |[pic] [pic] |

| |Interactive activities during the combined Boys and Girls Insaka and the young people taking part at the District Agriculture Show in |

| |Chadiza |

| | |

| |[pic] [pic] |

| |The body mapping exercise, the cards displayed have messages behind which youths have to act out using their body. The tool is about |

| |showing body anatomy and its development such as pubic hair, etc. and at what age such change occurs. After the activity the youths put|

| |the puzzle cards together to make it complete as shown in the photo. |

| | |

| |[pic][pic] |

| |Drama group performing a sketch to young people and the parents during a community sensitization meeting |

Annex 1 Progress against all indicators

|Progress against all indicators within log frame |Number: |Total number: Programme to date |Comments |

| |Current reporting period | | |

|Goal Level |

|Reduced reported teenage pregnancy |Project activities are on going | |Impact and results will be seen in year 3 |

|Reduced reported early marriages |Project activities are on going | |Impact and results will be seen in year 3 |

|Increased access and utilisation of Youth Friendly Services. |Project activities are on going | |Impact and results will be seen in year 3 |

|Increase in knowledge of health and reproductive health issues and rights |Project activities are on going | |Impact and results will be seen in year 3 |

|Objective 1: Outcome Level |

|1.1 Increase in advocacy and lobbying capacity of Local Non-Government Organisations, |Project activities are on going | |Impact and results will be seen in year 3 |

|Community Based | | | |

|Organisations and other community action groups | | | |

|1.2 Demand for quality adolescent health |Project activities are on going | |Will be measured in Year 2 |

|services for both girls and boys is | | | |

|increased | | | |

|Improved access and quality to youth health services |Project activities are on going | |Impact and results will be seen in year 3 |

|Objective 2: Outcome Level |

|2.1 Increase in knowledge of health issues and prevention among adolescents participating in |Project activities are on going | |Will be measured in Year 2 |

|programme ) | | | |

|2.2 Increase in reported positive health behaviours by young people (e.g. increase in reported|Project activities are on going | |Impact and results will be seen in year 3 |

|condom use during last sexual encounter | | | |

|2.3 Reduction in the proportion of adolescents girls who have unplanned pregnancy by the end |Project activities are on going | |Impact and results will be seen in year 3 |

|of the project | | | |

|Objective 3: Outcome Level |

|3.1 Increase in availability of integrated Youth Friendly Services in health facilities |4 |4 |Four Youth friendly Corners have been established |

| | | |offering various services such counselling, |

| | | |contraception, IEC , etc. These corners will come to|

| | | |a total of 9 by the end of year 2 |

|3.2 Increase health care providers who are more responsive to adolescent needs |13 |13 |13 healthcare providers have been trained by the |

| | | |project to be more responsive to adolescent health |

| | | |needs. |

|3.3 Increase in utilisation of health services by young people |Project activities are on going | |Expected by the end of Year 2 |

|Objective 1: Output Level |

|Number and type of stakeholders involved in advocacy and lobbying at district and community | | |The community members and peer educators are already|

|level | | |engaged in this process, further analysis to be |

| | | |held at the end of Year 1 |

|Number of community meetings held |43 |43 |43 community meetings have been held so far with |

| | | |peer educators and drama groups |

|Number and type of campaigns conducted |4 |4 |Awareness raising activities have been carried out |

| | | |in 3 international celebration days and the Plan |

| | | |75th Anniversary event |

|Number and type of community leaders/parents supportive for health for young people |17 (8 females, 9 Males) |17 (8 females, 9 Males) |The parents and elders that were directly trained in|

| | | |year 1. More trainings will be done in year 2 |

|Objective 2: Output Level |

|Number of adolescents (males and females) trained as peer educators |21 |21 |21 Youths (11 females and 10 Males) |

|Number of adolescents reached by peer educators |2,408 |2,408 |To date, community sensitisations have reached 2408 |

| | | |adolescents (1215 females and 1193 male) |

|Number of schools with active school health clubs and mentorship programmes. |8 |8 |8 school health clubs (4 boys, 4 girls) in each of |

| | | |the 4 schools in the project sites of the YHP |

|Number and type of action groups in the community/district. | | |Most groups will be formed in Year 2 |

|Number of outreach activities conducted in the communities |43 |43 |To date the YHP has carried out 43 community |

| | | |sensitisation activities |

|Objective 3: Output Level |

|Number of adolescents accessing youth friendly health services |2,408 |2,408 |This the number of adolescents reached to by the |

| | | |peer educators with various services |

|Number and type of health services offered by health facilities (including mobile) |6 |6 |Reproductive Health Information and Services |

| | | |including Family Planning for young people, |

| | | |Screening and treatment of Sexually transmitted |

| | | |infections (STIs), growth monitoring for under 5 |

| | | |children, antenatal and post natal care clinic for |

| | | |young mothers etc. |

|Number of trained health providers providing youth friendly services |13 |13 |13 healthcare providers trained to date |

|Number of referrals received for health services |17 |17 |These individuals were referred to the services |

| | | |providers and counsellors at the health centres by |

| | | |peer educators from the sensitisation meetings |

|Number of youth friendly corners established | 4 |4 |One in each clinic of the four communities targeted |

| | | |in the initial phase |

Annex 2 Progresss against Activity Plan

| |Key Activity |Description |Variance |Comment |

|1 |Stakeholder mapping |A stakeholder mapping exercise was held to identify clinics, |This is a continuous process as new |Although the main activity is completed, community |

| | |schools and relevant stakeholders in the project implementation|CBO and NGOs are being formed and |mapping will continue throughout the process as new|

| | |area. |come to conduct related activities in|CBOs and NGOs may become active in the project |

| | | |the communities. |areas. As the project extends into additional |

| | | | |communities, the activity will be revisited to |

| | | | |establish the presence of other organisations |

| | | | |present in the area. |

|2 |Baseline study |The Baseline was conducted through the implementing partners |Completed |The Baseline report has been completed and shared. |

| | |PPAZ. | | |

|3 |Stakeholder and Partner |A start up workshop was held in October 2011. |Completed |Participants in the workshop included |

| |sensitisation meeting/start-up | | |representatives from the district education and |

| |workshop | | |health authorities, staff from Plan Zambia and Plan|

| | | | |UK, PPAZ staff and the baseline consultant. |

| | | | |Objectives of the workshop were: |

| | | | |To share information and increase understanding of |

| | | | |the YHP. |

| | | | |To increase awareness of the situation on young |

| | | | |people’s health through the baseline and other |

| | | | |sources. |

| | | | |To build ownership among participants to implement |

| | | | |and monitor programme. |

| | | | |To introduce work planning and initiate activities.|

| | | | |To establish and strengthen relationships between |

| | | | |all the stakeholders implementing the programme. |

| |

|1.1 |Developing community advocacy |Following discussions on advocacy strategy, the document has |Completed |The advocacy strategy has been developed with the |

| |strategy on health rights of |been developed that will serve as a guide to engage with | |help of the Advocacy and Gender Coordinator at the |

| |young people |government stakeholders | |Country Office |

|1.2 |Training of drama groups for |These drama groups will tackle many issues pertaining to |Ongoing |One training was carried out for drama group |

| |community mobilization on key |cultural and traditional practices hindering young people’s | |members from the four initial communities targeted.|

| |health issues |health and will aim to increase awareness and instigate action | |They were equipped with attire and drums. |

| | |in their respective communities. | |Additional members will be trained when the project|

| | | | |extends to the additional communities. |

|1.3 |Training of parents, teachers and|Training was delivered in March 2012 for parent and community |Ongoing |The Topics covered during this training were: An |

| |community initiators on young |elder Educators. The training was attended by parents, | |adolescent Today, Challenges, Young People and SRH |

| |health issues. |initiation advisors, teachers and Area Development Committee | |Reproductive Health and Rights, Youth Friendly |

| | |Chairperson from the four targeted areas of Chadiza District. | |Health Services, Sexually Transmitted Infections, |

| | |With supervision from PPAZ, by the end participants had | |Gender Based Violence, Contraception and Teenage |

| | |prepared work plans to follow up on their learning. | |Pregnancy, Termination of Pregnancy Act of 1972, |

| | | | |Behaviour Change Communication, Counselling Skills |

| | | | |for Youth, Introduction to HIV/AIDS, Conflict |

| | | | |Management and Male Circumcision |

|1.4 |Raising awareness and organizing |The project participated in the commemoration of a number of |Ongoing |The drama group from Zemba RHC was invited to |

| |community advocacy meetings |international days including World AIDS Day in December 2011, | |participate at the 75th Anniversary celebration of |

| |through community action days or |World TB Day and Youth Day. | |Plan International to entertain guests and the |

| |international days e.g. Day of | | |entertainment mainly featured SRH messages; |

| |the African Child, World AIDS | | | |

| |day, | | | |

| |

|2.1 |Peer educator training |Peer Education training was carried out in November 2011 with |Ongoing |Topics included HIV/AIDs, prevention of STIs, |

| | |21 participants from the four communities | |family planning, rights, avoiding pregnancy, how to|

| | | | |communicate messages to others |

|2.2 |Adapt & distribute IEC/BCC |Materials were adapted and collated to be used as a handbook |Ongoing |Printing has been completed and the IEC/BCC |

| |materials |for Peer Educators to support them implement sensitisations | |materials are being used in during community |

| | | | |sensitizations by the young people |

|2.3 |Community radio programme |Training was carried out for Peer Educators in in radio |Ongoing. The process of signing a |For the radio training, 12 Peer Educators (6 males |

| | |programming and presentations. Personnel from various media |contract with one of the media houses|and 6 females) from the four project sites were |

| | |houses were also orientated on the aims and delivery of the |is in progress. Radio programmes will|trained along with the PPAZ Project Coordinator. |

| | |Young Health Programme. |begin in July 2012 |The purpose of the training was to see how the |

| | | | |media houses and the project in Chadiza could work |

| | | | |together. 12 media personnel from various media |

| | | | |houses were oriented. The media personnel will be |

| | | | |helping peer educators to conduct radio programmes |

| | | | |on SRH. |

| | | | |The programmes will be 30%in English and 70% in |

| | | | |local languages. The format will vary across |

| | | | |programmes – some will be live on air so listeners |

| | | | |are able to call in and participate in discussions,|

| | | | |others will be pre-recorded. |

|2.4 |Conduct outreach activities |Community outreach activities have been carried out jointly by |Ongoing |Community outreach activities included drama |

| | |Peer Educators and Drama group members to raise awareness of | |performances, guided discussions and the |

| | |issues around adolescent health, provoke discussion and provide| |opportunity for individual consultations. Condoms |

| | |a forum for young people to access individual guidance. | |were also distributed to young people in the area. |

| | | | |Peer Educators also participated in a traditional |

| | | | |ceremony in Chipata accompanied by health staff |

| | | | |from John Farm Rural Health clinic and 3 headmen. |

|2.5 |Girls groups |The girls groups have been formed in four schools in the four |Completed in 4 sites |The girls/boys clubs or Insakas have been formed in|

| | |project sites for the first phase | |four schools and the groups have since started |

| | | | |meetings were different sexual reproductive health |

| | | | |issues are discussed. These include issues of self |

| | | | |awareness such as body mapping, peer pressure and |

| | | | |how to deal with it, growing up and its challenges.|

| | | | |This is facilitated by the YAM members and the |

| | | | |teachers that were trained by the project. |

|2.6 |Boys groups |The boys groups have been formed in four schools in the four |Completed in 4 sites |As above |

| | |project site for the first phase | | |

|2.7 |Monthly YAM meetings |Three meetings were conducted | Ongoing |Three (3) YAM meetings have been held. The meeting |

| | | | |discussed issues relating to youth friendly corners|

| | | | |services and the equipment provided to them. |

| |

|3.1 |Adapt service provider manual for|The manual has been developed and the manual shall be used the |Done |The manual will be used to support the trained |

| |youth friendly health services |service providers and the youths as a reference for the | |health workers and the young people as they provide|

| | |provision of the services to the young people | |the services to the young people. |

|3.2 |Service provider training for |One training was carried out for service providers in the |Ongoing |This was a three day training for service providers|

| |youth friendly health services. |provision of Youth-friendly services | |from the four clinics of the YHP targeted areas. |

| | | | |Other participants included the traditional healers|

| | | | |and community-based distributors of contraceptives.|

| | | | |The topics covered were: An Adolescent Today and |

| | | | |Challenges, Young People and SRH Reproductive |

| | | | |Health and Rights, Youth Friendly Health Services, |

| | | | |Sexually Transmitted Infections, Gender Based |

| | | | |Violence, Standards For Youth Friendly Health |

| | | | |Services, Termination of Pregnancy Act of 1972, |

| | | | |Behaviour Change Communication, Counselling Skills |

| | | | |for Youth and Contraceptive and Family Planning. |

|3.3 |Strengthening of Youth services |A youth friendly corner was set up in each of the four clinics.|Ongoing |Clinics in extension communities will also receive |

| |at clinics through setting up | | |youth-friendly corners later. Zemba community’s YFC|

| |youth friendly services and | | |will be re-established once the roof of the clinic |

| |providing necessary equipment. | | |is fixed. |

| | | | | |

|3.4 |Training of Youth Counsellors |Thirteen youth counsellors were trained in youth friendly |Ongoing |Of the thirteen counsellors trained, 7 were female.|

| | |health service provision; | |The three day training was held 18th to 20th March |

| | | | |2012 and covered the same topics as the service |

| | | | |providers. One challenge experienced during the |

| | | | |training was the higher than anticipated |

| | | | |translation requirements between English and local |

| | | | |languages which caused the sessions to overrun. |

|3.5 |Establish Health Centre Advisory |Quality of Care committees were established in each of the four|Ongoing |Committees aimed to recruit 10-15 members in each |

| |Committees |targeted communities | |community to play a role in assessing and |

| | | | |monitoring the quality of services provided by the |

| | | | |health clinic. Meetings are planned to be held on a|

| | | | |quarterly basis. |

| |

| |Quarterly Review Meetings |A review was carried out in June and was combined with the |Ongoing |One formal quarterly review meeting was conducted |

| | |annual review of the project | |in June. Peer educators, counsellors and service |

| | | | |providers were present at the meeting. The meeting |

| | | | |was combined with the annual review |

| |Annual Review Meetings |Completed as above |Year 1 review carried out | |

| |End line Survey | |Planned to take place in 2014 |Will take place at the end of the project |

Annex 3 Global Measures

|Outputs |Number -current reporting |Total number- |Outcomes |When outcome |

| |period |programme to date | |measure expected |

|Total number of young people who have received health information through AZ|2408 |2408 |Examples might be: |Likely to be Yr 3 |

|YHP | | | |for outcomes |

| | | |% increase in knowledge of adolescents on health issues | |

| | | | | |

| | | |% decrease in myths/misconceptions amongst adolescents on various | |

| | | |health issues | |

| | | | | |

| | | |Improved access and services to address health needs of young | |

| | | |people evidenced by: | |

| | | |% increase in young people accessing services from health | |

| | | |clinics/counseling services | |

| | | | | |

| | | |Increased engagement of influencers in relevant | |

| | | |committees/groups/activities eg workshop attendance | |

| | | | | |

| | | |Increased support from community leadership for health | |

| | | |interventions for young people | |

| | | | | |

| | | |Number of referrals made eg by HIC and peer educators, counsellors,| |

| | | |teachers | |

|Number of young people who received information about: |2408 |2408 | | |

|Sexual and reproduction health | | | | |

|Mental health and emotional well-being | | | | |

|Substance abuse | | | | |

|Violence | | | | |

|Nutrition | | | | |

|Infectious diseases | | | | |

|Accidents/injury | | | | |

|Other health issue | | | | |

|Access to healthcare | | | | |

|Number of young people directly trained in delivery of interventions |21 |21 | | |

|Total number of frontline health providers who successfully complete |12 |12 | | |

|training programmes in adolescent health | | | | |

|Total number of influencers (parents, teachers, and leaders) reached by |17 (teachers, Indunas, |17 | | |

|programme |and parents) | | | |

|Estimated population reached via awareness raising/media campaigns |3904 |3904 | | |

|Issue specific measures: Community Benefit | |

|Guidance: Mandatory completion of data on template against key issues being addressed. Reporting not required on Global Community Support Database. | |

|Please note outputs by Issue are being identified in consultation with Global Community Support as countries define their primary focus area e.g. Sweden-mental health and well-being, UK-Access| |

|to Healthcare, Brazil-Sexual and Reproductive Health, India-Infectious diseases. | |

| | |

|Sexual and Reproductive Health – relevant measures to be confirmed with NGO | |

|Outputs |Number -current |Outcomes |When outcome |

| |reporting period | |measure expected |

|Number of debates and discussions on issues affecting gender and sexual health |26 discussions through |Reduction of reported early or undesired pregnancy | |

|-estimated population reached |radio programmes | | |

| | |% increase in the number of adolescents exhibiting responsible sexual health| |

| | |behaviours | |

| | | | |

| | |Reported change in perceptions of young males towards females | |

| | | | |

| | |% increase in knowledge of gender rights and issues | |

| | | | |

| | | | |

| | |% increase in knowledge of sexual reproductive health | |

| | | | |

|Number of adolescents (males and females) trained in gender awareness eg Plan Programme H| | | |

|and M | | | |

[pic]

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Using games to reach out

Various games played at the youth friendly corners kept the peers busy in the youth friendly corners and they had a lot of time discussing issues affecting them. The games also attracted other youths who were not particularly concerned about health information

Girls and Boys Insaka

An insaka is a gathering of girls and boys only and is meant to share experiences that relate to them. The Young Health Project facilitated the training and formation of the girls and boys Insakas. These have helped girls and boys open up to their fellow peers and discuss various things that affect them.

Radio Programme

[pic]

Community leadership

PPAZ implementation

(local partner)

Plan technical support and monitoring

Ministry of Education through the schools

And other government support

District Health Management Team through the Rural Health Centres

YHP youths helping fellow youths with SRH info.

Figure 1various parties playing a part in the YHP

Plan Health Programme Manager, Lusaka

Plan Health Coordinator,

Chipata

9 Community Development Facilitators,

targeted communities

PPAZ Project Coordinator,

Chipata

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