1. CSTL /RHIVA Sharing Meeting 2014 Reducing HIV in Adolescents Southern Sun O.R. Tambo - Johannesburg, South Africa 17-20 November 2014

2. Presentation Outline  A description of RHIVA Project  Case of RHIVA in Zambia  Implementation Challenges  Opportunities/Emerging Issues  Key lessons learnt

3. Reducing HIV in Adolescents A school-based, HIV prevention programme, conditional cash transfer to encourage positive behaviour change among adolescents, especially girls. Knowing status Positive healthy behaviour Career aspiration and planning Falls under CSTL health element Currently piloted in Mozambique, Namibia and Zambia

4. RHIVA Goals and Objectives Goals To reduce the number of HIV infections among adolescents in the SADC Region Objectives To incentivize adolescent students in Intervention 1 and 2 schools to engage in healthy behaviours and make responsible lifestyle choices To increase knowledge and understanding of Intervention 2 learners on HIV&AIDS/SRH, and on career development through strengthened life skills curricula To increase awareness amongst parents and school communities from Intervention 1 and 2 schools on the importance of supportive and protective environments for adolescents

5. Programme Theory of Change When adolescents are: incentivized to engage in positive behaviours, equipped with knowledge and skills on SRH and HIV prevention, equipped with knowledge on career choices, sustainable livelihoods and financial management, When parents and teachers are engaged in supporting adolescents in responsible decision-making, Then adolescents will: believe that the future holds opportunities for them, have confidence in their own abilities, will make healthy lifestyle choices and display responsible behaviours, THIS WILL REDUCE THEIR RISK OF CONTRACTING HIV.

6. RHIVA Intervention The intervention comprises of three cohorts: Control group: No intervention; assessed at baseline and end of program Intervention 1: Conditional cash transfer programme; parent workshops; periodic assessment of milestones; assessed at baseline and end of program Intervention 2: Conditional cash transfer programme; strengthened SRH and entrepreneurship curriculum; parent workshops; periodic assessment of milestones; assessed at baseline and end of program 21 schools (7 per cohort); approximately 200 learners per school = 2800 learners per country

7. A look at RHIVA in Practice: Zambia Achievements  RHIVA is being Implemented in 21 Secondary schools within Lusaka Province  More than 2,500 learners from 14 schools in Intervention Group 1 and Intervention Group 2  Approximately 1, 300 now know their HIV status through an HIV test; received cash voucher  About 1,054 parents successfully engaged as key stakeholders of the project implementation;  26 of teachers successfully trained as core facilitators of the ‘My Life, My Future’ programme in all intervention group 2 schools

8. Committed parents to RHIVA Programme

9. A look at RHIVA in Practice: Zambia Achievements  Successfully engaging 29 health centres in the provision of HCT services to learners on the programme;  Successfully conducted advocacy activities in all 21 schools through orientation and briefing meetings;  Strong collaboration with the Ministry of Education, Ministry of Health and Stakeholders, committed to effective implementation of the project in schools; shared goal to improve the health of young people in Zambia.

10. Implementation Challenges  Lack of real commitment by some parents, especially in Low-density areas, to allow full participation in the project implementation  Lack of administrative costs in the day-to-day management of project (activities-based budgets a sore);  Inadequate funds that cannot even cater for teacher’s entitlements such as transport refunds, lunch allowances etc.  OTHER CHALLENGES (?? MOZAMBIQUE? NAMIBIA?)

11. Opportunities/Emerging issues  Opportunity: Existence of HCT services and youth friendly services in all health centres in Zambia.  Opportunity: The Ministry of Education embraces the desire to reduce HIV among adolescents.  Emerging issues: Differences in the reporting systems and, above all, the tracking of RHIVA indicators through data collection in health centres that have specific interests.  Emerging issues: Lack of resources is quite an issues.

12. Key Lessons Learnt  Forming partnerships with organization(s) that are specialized in Mobile HCT service provision could have influenced objective data collection on HIV status of learners  One opportunity for RHIVA is the existence of HCT services and youth friendly services in all health centres  Engaging stakeholders and leveraging support for project goals can accelerate the implementation of RHIVA significantly. However, this has huge cost implications  Advocacy is an ongoing and evolving process; but critical to programme success  OTHERS?

13. Comments and Questions from the Floor & Other Panellists.