The International Organization for Migration (IOM), Save the Children Netherlands (SC) and Witwatersrand School of Public Health (WSPH) — the SRHR-HIV Knows No Borders Consortium — are collaborating to implement a holistic, regional project to improve sexual and reproductive health and HIV related outcomes amongst migrants (including migrant adolescents, young people and sex workers) as well as non-migrant adolescents, young people and sex workers and others living in migration-affected communities in six countries in the Southern African Development Community (SADC) region, including Eswatini, Lesotho, Malawi, Mozambique, South Africa and Zambia.
This compendium of stories of change and best practices is made possible by the generous support from the Government of the Netherlands. The contents of the compendium are the sole responsibility of the Consortium and do not necessarily reflect the views of the funder.
The ‘SRHR-HIV Knows No Borders’ Project has been designed as a holistic, regional approach to improve sexual and reproductive health (SRH) and HIV-related outcomes amongst migrants (including migrant adolescents, young people and sex workers), as well as non-migrant adolescents, young people, sex workers and others living in migration-affected communities. It is being implemented in selected high-volume migration-affected communities, including border communities, in all six countries.
This report aims to capture stories of change and best practices emerging from the project and represent a diverse selection of experiences, in terms of geographic representation, targeted beneficiaries, level of intervention and project intended outcomes. Taken together, they demonstrate a human rights-based project that is taking both an upstream and downstream approach, engaging widely with key stakeholders at local, national and regional levels and effectively utilising an intersectoral approach to create an enabling environment for target populations to access SRHR-HIV and related services.
Key findings from this documentation process include:
• Change Agents are providing a much-needed source of accurate health information, advice and social support for internal and cross-border migrants, who may lack such social support due to their mobility. They are also reaching vulnerable and key populations who may easily be missed by other lay health worker interventions.
• Change Agents’ availability to accompany clients to health facilities, or to be present at these facilities on pre-arranged days, provides support for individuals who may be uncomfortable or afraid to present alone, while the good relationships between Change Agents and health care workers at local facilities have been central to improving access to treatment and services for project beneficiaries.
• The use of duplicate referral boxes placed within clinics has allowed for Change Agents to track referral completion rates and conduct follow up visits with clients who have been referred but have not presented.
• The sensitisation work undertaken by the project for both health providers and non-health-provider stakeholders (such as health care workers, police, and immigration officials) is contributing to the creation of an enabling environment for migrants, sex workers and adolescents and young people to access SRHR-HIV-related care and services.
• Empowering migrants, sex workers and adolescents and young people (including Change Agents) with accurate SRHR-HIV and migration information, and a better understanding of their human rights, can provide individuals with more agency and decision-making power in their own lives.
• A combination of project interventions within the communities (e.g. the work of Change Agents and drama groups, Community Dialogues and comprehensive sexuality education) is creating spaces for issues of SRHR-HIV to be more openly discussed in communities.
• The further integration of menstrual hygiene management into project programming may help reduce girls’ vulnerability to gender discrimination, child marriage, exclusion, violence and poverty.
• The integration of livelihood components into SRHR-HIV programming for adolescents and youth and for sex workers could be explored for future interventions.
• The training and sensitisation of local and traditional leaders has been instrumental to the success of the project to date, playing an important role in ensuring the buy-in, ownership and potential sustainability of the project in some sites.
• The engagement of key stakeholders through regional technical consultations has proven an effective tool in filtering grounded migration and health priorities at local and national levels in project countries into key regional level processes that help shape regional frameworks for future engagement.
For more information please contact: Dr. Francis Bwambale Mulekya, Regional Migration Health Programme Manager - firstname.lastname@example.org