School-based safe spaces to empower AGYW

Key information

• Organisation: NACOSA
• Country: South Africa
• Region: Eastern and Southern Africa
• Stage of innovation: Stage 6: In the market and ready to scale
• Start date: 09/01/2023
• End date: 06/30/2025
• Type of innovation: Services delivery innovation: new or different way of providing a service
• Budget: $376,487.40
• Funders: South African Medical Research Council

Summary of intervention

Adolescent girls and young women (AGYW) often find HIV and sexual and reproductive health (SRH) services unfriendly and inadequate. Health facilities may be closed after school, and if they attend during school, they miss out on lessons. They frequently don’t access services, resulting in high teenage pregnancies and sexually transmitted infections (STIs), including HIV.

NACOSA is bridging this gap through Imagine — a project providing services in School-based Safe Spaces — familiar, safe and convenient environments. Safe Spaces are usually located close to female toilets so that AGYW can do pregnancy tests easily and discretely. Qualified staff, including registered nurses, work closely with school staff to offer youth-friendly clinical and psychosocial services.

AGYW do a needs assessment through a board game and are invited for private consultations where they can access e.g., STI and HIV testing, PrEP, antiretroviral therapy, pregnancy tests, contraception, antenatal services and general health screening, as well as referrals to further services.

Learners are incentivised to take up health testing services and SRH products, receiving loyalty points to buy items from vendors or the school tuckshop.

Between 1 July 2023 and 30 September 2024, over 80% of female learners did an HIV test, and over 60% did pregnancy tests. AGYW have become competent and confident in using health tests and products. They find the assessment game fun and informative, and health outcomes have improved through increased access, uptake and adherence to contraception, HIV testing and PrEP.

learnings

The project was moderately difficult to design, specifications and requires involvement of specialist construction project managers to keep contractors within specifications, cost and timeline.

However, showing a commitment to investing in schools creates a lot of good will and support.

next steps

The project will create an advocacy film on school-based Safe Spaces and aims to secure funds to expand 10-fold.

sustainability

To be sustainable requires expansion of the social impact bond model through multi-partner capital investors backed by the Department of Education and Department of Health via the treasury.

Find out more in this video by NACOSA.