Hivos Regional Fund: ASRHR in the Southern Africa Region

Between January 2018 and December 2022, 70 grants were distributed through the Regional SRHR Fund focusing on access to adolescent SRHR information and services, advocacy, awareness creation, ending early and unintended pregnancies, HIV/AIDS and other sexually transmitted infections (STIs), research, contraceptive services, LGBTI, sexual health, pleasure and rights. The overall impact has been measured by two key indicators 1) Percentage of women aged 15 19 who have given birth or are pregnant with their first child and 2) HIV prevalence by sex and age. Adolescent pregnancies appear to have increased in the region and the focus countries, since the 2018 baseline, except in Malawi. This can be partly explained by the comparability of the data sources between the baseline and endline evaluation, as different sources have been used due to the nonavailability of the same data sources. In addition, adolescent pregnancy rates in the region may have risen in part due to COVID19 and the lockdowns that occurred which prevented many from being able to access contraception as well as increased rates of SGBV. The impact regarding HIV prevalence in the region and the focus countries has improved against the 2018 baseline. However, given the rise in adolescent pregnancies and SGBV rates experienced during the COVID19 lockdowns, the rise in HIV in the region could increase in the short term. Selected results per objective include: Objective 1. Capacity strengthening The Regional SRHR Fund facilitated 18 youth-led organizations in securing mainstream SRHR funding between 2018 and 2022. The organisations underwent comprehensive training, mentorship, and skill enhancement programmes aimed at enhancing their organisational capabilities. As a result of this organisational development, these youthled organisations significantly improved their competencies in areas such as financial management, strategic planning, governance systems, resource mobilization, and monitoring and evaluation (M&E). This empowered youthled organisations to fortify their internal structures, establish robust governance frameworks, enhance financial oversight, increase their visibility, and broaden their funding base. Consequently, youth-led organisations not only became financially sustainable but also gained the capacity to carry out SRHR initiatives. Over the course of the programme's duration, the Fund continuously enhanced the communication and advocacy abilities of partner organisations. This ongoing commitment yielded significant results, with 55% of partner organisations, predominantly youthled and youth focused successfully holding authorities accountable. The programme contributed to young persons with disabilities demonstrated a growing sense of determination in advocating for their own agenda concerning ASRHR. An organisation in Zimbabwe organized a health dialogue, which served as a platform for forging partnerships aimed at developing a health strategy that embraces disability inclusivity. The dialogue saw the participation of representatives from the Ministry of Health in Zimbabwe, emphasizing the commitment to ensuring that the ASRHR needs and rights of adolescents and young people with disabilities are recognized and addressed. Objective 2. Knowledge management The Regional SRHR Fund increased access to crucial ASRHR information, which encompassed SRHR research and evidence, programming best practices, opportunities for funding and partnerships, and a wealth of key SRHR resources through the SRHR Fund newsletter. This achievement was realized through a multifaceted approach, including the facilitation of webinars focusing on pertinent SRHR topics and collaborative efforts with various organizations, networks, and SRHR experts to deliver uptodate evidence, practical experiences, and valuable insights within the field of SRHR. The Fund significantly enhanced access to comprehensive ASRHR information and promoted knowledge sharing by organizing 16 virtual webinars, each addressing various critical SRHR topics. In 2022, the Fund launched its dedicated website page and developed an online database specifically designed for youthled and youthfocused CSOs on the Hivos website. This strategic move was driven by the core objective of streamlining the distribution of crucial SRHR information to a diverse audience of partners and stakeholders, transcending geographical boundaries and extending its impact beyond the region. Youth Research Academies (YRAs) were established in several countries, including Zimbabwe, Zambia, Kenya, and Malawi, with a specific focus on involving young individuals in research to address gaps in ASRHR programming and policy. Health systems in both Malawi and Zimbabwe have demonstrated increased receptiveness to the latest research and knowledge in the field of ASRHR driven by young people. Consequently, there has been a notable acceptance of the recommendations proposed by young researchers, grounded in the evidence generated through the YRAs. In Zimbabwe, this commitment extended to authorities making pledges to establish additional youthfriendly spaces within healthcare facilities. Meanwhile, in Zambia, the Ministry of Health, in collaboration with its partners, embraced the YRA model, seamlessly incorporating it into the newly launched Adolescent Health Strategy spanning from 2022 to 2026. In Zambia, youth researchers developed and disseminated the SRHR position paper to a special parliamentary select committee and the National Youth Development Council in 2022. The position paper developed was derived from different countrywide research works done by youth researchers. Objective 3. Advocacy and awareness raising In 2022, the Fund took proactive steps to establish a supportive legal, policy, and social framework for adolescent consent and access to ASRHR information and services within the region. This effort involved convening of stakeholder consultative engagements in four countries: Kenya, Malawi, Zambia, and Zimbabwe. These engagements were conducted in collaboration with the respective Ministries of Health in each country and involved a broad spectrum of stakeholders. In total, these consultative engagements brought together 55 key stakeholders, including policy and decision makers such as Members of Parliament (MPs) and 48 CSOs representing youthled and youthfocused organizations. The collaborative discussions resulted in the identification of critical joint action points. One significant outcome was the recognition of the necessity to harmonize laws, policies, and guidelines related to consent for SRHR among adolescents and young people. Furthermore, the inclusion of the 'age of consent' agenda in the strategic priorities of Zambia and Malawi was a notable achievement stemming from these consultations. These strategic actions are expected to yield a favourable environment for the delivery and uptake of SRHR services among adolescents and young people throughout the ESA region in the long term. One of the primary objectives was to influence policy change through effective advocacy and as such the Fund increased knowledge and skills among youthled and youthfocused organizations to undertake evidencebased advocacy Objective 4. Coordination / convening The Fund strengthened collective action through the Community of Policy and Practice (CoPP). As an illustration, Hivos partnered with SRHR organisations with CoPP to organise a webinar, which aimed to raise regional awareness about opportunities for CSOs and youth to engage in implementing and monitoring the SADC SRHR Strategy and its associated scorecard. The Fund supported an organisaion in Zambia in organizing the Regional Adolescent Health Indaba (RAHi) to improve the coordination of SRHR efforts. RAHi, attended by over three hundred (300) participants from Southern African countries, emphasized meaningful youth engagement and innovation to reduce new HIV infections. It served as a platform for regional and national representatives, youth organizations, policymakers, and donors to share SRHR data and best practices within the SADC region. Objective 5. Special Initiative Fund The Fund increased regional cross learning and knowledge exchange on adolescent and youth SRHR through supporting of regional convenings and youth participation in the same. For example, through the Fund, an organization was supported to convene the World Association of Sexual Health (WAS) congress in Africa. The convening supported youth participation in the congress which promoted knowledge exchange on research and programming on sexual health and pleasure.

In 2017, Sweden's Regional SRHR team approved a four-year project proposal submitted by Hivos Southern Africa Hub. The project aims to build and strengthen strategic ASRHR partnerships and collaboration at the regional level, and to achieve outcomes that are inter-connected, mutually reinforcing and linked to the health and well-being needs of young people and adolescents in Eastern and Southern Africa (ESA). By December 2021, the project is expected to have achieved stronger and more coordinated youth-led and youth-focused civil society in Southern and East Africa that can promote, address and advance Adolescent and Youth Sexual and Reproductive Health Rights (ASRHR) and its interconnection to HIV at the regional level. The project was conceptualized to strengthen interventions on ASRHR in Southern Africa and further into East Africa with the aim of improving access to SRHR for young people and adolescents. The specific objectives of the project are: Objective 1: Capacity strengthening - Youth-led and/or youth-focused organizations are trained, mentored and upskilled in all areas of organizational and programmatic capacity to enable them to promote and advocate for improved access for adolescents and youth to SRHR services. Objective 2: Knowledge management - There is improved knowledge sharing, networking and data collection on SRHR in the region by youth-led and/or youthfocused organisations and individuals, as well as increased capacity for youth-driven research. Objective 3: Advocacy and Awareness Raising - Youth-led and/or youth-focused organisations have improved capacity to conceptualise, design and coordinate joint ASRHR advocacy and awareness-raising campaigns in the region. Objective 4: Convening and Coordination - Youth-led and/or youth focused organisations have enhanced capacity to coordinate SRHR activities and convene spaces through integrated and inter linked activities, including with similary organisations in East Africa. Objective Five: Special Initiatives: Responsive Grant Making The intervention will also make provision for a Special Initiatives Fund to support individual or organizational participation in key forums and strategic meetings to advocate and advance SRHR for all, support to innovative interventions, support to evidence based research, as well to respond to unexpected situations requiring immediate response in the broader SRHR realm. The contribution is all tied together by grant making which serves as a Critical Enabler - serving as the mechanism that funds an integrated set of strategies, activities and approaches that aim to improve the accessibility, acceptability, uptake, equitable coverage, quality, effectiveness and efficiency of ASRHR interventions and services.