Background: Kenya currently has an HIV prevalence rate of 6%, equating to around 1.6 million people living with HIV in the country. Kenya is also one of the six HIV ‘high burden’ countries in Africa. (National Aids Control Council 2014). In Kenya, young women have an HIV prevalence of 6.1% — four times higher than their male counterparts. Studies showed knowledge around HIV/AIDS prevention was high amongst youth, however many young people continued to engage in risky behaviours, such as multiple sexual partners and inconsistent condom use.
one2one is a sexual health and HIV hotline for adolescents and young people in Kenya. The service is peer-based and the call centre is staffed by trained and supervised youth counsellors. one2one is free when called from the Safaricom mobile network. To reach a wider community, one2one utilizes other communication platforms and social media such as radio and Facebook to pass on credible information on sexuality, productive and HIV via wall discussion, live chat (individual and group) and inbox messages.
The one2one hotline, one of the first of its kind in the East Africa region, was set up in 2006 to target sexual minorities, LGBTI and youth with sexual health messaging. Lucy Mung’ala, who was among those who set up the initiative, stated that “the idea was how can we give out services to people who are either scared of showing up at the LVCT Health center or going to clinics for treatment or people who were just questioning their sexuality at that time” (Hivos, 2015).
The Hotline offers a comprehensive 360-degree continuum of care by providing information, counselling and emotional support and referrals or linkage to care and treatment. It places a strong emphasis on effective referrals and quality assurance of services received.
Target Population: Youth, Sexual minorities, Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI), Rural and Urban, Male and Female.
Technology: one2one utilises a hotline plus various social media sites. Click here for full technical details.
Technology Use: one2one Youth Hotline is a tele-counselling service that provides credible, accurate, non-judgmental, confidential services on sexuality, reproductive health, HIV and relationship issues affecting youth such as sexual health empowerment and gender-based violence. The service is free of charge from a Safaricom line by calling or sending a text to 1190. The project also uses interactive SMS to address HIV and sexual health needs of the Most at Risk Populations (MARPS) and Vulnerable Groups (VG) who include the youth, Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) groups and the deaf community. Through a variety of radio programming, one2one seeks to increase awareness on reproductive health, sexuality, HIV/AIDS risks and reduction of infections among young people as well as providing them with sources of credible and accurate information and referral for services. The program also utilizes girl targeted Information Education Communication (IEC) print material, regular Question & Answer (Q&A) on email, an interactive one2one youth website with a chat functionality as well as weekly and other regular shows in youth-targeted radio stations
The Hotline offers anonymity and confidentiality around sensitive HIV topics to the programme target groups. This is vital to stop callers feeling they may be judged. The calls initially come through the Safaricom switchboard and are then transferred to the 1190 switchboard if there is a free line after which a counsellor takes up the call. In the first few minutes, the counsellor establishes the bio-data of the caller; their name, their sex, their location which are then loaded into the computerized system. The caller has access to a counsellor or nurse depending on the issues that they need counselling on. They are offered counselling and referral. If there is a need for a follow-up session this is scheduled with the consent of the caller. LVCT Health has a formal engagement with some clinics — such as the Tunza clinics and FHOK clinics to enable smooth and effective referrals for sexual and reproductive health services.
The hotline services are open from 8am-8pm every day. If a person calls outside these times, they can leave a voice message and a contact number and they will be called back during opening hours. Participants can also leave a message through a chat function and one2one will email them back during work hours.
The system makes data available to LVCT Health in real-time but is usually accessed on a weekly basis and analyzed to show trends over time and for quality control. The data provides insights into the counsellors’ performance as well as providing crucial intelligence on the issues being discussed. LVCT Health is able to instantly determine the number of calls coming in, topics of concern, call location, age of the callers, education levels, marital status, whether they are MSMs or not and other relevant demographic data.
Organizations and Partners: one2one is run by a Kenyan NGO based in Nairobi called Liverpool VCT, Care and Treatment (LVCT). LVCT are providers of voluntary counselling and testing (VCT) services in Kenya and have a wealth of experience providing counselling, HIV testing, care and treatment services throughout the country. LVCT Health was launched in Kenya in 1998 as a research project of the Liverpool School of Tropical Medicine (LSTM) located in Nairobi. Its core mandate was to conduct HIV and related epidemiological research, research into voluntary HIV counselling and the feasibility of setting up VCTs in Kenya.
Challenges and Lessons Learned: The range of calls to the hotline is wide and covers relationships, sexuality, psychosocial support, pregnancy and prevention, and sexual and gender based abuse, and HIV/AIDS.
Every month, the one2one Integrated Digital Platform reaches a large number of youth, as detailed below:
-More than 13,000 monthly callers on the one2one 1190 hotline
-More than 20000 impressions from conversations and chats with followers, fans and friends on Facebook
-More than 20000 impressions on Twitter interactions, mentions and retweets
-More than 1,000,000 teens through the question and answer columns in the Insyder Youth Magazine’s GurlTalk and BoyTalk columns (http://www.lvcthealth.org/one-2-one)
In terms of dissemination, one2one uses a variety of methods to inform people about the service — posters and business cards in schools, business places and youth events; advertising through the Youth Advisory Council members, counselling and testing mobilization activities, the one2one website and through the Insyder and other teen magazines. Additionally, the service pushes out marketing campaigns to rural areas as well, especially Central and Nyanza Province through the Youth Advisory Council mobilization activities.
Initially functioning as a 0800 line, LVCT Health faced key challenges managing the services. Management of data was amongst the biggest problems as counselors had to manually take notes when dealing with callers which presented challenges in ensuring the accuracy of data. Supervision and quality assurance was a challenge as supervisors could not rely on these manual notes taken by the counselors. Quality assurance and call quality were the other challenges.
Quality of the calls were often found to be poor and whenever calls dropped there was no system of calling back. The work load and the working conditions often left the counselors exhausted.
In 2011, LVCT Health acquired a short code (1190) from the then Communications Commission of Kenya (CCK) and approached Safaricom for a public-private partnership. Under this partnership, Safaricom subsidized the calls which meant that currently there is no cost to LVCT or the clients. Safaricom also provided LVCT Health office space, at a fee, at their call centre with modern technology. This improved the working condition for the counselors, enhanced call quality and the improved, modern software ensured all calls were recorded and real-time data was made available. With better call quality, data management and quality assurance in place, the number of calls to the line has steadily increased over the years.After this public-private partnership with Safaricom, the LVCT Health Youth Programme Coordinator, Eric Gitau stated that “The impact could be felt, in 2011 the number of calls that had come from 2010 to 2011 were 56,000 calls…due to this partnership this shot up 156,000 in the next year…since then it has been an upward trend. We maintained the 150,000 for about two years and then this year (2014) within half an year we were able to beat that number and we are expecting within one year we will have done 300,000 calls” (Hivos, 2015).
This case study was compiled using online Liverpool VCT, Care and Treatment and Hivos sources:
- HIV Situation in Kenya. Retrieved from http://blog.opendata.go.ke/hiv-situation-in-kenya/. Accessed on 21 March 2017.
- One2One Youth Hotline Best Practices (2015). Retrieved from https://www.hivos.nl/assets/2015/10/LVCT-Best-Practice-2-One2One-Hotline-Final-Presentation-Paper.pdf. Accessed on 21 March 2017.