Background: In Mozambique, 11.5 per cent of the population aged 15 to 49 were found to be living with HIV/AIDS according to the 2009 National Survey on Prevalence, Behavioral Risks and Information about HIV and AIDS in Mozambique (INSIDA) (DHS, 2009). Overall, the survey results reported that 13.1% of women and 9.2% of men age 15-49 were HIV-positive in Mozambique, showing that women were more affected than men in both urban and rural areas. These results support the findings from the 2014 UNAIDS Gap Report that girls and women bear a higher burden of the HIV/AIDS crisis and those young women aged 15–24 years old in sub-Saharan Africa are almost twice as likely as young men to be living with HIV. Low literacy levels, particularly amongst girls and women creates barriers in accessing information and restricts communication methods to mainly oral means, highlighting the importance of community-level communication such as radio broadcasts in local languages and in-person communication. However, in Mozambique, only 50% of households owned a radio set (DHS, 2011). Alternatively, a steadily growing mobile teledensity is providing a new cost-effective means of disseminating information, especially to hard to reach target populations.
To tackle the need for improved provision of information, the Geração Biz (“busy generation”) programme was run from 1999-2009 under Pathfinder with funding from UNFPA. This programme promoted reproductive and sexual health and HIV & AIDS prevention among adolescents using various innovative channels. Its main goals were to increase gender awareness, reduce the incidence of unplanned pregnancies, and decrease young people’s vulnerability to STIs, HIV, and unsafe abortion. Programme activities were first piloted in Maputo City and Zambezia Province in 1999. In 2000, the programme expanded to Gaza province and every few years, new provinces were brought in so that by 2007, activities were conducted on a national scale, in all provinces. Based on information from Pathfinder, over 2 million youth were reached during the 10 years of the project (Pathfinder, 2017).
In October 2015, as part of the continuing growth of this national, collaborative initiative of the Ministry of Health, the Ministry of Youth and Sports, and the Ministry of Education, UNICEF worked with these government bodies as well as Coalizão, a Mozambican youth association, to adapt UNICEF’s SMS-based U-Report and roll out a pilot programme in four of the provinces. U-Report is a free, SMS-based social monitoring platform that provides a platform for young people in developing countries to engage on issues pertinent to their well-being. Coalizão conducted research with target groups and their pre-launch surveys indicated that there was indeed a real and urgent need for accurate information on sexual and reproductive health for youth.
SMS Biz helps adolescents and youth, male and female, between 10 and 24 years of age, to access information on sexual and reproductive health, with a focus on open expression of problems and consolidation of responses. A counselling hub is managed by twelve young counsellors, equipped with ICT facilities and guidelines to respond to queries about HIV, gender-based violence, alcohol and drug abuse and other issues (UNICEF Stories, 2016).
Target Population: Adolescents, Male and Female, Urban and Rural, 10-24 years.
Technology: U-Report re-purposed its free Rapid SMS platform. RapidSMS is a free and open-source framework for rapidly building mobile communication programs for scale. Click here for full technical details.
Technology Use: Under the ongoing Geração Biz programme, U-Report re-purposed its free SMS platform to ensure continuous access to personalized HIV information for adolescents and young people. By utilizing simple 2-way SMS exchanges, youth were able to access real-time feedback, counseling, referral and linkages to other tool free platforms including the Child Helpline (116), Alo Vida Hotline (health counselling hotline), UNICEF Facebook page, PSI Technology for Development (T4D) Movercardo for condoms distributions monitoring and others. U-Report currently runs in several countries around the world by utilizing open-source software, namely RapidPro.
Adolescents can send and receive information using SMS from any type of mobile handset. The counselling hub responds to their questions and queries on sexual health and HIV prevention. SMS BIZ also offers weekly discussion questions to users who opt-in to the service. When subscribers answer a discussion question, SMS BIZ collects anonymous information on the health queries but also demographic data regarding their gender, age and area. Through this data, the SMS Biz team is able to assess the effectiveness of health services in specific communities as well knowledge gaps in reproductive health or HIV prevention issues. UNICEF can then work with partners in communities to provide information around these gaps. The majority of the SMS’s exchanged involve questions around sexual and reproductive health, HIV/AIDS and STI’s and relationships. To register for the service, a user has to text the word “juntar” to the toll-free shortcode 92222 and answer a few demographic questions.
Organization and Partners: UNICEF is a United Nations programme with headquarters in New York and offices around the world. UNICEF strives to promote the rights and well-being of every child through developmental and humanitarian assistance. Access UNICEF Innovation online at https://www.facebook.com/unicef.innovation/.
Challenges and Lessons Learned: Since SMS Biz is an SMS based programme, low literacy rates in Mozambique and low phone ownership, especially amongst girls and women, create accessibility and inclusivity issues in reaching the target population of this project.
Being able to learn about and discuss HIV related issues in private and confidentially is key to the success of such programmes. UNICEF Technology for Development Officer, Francelino Murela stated at the launch of the SMS Biz programme, “Most of the information given is available at local clinics but young people are scared to go to clinics because they don’t want to be seen by their family relatives. Stigma and discrimination are real challenges for young people” (Daily Vox, 2016) SMS Biz / U-Report has been growing quickly and in their first year, over 57,000 young Mozambicans registered for their information services.
This case study was compiled using the following online sources:
- Project websites: http://www.unicef.org.mz/en/our-work/what-we-do/communication-advocacy-and-participation/
- SMS BIZ/U-Report Mozambique: http://mozambique.ureport.in/
- HIV in 2009 Mozambique INSIDA. Retrieved from https://dhsprogram.com/pubs/pdf/HF33/HF33.pdf. Accessed online 20 March 2017.
- Inquérito Demográfi coe de Saúde 2011. Retrieved from http://www.dhsprogram.com/pubs/pdf/FR266/FR266.pdf. Accessed online 20 March 2017.
- Geração Biz Program. Retrieved from http://www.pathfinder.org/projects/geracao-biz/. Accessed online 20 March 2017.
- How SMS are helping to prevent HIV in Mozambique. Retrieved from https://www.thedailyvox.co.za/unicef-hiv-sms-biz-sexual-and-reproductive-health-mozambique-young-people/. Accessed online 20 March 2017.
Image sources: http://unicefstories.org/2017/10/10/the-biz-girls-of-mozambique-empowering-girls-through-sms/ and http://www.unicef.org.mz/sms-biz-ira-providenciar-aconselhamento-personalizado-aos-adolescentes/