Consultancy: Girls Empowerment Project

Globally, adolescent girls and young women (AGYW) between the ages of 10-24 account for more than half of the people living with HIV. In sub-Saharan Africa, the number of new infections among AGYW remains exceptionally high. Specifically, in 2017, approximately 340,000 new infections occurred among AGYW, which translates into 6,500 new infections every week (UNAIDS). While some of these AGYW were infected at birth from their HIV-infected mothers, a significant percentage was infected through sexual transmission. This alarming disproportionate burden of HIV prevalence among AGYW has been attributed to the failure to address structural determinants of HIV infection. These factors, which include social and economic drivers, such as unequal gender relations, poverty and discrimination, lack of livelihood options, barriers to accessing healthcare services, among others, reduce the benefits conferred by protective factors including education, economic assets, and legal protection.

In Uganda, 1 million people have died of HIV-related illnesses, and there are over 1.3 million people living with HIV (AVERT, 2017). Despite the readily available anti-retroviral therapy (ART), the country registers 230 HIV new infections a day, and more alarmingly, 76 Ugandans die of HIV-related causes every single day (UN, 2017). According to recent UNAIDS data, approximately 570 AGYW aged 15 to 24 get infected with HIV every week in Uganda.

CenRIDUG has been present in Uganda since 2018, providing developmental assistance to the country through strengthening the capacity of community health workers, and providing both technical expertise and resources to support the Government’s Child Day Plus (CDP) initiative. CenRIDUG currently operates in Kamuli and Luuka Districts in Eastern Uganda.

2. Background: Project

Grounded in the positive youth development (PYD) framework, the Buvuma Girls Empowerment Project (BUGEP) is a 12-month initiative funded by Gilead Sciences Inc. It aims to reduce the overwhelming burden of HIV on 1,250 adolescent girls and young women (AGYW) aged 10-24, including those with disabilities, in Buvuma District through the provision of comprehensive sexuality education (CSE). Specifically, CenRIDUG will contribute to improving the knowledge of HIV and sexual reproductive health and rights (SRHR) among AGYW by providing various services, including prevention and diagnosis of HIV/AIDS, counselling on family planning, prevention and management of gender-based violence, preventing unsafe abortion and providing safe abortion care, promoting menstrual hygiene and health, etc. Intensive social and behavior change communication (SBCC) activities, including workshops targeting community and traditional leaders, performed art festivals (PAFs), teen outreaches, etc. will be undertaken to narrow, reframe, and eliminate gender differences in sexuality, while bolstering those positive attitudes related to gender norms. Teen outreach activities, including volunteer community service; working as aides in health centers, witnessing/partaking in HIV counselling sessions, participating in HIV outreach events, etc. will be designed, based on the helper-therapy principle, to empower the AGYW by giving them a chance to be help-givers rather than help-receivers. These activities will seek to improve their skills and sense of self-efficacy, promote essential attitude change about perceived personal risk of HIV infection, develop a belief in the right to and responsibility for safe practices, promote greater open-mindedness concerning gender roles, and increasing the basic rights of those vulnerable to and affected by HIV and AIDS.

Given the high risk sexual behaviors among AGYW in Buvuma District, the anticipated outcome of the BUGEP is that AGYW are empowered to stay HIV-free. The project will thus pursue the following two (2) outputs towards achieving this outcome

i. Expected Result 1: Comprehensive knowledge of HIV and SRHR among AGYW increased, and

ii. Expected Result 2: Adoption of protective behaviors that reduce HIV transmission and acquisition increased

The project will be implemented in three (3) Sub Counties; Bweema, Lwajje, and Buwooya, across three (3) administrative units in Buvuma District.

3. Purpose of Baseline Assessment

The baseline survey is an important step in the implementation process. It would seek to gather and analyze both quantitative and qualitative data that will measure both the current status of key program indicators and their progress during the envisioned mid-term and end-line evaluations. It would serve as a benchmark for comparison of the changes achieved as a result of this preventive intervention. The baseline assessment will achieve the following objectives:

i. Collect valuable information of the current perceptions, knowledge, attitudes, social norms and practices, and beliefs of AGYW, community members, and community leaders, including traditional and religious leaders, relating to HIV transmission and prevention.

ii. Identify and map out district ‘hot spots’ and existing interventions by key stakeholders, including civil society organizations (CSOs), national and international NGOs in Buvuma District working on reducing the incidence of HIV infection in AGYW.

iii. Identify gaps, barriers, and challenges in providing high quality CSE to AGYW, including an analysis of the leadership skills gaps and capacity needs of the AGYW, and support/leadership from the districts health office (DHO).

iv. Conduct registry review of current HIV related health care services at neighboring health facilities/hospitals to determine the care cascade in the district, and the resulting estimates for PLHIV.

The assessment will collect, analyze and report data at three (3) levels:

i. District Level (Level 1)

ii. Health Facility Level (Level 2)

iii. Community Level (Level 3)

4. Scope of Work

The selected consultant will be expected to carry out the baseline survey, providing the following deliverables:

i. Draft of the baseline assessment protocol describing

a) Methodologies – propose an appropriate methodology for design, sampling, data collection and analysis, taking into consideration the purpose of the baseline assessment as stated in item 3 above.

b) Data collection tools and procedures, including data quality assurance strategy.

c) Detailed work plan with timelines and schedules.

ii. Conduct desk review and analysis of DHIS-2 data related to the project’s outcome variables.

iii. Draft a comprehensive report, including data tables with baseline measurements, for key output and process indicators to the CenRIDUG team with key findings for review and feedback.

iv. A report detailing the challenges, lessons learnt, risk and opportunities in providing high quality CSE to AGYW, including an analysis of the leadership skill gaps and capacity needs of the AGYW.

v. Facilitate a validation workshop among the project stakeholders to crosscheck accuracy and validity of the findings from the baseline.

vi. Present to the CenRIDUG a final report, no longer than 25 pages (not including annexes, executive summary, etc.) addressing the project’s objectives, and detailing and interpreting the findings with a table of all the indicators and their corresponding measures at baseline.