Over the past years there has been a stabilisation in the HIV epidemic in a majority of countries in the southern Africa region. Despite impressive successes, much remains in addressing the various structural factors that drive the epidemic. While new HIV infections have declined HIV-related deaths have risen by 50% among adolescents. Gender specific factors affect boys and girls in different ways. Mortality among 15- to 19-year-old HIV positive males[1] is higher than among girls as this age group is not accessing HIV and health services. AIDS and adolescent pregnancy are the leading cause of maternal mortality among teenage girls and young women. Adolescent fertility rates remain high at 108.2 live births per 1,000 girls aged 15–19. For many adolescent girls in the region, sex, marriage and pregnancy remains neither voluntary, consensual nor informed. Laws, systems and services related to SRHR are inadequate despite the numerous commitments and laws signed by governments of the region.

[1] Porth T et al. Disparities and trends in AIDS mortality among adolescents living with HIV in low- and middle-income countries. 20^thInternational AIDS Conference, Melbourne, abstract MOAC0101, July 2014.

Community driven and responsive health systems deliver improved outcomes for HIV and equitable and inclusive Sexual and Reproductive Health and Rights.

• 80’000 Adolescents and young people in target communities (target will be considerably increased based on current data analysis of previous phase)
• Girls and women
• Communities
  
• Health and Education Ministries of Zambia, Zimbabwe, Botswana, Tanzania and Malawi.
  
• Other SADC governments will be targeted through advocacy and interventions  at the regional level

• Increased community participation for integrated SRHR & HIV integration
• Increased utilization of integrated HIV and equitable and inclusive SRHR information and services by women and young people
• Informed decision making in communities on sexual health and rights with positive impact on women and young people
• Increased commitment by local, national and regional leadership to support equitable and inclusive SRHR

Risultati principali attesi:  

• 122 Community structures, including service providers capacitated to map HIV and SRHR issues and resources and women and young people supported in programming (outreach per community approx. 5’000 persons)
• Community structures capacitated to develop and implement advocacy strategies to address SRHR practices and norms harmful to women and young people.
• Increased dialogue between community, national and regional levels on equitable and inclusive SRHR. 

Risultati fasi precedenti:  

• 80 000 women and young girls reached with services and information on women’s & young girls’ SRHR.
  
• SAT partners in Malawi successfully lobbied the government to address national level Anti-Retroviral Treatment shortages and lobbied for the provision of mobile clinics thus bringing Anti-Retroviral Treatment at 5km instead of 42km walking distance.
• 85% of the targeted communities in Zambia and Malawi now report cases of Gender Based Violence (GBV) to the police as a result of awareness raising and community mobilisation activities. In most communities, traditional leaders have enacted by-laws to prevent gender based violence
• The Ministries of Health and Education in Zambia and Swaziland agreed to integrate Comprehensive Sexuality Education into their curriculum.

• SADC Secretariat- HIV/AIDS,& SRHR Units
• Governments in Zimbabwe, Zambia, Tanzania, Botswana and Malawi
• UNPFA and UNAIDS east and southern Africa and respective country level offices

Fase 3 01.10.2014 - 31.03.2018   (Completed)