BINTI NA MAAMUZI (DAUGHTER AND DECISIONS)

Uncovering local data on abuse to improve HIV/AIDS services for adolescent girls and young women
Tanzania

Background

Young people aged 15 to 24 years old are at the highest risk of acquiring HIV/AIDS, and abuse can increase this risk. A group of health professionals discovered that Tanzania’s District Health Information System (DHIS) does not have complete information about adolescents’ physical/sexual abuse and utilization of HIV/AIDS services in Ilemela District, Mwanza Region.

Photo Credit: Binti na Maamuzi team

Problem

Currently, DHIS shows only 258 abuse cases. However, a 2009 survey in Tanzania showed that nearly one in three girls and one in seven boys experience some form of sexual violence before turning 18. Rates of physical violence are also high: 72% of girls and 71% of boys. Ilemela has a population of over 402,000 and it is likely that actual rates of abuse are higher than those recorded in DHIS.

Solution

As health professionals that use health data to make district annual health plans, we want to use data on violence against adolescent girls and young women (AGYW) to improve access to health care services and reduce the local prevalence of HIV/AIDS. Binti na Maamuzi (BnM), which means Daughters and Decisions in Swahili, aims to empower AGYW to make data-driven decisions in the fight against abuse and HIV/AIDS, complementing the implementation of the National Plan of Action to End Violence against Women and Children (NPA-VAWC). BnM wants to increase AGYW’s awareness and access to healthcare services, as well as unmask the true magnitude of abuse, improve reporting of abuse among AGYW, increase health-seeking behavior for HIV/AIDS services, and generate evidence on abuse for policy-making decisions. The project will uncover local data on abuse, challenges in accessing information on HIV/AIDS and sexually transmitted infections (STIs), and challenges in accessing counseling and healthcare services for AGYW, all of which are important components in fighting against HIV/AIDS in this group.

The project will also introduce a mobile application that provides information on abuse and HIV/AIDS, types of healthcare services and the nearest locations. Sensitization on the mobile app will be done with community leaders, healthcare workers, social welfare officers and school teachers. The community at large will also be sensitized through local mass media and SMS messages. BnM will analyze and share the data collected through the mobile app in an online database, located on the BnM website for everyone to access.

Process

The first phase involved conducting interviews with 16 community members (including AGYW), 11 teachers, 4 social welfare officers, 6 healthcare workers, and 2 police from the gender-based violence unit. The interviews involved collecting preliminary data on abuse trends, although the focus was collecting user requirements for the mobile application.

The second phase involved developing the BnM mobile application, a database, and project website to share and capture information. The mobile app will provide information on abuse and HIV/AIDS, health facility locations and services offered. The app will enable users to make appointments with service providers and receive short messages about health-related information. The mobile application was tested with phone companies, district leadership and a select group of AGYW, then refined based on their feedback.

The last phase of the project will involve launching and publicizing the mobile app. BnM will create buy-in at different levels of local government and community (i.e. municipal and ward leadership). Buy-in will be followed by sensitization around abuse and HIV/AIDS among school matrons, healthcare workers and ward social welfare officers. The project will also involve the local media to publicize the mobile app.

Outcomes and Impacts

The BnM project complements Ilemela District’s goal to reduce HIV/AIDS prevalence to 2% by targeting AGYW. BnM aims to impact the lives of 25,000 girls and women aged 10-24 years among the estimated 76,442 in the population (Ilemela Projections, 2016). At an individual level, the project expects to see an increased awareness of abuse and HIV/AIDS and increased use of services related to HIV/AIDS and abuse among AGYW through use of the mobile app. At the community level, the project expects to see change in perceptions and attitudes towards abuse as a risk factor of acquiring HIV/AIDS. Through increased availability of data on abuse and HIV/AIDS among AGYW, the project seeks to see more policies with customized interventions to reduce HIV/AIDS infections among AGYW.

BnM will analyze the number of users who are downloading the mobile application, number of users who are making appointments with health care providers, trends of reporting abuse, and HIV/AIDS-related healthcare-seeking behavior.

Key Collaborators

The team is led by Emila Msangi, a health secretary, and includes a nurse, doctor, and accountant. Collaborators include social welfare officers, health care workers, and school teachers. The team benefited from a USD 23,060 grant from the Data for Local Impact Innovation Challenge (DLIIC). They have also received capacity building and mentorship from DLIIC, which has helped them develop the mobile system and connect with the health providers and the police gender-based violence unit. To learn more, visit http://www.dliinnovationchallenge.or.tz.