Exploring what works in Rwanda

Exploring what works in Rwanda Exploring what works in Rwanda - Start

Added : 2018-11-06 Views :2K

Download Presentation

Exploring what works in Rwanda




Download Presentation - The PPT/PDF document "Exploring what works in Rwanda" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.



Presentations text content in Exploring what works in Rwanda

Slide1

Exploring what works in Rwanda

Dr

Sabin

NSANZIMANA

Head of

HIV&AIDS

, STIs & OBBI Division Institute of HIV Disease Prevention and ControlRWANDA BIOMEDICAL CENTER

Slide2

HIV program in RwandaIntroduction to Sugar daddies project in Rwanda

Evidence from Kenya Plan for piloting, evaluating and scaling in RwandaPreliminary program design details for Rwanda

Way forward

Presentation Outline

Slide3

M5 •

3

AIDS is Caused by HIV

H

I

V

= Immunodeficiency

= Human

= Virus

The Virus causing AIDS

Slide4

M1 •

4

AIDS Defined

A

I

D

S

= Acquired = Get HIV from someone

who is infected

= Immune = The body’s defense system which protects the body from disease

= Deficiency = Not having enough

of something

= Syndrome = A group of symptoms associated with a particular disease

Slide5

M1 •

5

Transmission

Slide6

M1 •

6

M1 •

6

Slide7

Outline of NSP document – Strategic framework

7

B

New HIV infections are reduced by

2/3 - from 6K to 2K - by

June 2018

HIV related deaths are reduced by ½ from 5K to 2.5K by June 2018, and HIV morbidity is decreased

Prevention

Care and Treatment

Impact Mitigation

Health Support Systems, Coordination, and Strategic Information

People infected and/or affected by HIV have the same opportunities as the general population

Slide8

HIV

prevalence in Rwanda is

3%

Source: RDHS

2010

8

National Average: 3%

Male: 2.3%

Female: 3.6%

City of

Kigali 7.3%

Even in Kigali, disparity of prevalence, high pockets of HIV prevalence: FSWs: 56% (BSS2010).

Slide9

FSW:

51% (BSS SW 2010)

Pregnant Women in Sentinel Sites: 3.3% (

Sero-surveillance 2011)

Youth aged 15-24 Years: 1.6% ( DHS-2010)Men in uniform : 2,8% (

Rda Seroprev study , 2010)

Prisoners 4,7% ( Mobile VCT , 2010)

HIV Prevalence by Sex

HIV Prevalence by

Age

Source: RDHS 2005 & RDHS 2010

Source: RDHS 2010

HIV Prevalence

in Other Populations:

Epidemiological situation

Slide10

Prevalence among population aged 15–24 years

HIV among youth in Rwanda

Slide11

Sugar Daddies Risk

Information Program

Slide12

Why is this program important in Rwanda?

Evidence

from Kenya

Plan for piloting, evaluating and scaling in RwandaPreliminary program design details for Rwanda

Slide13

Goal: Promote

adolescents’ understanding of the role of cross-generational sex in the spread of HIV.Evidence:

A randomized evaluation in Kenya found significant reductions in teenage childbearing as a result of the program

. Why: Eliminating

cross-generational sex could break transmission of HIV

to youth populations – and thus end the disease.

Sugar Daddies Risk Information Program

Slide14

The Government of Rwanda has identified reducing cross-generational sex as critical to controlling the spread of HIV and keeping young people safe.

Older men

are

more

likely to have HIV than adolescent

boys: 3.5% of 30-34 year-old men have HIV in Rwanda vs. 0.3% of 15-19 year-olds (Demographic and Health Survey 2010)

One out of 10 girls has first sexual experience with a man ≥10 years older (Rwanda BSS 2009)Girls aged 20-24 are five times more likely to have HIV than same age boys (RDHS 2010)Young girls appear to be getting infected by older men, rather than by boys of their own age (RDHS

2010)Eliminating cross-generational relationships could end HIV.

Preventing Adolescent HIV: a national priority

Slide15

Data source:

RDHS 2010

Rwanda: HIV prevalence (%) by age & sex

Preventing Adolescent HIV: a national priority (Cont’d)

Slide16

Teenage childbearing in Rwanda(% of women ages 15-19 who have had children or are

pregnant)

Data source: World Bank, World Development Indicators

Teenage childbearing

Slide17

Source

: Rwanda Ministry of Education, In School Rapid Assessment on Unwanted

Pregnancies, 2011

Unwanted pregnancies most common in s1-S3

Slide18

Rwanda has made enormous strides in increasing access to education

Primary school net enrollment is nearly universal, at 96%In lower secondary school, female enrollment exceeds that of males (MINEDUC Statistical

Yearbook 2012)However, unintended pregnancies still cause girls to drop out of school

Reducing teenage pregnancies can help young girls stay in school and improve their life outcomes.

Teenage childbearing, a Barrier to Education

Slide19

Why is this program important in Rwanda

Evidence

from Kenya

Plan for piloting, evaluating and scaling in RwandaPreliminary program design details for Rwanda

Slide20

Trained project officer visited schools and spoke to grade 8 studentsStudents were shown a 10-minute educational video on

“sugar daddies”An open discussion on the role of cross generational sex in the spread of HIV followed the video screeningStudents were given detailed information about local HIV prevalence rates, by gender and age group

Evaluation: Sugar daddies campaign in Kenya

J-PAL affiliated professor

Pascaline

Dupas (Stanford University) evaluated a “relative risk information campaign” in Kenyan primary schools

Slide21

Girls reduced engagement in unprotected sex with older menTeenage childbearing with older men fell by 61%

No offsetting increase in childbearing with same-age partners -> After the campaign, girls were more likely to use condoms with younger boys

Most girls knew how HIV was spread but not that older men were much more riskyRisk reduction campaigns have greater success than total risk avoidance campaigns in schools (i.e. abstinence only education)

Girls responded to information on relative risk

Slide22

Why

is this program important

in Rwanda Evidence

from Kenya Plan for piloting, evaluating and scaling in Rwanda

Preliminary program design details for Rwanda

Slide23

Plan for Piloting, Evaluating & Scaling

Slide24

Phase 1: Visit a sample of schools to find out what girls already know about the relative risk of contracting HIV from older partners.

Phase 2: Design the program for the Rwandan context

Phase 3: A mini pilot to test the practical implementation of the program and the reaction of the community, teachers and students in order to best tailor the program to meet their needs

Phase 4: Full scale randomized evaluation in several hundred schools to test impact in Rwanda

Phase 5: If found to be effective, scale up to the rest of the country

Plans

Slide25

The Rwanda Biomedical Centre in the Ministry of Health is driving this process

Imbuto Foundation have been selected as an implementing partnerJ-PAL will offer technical assistance in designing and implementing the pilot and evaluation.

Partnerships

Slide26

Why

is this program important

in Rwanda Evidence

from Kenya Plan for piloting, evaluating and scaling in Rwanda

Preliminary program design details for Rwanda

Slide27

Implementing in schools will reach the widest distribution of students while targeting students on the brink of making sexual decisions Holding

the sessions during the school day would match the successful model from Kenya. An in-school program could target both boys and girls.The short 45 minute session including the educational video and discussion will not greatly impact class time.

Implement in Lower Secondary School Students

Slide28

The risk information program will be conducted during school hours by a trained facilitator.

40 minute program led by young, charismatic female facilitatorTo ensure an open discussion, the teacher will be asked to leave the room.

Content:10 minute video on sugar daddies

Present info on the HIV rates by age and gender in that areaClassroom discussion and Q&A on cross-generational sex

Program Curriculum

Slide29

Thank you


About DocSlides
DocSlides allows users to easily upload and share presentations, PDF documents, and images.Share your documents with the world , watch,share and upload any time you want. How can you benefit from using DocSlides? DocSlides consists documents from individuals and organizations on topics ranging from technology and business to travel, health, and education. Find and search for what interests you, and learn from people and more. You can also download DocSlides to read or reference later.
Youtube