World Health Organization, Harare, Zimbabwe.
The International Union Against Tuberculosis and Lung Disease, Harare, Zimbabwe.
Pan Afr Med J. 2022 Feb 16;41:131. doi: 10.11604/pamj.2022.41.131.29539. eCollection 2022.
in 2016, the partner-funded Smart-LyncAges participatory learning project explored the feasibility of a youth-friendly package including incentivized peer educators (PEs) to enhance adolescent sexual and reproductive health (ASRH) and voluntary medical male circumcision (VMMC) linkages. After 12 months of implementation, funding reduction resulted in reduced direct project monitoring and discontinuation of monetary incentives for PEs. We assessed if reduced funding after one year of implementation affected the performance and retention of PEs and uptake of VMMC and HIV testing in ASRH services by adolescents in Bulawayo City (urban) and Mount (Mt) Darwin District (rural) in Zimbabwe.
our study was an ecological study using routine data collected from March 2016 to February 2017 (intensive support) and March 2017 to February 2018 (reduced support). All the ASRH and VMMC sites in Mt Darwin and Bulawayo were involved. Participants included 58 PEs and all adolescents accessing VMMC and ASRH services. Retention of PEs measured by the submission of monthly reports and uptake of VMMC and HIV testing were the primary outcome measures.
the Smart-LyncAges project engaged 58 PEs with 80% aged 20-24 years. Two-thirds were male and 60% were engaged in peer education before the project. Retention of PEs was not negatively affected by funding reduction, with 70% retained up to 11 months after funding reduction. However, their performance, measured by submission of monthly activity reports and the number of adolescents reached with VMMC and HIV messages, declined while uptake of both VMMC and HIV testing was sustained.
sustained uptake of services was possibly due to heightened awareness of service availability and demand generation in the first year of implementation. Peer-led interventions are effective for health information dissemination. Monetary incentives determine performance, but are not the only reason for retention.
2016 年，由合作伙伴资助的 Smart-LyncAges 参与式学习项目探索了一种以青年为中心的方案的可行性，该方案包括激励性的同伴教育者（PEs），以加强青少年性与生殖健康（ASRH）和自愿男性包皮环切术（VMMC）服务之间的联系。在实施 12 个月后，由于资金减少，项目对 PEs 的直接监测和金钱激励减少。我们评估了实施一年后资金减少是否影响 PEs 的绩效和保留率，以及青少年在津巴布韦布拉瓦约市（城市）和 Mount Darwin 区（农村）接受 ASRH 服务中 VMMC 和 HIV 检测的情况。
我们的研究是一项生态研究，使用 2016 年 3 月至 2017 年 2 月（强化支持）和 2017 年 3 月至 2018 年 2 月（减少支持）期间收集的常规数据。参与研究的是 Mount Darwin 和 Bulawayo 的所有 ASRH 和 VMMC 服务点。参与者包括 58 名 PEs 和所有接受 VMMC 和 ASRH 服务的青少年。PEs 的保留率通过每月报告的提交情况和 VMMC 和 HIV 检测的采用情况来衡量，这是主要的结果衡量标准。
Smart-LyncAges 项目共招募了 58 名 PEs，其中 80%年龄在 20-24 岁之间。三分之二是男性，60%在项目之前就从事同伴教育。资金减少并没有对 PEs 的保留率产生负面影响，70%的 PEs 在资金减少后 11 个月仍保留下来。然而，他们的表现，通过每月活动报告的提交情况和接受 VMMC 和 HIV 信息的青少年人数来衡量，在资金减少后下降了，而 VMMC 和 HIV 检测的采用率保持不变。
服务的持续采用可能是由于在实施的第一年提高了对服务可用性和需求产生的认识。以同伴为基础的干预措施对健康信息传播是有效的。金钱激励决定了绩效，但不是保留的唯一原因。
