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MOH LISTEN PROCESS FOR SUSTAINABILITY THROUGH CPs

MOH LISTEN PROCESS FOR SUSTAINABILITY THROUGH CPs

Introduction

Since 2018, the LISTEN model has been implemented in several communities in Eswatini by the Ministry of Health of the KoE and Georgetown University Center for Global Health Practice and Impact (CGHPI. 

Through this approach, the LISTEN project has identified communities of practice in each implementing chiefdom where HCD is used to identify challenges and co-create sustainable solutions. In the Lobamba Lomdzala Inkhundla, the service CP which includes implementing partners and some community leadership members had a data sharing meeting where the Luyengo Clinic presented facility health data. The key focus of the presentation was on teenage pregnancy which was identified as a key issue for the community. The service CP in collaboration with the Leadership CP, initiated dialogues in the 6 zones in the community. The MOH-LISTEN project provided technical support to the CP in creating the engagement tool.

Key Insights

AGYW identified to be at risk:

Engagements with AGYWs

Engagements with parents and caregivers

Engagements with Male Partners

  • Introvert girls who often lack self-esteem are easily trusting of what males tell them
  • Those who use public transport to school are targeted by conductors
  • Girls from child-headed homes are vulnerable in cases of GBV
  • Girls in lower secondary school as males believe that they are virgins & will often approach them with the intention to be “the first”
  • Fear of being judged when seeking SRH services
  • Local health staff members are mostly local, which compromises confidentiality
  • Prefer branded condoms over “free ones”, but more expensive
  • Poverty which leads to transactional relationships
  • Vulnerability in child headed homes
  • Covid-19 resulted in school shutdown which led to Boredom
  • Lack of sex education
  • Lack of knowledge on services provided by clinic
  • Misinformation and lack of training on contraceptives
  • We have only one health facility (Luyengo clinic) where we are familiar with the staff and fear judgment/lack of confidentiality (trust)
  • Need to improve parent-child engagements
  • To be capacitated on SRH & services available to better guide and support AGYW
  • Workshops on the parent responsibility to raise a child
  • Let there be neighborhood watch for spotting old and married men dating AGYW
  • Let’s bring back some cultural practices that encouraged girls to take pride in their lives e.g., Reed dance
  • Improved communication between parents–teachers; to better support children
  • Lack of proper condom usage; open wrong, tearing the condom before use
  • We don’t afford branded condoms which are preferred over the free ones 
  • Inconsistent use of condom; need to maximize time with the girl and a condom can delay/make the girl lose interest
  • Limited access to SRH services for males
  • Increased transactional relationships; they have the means to support girls who need money
  • Multiple partners; acceptable and promoted with peers
  • Peer pressure as we compete in number of girls
  • Taxi conductors and drivers providing financial support to young girls
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