Adolescents

This document evaluates the Expansion and Scale-Up of HIV-Sensitive Social Protection in Eastern and Southern Africa initiative, implemented by UNICEF in Malawi, Mozambique, Zambia and Zimbabwe from 2014-2018 with support from the Dutch government. It assesses the extent to which the initiative met its objectives and achieved the expected results and documents the successes, challenges and lessons learned in the implementation.

Under the initiative, UNICEF Eastern and Southern Africa Regional Office (ESARO) and UNICEF Country Offices provided technical assistance to the four priority countries, and documented cross-country learnings. Activities under this initiative differed in their design and execution, allowing for adaptation to country contexts. In Malawi, activities focused on monitoring and evaluation of the National Social Support Policy; designing and implementing a system to refer cash transfer beneficiaries to HIV-related social services; and creating demand for HIV services among adolescents. In Mozambique, activities focused on providing policy-level support to the operationalization of the new social protection strategy, strengthening community-based and statutory case management, and conducting social protection fairs. In Zambia, the Government and UNICEF evaluated and scaled up a package of services that aims to increase the utilization of HIV services by adolescents. In Zimbabwe, the initiative focused on strengthening the child protection case management system and ensuring linkages between the country’s flagship cash transfer programme and HIV-related services, by using payment days to deliver services. In addition, the initiative’s regional component, led by UNICEF ESARO, focused on documentation and dissemination of best practices and overall technical assistance to the country offices involved.

This paper reviews the 2010 state of the evidence on the contribution of social protection to HIV prevention, treatment, care and support, as well as protection of key populations at higher risk of infection.

This UNAIDS guidance note summarises information on HIV-sensitive social protection, sets out key principles to provide a strong foundation for programming, and describes the potential of social protection to advance HIV prevention, treatment, care and support outcomes. This brief also presents case studies illustrating how HIV-sensitive social protection is working on the ground.

The audience is HIV policy-makers and programmers at global, regional, and country levels. It builds on the UNAIDS Business Case on Enhancing Social Protection, a UNAIDS/ UNICEF/IDS report of the evidence on HIV-sensitive social protection, and regional consultations with HIV and social protection specialists.

This policy brief outlines the key pathways through which social protection can address risk factors and contribute to preventing new HIV infections. It highlights country-level initiatives and provides policy implications and recommendations.

This brief is coauthored by UNICEF and Economic Policy Research Institute. University of Oxford, UNDP and the Transfer Project have contributed to content reflected in this brief, and USAID has endorsed the brief.

This review provides a conceptual framework for HIV-sensitive social protection policies and programmes and review the impact of social protection on HIV prevention and treatment outcomes in addition to social and economic care and support. It further provides recommendations for achieving core HIV impacts, comprehensive approaches, and expanding and sustaining HIV-sensitive social protection. 

This working paper from UNICEF Office of Research - Innocenti makes the case for investing in social protection efforts for adolescents. Reviewing governmental programmes, the paper examines whether and how current non-contributory social protection programmes are adolescent sensitive, and what their impacts are on adolescents.

This research brief defines 'cash plus' interventions, the menu of 'plus' components, and summarizes the evidence on their broad-ranging impacts. It further identifies lessons learned on how to make these integrated interventions work.

‘Cash plus’ interventions combine cash transfers with one or more types of complementary support. Types of complementary support can consist of (i) components that are provided as integral elements of the cash transfer intervention, such as through the provision of additional benefits or in-kind transfers, information or behaviour change communication (BCC), or psychosocial support, and (ii) components that are external to the intervention but offer explicit linkages into services provided by other sectors, such as through direct provision of access to services, or facilitating linkages to services.

Building on previous summaries, this brief summarizes the current evidence and lessons learned from the Transfer Project after more than a decade of research on cash transfers in sub-Saharan Africa.

Since 2009, the Transfer Project has generated rigorous evidence on the impacts of cash transfers in sub-Saharan Africa (SSA) and has supported their expansion. It aims to provide evidence on the effectiveness of cash transfer programmes, inform the development and design of cash transfer policy and programmes, and promote learning across SSA on the design and implementation of research and evaluations on cash transfers. The Transfer Project is a collaborative network comprising UNICEF (Innocenti, Regional and Country Offices), Food and Agriculture Organization of the United Nations (FAO), the University of North Carolina at Chapel Hill, national governments and researchers. 

ALL In to #EndAdolescentAIDS

Around the world, an estimated 2.1 million adolescents between the ages of 10 and 19 years were living with HIV in 2016. Some 260,000 older adolescents (aged 15–19 years) were newly infected with HIV in 2016, or nearly  a new infection every two minutes. Nearly three out of four new infections occurred in sub-Saharan Africa. And adolescent girls continue to be disproportionately affected. Globally, nearly two thirds (65 per cent) of new HIV infections among adolescents aged 15–19 years were among girls.

Progress in preventing new infections among adolescents remains unacceptably slow, with new infections declining by only 14 per cent since 2010. Equally concerning, between 2000 and 2015, annual AIDS-related deaths declined for all age groups except adolescents (aged 10–19 years).

Demographic realities further undermine recent hopeful trends. In sub-Saharan Africa, the region most affected by HIV, the youth population has begun to explode in size and will continue to do so, with projections indicating that the number of people younger than 20 will double in 2030. That means redoubled efforts will be necessary to prevent an increase in new HIV infections among adolescents.

This implementation brief examines the current efforts in eastern and southern Africa to accelerate and scale up evidence-based PrEP delivery platforms for adolescent girls and young women. The brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.

Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in eastern and southern Africa, however, they face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, but the current demand for PrEP by AGYW is low with suboptimal adherence.

Within the region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa is informed by knowledge and lessons learned emerging from a virtual thank tank and webinar convened by UNICEF together with WHO AFRO and the Global Fund, with support from the SIDA funded 2gether 4 SRHR programme, in early 2021.