The onset of the novel Coronavirus pandemic in Kenya interrupted the service delivery and engagements with adolescent girls and young women in the DREAMS programme at LVCT sites across the country. Following government directives on physical distancing and reducing social gatherings, girls and women’s routine meetings and visits to the safe spaces had to stop. At our DREAMS sites at Wasiembete, Oruba, Wiga and Kakrao in Migori County, we initiated and established social messaging groups. These proofed successful in providing continued HIV and violence prevention messages, interventions and services to the adolescent girls and young women and as a platform for continued peer support.
As staff at LVCT Health, we considered social messaging an appropriate and feasible option for maintaining communication with adolescent girls and young women. We already had experiences in using short message services (SMS) to send bulk messages to participants. But SMS appeared insufficient because getting individual feedback and follow up were challenging. Home visits by mentors and change agents proved to be hectic, they would reach only a few girls at a time while many others would miss out. In addition, frequent movements would expose mentors, change agents and girls to risk of infection with COVID-19.
Our social messaging strategy built on existing groups of adolescent girls and young women who are supported by their mentors. This helped staff and mentors to continue supporting the girls, sharing of social trends, key messages and updates on COVID-19, and peer support within the groups. The messaging app is also used for scheduling HIV and gender-based violence services, including HIV testing, PrEP initiation and refills, prevention and counselling services. As a result of the social messaging groups, we managed to maintain HIV prevention services for the adolescent girls and young women and meet most of our targets.
Access to accurate information and quality health services is essential for adolescent girls and young women during the COVID-19 pandemic. Most of them are now at home due to school closure and stay-home directives. The social and economic constraints that result from movement restrictions and other infection control measures expose adolescent girls and young women multiple risks including violence, early pregnancies and sexually transmitted infections, including HIV.
The social messaging groups assisted in conducting group education and discussions on condom use and PrEP, contraceptive methods, COVID-19, gender-based violence and respective service providers and referral centres. Phoebe (not her real name), a participant in the DREAMS programme, mentioned how the platform helped her: “Through the platform, I managed to make my home-made tap for running water. Anybody visiting me must wash his/her hands first.” Social messaging groups also helped in managing existing savings and loaning groups among adolescent girls and young women. This approach was embraced considering the free rates for small transactions offered by Safaricom during the pandemic.
The social messaging groups have also assisted the adolescent girls and young women to express themselves freely and raise their urgent and private concerns. “I equally feel safe here, meeting my fellow peers in groups and just discussing our issues as a normal safe space day, we wish this to continue even more,” applauded a DREAMS participant Bright (not her real name). This achievement has been propelled by constant advice and encouragement by our service providers to participants on feeling free to engage anyone from the teams in private conversation whenever they have private matters. We further use the messaging platform to collect feedback on how to improve the quality of our services.
However, only 85% of participants have active phone numbers – either personal or owned by a parent/caregiver. Therefore, not everyone has benefited from this noble idea. To resolve this, the mentors visit those who cannot be accessed through the social messaging groups. Another challenge is the lack of resources for data bundles and airtime, which are necessary for participating in the social messaging groups. LVCT sites support the girls with airtime, especially when vital discussions or key messages are scheduled. LVCT sites have embraced the innovation of social messaging groups and seek to support the virtual groups and engagements post COVID-19 pandemic.
The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) programme by PEPFAR started in Kenya in 2016. DREAMS is a comprehensive HIV prevention programme for adolescent girls and young women. Safe spaces and weekly mentoring sessions are essential part of the DREAMS programme, for the delivery of prevention services and messages and for engaging adolescent girls and young women who thrive on social connections, private communication and events like sports and open forums. Across the country, more than 58,000 adolescent girls and young women participate in LVCT Health DREAMS programme.