Nairobi — Three UN agencies in the country have announced a collaborative effort to promote adolescent-friendly sexual and reproductive health services in a bid to enhance HIV testing and treatment among the youth.
The program rolled out through a Development Impact Bond (DIB) for adolescent sexual and reproductive health (ASRH) will be led by UNFPA, UNAIDS, WHO, and the SDG Partnership Platform, in collaboration with the Government of Kenya, a global non-profit organization Triggerise, the Children's Investment Fund Foundation (CIFF), and Bridges Outcomes Partnerships.
The innovative Bond will fund the delivery of high-quality, adolescent and youth-friendly sexual and reproductive health services, including HIV testing and treatment, to adolescent girls aged 15-19.
Kenya experiences significant challenges with teen pregnancy and new HIV infections among adolescents.
One in six adolescent girls between 15 and 19 years has ever been pregnant. In 2022, an estimated 7,307 new HIV infections occurred among adolescents and young people aged 15- 24, accounting for 41% of all adult new infections in the country.
Adolescent girls and young women are particularly vulnerable and account for 78% of new HIV infections among adolescents and young people of the same age (National HIV Estimates 2023).
The ASRH DIB will address the problem of teenage pregnancy, new HIV infections, and AIDSrelated deaths among vulnerable adolescent girls in Kenya, focusing on challenges such as the lack of information about sexual and reproductive health and rights and inadequate access to services tailored to young people.
High-burden counties
The programme will be implemented in ten counties that experience a significant burden of HIV and adolescent pregnancy, including Nairobi, Mombasa, Kisumu, Homa Bay, Bungoma, Migori, Kisii, Nyamira, Kakamega, and Busia.
Bridges Outcomes Partnerships will provide upfront funding to Triggerise, in a two-year pay-forsuccess programme that will support the delivery of high-quality, youth-friendly sexual and reproductive health and HIV services to over 300,000 vulnerable adolescent girls, as well as the improvement of services in 150 public primary health facilities in the 10 high-burden counties.
The DIB will be implemented using Triggerise's Tiko platform, a mobile-based digital platform that connects adolescents to nearby public and private facilities offering free services.
The Tiko ecosystem brings together local actors including networks of health clinics, pharmacies, virtual channels, community-based organizations, and health workers who support youth in their decisionmaking for the health and wellness services they need to thrive.
Through the digital platform, Triggerise is able to track where every cent goes and assess impact every day with real-time reports and data-driven insights.
The government of Kenya through the Ministry of Health will provide the policy direction and overall stewardship of the programme, while the Council of Governors will ensure effective coordination of counties.
The 10 County governments involved will be responsible for provision
of SRH and HIV services to vulnerable adolescent girls.
"This innovative programme is quite timely and aligns perfectly with the government's ambitions of improving the health and wellbeing of the citizenry. It comes at a time when we as a nation are scaling up our efforts to address the challenge of teenage pregnancy, adolescent HIV, GBV and other harmful practices, through a multi-sectoral approach," said Dr. Bashir Issak, Head - Directorate of Family Health, Ministry of Health.
$10.1 million
The DIB is backed by $10.1 million in outcome funding provided by the Joint SDG Fund and the CIFF.
Once specific outcomes which are linked to improving adolescent health are achieved and independently verified, the upfront funding provided by Bridges Outcomes Partnership will be repaid through outcome funding provided by the Joint SDG Fund and CIFF.
Triggerise and its local delivery partners will have the flexibility to adapt and innovate in order to focus on what is having the greatest impact on the uptake of HIV and SRH services among adolescents.
"Triggerise is an amazing organization that has been providing access to high-quality adolescent sexual and reproductive health services to girls in Kenya for the last 7 years. By supporting them through the development impact bond, we hope to enable them to continue to grow their work in the country so that more girls can take control of their own health and, in doing so, enable them to live happier and healthier lives," said Bridges Outcomes Partnerships Investment Director Lucia Santirso Richards.
The UN Resident Coordinator, Dr. Stephen Jackson said, "for adolescents living in low-income settings, the barriers in access to accurate information and quality sexual and reproductive health services can be challenging to overcome. Many are facing financial obstacles, coupled with long distances to health facilities, and other socio-cultural factors that prevent them from this access. Even when services are available, concerns about privacy and service provider bias often discourage adolescents from seeking help. Such issues highlight the urgent need to support adolescents in relation to their sexual and reproductive health and rights."
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The ASRH DIB builds on a successful Phase One model previously implemented by Triggerise and funded by the Foreign and Commonwealth Development Office (FCDO) with CIFF as the investor, over an 18-month period from 2020 to 2022. During this first phase, the availability and uptake of SRH services among adolescents in Kenya was expanded, reaching a total of 251,000 girls with 383,000 services, far surpassing the target of 244,445 service visits.
Notably, the number of repeat service visits exceeded the initial target by 262%, with a total of 118,058 girls receiving repeat visits against an initial target of 45,000. The current launch takes this innovation to public sector facilities for the first time.
The CIFF Director, SRHR Girl Capital Africa, Julia Greenland said, "We are delighted to support this initiative - the Triggerise platform is exceptional in its ability to bridge technology and equity, and to put decisions on care directly in the hands of adolescent users. The innovative DIB approach has the potential to attract new and novel funders to this space, and we are excited to see its impact on the sector. The outcomes-based approach allows outcome funders like CIFF to motivate ambition on areas important to impact, and we are excited to see results as positive as those under our previous DIB investment".
