Integrating legal empowerment and social accountability to improve access to quality HIV services for adolescent girls and young women
|Date added||June 7, 2019|
Adolescent girls and young women (AGYW) are at a higher risk of HIV infection for a range of biological and socio-economic reasons, including poverty, gender inequality, and limited access to youth-friendly health services. In Uganda, HIV prevalence among young people aged 15-24 is estimated at 4.2% for women compared to 2.4% for men. AGYW are often subjected to a range of gender- and age-based biases, discrimination and violence, including sexual assault, forced marriage and trafficking. Both AGYW and their communities, often lack the economic, social-cultural support and resources to assert their rights and bring about their own protection and well-being.
In Uganda, behavioral, biomedical and structural interventions HIV prevention interventions have been implemented with laudable results at population level. In spite of these interventions, AGYW and their communities most often do not have the capacity, voice and power to hold duty bearers, including service providers, accountable for improved delivery of quality HIV-related services. Even when information is available, it has not enabled them to act. Furthermore, tools to demand improved HIV-related responses are lacking, including clear processes to access remedies and strong structures to press for quality services.
A community assessment and mapping conducted in Gomba and Mukono
districts at the start of the project that is the subject of this paper indicated that health facilities in both districts were not well-equipped to effectively serve AGYW, including survivors of GBV who need time-barred medical care. Facilities were found short of staff, infrastructure, utilities and supplies, and had gaps in client care generally. Support supervision was neither regular nor adequate. Guarantees for confidentiality and informed consent were not in place. The constitution of grassroots HIV response coordination structures was overdue.