Meaningful Adolescent Youth Engagement and Insight on the USAID DREAMS Ambassador Program: A Special Studies Project Restricted; Files Only

Abstract

Introduction: Although progress has been made in the global response to the epidemic, HIV among young women ages 15 to 24 in Sub Saharan African countries remains a serious problem and a critical global health issue. Increased vulnerability of HIV/AIDS can be attributed to structural, social and biological factors that have disproportionately affected HIV/AIDS rates among AGYW living in Sub-Saharan Africa. To address the disproportionate vulnerability and impact of HIV on AGYW, PEPFAR announced the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) program in 2015. PEPFAR, Johnson & Johnson, The Bill & Melinda Gates Foundation, Girl Effect, Gilead Sciences, and ViiV Healthcare began its partnership to create DREAMS and deliver a Core Package of evidence-informed interventions to 10 countries in Southern and Eastern Africa. Since 2015, DREAMS has expanded from its original 10 countries to 16 countries in Africa and in Haiti.

 

Purpose: Recognizing the importance of youth perspectives, experiences, and innovation, meaningful adolescent and youth engagement is an important principle that should be practiced across USAID and PEPFAR programs. Meaningful adolescent and youth engagement (MAYE) is an inclusive, intentional, mutually-respectful partnership between adolescents, youth, and adults within programming (Family Planning 2020, 2021). Gaps exist in capturing how youth engagement within the USAID DREAMS Ambassador program is defined and positively impacts AGYW.

 

Methods: A DREAMS Ambassador Activity was created in the interest of better understanding the strengths and challenges of the USAID DREAMS Ambassador program to enhance existing program activities, share lessons learned, and strengthen USAID’s overarching approaches to youth engagement across countries known as Operating Units (OUs). A descriptive research study consisting of a survey and focus group discussions was conducted on behalf of the USAID Office of HIV/AIDS (OHA) and its Youth Branch.

 

Discussion: Through the DREAMS Ambassador survey and Focus Groups, DREAMS Ambassadors and IPs identify Ambassadors as a positive influence on AGYW engagement, retention, and visibility of the program. DREAMS Ambassadors not only provide technical leadership through supporting DREAMS activities but also learn from their AGYW peers through sharing different views, challenges, and ways to overcome such challenges.

Table of Contents

Chapter 1: Introduction, 1

1.1. Background, 1

1.2. Purpose Statement, 6

Chapter 2: Literature Review, 7

2.1. Meaningful Adolescent and Youth Engagement (MAYE), 7

2.2. Clinic-Based Approaches, 9

2.3. Community-Based Approaches, 13

2.4. Known Gaps, Challenges and Limitations, 14

Chapter 3: Methods, 15

3.1. Research team and reflexivity, 15

3.2. Objectives, 16

3.3. Study Design, Participants, Data Collection, 17

3.4. Analysis and Findings, 19

Chapter 4: Results, 20

4.1. Implementing Partners, 20

4.2 Total of DREAMS Ambassadors and Age Bands, 22

4.3 Roles and Responsibilities, 23

4.4 DREAMS Ambassador Hours Reported, 24

4.5 DREAMS Ambassador Terms, 26

4.6 Criteria for Selecting DREAMS Ambassadors, 26

4.7 AGYW Involvement in Selection and Recruitment of DREAMS Ambassadors, 27

4.8 Training/ Supervision, 27

4.9 Resources, 28

4.10 Networking, 29

4.11 Youth Engagement, 29

4.12 Challenges and Recommendations, 30

Chapter 5: Discussion, 33

5.1. Strengths, 34

5.2. Value of Ambassadors, 35

5.3. Limitations, 38

5.4. Conclusion, 39

References, 41

Appendixes, 48

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Global Health HIV Adolescent Health Youth
Committee Chair / Thesis Advisor	Dr. Brian Zanoni, Emory University

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