CHAllenge Focus Areas
The Challenge generated more than 800 innovative ideas, with nearly half of selected ideas originating from new partners.
The winners proposed new approaches that apply to the six Focus Areas below in the 10 DREAMS countries, offer sustainable solutions that may be scaled or replicated to lead to long-lasting change, and demonstrate readiness for rapid implementation within two years. Winners are implementing their solutions over two years in the target districts of one or more of the 10 DREAMS countries: Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe.
Focus Area 1: Strengthening Capacity of Communities to deliver services
Strengthening the leadership and capacity of community-based organizations is key to improving delivery of health-related services. The Challenge is investing in innovative solutions to strengthen the leadership and capacity of community-based organizations, such as nonprofits, indigenous, and/or grassroots organizations, to support the expansion of interventions included in the DREAMS Core Package.
Girls and women often have little say in the decisions that affect them in Lesotho. One Challenge winner is creating an empowering and participatory documentary film to give them a platform to be heard. Once the film is complete, the girls will be trained to use the video as a tool to advocate for their rights.
Focus Area 2: Keeping Girls in Secondary School
The Challenge is investing $40 million in innovative solutions focused on keeping girls in secondary school, which dramatically reduces their vulnerability to HIV infection. A recent case study in Botswana compared the benefits of one additional year of education for young women. For girls with 10 years of education instead of just nine, the risk for HIV infection was cut nearly in half. This is a potential game changer, particularly as girls and young women account for 74 percent of new HIV infections among adolescents in sub-Saharan Africa.
Public libraries are a unique gateway for linking girls at risk of HIV infection to information and services that empower them to develop life skills, prevent HIV, and stay in school. One Challenge winner in Zambia is establishing new mentoring programs in public libraries to tackle discriminatory gender norms, provide health education, and foster girls’ resilience and determination to succeed.
Another winner is working to increase secondary school retention among pregnant girls and young mothers in Swaziland, Tanzania, and Zimbabwe. The organization is developing an early warning system to detect girls most at risk of drop-out, address harmful norms, and link them to health services.
Focus Area 3: Linking Men to Services
The Challenge is investing in pioneer solutions to engage young and adult men and inform and link them to HIV counseling and testing, treatment, and voluntary medical male circumcision services. Engaging men in discussions about sexual and reproductive health can result in behavior change in both men and women, and result in increased condom use, less transactional sex, less substance abuse, and increased couple communication.
A holistic community approach is vital to ending AIDS as a public health threat. One winner implementing in Zambia is reaching out to men at nightclubs to help decrease unsafe sex and transactional sex work.
Another winner in Kenya designed a solution that is engaging men through sports. By bringing pitch-side HIV testing, counselling, and local voluntary medical male circumcision services, they will reduce the risk of HIV infection for up to 11,000 adolescent girls and young women. Kenyan soccer coaches are being trained to teach adolescent men about health issues on the pitch using interactive soccer coaching drills.
Focus Area 4: Supporting Pre-Exposure Prophylaxis
Pre-exposure phrophylaxis (PrEP) is a way for people who do not have HIV, but who are at substantial risk of contracting it, to prevent HIV infection by taking a pill every day. This oral antiretroviral medication provides another effective option for prevention for people at high risk of HIV exposure.
One winner in Kenya is working with popular musicians and celebrities to engage the public and create a dialogue around the benefits of PrEP. They are using interactive websites, peer educators, and support groups to incorporate PrEP into conversations and create consumer-driven demand for the medication.
Another winner is implementing and comparing two strategies for PrEP delivery to women at risk of HIV infection. They are employing a data-driven approach to assess which strategy works best for wide use and support the creation of a national strategy that incorporates women's preferences and maximizes use of existing infrastructure to work towards ending AIDS as a public health threat.
Focus Area 5: Providing a Bridge to Employment
The Challenge is investing in solutions that provide a post-secondary school bridge to employment for young women (ages 19 to 24) to decrease their risk for transactional sex work and HIV. The availability and accessibility of employment opportunities can be critical factors in deterring young women from transactional sex work and significantly decreasing their exposure risk to HIV.
One winner from Mozambique is focusing on micro-franchising businesses. As these businesses become market ready, the program selects, trains, empowers, and supports young women to manage and operate the businesses. The program promotes entrepreneurship, job creation, and capacity building.
Another winner is implementing a demand-driven skills building program to improve employability prospects and income generating capacity for 1,000 disadvantaged girls in low-income households. The girls are learning technical, life, and business skills, including financial literacy and coding. They are also receiving job placement support.
Focus Area 6: Applying Data to Increase Impact
The Challenge is investing in innovative opportunities to increase the availability and use of data for DREAMS to inform policy and increase program impact. Solutions in this area are helping unlock datasets, fill data gaps, and improve data accessibility and use at the local and subnational levels. The collection, use, and release of actionable data is helping target populations at the greatest risk in geographic areas with the highest HIV/AIDS burden.
One winner is implementing a tool in Kenya, Uganda, and Tanzania to gather real-time feedback from the young women they support on aspects of their health and well-being. The solution is enabling programmers to quickly determine what is working, where, and why, and, in turn, allow for agile changes to implementation activities for improved results.
Another winner is deploying a multi-channel HIV/AIDS surveillance platform in Tanzania that uses mobile technologies and GIS mapping to provide a centralized location for two-way interactive communication and crowdsourcing data from DREAMS districts. This platform assists the Ministry of Health in monitoring and reacting to information in real-time to inform the mobilization of HIV/AIDS prevention and treatment resources.