Yathu Yathu ("For us, by us"): Design of a cluster-randomised trial of the impact of community-based, peer-led comprehensive sexual and reproductive health services for adolescents and young people aged 15 to 24 in Lusaka, Zambia
Yathu Yathu ("For us, by us"): Design of a cluster-randomised trial of the impact of community-based, peer-led comprehensive sexual and reproductive health services for adolescents and young people aged 15 to 24 in Lusaka, Zambia
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DOI：
10.1016/j.cct.2021.106568
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发表时间：
2021-09-24
影响因子：
2.2
通讯作者：
Ayles, H.
中科院分区：
文献类型：
--
作者：
Hensen, B.;Phiri, M.;Ayles, H.
背景资料：在撒哈拉以南非洲，15至24岁的青少年和青年人口不断增加，他们面临着艾滋病毒和其他可预防和可治疗的性传播感染的沉重负担。尽管有这种负担，青少年和年轻人是获得性健康和生殖健康服务最少的人群。这项试验旨在评估以社区为基础的同伴主导的性健康和生殖健康服务，结合新的激励“忠诚卡”系统，对艾滋病毒状况和性健康和生殖健康服务覆盖面的知识的影响。方法：一项具有嵌入式过程和经济学评价的整群随机试验（CRT）。讨论内容：由于几乎没有证据表明以社区为基础的同伴主导的服务对性健康和生殖健康服务覆盖面的影响，我们的研究将提供关键证据，以扩大我们对如何接触青少年和年轻人的知识。“会员卡”制度也是提供性健康和生殖健康服务的一种新办法。以会员卡形式的奖励支持提供基于社区的服务是一种创新，可能证明是改善获得性健康和生殖健康服务的简单战略。青少年和年轻人获得的性健康和生殖健康服务仍然不足;仍然迫切需要确定向青少年和年轻人提供性健康和生殖健康服务的途径。这一创新战略与当地卫生设施有着密切联系，有确凿证据表明它是否扩大了关键性的性健康和生殖健康服务的覆盖面，这将增加如何接触青少年和青年的证据基础。
Background: In sub-Saharan Africa, the growing population of adolescents and young people aged 15 to 24 face a high burden of HIV, and other preventable and treatable sexually transmitted infections. Despite this burden, adolescents and young people are the population least served by available sexual and reproductive (SRH) services. This trial aims to evaluate the impact of community-based peer-led SRH services, combined with a novel incentivised "loyalty card" system, on knowledge of HIV status and coverage of SRH services. Methods: A cluster-randomised trial (CRT) with embedded process and economic evaluation. Discussion: With little available evidence of the impact of community-based, peer-led services on coverage of SRH services, our study will provide evidence critical to expanding our knowledge of how to reach adolescents and young people. The "loyalty card" system is also a novel approach to providing SRH services. The delivery of community-based services supported by incentives in the form of loyalty cards is innovative, and may prove a simple strategy to improve access to SRH services. Adolescents and young people remain underserved by available SRH services; there remains a critical need to identify ways to provide adolescents and young people with access to SRH services. Rigorous evidence of whether this innovative strategy, with strong links to the local health facility, increases coverage of critical SRH services would add to the evidence-base of how to reach adolescents and young people.