Lending a hand: developing a support structure for young migrants in South Africa and Uganda

伸出援手：为南非和乌干达的年轻移民建立支持结构

• 批准号: MR/S023607/1
• 负责人: Janet Seeley
• 金额: $ 64.38万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS023607%2F1
• 关键词: Lending; hand; developing; support; structure

A significant proportion of young people in sub-Saharan Africa migrate to towns or cities, where they hope to find work and build their livelihood. Our aim is to develop and test the acceptability and feasibility of a protective support structure for young migrants (aged 14-24 years old) in urban settings in South Africa and Uganda as means of early intervention to reduce the harm of patterns of risk behaviour (sexual risk and violence) associated with youth migration. Specifically we will 1) establish a small peer supporter network in three sites (a small town in Uganda (Lukaya) and in South Africa (Mtubatuba) and an urban area (Mengo) in Kampala city in Uganda) to provide advice and support over the telephone to young migrants; 2) offer a drop-in centre or hub (a small rented shop or similar) staffed by a peer-supporter during the day and early evening who can provide information and onward referral to local health and social services, free condoms, access to a counsellor/nurse for advice and the use of a computer and printer for word processing (for letters and job applications) and 3) identify local (adult) champions and local resources/safe spaces to enable a supportive environment for the well-being adolescent and young people who are migrants. Our plans draw from our evidence base, gained through prior research in the two settings, and a Theory of Change which draws on a `protection-risk' conceptual framework. Our focus will be all young people who have migrated, with particular attention to new migrants (who are within six months of their move to the new location and particularly vulnerable to health-related risk and sexual exploitation) while still providing advice to migrants of longer standing, who may be planning a further move or trying to make a change in their employment. We will use mixed-methods to adapt, implement and evaluate the feasibility of an intervention. We will use participatory methods working with youth advisory groups in both countries already engaged in the design of this project, to develop and implement the intervention. Then we will conduct a mixed-methods process evaluation to assess which facets of the package are valued and test our assumptions about the challenges young migrants face and the appropriateness of the intervention offered. Finally, we will design a full-scale evaluation of the effectiveness and cost effectiveness of the feasible and acceptable elements of the intervention, which we anticipate will go on to be tested in a randomised control trial. The intervention is intended to support an individual migrant's ability to manage and adapt to their place of migration and identify the ways in which the key components of our intervention (positive role models/ "good" social network, safer environment, health and social support) may afford protection, supporting young migrants to demonstrate resilience with tangible impacts on health (e.g. safer sexual and reproductive health behaviours) and well-being (e.g. hope for the future).The work will be divided into four phases across 30 months: Phase 1 (months 1-3): recruitment of staff and other preparations; Phase 2 (months 4-9): Baseline assessment and co-designing the intervention with young people and other stakeholders; Phase 3 (months 10-21): Implementation of the intervention; Phase 4 (months 22-30): Analysis, dissemination and discussions on refinement of the intervention and, if the intervention is feasible, the design of a full-scale trial. On completion of the project we expect to have a contextually adapted, community-based, peer-delivered intervention, predicated on demonstrated resilience to improve health and well-being of mobile adolescents. We anticipate that this intervention will be scalable and reproducible in other settings in sub-Saharan Africa to reduce teenage pregnancy and the burden sexually transmitted infections including HIV-related morbidity and mortality in adolescent and young people.

在撒哈拉以南非洲，很大一部分青年人移徙到城镇或城市，他们希望在那里找到工作和谋生。我们的目的是在南非和乌干达城市环境中为青年移民（14-24岁）建立一个保护性支助结构，并测试其可接受性和可行性，以此作为早期干预手段，减少与青年移民有关的风险行为（性风险和暴力）模式的危害。具体来说，我们将1）在三个地点建立一个小型的同行支持者网络（乌干达（Lukaya）和南非的一个小镇）（Mtubatuba）和乌干达坎帕拉市的一个城区（Mengo），通过电话向年轻移民提供咨询和支持; 2）提供一个访问中心或枢纽（一个小的租来的商店或类似的）工作人员的同行-白天和傍晚的支持者，他们可以提供信息，并将其转介给当地的卫生和社会服务机构，免费避孕套，获得咨询师/护士的咨询，使用计算机和打印机进行文字处理（用于信件和工作申请）和3）确定当地（成人）冠军和当地资源/安全空间，为良好的环境创造支持性环境-青少年和年轻人是移民。我们的计划借鉴了我们的证据基础，通过先前在两种情况下的研究获得，以及一种基于“保护-风险”概念框架的变革理论。我们的重点将是所有已移徙的年轻人，特别关注新移徙者（他们在搬到新地点后六个月内，特别容易受到与健康有关的风险和性剥削），同时仍向可能计划进一步移徙或试图改变就业的长期移徙者提供咨询。我们将使用混合方法来适应，实施和评估干预的可行性。我们将采用参与式方法，与两国已经参与设计该项目的青年咨询小组合作，制定和实施干预措施。然后，我们将进行混合方法的过程评估，以评估一揽子计划的哪些方面受到重视，并测试我们对青年移民面临的挑战和所提供干预措施的适当性的假设。最后，我们将设计一个全面的评估的有效性和成本效益的可行和可接受的干预措施，我们预计将继续进行测试，在随机对照试验。干预的目的是支持移民个人管理和适应其移民地的能力，并确定我们干预的关键组成部分（积极的榜样/“良好的”社会网络、更安全的环境、健康和社会支持）可以提供保护，支持青年移徙者展示复原力，对健康产生切实影响（如更安全的性健康和生殖健康行为）和福祉（例如对未来的希望）。这项工作将分为四个阶段，为期30个月：（第1-3个月）：征聘工作人员和其他筹备工作;第2阶段（4-9个月）：基线评估和与青年和其他利益攸关方共同设计干预措施;第3阶段第四阶段（第22-30个月）：分析、传播和讨论干预措施的完善，如果干预措施可行，则设计全面试验。在项目完成后，我们预计将有一个适应环境的，基于社区的，同行提供的干预措施，预测显示出的弹性，以改善健康和福祉的移动的青少年。我们预计，这一干预措施将在撒哈拉以南非洲的其他环境中推广和复制，以减少少女怀孕和性传播感染的负担，包括青少年和年轻人中与艾滋病毒有关的发病率和死亡率。

项目成果

Young migrant men managing risk and seeking protection in a small town in Southern Uganda.

在乌干达南部的一个小镇，年轻的移民男子管理风险并寻求保护。

• DOI: 10.1016/j.jmh.2023.100191
• 发表时间: 2023
• 期刊: JOURNAL OF MIGRATION AND HEALTH
• 影响因子: 4.6
• 作者: Tumwesige, Edward;Asiimwe, Allen;Kawuma, Rachel;Bernays, Sarah;Seeley, Janet
• 通讯作者: Seeley, Janet