Dedicated and passionate Pact staff drive the success of DREAMS in South Africa
Behind every innovative development program is a team of dedicated people who enable the program to reach and support the communities that need it most. One such program, DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe), which started in 2015, is an ambitious public-private partnership funded by PEPFAR through USAID aimed at reducing rates of HIV among adolescent girls and young women (AGYW) in the countries with the highest HIV burden. Operating in 15 African countries, DREAMS is an ambitious effort to significantly reduce new HIV infections, unwanted pregnancy and sexual and gender-based violence among AGYW between the ages of 10 and 24 by addressing multiple causes of AGYW vulnerability. It aims to empower young women to make more informed decisions on their sexual health and be more aware of their rights so they can have brighter and healthier ￼futures￼.
In South Africa, Pact has been implementing and supporting DREAMS through a family strengthening initiative called Let’s Talk since October 2020 in three provinces: Gauteng, Limpopo and the Free State. So far, we have reached more than 9,000 AGYW and their caregivers. Facilitators, trainers, ambassadors and coordinators all work together to make DREAMS accessible and successful in reaching and supporting AGYW. Let’s Talk provides group work interventions that focus on building AGYW resilience and positive decision-making, HIV/AIDS and gender-based violence prevention as well as economic strengthening activities. These are coupled with linkages to key health services, including HIV testing, sexual reproductive health services and access to PrEP (pre-exposure prophylaxis).
Zandile Mqwathi is a social and behavior change communications manager. She trains facilitators and tailors the messaging to ensure it targets the communities they represent. “I take the existing manual and make sure it speaks to a local audience so that our messaging makes more sense in the communities we serve,” Mqwathi says. We also try to incorporate an element of fun in our work with young girls as we find this works better than just handing out brochures and helps us to engage better with them and their families.” For example, she developed comic strips that were effective for both AGYW and their caregivers to communicate better about sexual health.
Through Let’s Talk, youth feel more open to communicate around sexual health with their parents or caregivers. “Reaching caregivers is very important and we find that WhatsApp is a great platform for this,” Mqwathi says. “Tapping into existing structures like community groups helps us to reach more people.” Through the pandemic they are still reaching girls online, even though access to mobile data can be a challenge.
Tselane Lesemela, a DREAMS coordinator with Pact in South Africa, enjoys being part of the solution to creating positive social behavior change among youth, creating access to programs and supporting facilitators. “I make sure all the facilitators who are interacting with the girls and running the school programs have access to the resources they need,” she says.
Lesemela is part of the team that advocates for the program to school management. She supports the schools on a district and provincial level to engage with other DREAMS partners on how to work together to implement the program. “We have a great partnership with the schools and link them to other partners depending on the needs that arise,” she says.
Reaching AGYW can be challenging, but Pact’s South Africa team finds that being open and honest helps them to connect. “We are moving away from lecturing girls. We don't know their reality and the context of what they are experiencing, so we prefer an open discussion so we can see where they need more information and how best to support them,” Lesemela says. For example, many girls did not know that PrEP can help protect them from HIV and they wanted to know more. The team connected them to partners who were more informed about PrEP and who could provide access to it.
Speaking openly about sex in South African communities is not a common part of the culture, and Let’s Talk is helping to improve this dynamic. Staff have engaged with caregivers to be more supportive and understand the importance of PrEP. “We’re creating access to reliable information that empowers the young girls and their caregivers,” Lesemela says. “Parents are also empowered with new skills to communicate better regarding these sensitive topics and there is more openness and understanding.”
Kesholofetse Rampana, a DREAMS facilitator in the Free State, says the girls are learning more about HIV and unplanned pregnancy through the safe spaces that she creates. "I communicate to the girls on their level, which helps them to open up and share experiences, their challenges or to raise questions.The more we touch on topics and situations that connect with them, the more the discussions flow.” Rampana loves her work and sees how important her role is in helping shape a better future. “DREAMS is allowing young girls to make better decisions, which have a positive impact in their life. A young girl must have a dream and a vision to succeed in life.”
Pact began working in the Southern African region to reduce new HIV infections in 2000. We implement DREAMS in three countries in the region: Eswatini, South Africa and Zambia. In Zambia, Pact and our partners operate 53 DREAMS centers and have served more than 700,000 AGYW through the DREAMS program. In Eswatini, Pact is implementing DREAMS through the Ready, Resourceful, Risk Aware (Triple R) project, locally known as Insika Ya Kusasa, which is increasing the uptake of high-impact health services around HIV testing services, gender-based violence and sexual and reproductive health to AGYW.