In Zimbabwe, where two-thirds of the population is under 25, a new project will let university students order HIV self-tests, STI screening kits, condoms, and menstrual health products through a basic mobile phone platform and pick them up from smart lockers using a one-time code. This matters because young people in Zimbabwe face high rates of HIV and other sexually transmitted infections, yet often avoid clinics due to judgmental staff, inconvenient hours, and stigma. The project co-designs the digital self-care system with youth themselves, then tests whether it works in practice across tertiary education institutions. If successful, the intervention could bypass the barriers that keep young people from getting sexual and reproductive health services. The long-term impact could ripple across generations: fewer unplanned pregnancies, better educational outcomes for youth, lower HIV and STI rates in future adults, and a scalable model that Zimbabwe’s Ministry of Health could adopt nationwide. The research directly responds to World Health Organization and national calls for integrated, youth-centred service delivery.
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Background Africa is the only region in the world forecast to see rapid growth in its youth population. Two-thirds of the Zimbabwean population is under 25 years old. Zimbabwe faces a high prevalence of sexually transmitted infections (STIs), including HIV, disproportionately affecting youth. Unique barriers hinder youth from accessing sexual and reproductive health (SRH) services: inconvenient facility opening hours, judgmental providers, lack of confidentiality, and community stigma. The World Health Organization (WHO) 2022-30 Global Health Sector Strategies on HIV, viral hepatitis, and STIs, and Zimbabwe's Ministry of Health and Child Care (MoHCC) identify youth as a priority population and call for integrated person-centred approaches for service delivery. Self-care and low-technological digital innovations can reduce barriers and stigma in accessing SRH services among youth. Improving youth SRH could yield a triple dividend: improving their SRH, their SRH in adulthood, and their offspring's health and well-being. Aims and objectives This project aims to co-design, implement, and evaluate a digital self-care SRH intervention for youth attending tertiary education institutions (TEI) in Zimbabwe. The study has three specific objectives: Co-design a digital self-care intervention for integrated SRH services with youth attending TEI in Zimbabwe. Determine the feasibility, acceptability, and uptake of the digital self-care intervention and develop optimal user pathways for delivery of integrated SRH services for youth attending TEI in Zimbabwe Conduct a process evaluation of the digital self-care intervention and develop a toolkit to inform operationalisation, scale-up and sustainability of the intervention. Methods The project includes three work packages (WPs) supported by a Youth Advisory Committee (YAC). WP1 involves co-designing the digital self-care intervention with youth through four participatory workshops, followed by a designathon. WP2 will focus on piloting and implementing the intervention, which will offer SRH services, including HIV self-testing, STI screening, condoms, menstrual health products, and contraception ordered via a free digital platform accessible on mobile phones using Unstructured Supplementary Service Data (USSD). Processed orders will be delivered to grab and go smart lockers, accessible for pickup with a one-time access code. WP3 is a mixed methods process evaluation that utilizes routinely collected data, in-depth interviews, and focus group discussions with youth and stakeholders. Timelines for delivery The project spans four years, beginning April 2025. Youth engagement and intervention co-design will occur over 10 months in Years 1 and 2. Subsequently, the digital self-care intervention will undergo a stepwise roll-out: a 3-month pilot in Year 2, a 2-month refinement phase, and 9-months of intervention implementation in Year 3. Analysis, manuscript writing, and dissemination will take place in Year 4. Anticipated impact and dissemination This research aims to address critical barriers to youth SRH service uptake, directly responding to WHO and MoHCC calls to develop integrated HIV and SRH service delivery models, thus impacting policy formulation. Long-term impacts include improved youth educational outcomes through prevention of unplanned pregnancies, economic benefits from leveraging self-care, improved well-being among youth, and decreased HIV/STI infection rates in future generations. Findings will be disseminated to academia, youth, and policymakers.
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