Going beyond formation of QI Teams: Evidence based intervention gains AGYW get when community QI teams are functional
The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project established a community-based QI model of addressing HIV risk among AGYW comprising of setting up and making functional community QI teams to: (1) build skills of AGYW to stop risky behavior and to influence safer sex practices with their partners; (2) mobilize community resources to support AGYW and their partners to stop risky behavior; and (3) link AGYW, their partners, and their communities to HIV prevention services and commodities. The model of QI teams was premised on the understanding that targeting individual-level behaviors without addressing the larger contextual and structural landscape within which the AGYW live would give rise to recycling of risky behaviors and render HIV prevention efforts in vain and that QI teams are a means to address the diverse contextual needs of the AGYW in order to ensure that layered services offered to them had an enabling environment for their effectiveness. The AGYW nominated members of the community with whom they would work to address HIV risk factors within their communities. The teams' engagement with the AGYW in the different communities, showed that social-economic factors influence risky behaviours; for example, among the out of school AGYW, limited economic potential exposes them to HIV risk when they engage in transactional sex to provide for basic needs. Furthermore, similar factors influenced whether a young girl continued with their education –a known social vaccine for HIV. The QITs prioritized areas for improvement: 1) increasing AGYW linked to social economic empowerment activities; 2) increasing AGYW participating in income generating activities; and 3) increasing AGYW and male partners with a known HIV status. This case study discusses what QI teams were able to do for AGYW in their communities.