African Sisters Vision (ASV)

The problem we are solving is poor access to SRH services in disadvantaged communities (informal settlements and hard to reach populations). Access to Sexual and Reproductive Health (SRH) services and SRH literacy remain inadequate in disadvantaged communities, particularly in South Africa. Despite notable progress in enhancing access to family planning, contraception, and safe abortion services, many women still face significant barriers. This situation increases the risk of unintended pregnancies, with over 50% of pregnancies being reported as unintended, even though contraception is readily available at no cost.

Recent data from Statistics South Africa (Stats SA) highlights the severity of the issue. Between March 2021 and April 2022, 90,037 girls aged 10 to 19 years gave birth across all provinces. The most affected individuals come from middle-to-low-income communities, informal settlements, and hard-to-reach populations.

Contributing Factors:
Three key factors contribute to this problem:

1. Poor Healthcare Service Delivery and Quality of Care: Government Public Health Clinics (PHCs) often provide subpar services. Numerous studies have revealed issues such as long queues, extended waiting times, staff shortages, lack of necessary equipment and limited operating hours leading to frequent discontinuation of contraception. Additionally, long travel distances to PHCs and inadequate treatment from healthcare providers when missing appointments compound the issue.
2. Health Illiteracy: A significant portion of the affected population lacks basic health literacy, which hampers their ability to make informed decisions regarding contraception and SRH.
3. Social Challenges: Social factors, such as poverty, unemployment, and resultant sex work, contribute to unprotected sex. Gender-Based Violence, peer pressure to maintain a certain lifestyle, and other societal pressures exacerbate the problem.

This complex problem extends beyond teenage and unintended pregnancies. It also increases the prevalence of Sexually Transmitted Infections (STIs), jeopardizes individuals’ health, leads to school dropouts, unsafe pregnancy terminations, abandonment of newborns, and strains the country’s economy as more people become reliant on social grants.

By addressing these issues comprehensively, we aim to improve SRH access and literacy in disadvantaged communities and mitigate the far-reaching consequences of this problem.

Proposed Solution:
Our solution focuses on enhancing the accessibility of Sexual and Reproductive Health (SRH) services and SRH education. We aim to include women aged 15-35 in this endeavor.

Community Outreach and Mobilization:
To achieve this goal, we will conduct extensive community outreach and mobilization efforts. Our approach involves promoting a comprehensive range of SRH services, inclusive of information, screening, testing, prevention, treatment, and support. During our outreach, we will offer contraception and family planning services using a mobile clinic and facilitate bookings for necessary services.

Mobilization Strategies:
We will employ various strategies to reach our target audience, including:

• Engaging in community mobilization efforts.
• Collaborating with local high schools to gain parental and teacher consent for students’ access to our services.
• Launching social media campaigns and advertisements.
• Organizing community engagement activities.
• Forging partnerships with relevant entities such as the Departments of Health (DoH) and Education (DoE), as well as local non-profit organizations (NPOs) and non-governmental organizations (NGOs).

Targeting Underserved Areas:
Recognizing the presence of underserved informal settlements in our town, where basic amenities are lacking, we will direct our efforts to these communities. Our objective is to bridge the healthcare gap in these areas by providing essential SRH services and support.

Resource Collaboration:
To ensure the effectiveness of our initiative, we will establish Memoranda of Understanding (MOUs) with sub-district health institutions. These MOUs will facilitate the procurement of necessary resources and equipment, including contraceptive injections and pills.

Patient Coordination:
Furthermore, we will collaborate closely with public clinics, hospitals, and other stakeholders to streamline patient bookings, especially for services that require specific settings. Our commitment extends to conducting follow-up visits to ensure the continuity of care.

By implementing this comprehensive approach, we aim to significantly improve access to SRH services and education for targeted women in our community, with a particular focus on underserved areas and high schools.

Our initiative is specifically designed to cater to females aged 15-35 years who come from disadvantaged backgrounds and live far from Public Health Clinics (PHCs). Additionally, we plan to extend our services to high school students for whom parents and teachers have granted consent.

Challenges Faced by the Target:

1. Geographical Barriers: Many reside in remote areas, far from PHCs, making access to healthcare services difficult due to lack of transportation and limited resources.
2. Economic Hardship: A substantial portion of this group is unemployed and cannot afford travel expenses. They only seek medical help when extremely ill.
3. Education and Digital Divide: Many are uneducated, and some lack the means to access health information through social media due to limited data connectivity, resulting in health illiteracy.
4. Inadequate PHC Access: Local PHCs primarily serve those in proximity, leaving the more distant population underserved.
5. Working Hours: Individuals who work long hours often cannot access PHCs during regular working hours.
6. Weekend Services: PHCs’ limited operating hours, which exclude weekends, further hinder access, particularly for teenagers and those attending school for extra classes.

Expected Impact:
We firmly believe that by providing hassle-free access to services and information, we can significantly reduce the rates of teenage and unintended pregnancies, as well as cases of Sexually Transmitted Infections (STIs). Moreover, this initiative aims to address the issues of abandoned babies and unsafe pregnancy terminations.

Our comprehensive approach seeks to empower and support this underserved demographics, ensuring that they receive the vital Sexual and Reproductive Health (SRH) services and information they need to make informed decisions about their health and well-being. Through strategic outreach, partnerships, and resource allocation, we aspire to bring about lasting positive change in the lives of these individuals and the broader community.

Our team is uniquely positioned to address the pressing need for improved Sexual and Reproductive Health and Rights (SRHR) services in our communities. As women, we have firsthand experience and deep understanding of these needs, having witnessed them within our own communities.

Personal Connection:
I, personally, have been closely connected with a group of individuals who passionately advocate for the transformative power of such services. Engaging in meaningful conversations and listening to their thoughts and ideas inspired us to conduct extensive research.

Research-Backed Conviction:
This research served as a catalyst for our collective action. When we implemented the knowledge gained from our research in a program, the results were undeniably positive. This experience reinforced our belief that improved SRHR services are not only beneficial but essential for the well-being of our children and their future.

Personal Experiences:
Our team members also bring personal experiences to the table. We have had teenagers within our families who faced teenage pregnancies, prompting us to conduct interviews with these teenagers to gain deeper insights.

A Shared Understanding:
Our shared understanding is rooted in personal and close experiences, not only within our families but also among colleagues and acquaintances. These encounters have reaffirmed the critical need for accessible SRHR services.

From Disadvantaged Backgrounds to Devoted Advocates:
Importantly, our team comprises women from disadvantaged backgrounds. We have personally struggled to access SRHR services in the past. This shared history drives our commitment to making these vital services more accessible to those who need them the most.

Our team’s diverse backgrounds and shared commitment make us dedicated advocates for improving SRHR services, ensuring that no one in our communities has to face the challenges we encountered when seeking essential healthcare.

We have established a non-profit company with the primary mission of delivering essential health services to our community. While our organization is not yet operational due to financial constraints, our vision is unwavering.

Clinical Background:
As a qualified clinician, I had the privilege of working on a Covid-19 vaccination project in collaboration with the University of Pretoria and the Gauteng Department of Health (DoH). During this project, our focus was on reaching the hard-to-reach populations residing in informal settlements.

Expanding Our Services:
Building on the success of this project, we decided to incorporate additional health services. Among them, Sexual and Reproductive Health and Rights (SRHR) education and family planning (FP) became pivotal. Our efforts were met with overwhelming demand, as evidenced by our crowded tents, with approximately 70% of the women seeking FP services.

Intersection of SRHR and Covid-19 Vaccination:
It’s important to note that our involvement in Covid-19 vaccination had an unexpected but vital connection to SRHR. Many women, drawn by the availability of contraceptives, also chose to receive Covid-19 vaccinations. This symbiotic relationship significantly boosted our Covid-19 vaccination statistics.

Listening to the Community:
To better understand the needs of these women, we conducted interviews. Their feedback echoed the challenges mentioned earlier, including teenage and unintended pregnancies. Most notably, they strongly recommended the introduction of mobile clinics equipped to provide these essential services.

Our journey is rooted in the commitment to address the pressing healthcare needs of our community, particularly in SRHR. We aim to bridge the existing gaps and enhance access to vital services, building upon the invaluable insights gained from our experiences and the voices of those we aim to serve.

Our solution stands out in several innovative ways:

1. Holistic Approach: Our approach to addressing the issue of poor access to Sexual Reproductive Health and Rights (SRHR) services is comprehensive. While many initiatives focus solely on one aspect, such as education or service delivery, we combine various elements. We will not only provide information and services but also employ community mobilization, collaborations with local institutions, and technology integration for efficient service delivery.

2. Technology Integration: We hope to leverage technology to bridge gaps in healthcare access. The use of mobile clinics equipped with the latest medical technology will allows us to reach even the most remote areas efficiently. Additionally, we hope to employ data analytics to target our outreach efforts effectively and tailor our services to the specific needs of different communities.

3. Collaborative Partnerships: The aim is to actively engage with local authorities, non-profit organizations, and other stakeholders. This collaborative approach fosters synergy and resource-sharing, maximizing the positive impact of our initiative. By forging partnerships with the Departments of Health and Education, we integrate our services into existing systems, creating a sustainable model.

4. Community-Centered: Our approach revolves around the community. We want to empower women, particularly those from disadvantaged backgrounds, to actively participate in decision-making processes related to their SRHR. By involving them in our programs and education efforts, we create a sense of ownership and sustainability within these communities.

5. Impact on the Market: Our innovative approach has the potential to transform the SRHR market. By demonstrating the effectiveness of our model in improving access and outcomes, we hope to inspire other organizations and governments to adopt similar strategies. This could lead to a shift in the market towards more holistic, community-centered SRHR initiatives.

In summary, our solution is innovative due to its holistic and technology-driven approach, collaborative partnerships, community focus, and potential to catalyze positive changes in the SRHR space. We leverage both existing and new technologies, integrating them into a comprehensive model that can bring about lasting improvements in SRHR access and outcomes.

To create a transformational impact, we have set clear impact goals for the next year and the next five years:

Next Year Impact Goals
1. Increased Access: By the end of the next year, we aim to provide SRHR education and services to at least 40% of our women population in our target communities, particularly those from disadvantaged backgrounds and remote areas depending on the implementation of this program.

2. Awareness and Empowerment: We aspire to raise awareness of SRHR among 80% of the women we reach and empower them with the knowledge and resources to make informed decisions about their reproductive health.
3. Reduction in Unintended Pregnancies: Our goal is to contribute to a 10% reduction in teenage pregnancies and unintended pregnancies in our target areas.

How We Plan to Achieve

• Community Mobilization: We will intensify our community mobilization efforts to reach a broader audience and ensure that women are aware of the services we offer.
• Mobile Clinics: We will expand our mobile clinic operations to reach remote and underserved areas, ensuring that SRHR services are accessible to those who need them the most.
• Collaborations: Strengthening collaborations with local authorities, schools, and healthcare providers to maximize our reach and impact.

Five-Year Impact Goals

1. Broader Reach: By the end of the next five years, we aim to extend our services to serve at least 90% of our targeted women population , including young women and those living in hard-to-reach areas.
2. Comprehensive SRHR Education: We intend to provide comprehensive SRHR education to 95% of the women we reach, equipping them with the knowledge and skills to make informed choices.
3. Significant Reduction in Teenage Pregnancies: We aim for a 70% reduction in teenage pregnancies and a substantial decrease in unintended pregnancies, leading to healthier lives for women in our communities.

How We Plan to Achieve

• Scaling Mobile Clinics: We will further scale our mobile clinic operations and optimize the use of technology to reach even more remote areas.
• Advocacy and Policy Change: We will engage in advocacy efforts to influence policy changes that support SRHR access and education on a broader scale, impacting the lives of women beyond our immediate communities.
• Research and Continuous Improvement: We will conduct ongoing research, process evaluations, and gather feedback from our beneficiaries to continuously refine and improve our approach.

Additional plans:

1. Healthcare Services:
a. Establish and support clinics providing affordable and confidential SRHR services.

b. Train healthcare providers on SRHR best practices.
2. Gender Equality:
a. Develop programs to empower women and girls, promoting their autonomy.
b. Educate on consent, respectful relationships, and prevention of gender-based violence.
4. Policy Advocacy:
a. Push for comprehensive sex education in schools.

How Our Solution Creates Impact:

1. Activities:
• We plan to conduct extensive community outreach and mobilization.
• We will collaborate with local schools, healthcare providers, and stakeholders.
• We will leverage technology to reach remote areas and streamline services.
• We will provide SRHR education and family planning services.
2. Immediate Outputs:
• Increased awareness of SRHR among target populations.
• Greater accessibility to SRHR services, including contraceptives.
• Improved knowledge and decision-making capacity among women.
3. Intermediate Outcomes:
• Reduced rates of teenage pregnancies and unintended pregnancies.
• Lower incidences of Sexually Transmitted Infections (STIs).
• Increased healthcare-seeking behavior for SRHR services.
4. Longer-Term Outcomes:
• Enhanced overall well-being and empowerment of women.
• Lower social and economic costs associated with unintended pregnancies.
• Improved educational outcomes and opportunities for young women.

Supporting Evidence:
Our theory of change is grounded in third-party research, interviews with the target population, and findings from process evaluations. Research shows that comprehensive SRHR education and accessible services lead to improved health outcomes and reduced unplanned pregnancies. Additionally, our success in the Covid-19 vaccination project highlights the community’s readiness to seek healthcare when services are easily accessible. We believe that by empowering women with knowledge and accessible services, we can create a positive ripple effect, leading to healthier lives and brighter futures for our community.

Only 3 people are currently working on our solution team,

Namely:

1. Siphesihle Dladla, 076 6091 526

2. Lindiwe Vilakazi, 079 0845 687

3. Nompumelelo Makhanya, 079 718 6225

Less than 6 months, we have been actively busy ensuring that all the documents and registrations are correct, now we are actively looking for funding.

Our leadership team is intentionally diverse, comprising individuals from various backgrounds, including different ethnicities, ages, and educational experiences. We believe this diversity brings a richness of perspectives and insights that enrich our decision-making processes.

We are dedicated to continuous learning and growth in the area of Diversity, Equity and Inclusivity (DEI). Since we registered our nonprofit company we have been regularly engaging in workshops, seminars, and training programs to deepen our understanding of DEI issues and best practices.

We plan to actively involve our target communities in shaping our programs, by conducting regular surveys, focus groups, and consultations to ensure that the voices of marginalized groups are heard, and their needs are addressed.

Local Partnerships: We will prioritize collaboration with local organizations and institutions that have a deep understanding of the communities we serve. These partnerships will allow us to leverage their expertise and networks to ensure our services are culturally sensitive and relevant.

Tailored Outreach: Our communication and outreach efforts are going to be tailored to reach diverse demographics within our target population. This includes using multiple languages, culturally appropriate materials, and accessible formats to ensure inclusivity.

Equitable Service Delivery: We strive to provide SRHR services equitably, regardless of an individual’s background or circumstances. We do not discriminate based on factors such as age, gender, or socioeconomic status, and we will actively work to remove barriers to access.

Continuous Evaluation: We will regularly evaluate the impact of our programs on various demographic groups to identify disparities and areas where improvements are needed. We will use this data to adapt our strategies and ensure that our services are as inclusive and equitable as possible.

Transparency and Accountability: The aim is to be committed to transparency in our operations and regularly share data on our DEI initiatives, progress, and outcomes. We will hold ourselves accountable for achieving our DEI goals and welcome external feedback and scrutiny.

Our approach to DEI is not static; it’s a dynamic and will be an ongoing journey. We recognize that achieving true diversity, equity, and inclusivity is a continuous process, and we are dedicated to evolving and improving our practices to better serve the diverse needs of our communities.

Our business model is designed to create value for both the populations we serve and our organization’s sustainability. Here’s an overview of our business model:

Key Customers and Beneficiaries:

1. Target Populations: Our primary beneficiaries are women, particularly those aged 15-35, residing in disadvantaged communities, remote areas, and informal settlements. This group includes young women, mothers, and teenagers who face barriers to accessing quality Sexual and Reproductive Health and Rights (SRHR) services.

Products and Services:

1. SRHR Education: We plan to provide comprehensive SRHR education to empower women with knowledge about their reproductive health and rights. This includes information on family planning, safe sex practices, and sexual health.
2. SRHR Services: Our mobile clinics will offer a range of SRHR services, including access to contraceptives, reproductive health screenings, and prevention and treatment of sexually transmitted infections (STIs).
3. Community Engagement: We are going to engage in community outreach, awareness campaigns, and educational sessions to raise awareness and promote SRHR.

How we plan to provide these products and services:

1. Mobile Clinics: We will operate mobile clinics equipped with medical professionals and resources to deliver SRHR services directly to the target communities, including remote and underserved areas.
2. Community Outreach: Our team will conducts community engagement activities, collaborating with local schools, non-profit organizations, and healthcare providers to ensure a holistic approach to SRHR education and services.
3. Technology Integration: We hope to leverage technology for efficient outreach and to track the impact of our programs. Data analytics help us tailor our services to specific community needs.

Why They Want or Need Them:

• Empowerment: Women in our target populations want to be informed and empowered to make choices about their reproductive health and well-being. They seek knowledge and access to SRHR services to lead healthier lives.
• Accessibility: Many women face barriers to accessing SRHR services, such as geographical constraints and limited healthcare facilities. Our mobile clinics bring these services directly to their doorstep.

Our business model aligns the provision of valuable SRHR education and services with sustainability through diversified funding sources, ensuring that we can continue to make a positive impact on the populations we serve.

Our plan for achieving financial sustainability revolves around a multi-pronged approach to diversify funding sources and ensure that our revenue streams cover expected expenses. Here’s an outline of our strategy:

1. Donations and Grants: We actively seek sustained donations and grants from philanthropic organizations, governmental bodies, foundations, and private donors who share our commitment to improving Sexual and Reproductive Health and Rights (SRHR). We maintain strong relationships with these stakeholders and continuously apply for grants to support our programs and initiatives.

2. Fee-for-Service: While our primary focus is on providing SRHR services free of charge, we may introduce a fee-for-service model for individuals who can afford to pay. This approach helps generate revenue that can be reinvested to subsidize services for those in need.

3. Public-Private Partnerships: Collaborating with local healthcare providers and institutions allows us to explore service contracts with government agencies or healthcare authorities. These partnerships may involve reimbursement for specific SRHR services delivered through our mobile clinics.

4. Social Enterprises: We may consider launching social enterprises that align with our mission and generate revenue. For instance, producing and selling SRHR educational materials, branded merchandise, or products that promote sexual health awareness can contribute to financial sustainability.

5. Impact Investments: Exploring impact investment opportunities allows us to attract capital from investors who are aligned with our mission. Such investments can be channeled into scaling our operations and expanding our reach to serve more communities.

6. Fundraising Events: Organizing fundraising events, campaigns, and initiatives in collaboration with local communities, schools, and businesses can mobilize financial support while raising awareness about SRHR.

7. Diversified Funding Sources: We continuously seek out and diversify our funding sources to reduce reliance on any single entity or donor. This approach enhances our financial stability and resilience.

8. Financial Stewardship: Efficient financial management and transparency are essential. We maintain rigorous financial stewardship practices to ensure that funds are allocated effectively to programmatic initiatives and operations.

9. Monitoring and Evaluation: Regularly monitoring and evaluating the impact of our programs allows us to demonstrate tangible outcomes to donors and partners, strengthening our case for continued financial support.

Over the long term, our goal is to establish a sustainable financial model that allows our revenue streams to cover expected expenses, ensuring the continuity and growth of our mission to improve SRHR access and education for underserved populations. By diversifying funding sources and exploring various revenue-generating strategies, we aim to achieve this sustainability while maintaining our commitment to serving those in need.