| Program access |
Initiate enrollment in community and at schools before program start; plan with schools for enrollment during school hours and use community special events and/or one-on-one house visits to speed enrollment. Consider online enrollment if feasible. Work with schools to allow self-consent for students aged 18 years or older. Plan ahead to efficiently obtain parental consent. Expect resource and logistics complications relating to Internet, food, child care, transportation, and staffing. Work in advance to allow program access to eligible AGYW in tertiary education settings.
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| Health education |
Plan strategically with ministries, the private sector, NGOs, churches, and local authorities to identify an adequate number of appropriate safe spaces. Identify staff to manage most administrative tasks, such as program tracking, ensuring peer mentors can focus on their primary role and M&E staff can be free up to focus on data quality. Identify evidence-based, locally adapted, and developmentally appropriate HIV/GBV prevention curricula before program start or add content to existing curricula while awaiting approved content.
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| Health services |
Carefully evaluate which PrEP model will work best for AGYW in your particular DREAMS setting and plan ahead for logistics. Consider that many AGYW do not prefer to access PrEP at health facilities. Work with government supply chain offices to anticipate increases in stock use (e.g., HIV commodities and family planning) with onset of DREAMS program. Clearly communicate health services components of DREAMS to all stakeholders, especially HIV testing, PrEP, and family planning. AGYW program donors need to advocate for national school health policies that include provision of sexual and reproductive health services.
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| Social services |
Consider government managing high-risk GBV cases and DREAMS managing medium- and low-risk cases. Anticipate a high GBV case load and consider cadres to help manage cases (e.g., lay counselors and part-time social workers), in addition to full-time social workers. Work with stakeholders early in the planning process to explore possibilities for expanded post-GBV service delivery sites. Provide staff with trauma counseling training. Identify private spaces where AGYW can receive psychological counseling. Participate in advocacy efforts related to HIV/GBV linkages.
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