TOR – Short-Term Consultant to Assessing SGBV Service Delivery and Providing Capacity Building Support in 11 Public Health Centers in Addis Ababa 31 views

 About Tiko

At Tiko, we believe that young people deserve the power to choose where, when, and how they can realise their sexual and reproductive health and rights (SRHR). We are committed to creating a world where adolescents and young people (AYP) have more control over their health choices and pathways, to do more with their lives. As an established, African non-profit we use smart technology and data-driven insights to break through the barriers to accessing sexual health services, with verifiable results. The Tiko platform delivers sexual reproductive health (SRH), HIV and Mental Health services, through a network of stigma-free, reputable healthcare facilities, pharmacies, and community-based organisations, by investing in partners that deliver results, at no cost to the AYP. This places the power of choice into the hands of young people. Established in 2014, Tiko designs, implements, and scales access to sexual and reproductive health services for AGYW across six countries in Sub Saharan Africa (SSA): Burkina Faso, Ethiopia, Kenya, South Africa, Uganda and Zambia. At Tiko, we understand that addressing SRH needs does more than just improve individual health; it empowers young people to make informed decisions about their bodies and futures, leading to broader societal benefits.

Tiko’s current SRHR Approach

Tiko’s digital platform uses technology and behavioural insights to increase access to SRH services for AGYW in sub-Saharan Africa. Tiko connects AGYW to mobilisers from community-based organisations (CBOs), who generate demand for services and enrol AGYW as Tiko members; and public and private facilities, where they access free or subsidised services using high tech (WhatsApp), low tech (SMS) or no tech (a QR code enabled Tiko card) options – creating an ecosystem that drives positive SRH behaviour uptake. Mobilisers and service providers access Tiko through an Android app which registers, verifies and monitors their activities. Tiko rewards mobilisers with locally spendable points (called Tiko Miles) for successfully referring users to facilities and reimburses facilities for providing Tiko members with services. Tiko benefits AGYW by increasing their choice and rewarding them for taking up and continuing with services and rating their experience.

The platform leverages real-time data to analyse trends, allowing Tiko to use interactive dashboards to gain insights that allow us to nimbly adjust programming, maximising impact. By verifying interactions between mobilisers, AGYW, and service providers, we have confidence that every dollar invested has maximum value for those who fund our programs. Traditional approaches to improving SRH outcomes for AGYW focus on changing behaviour by raising awareness of the consequences of engaging in risky behaviour. Service provision has taken a generic approach, not considering the specific needs of young people. These fail to consider factors that can influence AGYW behaviour, including friends, family, community beliefs, financial constraints and access to facilities. AGYW are often reluctant or unable to access SRH services, for a variety of reasons including cost barriers, low quality of services and community stigma which represents a challenge for traditional health interventions. Our ecosystem-based platform tackles the problems described above from multiple points simultaneously by:

1. Addressing service quality through feedback loops which are used to support service providers in becoming more youth responsive.
2. Addressing hesitancy and intermittent use of services through peer engagement. Once engaged, the use of the reward system and behavioural nudges motivates engagement and continued positive health behaviours.
3. Providing service choice by removing the private sector service cost barrier through subsidies paid directly to providers.
4. Addressing community stigma through sensitization work linked to the ecosystem, and through the injection of Tiko Miles into the local economy.

Tiko’s current service package focuses on SRHR including contraception, HIV prevention and treatment and mental health and menstrual hygiene management, we would now like to expand up on this by integrating SGBV into our work.

SGBV and TIKO
Tiko is primarily an SRHR organization, however in addressing SRHR needs among adolescent girls we can no longer ignore the need for effective SGBV interventions, we are therefore proposing an approach that will refine Tiko’s continuum of care to enable Tiko to deliver SGBV services through its’ existing infrastructure and new community embedded partnerships.
Tiko will use new and existing partnerships with CBOs for demand generation activities with survivors of SGBV, building upon the existing ecosystems where demand is high. We will also incorporate the perspectives of rape survivors through our tested approaches when working to address teenage pregnancies through an integrated package of services. Our approach will be grounded in formative and/or implementation-based research on SGBV among 15 – 19-year-olds. Tiko will co design the primary and secondary research questions with CIFF and the other key stakeholders we would like to engage, to complement existing Kenyan data on SGBV while also addressing existing gaps in available information. The incidence and prevalence of SGBV among 15–19-year-olds is widely considered to be under-reported. As such, Tiko will develop a scope of work to commission an appropriate research agency to deliver this work, including the National Gender Equality Commission in Kenya as a key partner.

Tiko will also conduct a rapid situation analysis across all of our operational geographies in order to collate existing SGBV data, MOH policy and procedures for addressing SGBV, reporting tools at health facilities, existing prevention and response mechanisms including partners who already address information and education/advocacy, safe houses, trauma counseling, legal support, research and training on SGBV. This will enable us to lay the groundwork for SGBV implementation in all Tiko countries, after SGBV programme implementation has begun in Kenya.Our approach will also address an element of community sensitisation across gender groups to tackle community embedded and stigmatising notions of what does/does not constitute SGBV among local communities and providers. We are uniquely positioned to do this through the Community Based Mobiliser (CBM) model. CBMs will be able to use toolkits e.g those from the MOH to work with adolescents on these issues.

Tiko will also work to quickly adapt to working on SGBV through existing medical interventions e.g upskilling medical professionals to complete a form outlining the nature of SGBV experienced by the client, while assessing the need for integrated biomedical interventions such as Emergency Contraception (EC), Pregnancy testing, HIV and STI testing, prevention and treatment. We will work with existing providers to introduce trauma counseling at public/private health facility level. This would be a new area of work for Tiko, while tackling depression and anxiety is integral to Tiko’s current service delivery model, trauma counseling would be a new offer for us. Working on SGBV would also involve expanding Tiko’s current approaches to Safeguarding and Child Protection, however any holistic package of services would also need to address the issue of safety through an infrastructure of safe houses plus legal support for SGBV survivors. While Tiko is uniquely placed to deliver SGBV services through its ecosystem, we would have to forge new partnerships to address both areas.

Tiko has already begun to map out the requisite partnerships for both safe houses and legal support, which will enable us to rapidly onboard them onto the Tiko platform. It has also become increasingly apparent that there are existing models of community-based screening and case management of SGBV survivors already embedded in country level community health strategies. Tiko is now also looking at adapting these to onboard these approaches into the Tiko ecosystem. We will also re-orient mobilizers, accordingly. It is important to note that we are currently mapping SBCC materials for adoption, in collaboration with lead organizations such as the National Gender Equality Commission in Kenya. These will form part of the information, education and communication materials we will update for retooling our CBMs.

Finally, Tiko’s work in the area of SGBV will also contribute to Tiko’s future positioning and plans to become a gender transformative organisation carving out a necessary advocacy space for us, going forward. We also have plans to recruit an SGBV lead to specifically work on this critical area of work.