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Evaluation database

Evaluation report

2016 Brazil: Fique Sabendo Jovem: Evaluation Report



Author: Plan Consultancy

Executive summary

Fique Sabendo Jovem: Relatório de Avaliação

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report, and the executive feedback summary labelled as ‘Part 3’.

Background:

Fique Sabendo Jovem was conceived by UNICEF as an innovative strategy in the struggle against the HIV/AIDS epidemics among young people. After over three years since its creation, the strategy has reached six municipalities and carried out over two thousand tests in the two pilot municipalities only, Fortaleza and Porto Alegre. In both cities, the municipal health secretariats have adopted the program as a public policy and, at this moment, four other municipalities are beginning the FSJ activities: São Paulo, Manaus, Recife, and Belém.
In spite of the programme’s success, UNICEF intends to gradually transfer the management of the strategy to municipal health secretariats. Additionally, there is interest in keep expanding the program as a complementary strategy to fight against the HIV/AIDS epidemics among the young population.

The evaluation report presents the main findings related to objectives, strategies and management of the programme based on the experience of the two pilot cities.

Purpose/Objective:

The programme evaluation, after two years of implementation, was necessary to assess the successes that can be replicated, the lessons learned and the challenges yet to be overcome so that FSJ becomes effective, efficient and sustainable in all municipalities in which it is already or will be implemented.

Methodology:

The evaluation methodology was based on multiple tools, such as: i) desk review of existing documentation; ii) field visits with participatory techniques and individual interviews; iii) analysis of quantitative data.
The evaluation report presents the main findings related to objectives, strategies and management of the program based on the experience of the two pilot experiments.

Findings and Conclusions:

In Fortaleza, since the beginning of the programme, there has been significant increase in HIV/aids testing. Between 2013 and 2014, the year that testing campaigns began, there was an increase of 21.5%, which can be totally attributed to FSJ actions. In Porto Alegre, reports from the programme management team also indicate an increase in the number of tests after the beginning of the campaigns.
Treatment is still a challenge in Fortaleza, as only 67% youth tested positive initiated the treatment. Though this rate averages 43% in the world, and is similar to the national average of 63%, it is still far from the 90% goal stablished in the Paris Declaration. In Porto Alegre, 100% of the diagnosed teenagers followed the treatment.
Both municipalities were successful in prevention activities in centers of correctional measures. The FSJ Porto Alegre, besides doing the test campaign inside FASE, also taught municipal health technicians about gender and sexuality themes and trained health professional in fast testing procedures. As a consequence to FSJ actions, FASE started testing all new internees and providing preservatives to teenagers doing semi-open correctional measures. In Fortaleza, several campaigns were conducted in different education centers, but the actual context of violence which these centers are going through constrain the expansion of actions.
FSJ Porto Alegre was able to access schools through Galera da Curtição and, therefore, has been able to conduct prevention actions with school units. In Fortaleza, in spite of FSJ team’s persistence, no action was conducted in schools, as this is a traditionally challenging arena to enter. However, there are good signs that this objective will be met soon.
In addition to schools and education centres, the mobile unit also presents itself as a good opportunity for prevention actions.

Recommendations:

  • Expand the prevention and testing activities in both area and focus;
  • Continue and expand the interventions focused in the targeted public, as it has shown to be a very effective strategy;
  • Expand preservative distribution and, if possible, provide in more accessible places, such as schools;
  • Consider risk management strategies;
  • Refer the diagnosed teenager to units of his/her liking;
  • Reinforce adhesion and retention group reference in units and hospital, allowing for the expansion of access to care and support;
  • Teach health professionals about sex, gender and sexuality;
  • Expand monitoring in order to evaluate the viral load of diagnosed teenagers;
  • Empower mobilizing teenagers living with HIV;
  • Diversify mobilizing teenagers’ profiles in order to bring more teenagers to the interventions;
  • Enlarge municipal health secretariats’ teams and enhance partnerships with health units;
  • Build capacity of MHS workers in order to monitor the program;
  • Share intervention results with partners;
  • Find alternatives for human and financial resources reposition;
  • Update Facebook pages;
  • Conduct a study about the profile of the local teenager in order to define communication strategies.

Lessons Learned:

The mobile unit is a main driver of the programme’s success and contributes directly to the increase in testing. The fact that it is mobile, in addition to the visual identity, attracts a larger number of teenagers.
Peer-to-peer mobilization is the great differential of the program and contributes directly to the prevention and testing strategies, as a teenager feels much more comfortable with the presence of another teenager. Accessible language and absence of judgement are listed among the motives that make the mobilizing teenager a viable way to bring other teenagers to the health system.
Data collection is fundamental in order to discover the results and challenges of the program, as well as to orient strategies. FSJ Fortaleza has been able to tabulate and analyse these data more frequently than FSJ Porto Alegre, but does not share results with all partners. In Porto Alegre, there is a tardiness in data systematization, which is related to the team size.
The evaluation also recommended that test results should be delivered in a more private situation, because it may be possible to identify how much time a person spent in the post-test counselling.
Another challenge is the diagnostics delay, as it can take over 30 minutes  for the results to arrive, depending on the number of tests conducted.



Full report in PDF

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Report information

Year:
2016

Country:
Brazil

Region:
LACR

Type:
Evaluation

Theme:
Area Based Programs (normally covers several Health and other sectors)

Partners:
Municipal Administration organizations in Fortaleza and Porto Alegre, MAC, Ministry of Health

Language:
Others - Portuguese

Sequence #:
2016/002

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