INCREASE ACCESS TO SRHR SERVICES FOR SURVIVORS

Sexual and Gender-Based Violence is prevalent in Nigeria. A study by the Ministry of Women Affairs and Social Development and United Nations Population Fund (UNPFA) Nigeria, found out that 28% of Nigerian women aged 25-29 have experienced some form of physical violence since age 15. According to data from Plan International, 1.2 billion adolescents (aged 10-19 years) make up 16 percent of the world’s population. This percentage have been exposed to SGBV and deprived access to Sexual and Reproductive Health and Rights (SRHR) services which is essential to attaining full potential. Access to quality SRHR services and information is essential to protect their health and their ability to plan their lives. Yet around the world, harmful social norms, gender stereotypes, power imbalances, perceived need to control female sexuality and other inequalities make accessing information and services challenging, if not impossible for adolescent girls and young women. The fear of stereotypes in addition to the inability to identify youth-friendly SRHR service providers have led young survivors of SGBV to not report SGBV and receive the proper SRHR services required to avoid infection and pregnancy. In recent times, an adolescent gave a testimonial of how the lack of access to such information led to her giving birth at a young age to a child conceived from rape. This situation is disheartening and could be worse for young people in rural communities who have procured unsafe abortions and tried non-healthy ways of treating sexually transmitted infections leading to their deaths.  SRHR interventions have been inequitably distributed owing to limited knowledge, lack of access, and poverty with about 60% of adolescent girls and young women resident in rural areas where there are no means of accessing adequate services and information. 

The solution proposed is the development and deployment of a USSD (Unstructured Supplementary Service Data) otherwise known as Short Code, to improve the SRH outcome of young girls and address the root cause barrier to SRHR services. This is a scale-up of an existing innovation which is the development and deployment of a USSD to address the issue of inequitable distribution of SRHR services owing to limited knowledge, lack of access, and poverty. The Scale-up will provide information about youth-friendly SRHR service providers. The Short Code is easy and safe to use, and accessible to anyone with a mobile phone (smart or non-smart devices). It will be linked to artificial intelligence to aid data collection and monitoring of impact. The essence of the USSD is to reach a wider range of survivors especially those at the grassroots and rural community making available information regarding youth-friendly SRHR service providers closest to them. There will be a mapping of youth-friendly SRHR service providers within the project locations (Oyo and Nasarawa States). A baseline will be developed to assess which organisation/provider can be categorised as youth-friendly. After the collation of service providers, the unique code will be developed integrating the service providers, their location, and the kind of services they provide, thereby equipping vulnerable adolescent girls and young women with the relevant information.

The USSD uses codes made up of characters found on mobile phones usually starting with * and ending with #. A real-time communication session is created between a phone and another device (back end) using a USSD message and is typically a network or server.

WAP browsing, mobile money services, prepaid call-back services, menu-based information services, and location-based content services are all possible with USSD. This concept has been utilised by financial institutions and telecommunication companies to reach a wider range of the populace.

The initiative which is the first of its kind in the SRHR space has been used by Lawyers Alert to increase access to multi-sectoral services to victims and survivors of violence. https://youtu.be/Lss3XTwi4nE is a video developed to educate users on how to use the code. It will additionally provide a confidential and secure platform for reportage of GBV incidents. This will allow users to access services safely and discreetly without fear of discrimination and further violation. 

The USSD serves primarily adolescent girls and young women who are at risk or survivors of Sexual and Gender-Based Violence (SGBV) in grassroots and rural communities.  Violence against women and girls increased in Nigeria by 51% during the COVID-19 lockdown. This was evident in the various reports that have emanated from Nigeria in this regard. Adolescents who are socially and economically marginalised are the most vulnerable to SRHR problems that are driven by poverty, illiteracy, unemployment, lack of parental communication, and negative social pressure. They are also more vulnerable to sexual exploitation and abuse. According to a fact sheet on SRHR published by FEMNET “45 percent of women aged 15 to 49, never seek help or tell anyone about their experiences of gender-based violence”. This is owing to discrimination, stigmatization, and the practice of shaming the victim that have been woven deeply into the fabric of the society. Which has contributed to high maternal mortality, an increase in HIV/AIDS infection, and the procurement of unsafe abortions in the country. Lack of information on the existence of SRHR resources and services also meant that adolescent girls and young women could not help themselves when physically violated. Victims of rape could not get the needed medical assistance to avoid infection and pregnancy.

The USSD/Shortcode project is relevant as it leverages technology to provide a widely accessible platform for individuals, particularly women and girls affected by GBV in this context, to access SRHR services and information. It will enhance accessibility and reach for women in the grassroots and underserved areas who do not have a smartphone, lack internet connectivity, and resources. Through the USSD, young women and girls can access emergency services, immediate information, and relevant referrals to required GBV services, thus enhancing their well-being and safety. 

Lawyers Alert (LA) is best placed to deliver this solution as we are proposing a scale-up of an implemented project. LA developed a USSD code that have impacted almost 1000 beneficiaries across 5 locations in Nigeria providing information that increased their access to SRHR services towards attaining justice. The organisation has leveraged technology to advance Sexual and Reproductive Health and Rights recording tremendous success and leaving a mark as a trendsetter.  Seven years ago, we developed and deployed a web-based tool called LADOCKT (https://www.lawyersalertng.org/resources ), used principally to capture and analyse SRHR violations. LADOCT is instructive in that it is a web-based tool that automatically analyses violations at the grassroots as per location, age, type, and evidence trends. This was a milestone in our work in the introduction of technology, as it gave us enormous data that has led to informed interventions by Lawyers Alert, the government, and other partners. The tool which is probably the only of its kind in Nigeria has served as a coordinating hub for WROs in Nigeria in terms of inputting violations, networking, and enabling an organized manner of reaching lawyers. The development and deployment of USSD towards improving access to justice for survivors of SGBV through providing information on relevant and closest service providers is equally the first of its kind. It is therefore evident that Lawyers Alert possesses the needed capacity to deliver on the project building on lessons and targeting adolescent girls and young women as trust can be gained through easy access to youth-friendly service centres.

Lawyers Alert created and is managing an SRHR network in the country (Nigeria). The network is made up of about 80 WROs offering varying multi-sectoral services to victims/survivors of SGBV in Nigeria. Lawyers Alert in her 20 years of existence has successfully managed different projects in line with the strategic plan of the organisation, co-created with target beneficiaries. Law, Human Rights & Effective SRHR movement in Nigeria funded by AmplifyChange across the 6 geopolitical zones of Nigeria is one of those projects. The objective was to build the capacity of small & medium-sized organizations working on SGBV in Nigeria, and link them with stronger organizations towards joint advocacy on GBV; amongst others.

The Project team comprises experts with high technological proficiency. They possess advanced problem-solving skills, are well-versed in the usage of a variety of software and tools for project management, and understand the importance of client confidentiality and protection in the design of any innovation for vulnerable groups.

The solution in the past 1 year of launch have been able to serve about 1500 beneficairies providing them with information on relevant SRHR service providers most closest to them. 

The technological innovation of using USSD is probably the first of its kind targeted at tackling the inability of survivors and persons at risk of SGBV to access information and services. This enables them to reach out on time when violations occur and get adequate and prompt referrals, thereby reducing the impact of SGBV on survivors regardless of location. Recall that the USSD, can be used in a phone other than a smartphone, ultimately increasing the opportunity for girls in the grassroots and rural communities to access relevant information on SRHR service providers.

Unlike most existing strategies that depend on human availability for referral e.g., toll-free line, the USSD with the relevant configuration in place, will be operational 24/7. This is a system that has worked for both the banking and telecommunication sectors in Nigeria.  The Code will improve responses to sexual and gender-based violence, reduce the spread of infections and HIV/AIDS and reduce incidences of unsafe abortion or birthing a child conceived through rape for adolescent girls and young women in project locations.

The code will have a backend where information on service providers for each project location will be inputted to be made available to users of the USSD. The USSD is a great avenue to provide support without exposing the survivor to harm as the code leaves no trace.  The innovation prioritizes privacy and confidentiality, thus preserving the identity of users.

The impact goal for the next year is to increase access to SRHR information and services for 500 adolescent girls and young women.

In five years, the aim is to have significantly improved access to SRHR information and services to a total of 5,000 adolescent girls and young women, empowering them with knowledge and resources to make informed decisions about their sexual and reproductive health.

This goal reflects a substantial increase in the number of beneficiaries compared to the one-year goal, indicating the innovations' ability to sustain the commitment of service providers and meaningful impact over time.

This will be achieved through the following strategy:

• A project start-up meeting with youth-led organisations to unpack the project & understanding roles and responsibilities.
• Engaging a consultant to map service providers that offer youth-friendly essential services to survivors of SGBV
• A virtual meeting with identified service providers will be held to establish partnership and synergy towards the effective implementation of the project
• Two IT specialists will be engaged to develop and maintain both the front end and back end of the USSD.
• Unveiling and deployment of the USSD
• Media engagement (traditional and Social) in project states for awareness creation on SRHR for young people and the availability of the code.
• Monitoring and Evaluation: The M&E officer will monitor and track the results of the project alongside the developed milestones. There will be a reflection meeting with identified service providers.
• Project Close-out meeting for lesson sharing and learning

The USSD is all-inclusive as it addresses the root cause barrier to SRHR care amongst which are fear of stigmatization, transportation barriers, limited access to comprehensive SRHR education/information. The code provides the information of the nearest service provider, the service they provide and the contact of a focal person in the establishment thereby saving some cost for the survivor. The code improves access to comprehensive SRHR education as periodic messages will be sent to the beneficiaries of the code on different subject matter around SRHR. The Code provides an opportunity for adolescent girls and young women to freely inquire on the SRHR without the fear of stigma as privacy is guaranteed to all users of the code. It ensures that users can get information in a private and confidential way.

The code will result in young women and adolescent girls making informed choices about their sexual and reproductive health and well-being, exercising their bodily autonomy. They will have more control over what happens to them, which is crucial for living a healthy and fulfilling life. When young women and girls have the knowledge and resources they need, it increases their ability to fully participate in society premised on the information provided through the USSD. They can pursue their goals knowing they have the tools to take care of themselves.

The USSD in summary is an innovative solution that breaks down the barriers that can get in the way of young women and girls taking charge of their own SRHR, make them better choices, more confident, and be better able to lead healthy, and empowered lives.

For this project, a project team has been put together headed by a Project Manager. The team comprises of the project manager, project officer, monitoring and evaluation Officer, IT manager  and the Finance Officer all full time staff.  The team will be responsible for project implementation, monitoring and evaluation including reflection meetings for feedback and re-strategizing. The project team will periodically meet to ensure activities are implemented towards achieving the set milestones and indicators of success. 

In the cause of implementing this innovation, 2 IT specialists will be contracted to develop the back end for the code.

Lawyers Alert have been operational for over 2 decades. The organisation have experience in integrating technology in its work of advancing human rights. For the USSD concept, the organisation started developing a code for 5 States in 2022. This project builds on the challenges and success of the other states while focusing on youth friendly service providers girls and young women.  

At the core of Lawyers work is her dedication to humanity through promotion of huma rights. Equality and inclusion for all is a value that is mainstreamed in all affairs of the organsiation. 

Our innovation targets girls and vulnerable groups. The USSD caters to both men and women with the primary focus on girls and young women. The innovation aligns with the mission and core values of MiT. The Code and its benefits is assessable to young people regardless of gender and sexual identities. 

The innovation serves primarily adolescent girls and young women who are at risk or survivors of Sexual and Gender-Based Violence (SGBV) in grassroots and rural communities. It is a technology that advances and provides information on services providers for victims and survivors of SGBV towards improving access to information and services. A USSD will be developed otherwise know as Shortcode, easy to remember and it leaves no trace. The information provided to beneficiaries will differ as the AI integrated will shuffle responses from the information at the back end. 

Girls and young women need access to SRHR services to improve health options and influence decision making. Through the provision of adequate information on inclusive and youth friendly SRHR service providers, they will access SRHR services with ease. For survivors of SGBV, they can quickly access the needed and necessary health services to prevent contracting diseases, infection, viruses and most importantly avoid pregnancies as abortion is illegal in the country. 

This will benefit both the services providers and the young people. Our interaction will be with the service providers while our services will be used directly by girls and young women.

In ensuring financial sustainability, mapping of youth friendly service providers will be executed in line with indicators and metrics identified to ensure success e.g years of service provisions, review from clients, data protection policies amongst others. They will be service providers with proven track records of providing services. This method ensures that service providers will be available to provide services to customers/clients linked to them via the USSD. 

Lawyers Alert will keep sourcing for funds from other donors, applying for challenge and partnering with the private sector  towards renewing the back end subscription and paying the telecommunication company as usage of the code is free.