Sub-Saharan Africa has some of the worst sexual and reproductive health (SRH) outcomes globally. Sexual and Reproductive Health and Rights-HIV Knows No Borders (KNB) is a project covering six migration-affected countries in Southern Africa: Eswatini, Lesotho, Malawi, Mozambique, South Africa, and Zambia.
The project seeks to improve the sexual and reproductive (including HIV-related) health of both migrant and non-migrant adolescents and young people, sex workers and others who live in migration-affected communities.
Project strategies include generating demand for SRH services, encouraging providers to make these available, accessible and relevant, and ensuring that services are supported by policy- and decision-makers at local, national and regional levels. In these ways, the project supports members of migration-affected communities to exercise greater freedom of choice over their sexual lives.
In preparation for the project, baseline (quantitative) and needs assessment (qualitative) studies were conducted. The baseline involved 1800 respondents and the needs assessment consulted 265 key informants from a variety of beneficiary and stakeholder groups. Data collection was conducted between April and December 2018 in all the six project-implementing countries of Lesotho, Malawi, Mozambique, South Africa, Swaziland (Kingdom of Eswatini, also abbreviated as Eswatini) and Zambia.
Findings from the baseline confirm: consistently higher rates of HIV prevalence among women than men; considerable variation among countries in terms of people living with HIV who are enrolled on antiretroviral therapy (ART): low levels of comprehensive knowledge about sexual and reproductive health among target populations; and varying degrees of access to and quality of SRH services provided.
Key informants from beneficiary groups all reported challenges in relation to accessing and using SRHR-HIV services. Other challenges identified included irregular supply of commodities, for example condoms, and in all six countries the continuing criminalization of sex work.