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Adolescents and Social Norms Change

Strategy Note

2017 - 2020

Maputo, 24 March 2016

CPD 2017 – 2020 Outcome 6 – Adolescents and Social Norms Change

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Strategy Note

Contents

1. Introduction…………………………………………………………………………………………… 2 2. Priority issues and areas…………….………………………………………………………………… 3 3. Theory of Change for Programme Components……………………………………………………… 6 4. Results Structure……………………………………………………………………………………… 14

5. Monitoring Outputs and Demonstrating UNICEF’s Contribution to Outcomes……………………... 15 6. Resource Requirements………………………………………………………………………………. 15 7. External Risks and Planned Responses………………………………………………………………. 16

Annexes ……………………………………………………………………………………………………….. 18


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1. Introduction

At the core of the Adolescents and Social Norms Change Outcome is the promotion and protection of essential children and adolescents rights, with emphasis on girls, to help them adopt safe, healthy and protective behaviours and actively participate in development processes in their communities. A strong focus is placed on communication for development (C4D)1 to promote changes in social norms and practices in order to help break the cycle of inequities, gender discrimination and vulnerability, targeting adolescents (up to 19 years old), their families and communities. Thus, in close coordination with UNICEF programmes on Child and Social Protection, Education, Health, Nutrition and WASH; UN agencies and other development partners, this programme will contribute, through targeted social and behaviour change processes, to accelerating actions tackling critical issues affecting adolescents in Mozambique, such as ending early marriage and pregnancy; preventing children and adolescents from violence; improving school retention and learning achievement, demand and access to basic health, as well as to water, hygiene and sanitation. A special focus will be placed on reducing the risk of HIV infection towards an HIV-free adolescent generation. Young people meaningful participation and engagement will be promoted to strengthen their ability to influence both the process and the development programmes based on information sharing and dialogue among peers and intergenerational dialogue. Evidence-based policy and public advocacy will be essential for creating an enabling environment. Outcome 6, particularly output 2, will also contribute to the achievement of other outcomes by promoting positive behaviour and social norms and practices change in connection to key country programme priorities, such as child marriage, nutrition, among others. This Outcome is in line with UNDAF Output 4.2 (Key actors at local level able to contribute to the

transformation of discriminatory socio-cultural norms and harmful practices against women

and girls) and Outcome 7 on adolescents and youth actively engaged in decisions that affect their lives, health, well-being and development opportunities. More precisely Outputs 7.2 (Adolescent and youth capacity strengthened to actively participate in economic, social,

cultural and political development) and Output 7.3 (Increased demand for quality access to

ASRH and HIV prevention services). The programme is equally in line with UNICEF ESAR priority 4 on adolescents (By 2017, reduce prevalence of HIV, child marriage and violence

among adolescents by at least 20 per cent).

Partners: The main government counterpart would be GABINFO (ICS, RM, TVM), the Ministry of Health (Health Promotion Department – DEPROS; HIV, PMTCT and Adolescent Programme), the National AIDS Council (CNCS), the National Youth Institute and the Ministry of Youth and Sports, Ministry of Education Cross-sectoral Issues Department (Departamento de Assuntos Transversais); Ministry of Gender, Children and Social Welfare; Ministry of Justice. Other key partners are FORCOM, COREM, PIRCOM, COALIZAO, Save the Children, World Vision, Plan International, PCI Media Impact, Rede da Criança, ROSC, WILSA, CECAP, RECAC, Horizonte Azul, Parlamento Juvenil, N’weti, FDC, Child and Youth Associations (Scouts, Continuadores …), PEPFAR, CDC, USAID and Global Fund. Considering the scope of work, UN coordination will be essential with UNFPA, UN Women, UNAIDS, as well as UNJT on HIV in Mozambique.

1 According to UNICEF “Communication for Development (C4D) is a systematic, planned and evidence based strategic

process that is intrinsically linked to programme elements; uses consultation and participation of children, families,

communities and networks, and privileges local contexts; and relies on a mix of communication tools, channels and

approaches, to promote positive and measurable behaviour and social change”


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2. Prioritized issues and areas

Mozambique has some of the worst indicators concerning children and adolescents, particularly girls, across different sectors (health, education, protection) in a context of limited access to resources, services and harmful socio-cultural practices. As of 2011, it is estimated that 45 % of the population is under 15 years of age and 52% is below 18 years2. Further, according to the projections of the 2007 Census, the Mozambican population for 2014 was estimated at 25,041,922 inhabitants, of which nearly a quarter (24%) of the Mozambican population in 2014 was comprised of adolescents (10-19 years), distributed similarly between boys and girls. Almost one in two girls were reported to be married or in union before 18 years of age3. Child marriage is a human rights violation that denies millions of girls their childhood while putting put them at risk of early pregnancy, violence, abuse and neglect4. There is an early onset of sexual intercourse (22% of girls 15-19yrs and 17% of boys initiated sexual activity <15yrs); 9% of girls and 3% of boys 15-19 reported sexual violence. Intergenerational and transactional sex practices are prevalent throughout the country. ´

Spectrum epidemiologic models estimate that there are 120,000 adolescents in the country living with HIV of whom 80,000 are girls5. Estimates for 2014 show that 18,000 adolescents aged 15-19 were newly HIV infected that year, most of whom (14,000) were girls compared to boys (4,000). HIV prevalence is three times higher in girls than boys in the 15-19 year age-group (7.1% versus 2.7%) and 15-24 year age group (11.1% versus 3.7%). It is estimated that, of all, girls living with HIV, 60% were infected in the second decade (sexual transmission) versus their male counterparts (19%)6. Coverage of HIV testing among adolescents is low at 16%7. Similarly, coverage of treatment services among children and adolescents, despite recent progress, still remains unacceptably low at 32%, and is lower than adult coverage (40%) (2014, MISAU).

Children have consistently been set aside participation and discussion forums, and the ones who mostly suffer from socio-economic exclusion and inequalities. It is fundamental that society acknowledges them as active subjects of rights. Thus, paving a way for their participation and empowerment in an inclusive and democratic platform.8 The institutions have been failing them. Knowledge in fields such as health, nutrition, gender roles, HIV and the beliefs and attitudes that shape behaviours, are to a large extent rooted in local cultures and traditions and transmitted and sustained by community institutions, religious leaders and opinion-leaders (the madrinhas and matronas involved in girls’ initiation rites, traditional birth attendants, traditional medical practitioners, chiefs and régulos, among others). Secondary school drop-out rate was reported at 78% in girls and 75% in boys. The low levels of literacy (especially among females) means that access to information is mainly oral,

2 Instituto Nacional de Estatística - INE, 2010 3 Mozambique has one of the highest rates of child marriage in the world (ranked 10th highest rate of child marriage globally) affecting almost one in every two girls (48% for marriage below age 18, DHS 2011). 4 Additional information after VAC survey 5 UNAIDS Global AIDS Report 2014 6 Overall, over 50% of all adolescents living with HIV are estimated to have been infected during the second decade of life through sexual transmission. 7 DHS, 2011 8 Dra. Elenna Colonna 2011, PHD in Sociologia da Infância.


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highlighting the importance of community-level communication, especially radio broadcasts in local languages and face-to-face communication.

In relation to the enabling environment, with few exceptions, current policies and guidelines, across different sectors do not address the specific needs of adolescents of different ages. Overall, there is weak coordination for adolescent action within and across government and non-government sectors. Current monitoring and evaluation systems and platforms do not appropriately capture adolescents (i.e. lack of age disaggregation to capture 10-14 and 15-19 year olds) thus representing a major bottleneck to ensure relevance and quality of adolescent programming. The described inequities, particularly the gender-based ones referring to child marriage, violence and HIV, constitute a violation of the Convention on the Rights of the Child (CRC) and they undermine efforts to reduce poverty and achieve the Sustainable Development Goals. Therefore, in line with the situation, the PQG, the 2016 – 2020 UNDAF, UNICEF ESAR priority 4 and the SDGs, three priority areas are defined to address the key issues affecting adolescents in Mozambique and ultimately, Adolescent’s empowerment:

1. Strengthen evidence-based policy and enabling environment for adolescents, including key interventions looking at policy development/review (in depth analysis on needs/gaps), resource mobilization and leveraging (ensuring implementation of key priority interventions), and monitoring and evaluation (evidence of what works for adolescents in Mozambique and strengthen M&E system data disaggregation highlighting data on adolescents access to services). Public advocacy with particular focus on child marriage, gender-based violence and HIV prevention will be key to create awareness of the general public, contributing to a more adolescent-sensitive enabling environment.

2. Social norms and practices integrated programming in order to promote social and behavior change communication in support of programme integration, particularly for the Second Decade (10-19 years), to prevent child marriage, gender-based violence and HIV infection amongst adolescents through different integrated communication platforms9, with focus in Zambezia and Nampula provinces. This priority area will ensure multisector coordination internally in UNICEF to provide support to government in the operationalization of the adolescent component of the PEN IV, the C4D strategy against child marriage, as well as the design of a specific social mobilization initiative against gender-based violence based on VAC survey results. In addition, this priority area is critical for supporting UNICEF programmes for the overall fulfillment of children’s (up to 18 years) rights to health, nutrition, WASH, education and protection. By tackling current issues affecting children the country programme will be preventing that adolescents in the future continue to be deprived of their basic rights.

3. Adolescents’ active engagement should be prioritized in order to help them develop their citizenship skills, have adequate participation space and their voice is heard (influence) in issues of their interest, in line with the Convention on the Rights of the

9 Integrated communication platforms promoted by UNICEF Mozambique to be continued in the next country programme:

Radio drama ‘Ouro Negro’, SMS Biz/U-Report, Community Radios integrated mobilization, Mobile Units outreach, Religious leaders’ alliance…


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Child (articles 12, 13 and 15).10 Adequate conditions will be created for adolescents to engage in peer to peer discussions and counselling on HIV, child marriage and gender-based violence prevention. Young people participation will contribute to the development of multiple skills required in their development and future roles as adult citizens.

Adolescents mainstreaming in the 2017 – 2020 country programme – while this outcome will contribute to build adequate knowledge, attitude and practices around ending child marriage and preventing gender-based violence and HIV, among other key issues affecting adolescents and children, it will be successful only if services and commodities with the required quality are available to meet the demand. Therefore, this Outcome is an integrated component of a multisector programme which includes the health outcome comprising PMTCT, TARV and partnerships with different initiatives; the nutrition outcome for supplementation with iron and folic acid tablets for girls in reproductive age; the child protection outcome linking the prevention response to the community based case management, providing and strengthening district level social protection and referral services to the poorest and most marginalized families with children, including people affected by HIV, violence and child marriage; the education outcome as part of the efforts to keep girls in school.

Specifically on HIV, the Adolescents and Social Norms Change Outcome focuses more on the demand creation, through C4D to increase enrolment, adherence and retention in HIV services including HTC, PMTCT, and HIV care, treatment and support for adolescents. Importantly, a United Nations Joint Team for HIV/AIDS (UNJT) is already established and functioning to coordinate actions by the UN. Thus, UNICEF and the UNJT will make critical inputs to influence the national HIV programme with major partners such as the Global Fund and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) driving most support, with and partners, to the government for service delivery. As Mozambique enters a new era of “Test & Treat” following the adoption of the “90/90/90” targets to be reached by 2030, the country needs to define balance among priority actions for prevention of HIV infection so as to improve performance and effectiveness of the national programme, accurately estimate financial requirements, and mobilize required resources, domestically and internationally to meet these goals.

10 One of the fundamental rights of children is participation. “Children have the right to take part in discussions on matters that affect them. They have the right to be heard and their views seriously considered” (UN CRC 1989). According to UNICEF “Participation represents the right of rights holders, including children, to demand their rights and to hold duty bearers to account. Rights holder participation and duty bearer accountability are complementary parts of a human rights-based approach, which develops the capacity of rights holders to claim their rights and of duty bearers to meet their obligations to respect, protect and fulfil human rights in society.” 2 O’Kane, C. (2004), p.2.


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Therefore, the Adolescents and Social Norms Change programme would help create demand while the different Outcome sectors will help provide the necessary services to address the need of the different age group of adolescents, 10 to 14 and 15 to 19 years old. In addition to internal coordination, other external partners will also help guarantee that services are made available with the required quality.

3. Theory of Change for Programme Components

Young people are the fastest growing segment of the population in Mozambique, facing different challenges from the ones already mentioned above, such as lack of jobs and adequate skills development. Although this is recognized by UNICEF, based on the organization’s mandate, the focus of the theory of change of this Outcome will be on helping adolescents adopt healthy and protective behaviour with their active participation, and a special focus on HIV/AIDS to contribute to the national growth. As an organization concerned by the holistic approach to children and adolescents, active advocacy will help further the discussions on youth employability and generating skills for livelihoods in close coordination with other organizations, such as UNFPA.

The theory of change of this Outcome is based on the assumptions that UNICEF will effectively contribute to adolescents’ development if the organization address key issues influencing their wellbeing (Health, Nutrition, HIV), development (Education), protection


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(Child Marriage and violence) and participation (Exercise of Voice and Rights) in an integrated manner, with focus on policy dialogue, as well as positive change on social norms and practices through C4D. To integrate the different components in a sustainable manner, adequate policies and capacities should be in place and in use to create an enabling environment for adolescents at district, provincial and national level.

The Social Ecological Model (SEM)11 is the framework to be used to link the different programme components on C4D and Adolescents’ Engagement. The SEM will help with targeting groups for specific interventions, as well as with isolating individual, household, community, institutional and societal-level indicators for monitoring and evaluation.

Evidence-based Policy dialogue for enabling environment – In order to advocate and monitor policies and strategies12 that will promote equity for adolescents and help the implementation of different instruments, it is key to help establish and actively participate in coordination and integration mechanisms, such as the UN-Inter-Agency Network for Adolescents and Youth Development recommended in the UNDAF. Other coordination and

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The SEM will help to address variables at the level of individual and group knowledge, and in relation to attitudes, beliefs,

individual and collective efficacy, motivations, behaviours, social and cultural norms, community and institutional infrastructure, and in relation to policy advocacy and governance.

12 National development frameworks and planning instruments, such as the Agenda 2025, reflecting the long-term vision of

the country; the 5 year plan (2015-19) of the new Government of Mozambique; and the PARP 2011-2014 provide the overall context for accelerating programming targeting young people, including young women and their sexual and reproductive health and rights. The National Youth Policy was approved in December 2013, and provides a holistic direction towards an increase in youth development and participation in various processes, including the promotion and provision of sexual and reproductive health information and services. Adolescents are one of the priority groups in the new HIV National Plan (PEN IV 2015 – 2019).


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advocacy mechanisms for adolescents, such as the informal network of main organizations promoting child engagement in Mozambique should be also technically supported to be able to influence adolescents’ participation in development fora of their interest thus shaping the dialogue according to their real needs and aspirations. In the next country programme, UNICEF will also continue to invest in the All In initiative for advocacy at national level towards consolidating political commitment. A pivotal piece to achieving this will be

evidence generation, knowledge management and support to strengthening M&E systems to ensure consistency of sound adolescent-sensitive policy, programming, public and private advocacy, resource mobilization from donors and leveraging, especially from the government. According to All-In (Phase I) rapid assessment the main gaps identified are the lack of disaggregated data for adolescents aged 10 -14 and 15 – 19 as well as the lack of updated data for most of the indicators used in the assessment.13 The second aspect referred by the report is the need for a deep analysis of both social and cultural norms in the targeted geographic areas as well as of programmatic gaps of each one of the priority populations that were identified in the phase I of the evaluation, in order to better identify the real causes and respective action points to be implemented. This will be done in coordination with the programme on Social Inclusion prioritizing quality and disaggregated data on adolescents to identify key inequities. Aggressive advocacy for resource leveraging from other stakeholders (PEPFAR/UN/Civil Society/Bilateral) to strengthen programming for adolescents should be conducted, including the implementation of PEN IV second decade component, particularly taking into consideration the funding needs for paediatric treatment. A special advocacy should also be conducted for inclusion of adolescents’ issues and age/sex disaggregated data in specific strategies and policies. Policy dialogue and resource leveraging for child marriage and gender-based violence will be conducted in collaboration with the Child and Social Protection Programme. In order to reinforce initiatives conducted by adolescents, it is necessary to support an adolescent-led situation analysis, with focus on child participation; that will guide their work till 2020.

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The assessment used the 2009 and 2011 data, which are the only one available


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Why What When With Whom

1. Ensure a more effective and sustainable multi-sectorial response on adolescence sensitive issues

Creation of coordination

and integration mechanisms

on adolescence (example: UN Inter Agency Network for Adolescents and Youth Development – UN-IANYD)

2017 for creation and throughout the country programme for implementation

Ministry of Health (Health Promotion Department – DEPROS, HIV, PMTCT and Adolescent Programme), National Aids Council (CNCS), National Youth Institute and Ministry of Youth and Sports, Ministry of Education, UNFPA, UNAIDS, UN Women, UNJT on HIV in Mozambique, CDC, USAID, Global Fund, PEPFAR.

2. Produce solid and disaggregated evidence to inform, implement and monitor adolescent sensitive policies and strategies

Creation and strengthening

of integrated MNE system

on adolescent-sensitive

issues and programmes

Throughout the country programme

Ministry of Health (Health Promotion Department – DEPROS, HIV, PMTCT and Adolescent Programme), National Aids Council (CNCS), National Youth Institute, Ministry of Youth and Sports, UNJT on HIV in Mozambique, PEPFAR

3. Ensure that adolescent sensitive policies and strategies include youth generated evidence and priorities

Adolescent led analysis with

focus on child participation

2017 Ministry of Health (Health Promotion Department – DEPROS, HIV, PMTCT and Adolescent Programme), National Aids Council (CNCS), National Youth Institute,


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Social norms14

and practices integrated programming – To reduce harmful social norms and practices, affecting children and adolescents’ wellbeing; which are rooted in the local culture and religion in targeted communities, with focus in Zambezia and Nampula, it is fundamental to contribute to sectoral programmes results in the areas of child protection, health, nutrition and WASH. As an example, some socio-cultural factors appear to play a major role in the adolescents’ girls life, by shaping norms on the age of marriage. Initial research suggests that a link exists between the initiation rites important life-cycle events and early marriage, endorsing as a social norm the idea that, once initiated in their early teens, girls are ready for marriage and procreation, besides being taught a general sense of female submissiveness to men. However, the existence of social norms leading to child marriage and gender based violence will have to be systematically studied through quality research before informing appropriate programmatic responses.

Both the Government of Mozambique and UNICEF consider communication for behaviour and social changes strategic to help accelerate results for children, as recognised in the 2015-2019 National Health Promotion Strategy, the Nutrition SBCC strategy and the ongoing preparation of the Child Marriage C4D Strategy. It is expected that with the results of the Violence against Children (VAC) survey, a clearly defined C4D strategy will be drafted and implemented to tackle gender-based violence social practices.

In order to achieve the desired behavioural and social changes, a mix of key strategies and approaches will be used. a) UNICEF’s advocacy and investment will be essential for the optimal integration of C4D into government systems and programmes; for institutional capacity development; for increased C4D resource allocation; and, for greater involvement of civil society partners and other stakeholders in C4D initiatives. b) Behaviour change

communication to specifically help promote change at the family level based on the innovative concept of “Model Family” from the Health Promotion Strategy15. In order for a family to be considered as model, the strategy promotes key behaviours essentials for the survival of children, increasing their chances of reaching to adolescence. This strategy will be also used as an entry point for PMTCT and TARV. Specific behaviour change communication aiming at HIV prevention, delay of sexual debut, particularly girls, and adolescents living with HIV will be promoted to help them stay healthy, alive and reach viral load suppression and reduce risk of transmission by promoting demand and retention into

14 As stated in ESARO C4D strategy, social norms refer to the perceived standards of acceptable attitudes and behaviours within formal and informal networks. These are “unwritten rules” adhered to in a person’s family or peer group, and within a community or society. Norms can generally be defined as those regulating factors that determine how a person behaves in a particular context. Individuals may engage in specific behaviours as a result of their perceptions about (1) the consequences of not conforming to social norms, (2) what others in their social network are doing and how they are behaving, and/or (3) what others in their social network think they should be doing. Because social norms are collectively formed and operate through perceptions of others’ attitude and behaviour, efforts to address social norms necessarily need to take on a network, community, and collective-based approach (e.g. through interpersonal and community dialogue, social mobilization, and advocacy). 15

To be implemented in support to the Health and Nutrition Outcomes

Ministry of Youth and Sports, UNJT on

HIV in Mozambique, Child Parliament, Youth Parliament, Ministry of Gender, Child and Social Action, Ministry of Education, PEPFAR


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adolescent friendly HTC, peer care and support, ARV treatment, PSS for adolescents and their families. c) Social mobilization and community-led change will be conducted based on a multi-channel approach and participatory interventions in order to effectively engage community members to adopt positive social and behaviour changes. This will include leveraging partnerships with community-based organizations and social networks, including alliance with key influencers such as religious leaders fundamental for the fulfilment of key programmatic priorities at community level. Additional investment should be made, in the country programme, in terms of traditional and community leaders’ engagement, including “matronas” and traditional healers in community based dialogue initiative. There will be continuity of the weekly radio programmes produced in Portuguese and National languages in more than 50 community radios, as well as the outreach through multimedia mobile units and the community theatre to reach the most hard to reach areas of selected districts. d) Entertainment-Education (E-E) will be one of key C4D strategy to move beyond an awareness-generation model, aiming at change of perceptions and social norms. The long-running entertainment-education16 radio drama Ouro Negro (with a focus on developing additional collateral participatory programmes and products to reach priority target audiences) is designed not only to bring individual change in knowledge or attitudes, but also to impact social change and, in turn, social norms, meant as the unwritten rules that guide behaviour. Many of the health, nutrition, and education topics covered in Ouro Negro are complex and involve each of the layers of the social ecological model. Many individuals (70%) reported behaviour change and 44% knew at least one other person who had changed a behaviour, most often a friend or neighbour. Monitoring data indicates a reach of approximately 1.2 million listeners at the end of the 1st season, with a high potential to systematically reach young listeners. The 15-24 age group had the highest respondent proportion of the rapid assessment surveys (38%), revealing a high interest towards the product amongst youths. e) Positive deviance will be one of the key underlying approaches to be implemented while interacting with the community. It is based on the idea that in every place, specific individuals or groups – facing the same limited resources and challenges as everyone else – engage in uncommon positive behaviors and strategies that enable them to find better solutions to problems than their peers. The positive deviance approach will also help empower communities by strengthening and maintaining existing positive attributes.

These C4D platforms will be used to address, in an integrated and participatory manner, gender-related barriers and bottlenecks, as well as enabling factors towards adolescents key programmatic priorities aiming to benefit disadvantaged children, adolescents and families.


1. Promote healthy, behaviours and practices aiming at reducing risk of transmission, by increasing demand and retention into

HIV Prevention

Strategy and

Operational Plan

implementation

2017 and throughout the country programme

Ministry of Health (Health Promotion Department – DEPROS, HIV, PMTCT and Adolescent Programme), National Aids Council (CNCS), National Youth Institute and Ministry of Youth and Sports, Ministry of Education, UNFPA, UNAIDS, UN

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The basic purpose of E-E methodological approaches is to educate and engage, catalyze interpersonal communication and a basic questioning of pre-existing social norms leading to changed attitudes and behaviors.


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adolescent friendly HTC, peer care and support, ARV treatment, PSS for adolescents and their families

Women, UNJT on HIV in Mozambique, USAID, Global Fund, PEPFAR

2. Prevention of child marriage

End child marriage

C4D strategy

implementation

2017 and throughout the country programme for implementation

MGCAS/MINED

3. Prevent gender based violence

Development and

implementation of C4D

strategy on gender

based violence

After the VAC survey and throughout the country programme for implementation

MGCAS

4. Ensure engagement of key influencers at community level in social mobilization activities for promotion of healthy behaviours and social change.

Leveraging partnership

with community based

organization and social

networks

Depending on the PCA/ approved work plan with implementing partners

COREM/COALIZÃO/PIRCOM/ IMT/ MoH/ Health Community Committees.

5. Use of a combination of channels to promote sustained behaviour change among most vulnerable families and target groups.

Community radios and

RM programmes


ICS/ FORCOM

Multimedia mobile unit


ICS

Community theatre Throughout the country programme

GTR/CTK

Entertainment -

Education


PCI Media impact/ WFP/ RM/ICS/ DREXEL University

Adolescents engagement (space, voice and influence) – Adolescents engagement strategies should be age appropriate to guarantee their full participation in line with the CRC, as well as contribute to achieve key programme results. Despite great advances, most children in Mozambique still lack basic knowledge of their rights, and even when they do, they sometimes do not know how to express their concerns and fulfill their rights. The family and school can also be barriers to children expressing themselves due to limited openness to effective dialogue with them. Therefore, inappropriate family and community cultural practices, as well as enabling/facilitating factors must be taken into account in the process of promoting adolescents’ participation and dialogue.

UNICEF Mozambique is making progress towards a more effective child engagement in development and rights promotion, mainly through two child participation projects: Child to Child (C2C) media programme production and presentation, as well as, Child Parliament, a platform for dialogue in order to engage adolescents and youth up to 18 years old in an open debate on issues that concern them. Assessments of the Child to Child Media Network and the Child Parliament revealed that both projects are important platforms for child participation. The fact that both platforms are established at national, provincial and district levels paves a way for greater potential in reaching as many children as possible in Portuguese and local languages. In the next country programme, both child/adolescents participation platforms will be reinforced in order to maximize results and strengthen its processes so to become more representative with clear mandate, inclusive and transparent.


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Technical support should be provided to help adolescents, the government and CSOs develop M&E systems that would ensure that the discussions and issues at community level are escalated to the different levels in a democratic manner through the child parliament for advocacy with the government and through C2C for public advocacy and peer communication.

Special investment should be made to mainstream child participation principles in “natural spaces” of adolescents gathering, such as the community committees, schools, places of worship, clubs, youth associations, among others. The focus of adolescents’ discussions will be to ensure that their perspectives are reflected at the decision-making level so as to appropriately addressing the drivers behind increased risk of HIV Infection in adolescents namely, weak power of decision (particularly of younger girls); gender based violence, stigma & discrimination; lack of access to SRH, HIV testing, PMTCT and ARV treatment services; quality of education and retention in secondary school; child marriage; early sexual debut; transgenerational sex; and, transactional sex, amongst others. The recommendations from different adolescents’ spaces should feed the discussions at child parliament and C2C.

To build on encouraging results achieved so far, UNICEF will continue to provide technical support both to adolescents as well as to their mentors. In addition, UNICEF will focus on innovation for adolescents and capacity building. On innovation, the SMS Biz/U-Report mobile technology initiative will be expanded both in terms of reach and themes covered to engage adolescents and young people with relevant information and peer counselling. Digital media engagement targeting adolescents will be equally promoted, especially on Facebook, supporting online discussions on issues of their interest. Capacity building and skills development will be implemented for: a) Adolescents & youth to develop their competencies to articulate and engage in advocacy for the improvement of their participation in the dialogue for development. They will develop competencies and acquire knowledge to understand, process and articulate their concerns and demands, based on evidence. b) Leaders & officials to lead to the creation of a conducive environment for effective child participation, through greater awareness on adolescents and youth issues and understanding of the benefits of young people engagement and youth led-development. c) Parents and

other caregivers (including mentors and educators) to transform them as “enablers” of child participation and of inter-generational debates, at home, school and community level. Caregivers need to understand what effective child participation is and why it is important. Children should be seen as individuals with their own right, entitled to express opinion in their family and participate meaningfully in the development of their community. The process involving parents and caregivers will be integrated in the behavior and social change strategies mentioned above.


1. Develop adolescents and youth communication competencies to better engage in

Capacity building of

adolescents, as well as

technical and financial

support to organizations

promoting child

engagement in


MGCAS, MINED, MJD, Coalizão, Child Parliament, Youth Parliament, Rede da Criança, Radio Mozambique, TVM, FORCOM, ICS, ROSC and key stakeholders.


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advocacy events and national development dialogue, to voice their needs and inspirations.

Mozambique

2. Guarantee children and adolescent full participation in line with CRC, and to contribute to achieve key programme results

Child and Adolescent

Engagement Strategy

implementation


Ministry of Health (Health Promotion Department – DEPROS, HIV, PMTCT and Adolescent Programme), National Aids Council (CNCS), GABINFO, National Youth Institute, Ministry of Youth and Sports, Ministry of Gender, Child and Social Action, UNJT on HIV in Mozambique, Youth Parliament, Coalizao, CECAP, UNFPA, UN Women, Child and Youth Associations (Scouts, Continuadores), PEPFAR

3. Equip adolescents and young people with relevant information through their engagement in peer counselling.

SMS Biz/U-Report mobile

technology initiative

2017 Coalizão, MISAU, CNCS, UNFPA, MINED, MJD and youth associations.

4. Results Structure (Outputs and Outcomes, and the Associated Indicators)

Outcome: By 2020, adolescents, particularly girls, their families and communities adopt key healthy and protective behaviours and are engaged in the development process.

Key indicators: 1. # of new infections in adolescents (aged 10-19) 2. # of adolescents 15-19 who were tested for HIV and received their results in the past

12 months 3. Incidence of violence against children (up to 19 years) reported to the police 4. # Adolescents-initiated advocacy on HIV prevention, child marriage and gender-

based violence

Output 1: By 2020, multisector coordination on adolescent-sensitive issues, evidence-based policies and strategies, with a focus on HIV/AIDS, are in place.

Key indicators: 1. UN-Inter-Agency Network for Youth Development (UN-IANYD) established with

UNICEF contribution and functional


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2. National HIV/AIDS strategies that include proven high-impact evidence-based interventions to address HIV among adolescents and key populations developed, tested and evaluated

3. Adolescents sensitive disaggregated indicators embedded in National Management information systems in key sectors related to adolescents (health, education and protection)

4. Adolescent-led situation analysis, with focus on child participation, developed and disseminated

Output 2: By 2020, disadvantaged children, adolescents and families benefit from behaviour and social norms/practices change programming on integrated sector priorities.

Key indicators: 1. GABINFO national C4D strategy, including national C4D capacity plan, developed

and being implemented for behaviour and social norms/practices change 2. # of social influencers at community level (religious leaders, traditional and

community leaders, and traditional healers) trained in key family competencies and mobilised to implement local C4D plans at community level.

3. # and % of adolescents and young people (15-19; 20-24;15-24) with comprehensive knowledge on HIV prevention

4. % of people engaged as radio drama regular listeners that have reported an adoption of key priority behaviours

Output 3: By 2020, more adolescents engaged in participation platforms are empowered to voice out child rights in focus provinces.

Key indicators:

1. # adolescents (10 – 19) trained on child rights and participation related issues (child-to-child media programme, child parliament sessions and other selected adolescents fora)

2. # of adolescents and youth associations participating in national/provincial Technical Working Groups /discussion tables as well as in annual development observatories in selected provinces

3. % of adolescents and young people (10 – 24) engaged and counselled through SMS Biz platform that report an increased safer self-reported behaviours

5. Monitoring Outputs and Demonstrating UNICEF’s Contribution to Outcomes

Under this Outcome, key behaviour and social norms affecting adolescents should be defined in order to have an initial baseline that will mix quantitative and qualitative data to help measure the outputs. The data will also enable the establishment of mid-lines and end-lines to assess UNICEF contribution to adolescents’ empowerment. Annual monitoring of specific C4D strategies, such as the Health Promotion Strategy, the C4D Strategy to Eliminate Child Marriage, the Religious Leaders Engagement Strategy, Child and Adolescents Engagement Strategy, Nutrition SBCC strategy, as well as the HIV prevention strategy (still to be drafted), will enable assessment of process implementation, as well as provision of information on the CO reach to different target groups. An audience analysis should be conducted, as well as mapping of key community and traditional groups in Zambezia and Nampula to provide


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additional data for monitoring. C4D capacity assessment should be conducted to better determine and strengthen monitoring capacities within the government and CSO at national level, with particular focus on Zambezia and Nampula. Technical inputs should be provided to other cross-sectoral surveys, including DHS, to ensure disaggregated data by age, gender, rural/urban, etc, and relevant to adolescents are available for monitoring and assessment. Specific social norms studies addressing key issues affecting adolescents, such as HIV, child marriage and gender-based violence, should be conducted, in order to have qualitative information on barriers, as well as positive deviants. IMASIDA and DHS will be essential surveys to assess the progress of the outcome and UNICEF contribution to HIV prevention among adolescents. VAC survey will provide the baseline to monitor gender-based violence, particularly among adolescents.

6. Resource Requirements

It will be required an estimated amount of USD 26,000,000 to fully implement this Outcome, including staff time and technical assistance (consultants) to promote adolescents’ engagement and communication for development (C4D) initiatives. 38,46% of the total budget ($ 10,000,000) will be funded from Non-Grant and the remaining 61,54% ($ 16,000,000) will be funded from Other Resources. Fundraising and resource leveraging will be done, especially for HIV prevention within the ALL-In framework, as well as for child marriage and gender-based violence prevention. C4D activities should be mainstreamed in all country office fundraising proposals. To deliver the required results, the required staffing will be comprised of one International Professional (IP) at P5 level, one IP at L4 level, one IP at L3 level, two National Specialists at NOC level, three National Officers at NOB level, one National Officer at NOA level and one General Service staff at GS6 level.

Adolescents and Social Norms Change Programme

2017 2018 2019 2020 Staff Total

Output 1: By 2020, multisector coordination on adolescent-sensitive issues, evidence-based policies and

strategies, with a focus on HIV/AIDS, are in place

RR 40,120 71,593 100,000 100,000 849,043 1,160,756

OR 400,000 400,000 400,000 400,000 53,600 1,653,600

Total 440,120 471,593 500,000 500,000 902,643 2,814,356

Output 2: By 2020, disadvantaged children, adolescents and families benefit from behaviour and social

norms/practices change programming on integrated sector priorities

RR 1,000,000 1,000,000 1,000,000 1,000,000 1,144,578 5,144,578

OR 1,946,400 2,000,000 2,000,000 2,000,000 1,163,132 9,109,532

Total 2,946,400 3,000,000 3,000,000 3,000,000 2,307,710 14,254,110

Output 3: By 2020, more adolescents engaged in participation platforms are empowered to voice out

child rights in focus provinces


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RR 664,776 700,000 700,000 700,000 929,890 3,694,666

OR 1,202,743 1,201,845 1,200,911 1,200,911 430,458 5,236,868

Total 1,867,519 1,901,845 1,900,911 1,900,911 1,360,348 8,931,534

Total Outcome 5,254,039 5,373,438 5,400,911 5,400,911 4,570,701 26,000,000

7. External Risks and Planned Responses

Traditionally, funding for adolescents and youth related initiatives have been scarce and in a context of competing priorities and cyclical natural disasters, there is a considerable risk that the necessary resources might not be made available (e.g. 10% cut in the National Youth Council – CNJ – to assist the victims of 2016 natural disasters). Therefore aggressive fundraising should be conducted with potential donors, as well as evidence-based advocacy for GoM resource leveraging.

The lack of disaggregated data on adolescents related issues constitutes a risk due to its negative impact on evidence-based policy dialogue, resource mobilization, programming and public advocacy. Technical inputs should be provided to existing surveys to make sure disaggregated data on adolescents are available. Qualitative studies should also be conducted.

Limited local partners’ capacity in C4D (including consulting firms for conception, implementation and M&E), as well as in child and adolescents effective engagement, is a considerable risk. A C4D capacity assessment and consequent operational plan should be developed. Considerations will be given to south-south and/or triangular collaboration to enhance the national C4D competencies. The child and adolescents participation strategy should incorporate a strong capacity development of both children/adolescents, their mentors and families.

The lack of integration between different community committees is a risk due to their working in silos and in a vertical manner. Even if in some cases the committees are constituted by the same individuals, the issues are not treated in a cross-sectoral manner. A starting point to address this issue would be the mapping of existing community committees in areas of convergence in Zambezia and Nampula, and promote integrated planning, implementation and monitoring. Districts leadership should be equally engaged in the integration process.

The limited access and quality services might not be proportionate to demand created for the adolescent-sensitive issues, including response to HIV, GBV and child marriage. To mitigate this, a close coordination will be conducted among different UNICEF sector programmes, as well as with key partners. For each demand related activity there is a corresponding output for service delivery within UNICEF programme sector or implementation partners.

Access to technology might equally be a challenge to adolescents, particularly the most vulnerable. Therefore UNICEF is planning to continue investing in simple technology


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applications that do not require very sophisticated equipment. The use of mobile phone apps will be more and more promoted.

Annexes:

Figure 1: Theory of Change for Adolescents and Social Norms Change

Figure 2: Results Structure for Adolescents and Social Norms Change

Figure 3: Monitoring Framework for Adolescents and Social Norms Change

C4D support to the 2017-2020 Mozambique Country Programme

Mozambique National HIV Response (UNICEF contribution)


0


1


2

Figure 3 – Adolescents and Social Norms Change Monitoring Framework

Key results Progress indicators Baseline Targets Means of verification

Sustainable development goals: Goal 5 - Achieve gender equality and empower all women and girls

UNICEF Vision: UNICEF’s vision is to ensure that no children (up to 18) are vulnerable, all children have access to quality basic social services, and

all children have equal opportunities to fulfil their rights.

National Development Plan Priority (PQG): Pilar 2 - Promote development of Human and Social Capital. Strategic Objective 4: Promote the

participation of youth in socio-cultural, sports and economic activities

UNDAF Outcome 7: Adolescents and youth actively engaged in decisions that affect their lives, health, well-being and development opportunities

(Outputs 7.2: Adolescent and youth capacity strengthened to actively participate in economic, social, cultural and political development; 7.3: Increased

demand for quality access to ASRH and HIV prevention services)

UNDAF Outcome 4: Disadvantaged women and girls benefit from comprehensive policies, norms and practices that guarantee their human rights

(Output 4.2: Key actors at local level able to contribute to the transformation of discriminatory socio-cultural norms and harmful practices against

women and girls).

Programme Outcome

By 2020, adolescents,

particularly girls, their

families and

communities adopt key

healthy and protective

behaviours and are

engaged in the

development process.

# of new infections in

adolescents (aged 10-19)

Will be available end

2016

Girls

Boys

TBC17

SPECTRUM yearly report

# of adolescents aged 15-19

who were tested for HIV and

received their results in the

past 12 months


2016

Boys

Girls

TBC18

IMASIDA and/or DHS

17

Targets are being discussed by the Government 18

Targets are being discussed by the Government


3


Incidence of violence against

children (up to 19 years)

reported to the police

N/A

Girls

Boys

VAC available early

2017

VAC

Annual Report of the Ministry

of Interior

Linha Fala Criança report

# Adolescents-initiated

advocacy on HIV prevention,

child marriage and gender-

based violence

No

At least 6 advocacy

initiatives with

decision-makers

Partners’ reports (Child

Parliament, C2C, Save the

Children, Rede da Criança,

MGCAS, MJD)

Programme Outputs

1. By 2020, multisector

coordination on

adolescent-sensitive

issues, evidence-based

policies and strategies,

with a focus on

HIV/AIDS, are in place.

UN-Inter-Agency Network for

Youth Development (UN-

IANYD) established with

UNICEF contribution and

functional

No Yes UNICEF Annual Report

National HIV/AIDS strategies

that include proven high-

impact evidence-based

interventions to address HIV

among adolescents and key

populations developed, tested

and evaluated

No Yes Strategies and evaluation

reports available

(communication strategy,

PEN IV,

Health Testing and Counseling

- ATS)

Adolescents sensitive

disaggregated indicators

embedded in National

Management information

systems in key sectors related

to adolescents (health,

education and protection)

No Yes INE surveys

Adolescent-led situation

analysis, with focus on child

participation, developed and

disseminated

No Yes Printed document

Report of dissemination plan

implementation

UNICEF Annual Report


4


2. By 2020,

disadvantaged children,

adolescents and families

benefit from behavior

and social

norms/practices change

programming on

integrated sector

priorities

GABINFO national C4D

strategy, including national

C4D capacity plan, developed

and being implemented for

behaviour and social

norms/practices change

No Yes National C4D strategy and

implementation report

available

C4D capacity plan and

implementation report

available

# of social influencers at

community level (religious

leaders, traditional and

community leaders, and

traditional healers) trained in

key family competencies and

mobilised to implement local

C4D plans at community level

2,500 20,000 Partners reports (COREM,

PIRCOM and Coalizao)

# and % of adolescents and

young people (15-19; 20-

24;15-24) with comprehensive

knowledge on HIV prevention


2016

TBC19 IMASIDA and/or DHS

% of people engaged as radio

drama regular listeners that

have reported an adoption of

key priority behaviours

No 500,000 Drexel University and

Intercampus external reports

19

Targets are being discussed by the Government


5


3. By 2020, more

adolescents engaged in

participation platforms

are empowered to voice

out child rights in focus

provinces

# adolescents (10 – 19) trained

on child rights and

participation related issues

(child-to-child media

programme, child parliament

sessions and other selected

adolescents fora)

1,600 children and

adolescents in media

programmes + 114

children and adolescents

in child parliament

sessions, making a total

of 1,714 children and

adolescents.

No information on

number of children and

adolescents

participating in other

fora. Therefore the

baseline should be 0.

At least 50% of

members from each

mapped child and

adolescent platform are

fully trained.

Annual reporting on child

engagement;

UNICEF Annual Report

# of adolescents and youth

associations participating in

national/provincial Technical

Working Groups /discussion

tables as well as in annual

development observatories in

selected provinces

No TBC20 Partners’ minutes from

meetings (attendance list)

% of adolescents and young

people (10 – 24) engaged and

counselled through SMS Biz

platform that report an

increased safer self-reported

behaviours

12,000 200,000 UNICEF Annual Report and U-

Report dashboards

20

Targets to be confirm after mapping


6


7

MOZAMBIQUE NATIONAL HIV RESPONSE (UNICEF contribution)

Under the coordination of the National Counsel to Combat HIV/AIDS (CNCS), the National Strategic HIV and AIDS plans (PEN IV) articulates a multisector response that combines the provision of prevention, care & treatment and mitigation interventions adapted to the social context in view of a healthy society with better quality of life, free from risk of new HIV infections and AIDS. PEN IV considers a holistic approach to the general population, but also has particular focus on priority populations so as to specifically address needs and increase impact of the response. Inspired on the HIV Investment Framework, PEN IV focuses, both, on basic program activities (impacting on reducing HIV transmission and HIV-related morbidity and mortality) and catalytic interventions (creating the enabling environment, synergies and conducive conditions to generate the necessary demand and maximize investments & performance in each program activity).

UNICEF SUPPORT ACTION TO MOZAMBIQUE NATIONAL HIV RESPONSE

Target population: according to the distribution of labor within the UNJT, UNICEF, will address: adolescents (10-19 years, both adolescents at risk of infection and HIV+ adolescents); HIV+ Pregnant women and mothers; HIV-exposed infants; HIV+ children (1-9); and, Orphans and Other Vulnerable children.

Programmatically, UNICEF will support the National Response as follows: a) Basic Programme Activities: Social and Behaviour Change Communication; HIV Testing &

Counselling; PMTCT; HIV Treatment for children & Adolescents; Mitigation (nutritional support & OVC support).

b) Catalytic Interventions: community mobilisation; mass media; reduction of violence against children, women and adolescents; evidence generation; policy & Advocacy.

c) Synergies: from the HIV support platform, UNICEF will ensure wider synergies with developments on HSS; community systems strengthening; child & social protection platforms; education; and government financing platforms.

Strategically, UNICEF will focus on the demand side, through C4D (social norms and practice change), to increase enrolment, adherence and retention in HIV services offered under the relevant Basic Programme Activities relevant to UNICEF. Such support to demand creation will maximise investments made on service delivery platform heavily supported by the Global Fund and the United States Presidents Emergency Relief Plan for AIDS relief (PEPFAR).

Coordination, multisector coordination will be ensured across UNICEF outcomes to guarantee a coherent support to the national response. Through the United Nations Joint Team for HIV/AIDS (UNJT) coordination, UNICEF action will form part of the overall UN support to the HIV national response. Similarly, UNICEF will ensure sound representation for: coordination with government and partners;


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policy & advocacy; and, resource leveraging and mobilization in all areas of the response supported by UNICEF.

UNICEF SUPPORT ACTION TO MOZAMBIQUE NATIONAL HIV RESPONSE WITHIN THE

COUNTRY PROGRAMME CONTEXT

BASIC PROGRAMME ACTIVITIES

CATALYTIC INTERVENTIONS

SYNERGIES:

Health Outcome

•PMTCT

•HIV Treatment for children & Adolescent

• Treatment of Acute malnutrition for HIV+ children

Nutrition Outcome

• Promotion of Exclusive Breastfeeding

• IYCF

Child Protection Outcome

•Support to OVC

Adolescents and Social Norms

Change Outcome

•Social and Behaviour Change Communication

•Demand creation for HIV Testing & Counselling

H&N Outcome

•Community mobilisation

•Evidence generation


•Reduction of violence against children, women and adolescents

•Evidence generation

Adolescents and Social Norms Change

Outcome

•Evidence and knowledge management

•Policy dialogue and public advocacy

•Community-led change (community mobilisation)

•Mix media (mass media, community radios, entertainment-education, etc)

•Innovation (SMS Biz/U-Report)

•Integrated adolescents participation


9

H&N Outcome

• HSS

• community systems strengthening


•community systems strengthening

•child & social protection platforms

Adolescents and Social Norms

Change Outcome

•Community systems strengthening

•Innovation (SMS Biz/U-Report)

•Mix media (mass media, community radios, entertainment-education, etc)

Social Inclusion

Outcome •Social protection

•Government financing platforms

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