Stepped Care Model for Sexual Health

Stepped Care Model for Sexual Health

Having the right information and service in the right place, at the right time delivered by the right digital solution or person to meet the specific needs of young people. That is what Stepped Care is about.

The innovative and holistic sexual and reproductive health self-care model created by our organisation – with over 10 years of success in the Netherlands, has expanded to South Africa, Kenya, Mozambique and Indonesia.

Stepped care guidelines for implementation

This document provides an overview of experiences, lessons and challenges in implementing the Stepped Care Model. The guidelines are meant for implementers, researchers, policy-makers and donors to reduce fragmentation, stimulate cooperation between health providers and support young people to lead healthy sexual and reproductive lives.


Cover of the guidelines document

Why a stepped care model?

Right when young people begin exploring their own sexuality, access to information is withheld because of social norms around sexuality and limited availability of youth-friendly services among others, fueling the fear of stigma and discrimination.

Besides, everybody is different. So young people have different kinds of issues and information needs when it comes to sexual and reproductive health. Some may be helped by reading a self-help online article. Others could benefit from a phone-call with a peer-support group. Still others may have a physical examination from a licensed doctor. Therefore, different services need to be provided, aligned with the level of complexity and level of self-care possible.

Brenda & Joy
Brenda & Joy

What is Stepped Care?

The Stepped Care model for sexual and reproductive health is a youth-centered approach that is responsive to the needs of young people, at the lowest possible cost.

It is a robust digital health ecosystem facilitating collaboration among stakeholders and organising online and offline SRHR services in a meaningful way for young people. Services that are non-judgmental, age appropriate and sex positive, to help young people navigate and access to the right services and information.


What if we revolutionize SRHR services for young people? Watch the video!

How does it work?

Stepped Care encourages all stakeholders in the field of sexual and reproductive health for young people to coordinate their efforts. A unified branding, messages and links between services guides individuals to a web-based platform that provides quality and engaging comprehensive SRHR information. From this point, digitally-delivered personalized information guides the individual. Self-assessments provide tailored advise and refer to additional online and offline services according to the individual’s needs. As moving through a care-seeking journey, the individual is referred to higher steps of the model that incorporate human contact through chat services, hotlines and eventually face-to-face services with healthcare and medical professionals as needed. The lower the step of the model, the higher the reach and self-care, and the lower the cost of services.

All stakeholders working together under the same branding can achieve higher levels of sustainability, increase reach of messages and services, and ultimately lower the burden on the healthcare system.

Infographic Stepped Care Model
The Stepped Care model
The Stepped Care model

Stepped Care has potential to expand provision of good quality HIV prevention and care more widely into areas of public health care, SRH and HIV services
- WHO Technical expert

8 ways how Stepped Care is changing the game

  1. Increases access to sex-positive and youth-friendly comprehensive sexuality education
  2. Increases uptake of self-care products and health services
  3. Empowers young people by building self-efficacy, health literacy and self-care
  4. Lowers burden on the healthcare system and reduces cost
  5. More efficient use of healthcare services and resources
  6. Facilitates integration of digital health solutions into formal health systems
  7. Decreases fragmentation of youth programs and digital solutions
  8. Increases collaboration among donors, government, private, multi-lateral and international organisations and implementers
two girls having fun
Brenda and Joy are changing the game
Brenda and Joy are changing the game

Built on 10 years of success in the Netherlands – time to scale

Aidsfonds - Soa Aids Nederland together with the Netherlands National Institute for Public Health and Environment, have successfully built up the Stepped Care Model in the Netherlands. The youth-brand Sense provides all youth-friendly online and offline SRHR and HIV information and education. Sense supports 3,9 million young people in the Netherlands annually.

Building upon 10 years of experience from Sense in the Netherlands, Aidsfonds has taken the initiative to scale the model internationally. Currently we are contextualizing and implementing Stepped Care in South Africa, Kenya, Mozambique and Indonesia 👇

Stepped Care in Kenya, Indonesia, Mozambique and South Africa

Watch how health professionals improve SRHR support

Stepped Care helps health professionals to empower young people to make informed decisions. “Young people get informed anonymously while at home, and apply what they learned. Those with more complex issues who do wish to see me are better prepared and I have more time to help them.”

Watch the video to see how health professionals benefit from the Stepped Care Model when addressing young people's sexual health needs

Watch how young people take better care of their sexual health

Stepped Care facilitates self-care by empowering young people to easily find reliable answers to all their questions, in ways they prefer. “I watched personal stories of other young gays. It helped me find a peer WhatsApp group where I felt comfortable. I’m now moderating this group and helping others.”

Watch the video to see how Stepped Care enhances self-care of young people

The Stepped Care Model shows how digital interventions can be integrated into the physical space. It opens many opportunities I haven’t seen before
– Director of Praekelt

Self-care is crucial to end AIDS

According to the WHO self-care interventions are among the most promising and exciting new approaches to improve health and well-being. Condoms, HIV self-testing, PrEP, self-sampling for STIs and digital health solutions that consumers demand to use on their own have led to a greater configuration of self-led HIV prevention, treatment and care possibilities than ever before.

Self-care provides even more opportunities for people living with HIV and who have avoided traditional HIV services for fear of stigma. "Before you can take care of yourself, you have to love yourself first."

Group of four young people taking a selfie
Group of young people taking a selfie
Group of young people taking a selfie

Interested to know more?

Are you interested to financially support the scale up of the Stepped Care Model so more young people can live healthy sexual lives? We are looking forward to jointly exploring opportunities. Be invited to contact Aidsfonds' Leon Essink to share your thoughts and ideas.

Portrait of Leon Essink
Leon Essink
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