GUSO Flexi implements an innovative business model (Healthy Entrepreneurs) in three districts in Uganda. In total 750 GUSO peer educators are trained to become community health entrepreneurs. They reach out to the youth and other members of their community with integrated SRHR and HIV information on their tablet and by selling SRHR and health products and medicine, and adequate referrals to youth friendly services.
By combining peer educators and peer providers models, GUSO Flexi creates an effective and efficient community service delivery model in Uganda which offers young people the SRHR and HIV information and services they desire. It also empowers young men and women in generating an income through their employment as Healthy Entrepreneur.
GUSO Flexi is part of the larger Get Up Speak Out (GUSO) programme, focusing on integrated SRHR/HIV community service delivery. It is implemented by the Uganda SRHR Alliance.
GUSO Flexi meaningfully engages and empowers young people in all their diversity. It contributes to the following three goals:
- Provision of an integrated range of SRHR services and HIV testing, prevention and treatment methods
- Improved access for people living with HIV to SRHR services
- Provision of holistic sexuality education, which includes attention to gender relations and stigma surrounding HIV/AIDS
GUSO Flexi consist of 6 components:
1. Provision of community services via Healthy Entrepreneurs
2. Training peer educators in SRHR and HIV education
3. Community mobilization and awareness raising to create demand for youth friendly services
4. Empowering young people to hold their duty bearers accountable for delivering quality services
5. Improving the referral system to quality youth friendly services
6. Operational research
950 peer educators, out of which 750 will become community health entrepreneurs, each reaching 350-450 directly.
The flexibility fund project funded by the Netherlands Ministry of Foreign Affairs is part of the GUSO program.
Based on a country analysis, the Get Up Speak Out (GUSO) programme chooses Uganda because of the eminent SRHR and HIV needs: The target population in East Central Uganda is characterized by a high teenage pregnancy rate (30.3%) with the median age of first marriage being 17.3 years; high HIV prevalence (7.2%); and a high fertility rate. Young people’s access to SRHR and HIV services and information is limited -only 39% of those aged 15-24 years have comprehensive knowledge of HIV- and yet many are sexually active and experience preventable SRH problems.
In Uganda, young women aged 15–24 years are 2.5 times more likely to be living with HIV (5%) than men of the same age (2%). Girls in particular face multiple vulnerabilities due to disempowering social norms around gender. A recent study in Uganda found that HIV incidence was four times greater among adolescent women aged 15-19, compared to adolescent men of the same age, suggesting that ‘HIV risk is high as soon as young women initiate sexual intercourse’.