SAUTI Project

SAUTI closes: five years of WORTH+, hotspots and harm-reduction across Dar

ASUTA wraps up the SAUTI consortium with a portfolio of mature WORTH+ groups, hotspot biomedical teams and a measurable shift in how Dar es Salaam approaches HIV among vAGYW.

ProjectSAUTI · USAID · PEPFAR · Jhpiego · EngenderHealth · Pact · NIMR
Published27 Sep 2019
LocationTemeke · Kinondoni · Kigamboni
Field Dispatch

In September 2019, ASUTA closed out its role in the SAUTI Programme. After five years of community-based combination prevention work across Temeke, Kinondoni and Kigamboni, the question is the right one to ask: did this project change anything?

Four outcomes anchored the SAUTI design. ASUTA, working alongside Jhpiego, EngenderHealth, Pact and NIMR, contributed materially to all four:

  • Increased and timely use of HIV prevention and family planning services by KVPs across all three districts
  • Improved positive behaviours and social norms at individual and community levels
  • Reduced vulnerability among vAGYW and FSW through novel structural interventions — most visibly the WORTH+ economic-empowerment groups
  • Increasingly sustainable HIV prevention services for KVPs, embedded in LGA structures and run with community-based health service providers (CBHSPs)
01

WORTH+ — the structural backbone

ASUTA's largest structural contribution was scaling and mentoring WORTH+ groups — savings and empowerment circles for vulnerable young women, layered with HIV prevention and livelihoods support. Over the life of the project, ASUTA's empowerment workers and ward-level leaders moved WORTH+ from a pilot in DREAMS areas to a routine offer for vAGYW and, later, for PrEP users.

The point of WORTH+ is not the savings ledger. It is the platform: a regular, safe, peer-led space where adolescent girls and young women come back week after week — and where biomedical services, SBCC, GBV screening and PrEP can find them.

WORTH+ groups became the room where prevention conversations actually stuck — because the women were already in the room for their own reasons.
02

Biomedical service delivery — at hotspots, not just in clinics

Through the life of SAUTI, ASUTA's mobile biomedical teams delivered HIV testing, STI screening, GBV response, family planning and linkages to care and treatment at three points: (1) hotspots themselves, (2) inside SBCC and WORTH+ group sessions, and (3) in private residences where index-testing partners or biological children could not safely access hotspot services.

Daily Sauti data reports drove which hotspots got the next team, which CBHSPs needed coaching, and which clients had defaulted on care. By 2019, the targets the project committed to in 2016 — 80% individual education for FSWs, 100% for MSM, 100% group education for vAGYW — were not just on paper. They were on the daily dashboard.

03

What SAUTI leaves behind

Three things outlast the grant. First, a generation of CBHSPs — male and KVP — trained to do active mobilisation, demand creation and defaulter tracking. Second, a deepened ASUTA–LGA relationship in Temeke, Kinondoni and Kigamboni that opens the door for everything that followed (EpiC, AHADI, Afya Yangu). And third, a set of guiding principles — meaningful engagement of LGAs and CSOs; client-centred differentiated service delivery; data-driven learning; nimble response — that ASUTA still runs every project against today.

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