Submission ID 118379
| Issue/Objective | The artisanal and small-scale mining (ASM) sector in Uganda employs 40,000 women, including Adolescent Girls and Young Women (AGYW) who experience multiple gendered socio-economic and health vulnerabilities that affect their wellbeing. These AGYW are at the fringes of society, facing extreme poverty, which increases the risk of sexual and reproductive health (SRH) challenges including risky sexual behaviors, high prevalence of sexually transmitted infections, and teen pregnancies. ASM communities' limited access to basic services, including health care, impacts AGYW's wellbeing. The dearth of studies addressing the impact of crises on the wellbeing of AGYW in ASM in Uganda prompted the assessment of the AGYW's situation and based on the findings, we piloted an intervention to enhance their health and economic resilience. Objective To assess the effectiveness and factors contributing to peer mentors' role in nurturing resilience for sexual and reproductive health in artisanal mining communities. Peer mentors are youth ranging from 16 to 26 years (24 years when they were recruited) within artisanal mining communities, whose lives have been impacted through the intervention, as change agents, to impact their peers in the sector, particularly in the area of sexual and reproductive health. Their role is essential ensuring that marginalized AGYW are not left behind with respect to their health and general wellbeing. |
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| Methodology/Approach | The paper is based on an implementation research phased study that used a mixed-methods design to collect data, and participatory approaches to prioritize needs and design an intervention to address the needs. The study was conducted in gold mining communities of Eastern and Central region. Methods of data collection included a survey of 810 AGYW; 25 key informant interviews (KI); 10 in-depth interviews; 8 focus group discussions, and 5 participatory multi stakeholder workshops. Study findings were used to raise awareness and advocacy concerning the AGYW's situation and priorities. Capacity development in SRH, life skills and advocacy, plus financial literacy, business skills were among the co-identified and piloted aspects of the integrated intervention. We trained peer mentors and facilitated formation of integrated village saving and loans associations. Training modules and refresher training were intermittently conducted over a period of four months, during which trainees were encouraged to implement what they had learnt. Peer mentors (20) were also trained on approaches of engaging their peers, availability of resources at community level and referral pathways. The project commenced in October 2022 and phased out in March 2025. |
| Results | Our research results revealed a high prevalence of risky (sexual) behaviors and poor SRH outcomes: 19% consumed Alcohol/substance; 22% had multiple sexual partners; and 40% had a self-reported STI. Poverty, social alienation and lack of guidance were major contributing factors to the poor SRH outcomes. The trained peer mentors mobilized other AGYW to join the saving group, where they received training that resulted in behavior change. Peer mentors in the 3 settings reached 2473 recorded persons (73% females), in addition to school outreaches 720 pupils within a period of three four months, covering a diversity of SRH topics which included family planning, condom use/safer sex, HIV/AIDS and STIs prevention, puberty and menstrual and personal hygiene, risks of early sex gender based violence, plus saving and investment in income generating activities. Peer mentors participate in mobilization of AGYW to access services during outreaches and provide escorted referrals of patients/clients to health facilities. They have become role models in their communities and are being engaged by district based programs to partner in implementation of interventions at community level. Partnerships between peer mentors, public health facilities and non-government organizations that provide SRH services is essential for effectiveness and sustainability. A participatory approach that nurtures self-determination where young people/ peer mentors understand their critical role in changing their lives and improving their health and facilitating positive change among their peers is essential. Among last mile youth whose sexual and reproductive health situation is driven by poverty and affected by social isolation, an integrated approach that emphasizes capacity development and support towards socio-economic resilience is essential. In this case, formation of an association that addressed economic, social and health issues was beneficial |
| Discussion/Conclusion | In addition to the intensive youth friendly participatory facilitation approach and the rich content delivered in the training, the effectiveness of the peer mentors is linked the fact that they address problems that they have experienced. The intervention resulted in behavior change, which is critical in the ASM communities. These young peer mentors have become empathetic champions of AGYW in ASM, ensuring that they are not left behind with respect to SRH and economic wellbeing. |
| Presenters and affiliations | Betty Kwagala Makerere University Edith Nakasolya Uganda Youth Development Link Lydia Kapiriri Macmaster University Patricia Ndugga Makerere University Fred Ngabirano Ministry of Gender, Labor and Social Development Miriam Mutabazi Makerere University |
