Working with government
Botswana has many structural support programmes, intended to help lift people out of poverty, improve their educational qualifications, and support them to set up enterprises, from very small scale to much larger. These programmes were not intended to help prevent HIV, nor were they geared to benefit young women. Young women are under-represented among programme beneficiaries. The recruitment survey of young women (aged 15-29, nit in school and not in work) as part of INSTRUCT confirms that many young women are not aware of the programmes, do not realise they are eligible, or simply do not apply to them. The INSTRUCT trial asks: What if these programmes could be made more accessible for marginalized young women? Would this help the young women to start making choices to protect themselves against HIV, and hence reduce HIV infections among them?
The INSTRUCT trial seeks innovative ways to help make existing government support programmes more accessible for young women. INSTRUCT fieldworkers give young women information about the programmes when they invite them to focused workshops, and local programme officers attend the workshops to answer questions from the young women and advise them about how to apply.
Fuzzy cognitive mapping
Fuzzy cognitive mapping is a participatory technique that allows the views of different stakeholders about the causes of an issue or problem to be taken into account fully when looking for ways to tackle the problem. Groups of stakeholders create maps to show their knowledge and ideas about the things that are related to an outcome – in this case the outcome of young women benefiting from government support programmes.
In each of the five INSTRUCT intervention districts, groups of programme officers and groups of young women have separately produced their maps about this issue. The 7-10 participants in each group all write their ideas about the causes on small, wipeable magnetic tiles, then place them on a magnetic board with the outcome in the centre. They eliminate duplications and group their ideas into categories, then draw lines to see how they relate to the outcome, directly or indirectly, and agree on the strength of the links on a scale of 1-5.
The groups of programme officers and young women come together to compare their maps, noting causes they both agree on (that appear on both their maps), and causes that only appear on one map or the other.
After the fuzzy cognitive mapping exercise, and using the maps and comparisons of maps, the groups of programme officers and young women sit together to discuss priority concerns highlighted in both maps, and to co-design solutions to these problems. Some fast turnaround local solutions can be implemented immediately. They also identify longer term solutions requiring action at a higher level.
The INSTRUCT team presents consolidated concerns from the groups to the Ministerial Performance Improvement Committees of the relevant ministries, to consider wider actions.