First social impact bond for the SAMRC: A novel financing strategy to address the health and social challenges facing adolescent girls and young women in South Africa

Abstract

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. A social impact bond (SIB) is an innovative financing mechanism to attract investors to social programmes traditionally funded by governments. In this article, in celebration of the 50th anniversary of the South African Medical Research Council (SAMRC), the authors describe the SAMRC's first foray into this new world of financing through a SIB to improve the health and quality of life of adolescent girls and young women (AGYW). The AGYW SIB is in its preparatory phase and is scheduled for implementation in 2020. The authors describe the mechanism, including financial flows and the process of customising the SIB to meet the needs of AGYW, focusing on HIV prevention and treatment and the prevention and management of unintended pregnancies in schoolgoing AGYW. The authors outline an approach to designing the package of interventions, the metrics associated with such a programme and the business model. It is hypothesised that the proposed approach will lead to an improvement in programmatic outcomes, monitoring and evaluation tools and cost-effectiveness, and will develop key learning data for the future use of SIBs in health service delivery.

Associations Between Patterns of Alcohol Use and Viral Load Suppression Amongst Women Living with HIV in South Africa

“…This paper analyses baseline data on women receiving treatment for HIV who participated in Project MIND—a three-arm cluster randomized controlled trial comparing the effectiveness of different resourcing approaches to integrating counselling for unhealthy alcohol use and depression into HIV care (Trial Registration Number: PACTR201610001825403). Trial methods are described in detail elsewhere [ 27 ].…”

“…Addressing this information gap is important for the design of interventions aimed at improving rates of viral suppression among WLWH, such as the South African Medical Research Council’s Social Impact Bond for Adolescent Girls and Young Women [ 27 ]. If alcohol consumption patterns characterized by abstinence or light drinking are associated with greater likelihood of ART adherence and viral suppression, then interventions that promote abstinence or very limited use of alcohol may be indicated.…”

Social vulnerability, parity and food insecurity in urban South African young women: the healthy life trajectories initiative (HeLTI) study

“…This should reinforce calls for improved contraceptive and reproductive health services for young women in the preconception period. Additional initiatives that may benefit young women include the planned South African (SA) Medical Research Council (SAMRC) social impact bond, an initiative to attract investors to support programmes promoting adolescent girls and young women's sexual and reproductive health and targeting the social challenges they face [59]. Indeed, many of the interventions proposed by the SAMRC share significant overlap with those employed in the WHO-HeLTI trial in South Africa [60], including HIV testing with support to link to care; monitoring frequency and type of contraception use; supporting safe pregnancies (including early presentation for foetal ultrasound assessments) and psychosocial and behavioural interventions for improved physical and mental health.…”

Adolescent girls and young women: Policy-to-implementation gaps for addressing sexual and reproductive health needs in South Africa

“…To support this effort, we reviewed the policy environment and identified critical issues for researchers and policymakers to consider when developing and implementing programmes in this field. [2]…”

“…Table 1 lists these policies and guidelines, grouped according to outcomes of the social impact bond for AGYW. [2] SA needs policies and guidelines for effective interventions that empower people, particularly those who are most vulnerable, such as AGYW. [5] Mugabe [6] suggests the following features of good policies and policymaking processes: The SRH policies and guidelines (Table 1) are underpinned by some of the features Mugabe [6] alludes to.…”